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Introdução: O transtorno bipolar (TB) é um problema crônico, de evolução cíclica, altamente prevalente na população geral e está associado a importante incapacitação dos pacientes e a déficits cognitivos e funcionais, constituindo, assim, um importante problema de saúde pública. A etiologia do TB parece ser multifatorial, resultante da interação entre fatores genéticos e ambientais; estudos apontam que a predisposição para manifestação de episódios pode advir da exposição a maus-tratos na infância (MTI), que comprometem o desenvolvimento emocional, cerebral e cognitivo das crianças e estão presentes em 30% a 60% dos portadores de TB. No TB, os MTI vem sendo associados com idade de início mais precoce, pior evolução clínica, maior incidência de comorbidades, apesar da literatura ser escassa e não conclusiva, tem sido associado também a alterações do funcionamento cognitivo e da morfologia cerebral. Objetivo: Investigar se o perfil cognitivo e a morfometria cerebral de portadores de TBI eutímicos diferencia-se com a exposição ou não a maus-tratos sofridos na infância. Método: 75 portadores de TBI eutímicos, com idades entre 18 e 45 anos, atendidos no ambulatório do Programa de Transtornos Afetivos (GRUDA) IPq-HC-FMUSP, sendo 32 sem história de MTI e 43 com história de MTI, de acordo com o ponto de corte do Childhood Trauma Questionnaire (CTQ) e 46 voluntários sadios do ponto de vista físico e mental, com idades entre 18 e 45 anos, sem história de MTI de acordo com o CTQ e sem parentes de primeiro grau com transtornos psiquiátricos foram submetidos a uma bateria de testes neuropsicológicos que avaliou as funções atencionais, mnêmicas, executivas e cognição social e a um estudo de imagem por ressonância magnética. Resultados: Os resultados apontaram para uma diferença de desempenho cognitivo entre os grupos em uma das medidas de flexibilidade mental (p=0,04), em uma de raciocínio matricial (p=0,035) e na capacidade de reconhecimento de emoções faciais de tristeza (REF, p=0,022). Em relação à morfometria cerebral, pôde-se observar que o volume do Núcleo Caudado apresentou diferença estatisticamente significativa entre os três grupos, tanto no hemisfério direito (p=0,002) como no esquerdo (0,008). No hemisfério esquerdo, a área do Órbito Frontal Medial (p=0,0466), a área do Pré-cuneo (p=0,0193) e a área do Parietal Superior (p=0,0063) apresentaram diferenças estatisticamente significativas. No hemisfério direito, a área do Órbito Frontal Medial (p=0,0200), a área do Pré-cuneo (p=0,0337), a área do Parietal Superior (p=0,0007), a espessura da Parte Triangular do Córtex Frontal (p=0,0013), a espessura do Pré-central (p=0,0307) e a espessura do Frontal Superior (p=0,0425) apresentaram diferenças estatisticamente significativas. Por fim, a partir de uma análise exploratória, pôde-se observar que no grupo de portadores de TB com MTI os resultados apontam para possíveis associações entre regiões cerebrais e desempenhos cognitivos, sendo elas: volume do Hipocampo Direito e o TMT-B (pinteração= 0,002, r = -0,40, pr=0,013), área do Giro Superior Frontal Direito e o SCWT-I (pinteração= 0,0008, r = -0,36, pr=0,0185), área do Órbito Frontal Medial Esquerdo e o FCR-cópia (pinteração= 0,004, r = 0,49, pr=0,014), espessura do Órbito Frontal Medial Direito e COWAT-total (pinteração= 0,004, r = 0,46, pr=0,003), espessura do Frontal Medial Rostral Esquerdo e WCST-erros (pinteração= 0,007, r = -0,42, pr=0,007). Conclusões: Apesar da limitação do tamanho amostral e do número de comparações estatísticas realizadas, este é o primeiro estudo a avaliar a associação entre MTI, funcionamento cognitivo e morfometria cerebral. Os resultados foram sugestivos de que a magnitude das correlações entre as características morfométricas e cognitivas podem ser moduladas pela exposição a MTI e pelo status de caso (portador de TB) / Introduction: Bipolar disorder (BD) is a chronic, cyclically-evolving problem that is highly prevalent in the general population and is associated with significant disability of the patients and cognitive and functional deficits, thus constituting an important public health problem. The etiology of BD seems to be multifactorial, resulting from the interaction between genetic and environmental factors, and studies show that the predisposition to the manifestation of episodes of BD may result from exposure to childhood maltreatment (CM), which compromises the emotional, cerebral and cognitive development and seems to be present in between 30 and 60% of BD patients. In BD, CM have been associated with earlier onset age, worse clinical course, higher incidence of comorbidities and, although the literature is scarce and not conclusive, it has also been associated with changes in cognitive function and brain morphology. Objective: To investigate whether the cognitive profile and the brain morphometry of patients with euthymic BD differ between those exposed or non-exposed to CM. Method: 75 euthymic BD patients, aged between 18 and 45 years, attended at the ambulatory of the Affective Disorders Program (GRUDA) IPq-HC-FMUSP, 32 of which had no history of CM and 43 with a positive history of CM according to the cut-off of the Childhood Trauma Questionnaire (CTQ) and 46 physically and mentally healthy volunteers, aged 18-45 years, with no history of CM according to the CTQ and no first-degree relatives with psychiatric disorders were submitted to a battery of neuropsychological tests that evaluated attentional, mnemonic, executive, and social cognition functions and a study of magnetic resonance imaging. Results: The results point to a difference in cognitive performance between groups in one of the measures of mental flexibility (p = 0.04), in one of matrix reasoning (p = 0.035) and in the ability to recognize facial emotions of sadness FER, p = 0.022). Regarding cerebral morphometry, it can be observed that the volume of the Caudate Nucleus showed a statistically significant difference between the three groups, both in the right hemisphere (p = 0.002) and in the left hemisphere (0.008). In the left hemisphere, the area of Medial Orbital Frontal (p = 0.0466), the area of Precuneus (p = 0.0193) and the area of Superior Parietal (p = 0.0063) presented statistically significant differences. In the right temisphere, the area of Medial Orbital Frontal (p = 0.0200), the area of Precuneus (p = 0.0337), the area of Superior Parietal (p = 0.0007), the thickness of Pars Triangularis (p = 0.0013), the thickness of Precentral (p = 0.0307) and the thickness of Superior Frontal (p = 0.0425) presented statistically significant differences. Finally, from this exploratory analysis, it is possible to observe that in the group of BD with CM the results point to possible associations between brain regions and cognitive performance, specifically: Right Hippocampus Volume and TMT-B (pinteraction = 0,002, r = -0,40, pr=0,013), Right Superior Frontal Area and SCWT-I (pinteraction = 0.0008, r = -0.36, pr = 0.0185), Left Medial Orbital Frontal area and FCR-copy (pinteraction= 0,004, r = 0,49, pr=0,014), Right Medial Orbital Frontal Thickness and COWAT-total (pinteraction = 0.004, r = 0.46, pr= 0.003), Left Rostral Medial Frontal Thickness and WCST-errors (pinteraction = 0.007, r = -0.42, pr = 0.007). Conclusions: Despite the limitation of the sample size and the number of statistical comparisons performed, this is the first study to evaluate the association between CM, cognitive functioning and brain morphometry. The results are suggestive of the magnitude of the correlations between the characteristics morphometric and cognitive variables can be modulated by exposure to CM and by case status (BD patients)

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We hypothesized that the formation of malevolent introjects undermines the development of self-compassion, which in turn produces greater feelings of shame. We hypothesized that these feelings of shame account for concurrent depressive symptoms in adulthood. To test these hypotheses, we proposed a multiple mediator mediation model in which our independent variable was childhood maltreatment. We modeled child maltreatment as negatively predicting our first mediator, self-compassion, which in turn positively predicted internalized shame. We modeled internalized shame as positively predicting scores on our dependent variable, adult depressive symptoms. Participants were 158 adults fluent in English who were community members and college students living in a southwestern American metroplex. The model accounted for 61.8% of the variance in depressive symptoms in adulthood. A significant indirect effect from child maltreatment passed through both our mediators and ended in depressive symptoms in adulthood. We discuss limitations and theoretical and clinical implications, and future directions.

Syftet med den här uppsats är att undersöka varför människor med barndomstrauma kan finna mytologiska symboliska berättelser i existentiell kultur läkande. De frågor som ställs är: På vilket sätt kan berättelser om superhjältar ge ökad förståelse om barndomstrauma, både för de som själva upplevt det, samt de som inte upplevt det? Hur kan berättelser om superhjältar verka psykiskt läkande vid barndomstrauma? Vilken betydelse har känslor i läkandeprocessen av barndomstrauma? Material som använts är TV-serien Moon Knight och kommentarer från YouTube. Teoretiska perspektiv som används är positiva psykologiska teorier, John P. Wilsons avgrundupplevelse och Viktor Frankls viljan till mening samt analytiska teorier om filmtolkning och hur det digitala samhället kan ge en existentiell kontext, med Jung, Tilander och Duppils forskning. Metoden som använts är grundad teori (GT). Tidigare forskning har visat ett samband mellan meningsskapande och populärkultur, främst berättelser om superhjältar, likaså de psykiskt läkande effekter film och TV-serier kan ha. Barndomstrauma har visat både negativa risker och positiva aspekter och har stor psykisk inverkan även i vuxen ålder. Den här uppsatsen visar ett samband mellan barndomstrauma och en ökad förmåga, förståelse, begär och upplevelse av existentiellt meningsskapande från mytologiska symboliska budskap från populärkultur, i uppsatsen benämns det existentiell kultur som även förklaras närmre. Det ger psykiskt läkande effekter och bidrar till välbefinnande och själslig helhet som kan jämföras med det som kan upplevas i religiösa sammanhang. Dessa resultat är viktiga eftersom barndomstrauma och meningsskapande i populärkultur är relativt outforskade områden men som kan komma till hjälp för barn och vuxna som upplevt barndomstrauma. Det blir ett sätt att både förstå och hjälpa dessa, likaså ett sätt för dem att enklare förstå sig själva för att sedan kunna läka och finna välbefinnande. / The aim of this paper is to investigate why people with childhood trauma can find mythological symbolic stories in existential culture healing. Questions asked: In what way can stories about superheroes provide increased understanding about childhood trauma, both for those who have experienced it themselves, as well as those who have not? How can stories about superheroes have a psychological healing effect following childhood trauma? What is the importance of emotions in the healing process of childhood trauma? Materials used are the TV series Moon Knight and comments from YouTube. Theoretical perspectives used are positive psychological theories, John P. Wilson's the abyss experience and Viktor Frankl's will to meaning as well as analytical theories about film interpretation and how the digital society can provide an existential context with Jung, Tilander, and Duppils’ research. The method used is grounded theory (GT). Previous research has shown a connection between meaning-making and popular culture, mainly stories about superheroes, as well as the psychological healing effects from films and TV series. Childhood trauma has shown both negative risks and positive aspects and has a large psychological impact even in adulthood. This paper shows a connection between childhood trauma and an increase in ability, understanding, desire and experience of existential meaning-making from mythological symbolic messages from popular culture, called existential culture in this paper, a term that will be explained. It provides psychological healing effects and contributes to well-being and a spiritual wholeness that can be compared to some religious experiences. These findings are important because childhood trauma and meaning-making in popular culture are relatively unexplored areas but can be helpful for children and adults who have experienced childhood trauma. It becomes a way to both understand and help these, as well as a way for them to understand themselves more easily, to heal and find an inner peace.

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The experience of complex childhood trauma produces a ripple-effect that psychologically impacts trauma survivors’ functioning in multiple areas. The aim of the current study was to investigate and describe the interplay between complex trauma, subsequent personality development and later psychopathology by means of the multiple case study method of six female psychiatric patients attending treatment at a tertiary psychiatric hospital within Gauteng, South Africa. This was accomplished by assessing and qualitatively analysing the results of a carefully selected battery of personality and other psychometric assessments presented to study participants. The results indicated that the experience of complex childhood trauma impacted the study participants’ personality in predictable ways, which further influenced the psychopathology they displayed as psychiatric patients. These findings aid in describing the psychological impact of complex trauma on the research participants, and also offers support for reconnecting past traumas to the current psychopathologies of psychiatric patients. / Psychology / M.A. (Clinical Psychology)

Self-injurious behaviour (SIB) is recognised as a difficult behaviour to work/deal with and Community Support Workers (CSW‟s) who work with this behaviour may not have any formal training in the field of SIB. This study was therefore aimed at assessing the needs of CSW‟s working in the field of self-injurious behaviour amongst adolescents. A qualitative approach was used, the study was of an explorative nature and the researcher made use of purposive non-probability sampling to select respondents who were willing to participate in one-on-one semi-structured interviews with the researcher. This data was then analysed by the researcher making use of Creswell‟s spiral of analysis. The data collected was sorted into themes, sub-themes and categories and interpreted according to literature. The study identified that there are specific needs amongst CSW‟s who work with adolescent SIB in the specific areas of support and education/training. / Social Work / M. Diac. (Play Therapy)

The purpose of the current study was to investigate the relationship between Borderline Personality Disorder (BPD) symptoms and childhood experiences, and to explore the role of Early Maladaptive Schemas and core beliefs as variables possibly mediating this relationship. Previous research with clinical samples has established a strong link between childhood maltreatment and adult BPD (& other PD) symptoms in clinical samples. However, difficulties with these studies limit the specificity of results. For example, BPD has been shown to be highly comorbid with other axis I and axis II psychiatric conditions. Given that studies examining the relationship between BPD and childhood maltreatment generally fail to control for these comorbid conditions, the specificity of their results must be questioned. Furthermore, it has been well established that childhood familial environment is strongly related to childhood maltreatment. Again studies examining the relationship between BPD and childhood maltreatment have generally failed to concurrently assess childhood familial environments, hence opening the possibility that the relationship between BPD and childhood maltreatment may be due to family functioning rather than childhood maltreatment per se. Finally, studies linking childhood maltreatment with adult BPD have primarily utilized clinical samples. However, the primary use of clinical samples to examine the aetiology of disorders in this context ignores the vast literature showing adequate psychological functio ning for the majority of individuals exposed to childhood maltreatment. Hence, the primary aim of the current study was to examine the relationship between childhood maltreatment and adult BPD symptoms in a primarily non-clinical sample whilst statistically controlling for commonly comorbid axis I and axis II symptomatology and concurrently measuring childhood familial functioning. It was a secondary aim of the current study to examine the mediating effects of beliefs on the relationship between childhood factors (i.e., childhood maltreatment & childhood familial functioning) and adult BPD symptomatology. That is, cognitive-behavioural theorists argue that personality disorders may be triggered by adverse childhood experiences leading to maladaptive beliefs (or schemas) related to the self, others, and the world, and it is these beliefs which lead to the behavioural disturbances evident in personality disorders. One hundred and eighty-five primarily non-clinical participants completed questionnaires measuring a variety of axis I and axis II symptoms, early maladaptive schemas and core beliefs, as well as retrospective reports of family functioning and childhood maltreatment. Results showed a significant relationship between childhood factors and adult BPD symptomatology. For example, the largest correlation between BPD symptoms and a childhood factor was .27 (for childhood emotional abuse). Furthermore, early maladaptive schemas and core beliefs were found to mediate the relationship between childhood factors and adult BPD symptomatology thus supporting cognitive-behavioural theories of personality disorders. However, early maladaptive schemas and core beliefs were also found to mediate the relationship between childhood factors and other Axis I and Axis II symptoms. Hence, it was concluded that while there was some support for a cognitive mediation hypothesis for BPD symptoms, future research is needed in exploring the specificity of the cognitive mediation hypothesis for BPD.