Stress and monotonous work contribute substantially to the development of chronic musculoskeletal disorders. Yet, the pathophysiological mechanisms underlying the process, particularly the involvement of autonomic regulation, remain unclear. It has been suggested that altered motor control resulting from distorted sensory information from fatigued muscles may be an important component in the development of musculoskeletal disorders. Animal studies have shown that sympathetic nervous system activation exerts actions in skeletal muscles, such as vasoconstriction and modulation of afferent information from muscle spindles. However, few attempts have been made to address this issue in humans. Therefore, the first aim of the thesis was to investigate the impact of repetitive computer work with and without additional stressors on muscle oxygenation and position sense in the upper extremity. Assuming an important role of stress in the development of chronic musculoskeletal symptoms, one may expect open or latent manifestations of such symptoms in patients with non-specific stress-related illnesses. It is possible that sympathetic activation may influence pain perception, and that treatments aimed at reducing stress may also affect the pain experience. Thus, the second aim of the thesis was to evaluate the effects of a cognitive-behavioral training program and a physical activity program for patients with stress-related illnesses on autonomic reactivity, pain, and perceived health. First, a laboratory model of computer mouse use was characterized in terms of biomechanical exposure of the wrist, and wrist position sense was determined before and after 45 minutes of continuous mouse use. Then, the effects of performing the computer mouse work under time pressure and precision demands were determined. Autonomic activity and muscle oxygenation in the upper extremity were measured during the work, and wrist position sense was assessed before and after the work. When patients with stress-related illnesses were compared to healthy individuals in autonomic reactivity to functional tests, pressure-pain thresholds, and ratings of health, indications of a relation between autonomic reactivity and symptoms of pain was found. Hence, in a subsequent evaluation of a cognitive-behavioral training program and a physical activity program for patients with stress-related illnesses, post intervention effects on autonomic reactivity to functional tests, pressure-pain thresholds, ratings of health and return-to-work were studied during a period of 12 months after the intervention. The main findings were the following. 1) Wrist kinetics data obtained during the computer mouse work showed similarities to previously presented data for mouse-operated design tasks. 2) When time pressure and precision demands were added to the computer work, increased autonomic activity paralleled with decreased muscle oxygenation in the upper extremity was found. Wrist position sense accuracy, however, did not decrease after the work as it did when the work was performed without the additional demands. The result is intriguing, as it does not appear to be in concordance with previous animal studies. 3) Patients with stress-related illnesses showed higher autonomic reactivity to cognitive and physical laboratory tests than healthy control subjects. They also had substantially lower pressure-pain thresholds in the back, and rated poorer health and health-related behavior than the control subjects. 4) We found little difference in effect of cognitive-behavioral training and physical activity, compared to usual care, for patients with stress-related illnesses. Patients in the control group showed an improvement of about the same magnitude as in the treatment groups over the 12-month follow-up period. The present findings indicate a non-additive relation between autonomic activity during repetitive work and position sense inaccuracy. Furthermore, patients with stress-related illnesses often reported pain in the neck, shoulders, and lower back. This was associated with lower pressure-pain thresholds in the back and a modest increase in sympathetic reactivity to physical and mental tests, which might suggest a potential use of these methods in the clinical examination and rehabilitation of patients with stress-related illnesses.

Priestley's One-to-One CBT programme is intended to reduce criminal recidivism. Data were collected from 1484 programme rounds in Sweden. 776 of these cases contained the data necessary for this study and were used in the analyses. The data included pre- and postprogramme test scores on areas addressed in the programme. The purpose of this study was to examine whether the tests or background data of participants have predictive properties for dropout and recidivism and whether test scores differ between sub-groups. To do this, t-tests and logistic regression analyses were performed. There were significant improvements on all scores post-programme. Only age predicted completion, with older participants being more likely to complete the program. Several variables were found to have predictive properties for recidivism. The most potent predictor for nonrecidivism was programme completion. The study finds a relation between some of the tests measuring psychological change, and recidivism. This partly supports the theory behind the programme.

No description available.

It is important to understand the development of depression, and how a family component to treatment affects early adolescent girls’ depression given the association between depression and negative future outcomes. A potential vulnerability to depression is the cognitive triad, which encompasses beliefs about the self, world, and future and is shaped by early learning experiences. Research indicates that the vulnerability originates from parent-child relationships and family messages, which are important in the development of youth cognitive styles. Previous research also indicates that family variables are important factors to consider in the treatment of depression. The purpose of the current study was to expand previous research by examining the roles of perceived family messages and the cognitive triad in the development of depression for early adolescent girls. The study also explored whether parent gender differentiated how family messages affect girls’ cognitions and depressive symptoms. The study evaluated how the addition of a parent training component to a school-based, group-administered CBT intervention affected change in the model’s variables in comparison to group-administered CBT intervention alone and a monitoring control condition. Participants included early adolescent girls diagnosed with depression and caregivers in the parental treatment component. Girls were randomly assigned to a CBT, CBT+PT, or minimal contact control condition. Ratings of girls’ perceptions of family messages, cognitions, and depressive symptoms were obtained at pre-treatment and post-treatment. Results from structural equation modeling indicated significant effects from perceived family messages to girls’ cognitions. Further, girls’ cognitions mediated the relation between perceived family messages and girls’ depressive symptoms at post-treatment for participants within the CBT and monitoring conditions. No significant differences were evident between parent gender and perceived messages. Results indicated that the addition of a parent component to the CBT intervention did not significantly differ from the CBT intervention alone in its effects on the variable relations within the model at post-treatment. Supplemental analyses highlighted parent attendance as a significant factor, with larger effects from the family messages on girls’ cognitions appearing when parents attended majority (six or more) of the eight parent training sessions. Implications, limitations, and areas for further research are discussed. / text

The purpose of this qualitative descriptive study is to describe men’s experiences of depression in order to provide direction for future research of the screening, diagnosing, and treatment of men's depression. Previous research indicates that men experience different depressive symptoms than women, and there is a possibility that men's depression is not being adequately captured by current screening standards, which would theoretically lead to a large number of men with unrecognized, undiagnosed, and untreated depression. If this is the case, this may explain the disproportionately low number of men diagnosed with depression compared to women, in contrast to the disproportionately high number of men who complete suicides. There is a need in the literature for descriptions of depression experienced by men in order to determine the adequacy of current psychometric screening tools and approaches to treatment which are currently in practice. This qualitative study seeks to begin to fill in this gap in the literature. Key findings indicate that intentionally and unintentionally hide their feelings of depression, and that men experience anger as an early sign of depression. In addition, men often do not recognize their distress as depression until someone else suggests they seek professional help; and men use various methods of distraction to cope with their distress, including excessive working, sleeping, eating, TV watching, and alcohol consumption. Recommendations for further research are discussed.

THE PURPOSE OF THE STUDY WAS TO INVESTIGATE THE EFFECT OF A COGNITIVE BEHAVIORAL GROUP COUNSELING PROGRAM ON THE LEARNED RESOURCEFULNESS LEVEL AND AUTOMATIC THOUGHT PATTERNS OF FIFTH GRADE ELEMENTARY SCHOOL STUDENTS. THE STUDY CONSISTS OF TWO PHASES. IN THE FIRST PHASE, CHILDREN&#039 / S VERSION OF SELF-CONTROL (C-SCS) AND COGNITIVE TRIAD INVENTROY FOR CHILDREN (CTI-C) WERE GIVEN TO 232 FIFTH GRADE STUDENTS IN TWO ELEMENTARY SCHOOLS IN ANKARA. THE DIFFERENCES AMONG THE AUTOMATIC THOUGHT PATTERNS (CTI-C) OF THE STUDENTS BY GENDER AND LEARNED RESOURCEFULNESS (C-SCS) WERE EXPLORED USING A 2 (GENDER) X 2 (HIGH-LOW LEARNED RESOURCEFULNESS) FACTORIAL MANOVA. RESULTS SHOWED THAT STUDENTS WHO WERE HIGHLY RESOURCEFUL SCORED SIGNIFICANTLY HIGHER IN TOTAL, NEGATIVE VIEW OF SELF, FUTURE AND WORLD AND POSITIVE ViEW OF SELF, FUTURE AND WORLD. AN EXPEROMENTAL DESIGN WITH ONE TRAINING AND TWO CONTROL GROUPS (PLACEBO-ATTENTION AND NO-TREATMENT) AND THREE MEASUREMENTS (PRE, POST AND FOLLOW-UP) WERE USED IN THE SECOND PHASE OF THE STUDY. 45 STUDENTS (27 MALES, 18 FEMALES) WHO HAD LOW LEARNED RESOURCEFULNESS AND NEGATIVE AUTOMATIC THOUGHT PATTERNS WERE RANDOMLY ASSIGNED TO ONE TRAINING AND TWO CONTROL GROUPS. &#039 / COGNITIVE BEHAVIORAL GROUP COUNSELING PROGRAM&#039 / WAS IMPLEMENTED TO THE COGNITIVE BEHAVIORAL TRAINING STUDENTS&#039 / OVER A PERIOD OF 15 SESSIONS. THE SESSIONS WERE HELD ONCE A WEEK AND LASTED IN 90 MINUTES. STUDENTS IN THE PLACEBO-ATTENTION CONTROL GROUP PLAYED NON-THERAPEUTIC GAMES LiKE LOTTO, GAME OF NAME-CITY-ANIMAL-PLANT, HANGING A MAN, SILENT MOVIE AND SOLVED SOME PUZZLES. THE NO-TREATMENT CONTROL GROUP SUBJETCS DID NOT RECEIVE ANY TRAINING. REPEATED MEASURES ANALYSIS OF VARIANCE WAS USED TO ANALYZE THE DATA COLLECTED IN THE EXPERIMENTAL PHASE OF THIS STUDY. CONTRARY TO THE EXPECTATIONS, THE RESULTS INDICATED THAT &#039 / COGNITIVE BEHAVIORAL GROUP COUNSELING PROGRAM&#039 / DID NOT IMPROVE LEARNED RESOURCEFULNESS LEVELS AND INCREASE POSITIVE AUTOMATIC THOUGHT PATTERNS OF STUDENTS.

Os transtornos de ansiedade (TAs) estão entre os principais problemas que acometem crianças e adolescentes, podendo atingir uma prevalência de até 24,9% ao longo da vida. A eficácia do tratamento de TAs na infância e na adolescência tem sido demonstrada em estudos de curto prazo de terapia cognitivo-comportamental (TCC), mas ainda são poucos os estudos que avaliam a eficácia da terapia de longo prazo. Portanto, a presente pesquisa tem por objetivo realizar uma revisão sistemática de estudos de seguimento sobre TCC com crianças e adolescentes com TAs (artigo 1) e verificar a resposta a longo prazo da terapia cognitivocomportamental em grupo (TCCG) em relação à intensidade dos sintomas de ansiedade e depressão e à qualidade de vida (artigo 2). Para a realização do primeiro artigo (revisão sistemática), foram consultadas as bases de dados Pubmed e Isi Web of Science. Foram considerados como critérios de inclusão: estudos de coorte após TCC para TAs na infância e na adolescência. Foram excluídos os estudos com período de seguimento inferior a um ano. Para a apresentação dos achados dos estudos, foram considerados os resultados significativos (p<0,05). Em relação ao método utilizado na elaboração do segundo artigo (seguimento não controlado), a pesquisa envolveu 20 adolescentes que realizaram 14 sessões de TCCG para TAs e foram reavaliados após 2 anos do término da intervenção. Para avaliar os desfechos, utilizaram-se os instrumentos antes da TCCG, no final (4 meses) e após 2 anos: Autorrelato para Transtornos Relacionados à Ansiedade na Infância (SCARED-C); Inventário de Depressão Infantil (CDI); Impressão Clínica Global (CGI); Escala de Funcionamento Global (CGAS) e Qualidade de Vida de Jovens (YQOL). O estudo foi aprovado pelo Comitê de Ética em Pesquisa do Hospital de Clínicas de Porto Alegra (nº 110181). Os adolescentes e seus responsáveis assinaram o termo de consentimento livre e esclarecido (TCLE). Como resultado da revisão sistemática, obteve-se um total de 10 artigos que preencheram os critérios de inclusão. O período de seguimento variou entre 12 meses a 13 anos e, em geral, os resultados indicaram a manutenção dos ganhos com a TCC de curto prazo. No entanto, os estudos apresentaram limitações, principalmente em relação ao método, como ausência de grupo controle e perdas de seguimento. No estudo de seguimento, um total de 19 (95%) adolescentes com média de idade de 12,3 (DP=1,0) anos foi avaliado. Houve redução significativa (p<0,001) da gravidade dos sintomas (CGI) e melhora do funcionamento global (CGAS) em comparação com a avaliação inicial. A qualidade de vida geral no seguimento melhorou significativamente (p=0,041) em comparação com a avaliação inicial e final da 7 TCCG. Os sintomas específicos de ansiedade e depressão não apresentaram mudanças significativas (p=0,071 e p=0,206, respectivamente). Os resultados do trabalho sugerem a manutenção dos benefícios da TCC de longo prazo e encorajam a sua utilização entre adolescentes com TAs. / Anxiety disorders (ADs) are among the most prevalent conditions affecting children and adolescents with a lifetime prevalence of up to 24.9%. The efficacy of treatment for ADs in childhood and adolescence has been demonstrated in short-term studies of cognitivebehavioral therapy (CBT), but few studies have investigated the long-term effects of this treatment. Therefore, the present study aimed to systematically review follow-up studies of CBT in children and adolescents with ADs (article 1) and explore the long-term effects of group cognitive-behavioral therapy (GCBT) on quality of life and symptoms of anxiety and depression (article 2). The systematic review was based on a search of the PubMed and ISI Web of Science databases. Articles reporting cohort studies of CBT for ADs in childhood and adolescence were included in the review. Studies with follow-up periods of less than one year were excluded. Results were considered significant at p < 0.05. The second article consisted of an uncontrolled follow-up study involving 20 adolescents who underwent 14 sessions of GCBT for ADs and were assessed at three time points (before and after treatment, and two years after the end of treatment) with the following instruments: Screen for Child Anxiety Related Emotional Disorders, child (SCARED-C); Children's Depression Inventory (CDI); Clinical Global Impression (CGI); Children’s Global Assessment Scale (CGAS) and Youth Quality of Life (YQOL). The study was approved by the Hospital de Clínicas de Porto Alegre Research Ethics Committee (protocol number 110181). Participants and guardians provided written informed consent prior to participation. Ten articles were included in the systematic review. Follow-up periods ranged from 12 months to 13 years, with most studies indicating that the effects of short-term CBT remained stable over time. However, the studies presented a series of methodological limitations, such as lack of control groups and follow-up losses. In the present follow-up study, a total of 19 (95%) adolescents with mean age 12.3 (SD=1.0) years were assessed. There were significant reductions (p<0.001) in symptom severity (CGI) and improvements in global functioning (CGAS) over the course of the study. General quality of life improved significantly at follow-up (p=0.041) as compared to assessments immediately before and after GCBT. There were no significant differences in anxiety and depression symptoms (p=0.071 and p=0.206, respectively). Results of the present studies indicate that the benefits of CBT are maintained over time, and that this method is suitable for the treatment of ADs in adolescents.

Submitted by Noeme Timbo (noeme.timbo@metodista.br) on 2017-01-25T12:53:43Z No. of bitstreams: 1 RicardoDuraes.pdf: 2397528 bytes, checksum: 3131144d042e53cdfcb5df2acb1abbc2 (MD5) / Made available in DSpace on 2017-01-25T12:53:43Z (GMT). No. of bitstreams: 1 RicardoDuraes.pdf: 2397528 bytes, checksum: 3131144d042e53cdfcb5df2acb1abbc2 (MD5) Previous issue date: 2016-11-16 / Automatic thoughts, emotions, behaviors and physiological responses have relationships with each other and are directly linked to the attribution of the causes, beliefs, values, attitudes and expectations in the relationship of couples and are associated with marital satisfaction and psychological distress. The aim of this study was to identify cognitive distortions couples and intervene from cognitive-behavioral therapy and increase levels of marital satisfaction. The sample consisted of 16 heteroafetivos couples, Brazilian, 18 years, literate and at least one year of marriage. Thus, the average age of the sample was 30.4 (SD=4,13) years and the majority (37.5%) reported having completed high school. The following instruments were used: Marital Satisfaction Scale (ESC); Dyadic Adjustment Scale (DAS); Relationship Belief Inventory (RBI); Marital Social Skills Inventory (IHSC); Automatic Thoughts Questionnaire (ATQ); Dysfunctional Attitude Scale (EAD); Back Depression Inventory - (BDI) and Beck Anxiety Inventory (BAI) applied before and after cognitive behavioral intervention, and a Questionnaire Sociodemographic. In the procedure, the couples came by 12 therapy sessions for 50-minutes weekly with cognitive-behavioral approach. Only the second session was individual. However, the first and the other sessions were combined. The results discloused as the most frenquentes cognitive distortions have the Mind Reading 34.4% (n = 11) and Hipergeneralization 31.3% (n = 10). In terms of final considerations it was observed that the cognitive behavioral intervention showed its effective, and then, corroborating improvement in marital satisfaction of most couples. Thus, the correlations of paired samples showed statistical significance (p=0,00) in the improvement of the levels of marital satisfaction, depression, anxiety, marital social skills and automatic thought compared to before and after the intervention. / Os pensamentos automáticos, as emoções, os comportamentos e as respostas fisiológicas têm relações entre si e estão diretamente ligados às atribuição das causas, crenças, valores, atitudes e expectativas na relação dos casais e estão associados à satisfação conjugal e sofrimento psíquico. O objetivo desse estudo foi identificar distorções cognitivas em casais e intervir a partir da terapia cognitivo-comportamental e aumentar os níveis de satisfação conjugal. A amostra foi composta por 16 casais heteroafetivos, brasileiros, maiores de 18 anos, alfabetizados e com no mínimo um ano de união. Assim, a idade média da amostra foi de 30,4 (DP=4,13) anos e a maioria (37,5%) relatou ter ensino médio completo. Foram utilizados os seguintes instrumentos: Escala de Satisfação Conjugal (ESC); Escala de Ajustamento Diádico (DAS); Inventário de Crença Sobre Relacionamento (RBI); Inventário de Habilidades Sociais Conjugais (IHSC); Questionário de Pensamentos Automáticos (ATQ); Escala de Atitudes Disfuncionais (EAD); Inventário Back de Depressão – (BDI) e Inventário Beck de Ansiedade (BAI) aplicados antes e depois da intervenção cognitivo comportamental, além de um Questionário Sociodemográfico. Quanto ao procedimento, os casais passaram por 12 sessões de terapia de 50 minutos com base cognitivo-comportamental. Somente a segunda sessão foi individual. No entanto, a primeira e as demais sessões foram conjuntas. Os resultados mostraram que as distorções cognitivas mais frenquentes foram a Leitura de pensamento 34,4% (n=11) e de hipergeneralização 31,3% (n=10). Foi possível observar que a intervenção cognitivo comportamental se mostou eficaz, corroborando melhora nas satisfação conjugal da maioria dos casais. As correlações de amostras emparelhadas apresentaram significância estatística (p=0,00) na melhora dos níveis de satisfação conjugal, depressão, ansiedade, habilidades sociais conjugais e pensamentos automáticos comparado com o antes e depois da intervenção.

Objetivou-se adaptar e avaliar um modelo de intervenção cognitivo-comportamental para meninos vítimas de Violência Sexual (VS), derivado de um modelo avaliado com meninas. A dissertação é composta por um artigo teórico sobre VS contra meninos, um capítulo que descreve o processo de adaptação do modelo, um relato de experiência sobre a produção e utilização de um documentário sobre VS contra meninos utilizado na aplicação do modelo adaptado e um artigo com os resultados dessa aplicação. Três meninos vítimas de VS com idades entre oito e 16 anos foram avaliados antes e após a intervenção por meio de instrumentos psicológicos quanto a sintomas comumente presentes em vítimas de VS. A aplicação do modelo adaptado foi avaliada por três juízes independentes por meio de seis indicadores. As avaliações sintomatológicas dos participantes e a da aplicação do modelo adaptado se constituem como evidências iniciais sobre sua ação terapêutica. / This work aimed to adapt and assess a cognitive-behavioral intervention model for boys who are victims of sexual violence that was derived from a model that evaluated girls. The master thesis consists of a theoretical article about sexual violence against boys; a chapter describing the process of adapting the model; a report on the experience of producing and using the documentary about sexual violence against boys while applying the adapted model; and an article with the results from this application. Three boys between the ages of eight and 16 who had been victims of sexual violence were evaluated, through psychological instruments before and after the intervention, in terms of symptoms common to sexual violence victims. Three independent judges evaluated the application of the adapted model through six indicators. The evaluations of the participants’ symptoms as well as of the adapted model’s application provide initial proof of therapeutic effectiveness.

O presente estudo avaliou a efetividade de uma tecnologia social de capacitação profissional em um modelo de grupoterapia cognitivo-comportamental voltado a psicólogos que trabalham com o atendimento clínico de crianças e adolescentes vítimas de abuso sexual. O Estudo I avaliou o impacto da capacitação profissional nos índices de esgotamento emocional (burnout) e de tensão ocupacional (job strain) dos participantes, bem como o impacto no trabalho. Participaram 30 psicólogos que trabalham em instituições públicas do Estado do Rio Grande do Sul. Do total da amostra, 19 compuseram o grupo experimental (G1, formado por participantes da capacitação profissional) e 11 compuseram o grupo de comparação (G2, formado por não-participantes da capacitação profissional). Os instrumentos utilizados foram o Job Content Questionnaire; o Maslach Burnout Inventory, a Escala de Impacto do Treinamento no Trabalho e uma ficha de dados biosociodemográficos. Para G1, foi observado um elevado índice de impacto no trabalho. Referente aos índices de burnout, a exaustão emocional e a baixa-realização no trabalho mantiveram-se estáveis entre T1 e T2, enquanto a despersonalização diminuiu. Para G2, todos os indicadores de burnout aumentaram significativamente. Em relação aos níveis de tensão ocupacional, a demanda de trabalho aumentou para G1, enquanto que se manteve estável para G2. Já os níveis de ‘controle no trabalho’ mantiveram-se estáveis para G1, enquanto houve diminuição significativa para G2, sobretudo devido à diminuição dos índices da variável ‘uso de habilidades’. O Estudo II objetivou avaliar o processo da capacitação profissional, visando a observar as potencialidades e limitações do programa oferecido. A amostra foi composta por 28 psicólogos participantes da tecnologia social de capacitação profissional. Os participantes responderam a um questionário de dados biossociodemográficos e a fichas de avaliação da capacitação, ao final de cada encontro. Os resultados obtidos mediante a ficha de avaliação apresentaram um nível elevado de satisfação com o programa de capacitação profissional oferecido. Sugestões e comentários adicionais, bem como opiniões sobre os aspectos mais positivos e mais negativos do curso forneceram subsídios para melhoramentos em edições futuras. Os resultados dos dois estudos sugerem que a Tecnologia Social de Capacitação Profissional é um recurso importante para a formação teorico-prática, bem como para o bem-estar no trabalho dos profissionais que lidam com a demanda do abuso sexual infanto-juvenil no Estado do Rio Grande do Sul. / This study evaluated the effectiveness of a social technology of professional training in a cognitive-behavioral group-therapy model, addressed to clinical psychologists who treat children victims of sexual abuse. Study I evaluated the effects of the professional training in the indexes of burnout and job strain of the participants, as well the impact of the training at work. The sample was composed by 30 psychologists who work in public institutions at the state of Rio Grande do Sul (Brazil). From the total sample, 19 were part of the experimental group (G1, composed by participants of the training program) and 11 were a comparison group (G2, formed by non-participants of the training program). The instruments were the Job Content Questionnaire, the Maslach Burnout Inventory, the Job Training Evaluation Scale and a bio-sociodemographic protocol. The results showed that the training program presented a high impact on the job performance. Regarding to the burnout indexes in G1, the results showed that exhaustion and reduced personal accomplishment remained stable, while depersonalization presented a significant reduction, through T1 to T2. To G2, the three burnout domains increased significantly. Regarding to the job strain levels, the workload increased to G1 and remained stable for G2. The levels of control remained stable for G1, while for G2 they decreased, mainly due to lower rates of the skill discretion indexes. Study II aimed to evaluate the process of the professional training program. The sample was composed by 28 psychologists whom participated of the training program. Participants responded a bio-sociodemographic protocol and the session evaluation form. The indicators of the evaluation forms presented a high level of satisfaction with the professional training program. Suggestions and additional commentaries, as well opinions about the most positive and negative aspects of the program provided subsidies to improve future editions of the training program. The results of both studies suggest that the Social Technology of Training Program is an important resource to the theoretical and practical qualification as well as for the well-being of the professionals who work with child victims of sexual abuse at the Rio Grande do Sul state, in Brazil.