La question du lien entre traumatisme et addiction fait aujourd’hui l’objet de multiples recherches psychopathologiques, épidémiologiques ou encore neurobiologiques. Dans une approche psychodynamique, ce travail de thèse propose d’explorer le sens de la répétition compulsive addictive sous l’angle du traumatisme psychique. Il interroge en quoi le recours aux addictions traduit, aux côtés des effets négatifs de déliaison et d’anesthésie psychique, qui luttent contre le retour de l’expérience traumatique, une recherche insistante d’élaboration des situations extrêmes de la subjectivité. En effet, la traumatophilie addictive vient également dans un mouvement sensoriel extrême auto-administré, réactualiser les expériences de détresse primaire en attente d’intégration, effet positif du traumatisme. A partir d’une méthodologie croisée à dominante qualitative composée d’outils standardisés (MINI et TAS-20), d’épreuves projectives (Rorschach et TAT) et d’entretiens non-directifs de recherche, nous rencontrons 6 sujets hospitalisés pour sevrage de leur addiction aux substances psychoactives, ainsi que pour leurs troubles psychotraumatiques. Nous discutons de l’impact des traumatismes se révélant hypercomplexes et multicausales et constatons qu’il est nécessaire, en parralèle à des événements de vie potentiellement traumatiques, d’être attentif aux traumas liés à la qualité de la relation à l’objet primaire et aux atteintes de l’intégrité corporelle. Nous repérons des fonctions de protection ou encore de réparation narcissique, tout en considérant pour autant qu’il ne s’agit plus uniquement d’envisager le défaut de mentalisation et de contenance ni le besoin de lever l’addiction, pour accéder au vécu traumatique. En effet, les formes d’addictions traumatiques représentent également une tentative de retournement passif-actif par l’emprise, cherchant paradoxalement à soigner le mal en s’infligeant un autre mal « contrôlé », soit d’avoir le sentiment d’être acteur de son existence, quand bien même c’est au prix de l’autoconservation. Elles sont notamment porteuses d’un message adressé à l’objet, et révélatrices des traumatismes en attente de contenance et d’interprétation. Les traumas narcissiques risquent, si l’expérience ne peut s’historiser, de continuer inlassablement à se répéter corporellement si personne ne se prête à entendre la recherche insistante de figuration et de symbolisation contenue dans les mises en acte addictives. / Today, the question pertaining to the link between traumatism and addictions is prevalent in multiple research areas including epidemiology, psychopathology and neurobiology. From a psychodynamic approach this thesis aims to explore the meaning of compulsive addictive repetition from the perspective of psychological trauma. It explores the way in which, despite the negative impact of psyche anesthesia and disconnection, which struggles against the return of the traumatic experience, the act of resorting to addictions represents a quest, which insists upon the elaboration of extreme subjective situations. Indeed, in an extreme self-administered sensorial movement, addictive traumatophilia also recreates the primary distressing experiences waiting to be integrated. This would constitute the positive effect of the trauma. Using a cross methodology with a dominant qualitative approach, comprised of standardized tools (MINI and TAS-20), projective tests (Rorschach and TAT) and non-directive research interviews, we met six subjects hospitalized for withdrawal from psychoactive substances and for their psychotraumatic difficulties.We discuss the impact of extremely complex and multi-causal traumas and grasp the necessity of being attentive to traumas related to the quality of the relationship with the primary object and to the integrity of the body, in parallel to life events, which are potentially traumatic. We identify protective functions or narcissistic repairs, while considering that gaining access to the traumatic experience is no longer only about the faults of mentalization and of containment. Indeed, the forms of traumatic addictions equally represent an attempt of a passive-active reversal by influence, seeking paradoxically to heal the hurt by inflicting another “controlled” pain, to have the feeling of being in control of one’s own existence, even if it comes at the price of self-preservation. It is to be noted that they carry a message addressed to the object, which reveal the traumas waiting to be contained and interpreted. If the experience cannot be integrated and if no one is able to listen to the insistent research of figuration and symbolization found in the addictive behavior, narcissistic traumas may continue on tirelessly repeating themselves through the body.

A partir da experiência clínica com pacientes em UTI, foi realizada uma pesquisa que teve como objetivo compreender a experiência subjetiva destes, considerando o ser humano como ser biopsicossocial, levando em conta não só a enfermidade orgânica ou suas condições clínicas, mas também seus aspectos psicológicos, sua história, percepções, angústias, medos e fantasias. Os participantes selecionados tinham mais de 18 anos de idade, estavam aptos para se comunicar adequadamente - sem o impedimento de lesões ou equipamentos - e, segundo a equipe de enfermagem, possuíam condições clínicas que permitiam a participação no estudo. O método de pesquisa foi o clínico-qualitativo e, dessa forma, a coleta de dados foi realizada a partir de entrevistas semi-dirigidas, com tempo médio de trinta minutos, que aconteceram no leito de UTI, preservando a postura psicanalítica de escuta e acolhimento. Antes de sua realização, foi utilizada a escala mini-mental para verificar o nível de consciência. As entrevistas foram transcritas e a partir da leitura destas, emergiram algumas categorias, que foram analisadas. A análise das entrevistas revelou uma percepção ambivalente da UTI. Ao mesmo tempo em que é um local de elevada sofisticação tecnológica, o que lhes transmite segurança, é também um espaço de contato com suas próprias limitações. A análise revelou ainda ser este, um momento de dificuldade para muitos dos pacientes, por conta da existência de feridas narcísicas, vivência de castração, desamparo, distância da família, angústia de morte, entre outros. Tal momento, no entanto, dependendo de suas crenças ou histórias de vida, além de difícil, é também comumente visto por eles como um período de reflexão sobre sua existência e até mesmo de amadurecimento / From clinical experience with ICU patients, a survey was conducted aiming to understand their subjective experience, considering the human being as a biopsychosocial being, taking into account not only the organic disease or clinical conditions, but also his psychological aspects, history, perceptions, anxieties, fears and fantasies. The selected participants were 18 or more years old and able to communicate properly - without injuries or equipment - and, according to the nursing staff, had medical conditions that allowed the participation in the research. The research method was the clinical-qualitative one, and thus the data collection was obtained by semi-directed interviews with an average of thirty minutes performed in the ICU bed, preserving the psychoanalytic approach of listening and reception. Before its completion, the minimental scale was used to assess the level of consciousness. The interviews were transcribed and from their reading, some categories emerged, that were analyzed. This analysis revealed an ambivalent perception of the ICU. While it is a place of high technological sophistication, which gives safety to them, it is also an area of contact with their own limitations. The analysis also revealed that this is a time of difficulty for many patients because of the existence of narcissistic wounds, experience of castration, helplessness, distance from family, fear of death, among others. This moment, however, depending on their beliefs or life stories, besides difficult, it is also commonly seen by them as a period of reflection on their lives and even on their personal growth

A dor é uma experiência emocional e sensorial desagradável, associada ao dano real ou potencial de alguma região do corpo. Segundo a International Association for the Study of Pain, ela é sempre subjetiva, pois sua percepção é aprendida com a vivência pessoal de cada indivíduo. A lombalgia atinge cerca de 80% da população adulta e sua cronicidade pode estar relacionada com diversos fatores. Objetivou-se compreender a dinâmica psíquica das pessoas com lombalgia crônica por artrose facetária selecionadas para o estudo, partindo da perspectiva da psicossomática (campo de conhecimento que trabalha na interface entre os aspectos mentais, físicos e sociais) em uma compreensão biopsicossocial. Constitui-se em uma pesquisa descritiva de caráter clínico-qualitativo. Como método, foram definidas duas frentes de trabalho: revisão bibliográfica e estudo de campo. Na primeira realizou-se revisão bibliográfica acerca do tema dor e psicologia. A base de dados utilizada foi Biblioteca Virtual em Saúde (BVS-PSI). Levantou-se todo tipo de publicação através de uma terminologia padronizada no site BVS-PSI. Foram mantidas para análise de conteúdo do texto completo as publicações que fizeram referência à dor crônica lombar e que apontarem presença de psicologia, personalidade e/ou dinâmica psíquica no título ou no resumo. Na segunda etapa foi formulada avaliação psicológica de 6 pessoas, 3 do sexo feminino e 3 do sexo masculino, com idade de 20 a 60 anos, sendo que todos possuíam diagnóstico de lombalgia crônica devido a artrose facetária. Foram realizadas, nesta ordem, entrevista clínica semi-dirigida, Escala Visual de Dor (EVA) e Teste de Apercepção Temática (TAT). A partir d levantamento bibliográfico constatou-se que nenhuma pesquisa desenvolveu descrição detalhada da psicodinâmica de pacientes com dor lombar crônica. Cada participante apresentou dinâmica psíquica única, dando sentido a sua dor e ao seu tratamento a partir de sua experiência peculiar. No entanto, a dor foi percebida pelos participantes como um sinal de que eles têm limites. A relação estabelecida pelos participantes com sua dor e com seu tratamento esta diretamente relacionada com o modo como lidam com a vida. Conclui-se que tanto a dor lombar por artrose facetária altera a subjetividade e a objetividade da vida dos participantes da pesquisa, como o modo como lidam com a vida interfere em sua dor e tratamento. Compreender a dinâmica destes pacientes pode auxiliar no manejo de tratamentos mais eficazes. Por este motivo destaca-se a necessidade de olhar para o ser humano acometido pela dor, e não somente para a dor que acomete o ser humano. Propõe-se que mais pesquisas sejam realizadas a partir desta compreensão, o que implicará uma clinica preocupada com o ser humano em seu complexo funcionamento / Pain is an unpleasant sensory and emotional experience associated with actual or potential damage of any region of the body. According to the International Association for the Study of Pain, it is always subjective, once its perception is learned through personal experience of each individual. Low back pain affects about 80% of the adult population and its chronicity may be related to several factors. This study aimed to understand the psychological dynamic of the selected people with chronic low back pain by facet arthrosis, from the perspective of psychosomatic (field of knowledge working at the interface between the mental, physical and social aspects) in a biopsychosocial understanding. This is a descriptive research using clinical and qualitative approach. The methodology used was literature review and field study. The literature review was held on the subjects of pain and psychology. The database used was the Biblioteca Virtual em Saúde (BVS-PSI). Every type of publication was raised through a standardized terminology in BVS-PSI website. For full-text content analysis the publications were selected if they had reference to chronic low back pain and the presence of the terms psychology, personality and /or psychic dynamics on the title or abstract. In the second stage of the study, the psychological evaluations of 6 people, 3 females and 3 males were done. They aged 20-60 years, and all had been diagnosed with chronic low back pain due to facet arthrosis. Then, it was carried out, in order, the semi-directed clinical interview, the Pain Visual Scale (VAS) and the Thematic Apperception Test (TAT). From the literature it was found that no research has developed detailed description of the psychodynamics of patients with chronic low back pain. Each participant had unique psychic dynamics, and they gave meaning to pain and treatment from their peculiar experience. However, the pain was perceived by participants as a sign that they have limits. The relationship established by the participants with their pain and its treatment is directly related to the way they deal with life. We concluded that both the low back pain by facet arthrosis changes the subjectivity and objectivity of the participants life, so do the way they deal with life interferes on their pain and treatment. The understanding of the dynamics of these patients may help the management of more effective treatments. Therefore there is the need to look at the human being affected by pain, not only at the pain that affects the human being. It is proposed that more research is done on this understanding, which will lead to a clinical practice that is concerned about the human being on his complex operation

Orientadores: Maria de Lourdes Setsuko Ayrizono, Frederico Camelo Leão / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-25T05:27:18Z (GMT). No. of bitstreams: 1 Acciari_ArleteSilva_M.pdf: 1483280 bytes, checksum: 5d8937c9decda267b2ccf2c0f397a615 (MD5) Previous issue date: 2014 / Resumo: Introdução: A doença de Crohn é uma enfermidade crônica, com tratamento contínuo e prolongado. Além de sintomas físicos como dor abdominal, diarreia e emagrecimento, os pacientes são acometidos por crises de ansiedade, depressão e perda na qualidade de vida, necessitando de acompanhamento psicológico. Objetivo Geral: Avaliar os efeitos da Psicoterapia Breve Transpessoal em pacientes com doença de Crohn. Objetivos Específicos: Analisar os resultados da Psicoterapia Breve Transpessoal quanto à saúde geral, qualidade de vida, ansiedade, depressão e estados de desesperança e observar possíveis correlações entre as condições psicológicas e a atividade da doença de Crohn. Casuística e Métodos: A amostra foi composta por 11 pacientes com doença de Crohn, de ambos os sexos e com idade entre 25 anos e 55 anos. Utilizou-se o método clínico e o procedimento consistiu no atendimento em Psicoterapia Breve Transpessoal com referencial teórico da Abordagem Integrativa Transpessoal, com coleta de dados antes e depois da psicoterapia. Para a coleta de dados foram utilizados os seguintes instrumentos: Questionário Sociodemográfico, Índice de Atividade da Doença de Crohn, Inflammatory Bowel Disease Questionnaire, Questionário de Saúde Geral de Goldberg, Inventário de Ansiedade, Inventário de Depressão e Escala de Desesperança. Utilizou-se da análise descritiva e a metodologia estatística, com teste de Wilcoxon. Resultados: A intervenção mostrou-se eficaz para todos os instrumentos avaliados (p<0,05), com melhor resultado para redução da depressão (-76,8%), seguido da ansiedade (-62,0%) e redução no estado de desesperança (-61,2%); com melhora no estado de saúde geral (40,4%) e na qualidade de vida (35,3%). A atividade da doença avaliada pelo Índice de Atividade da Doença de Crohn apresentou redução de -38,1%. Conclusão: O processo psicoterapêutico trouxe significativos benefícios aos pacientes com doença de Crohn, com redução dos níveis de ansiedade, depressão, estado de desesperança; melhorou o estado de saúde geral e a qualidade de vida dos pacientes com DC. Houve uma melhora nas condições psicológicas dos pacientes com DC, demonstrando a correlação direta entre aspectos psicológicos e a atividade da doença / Abstract: Introduction: Crohn¿s disease is a chronic illness with continuous and longstanding treatment. In addition to physical symptoms such as abdominal pain, diarrhea and slimming, patients are affected by anxiety crises, depression and loss in life quality, requiring psychological assistance. General objective: Evaluating the effects of Transpersonal Brief Psychotherapy on patients with Crohn¿s disease. Specific Objectives: Analyzing the results of Transpersonal Brief Psychotherapy on general health, life quality, anxiety, depression and states of hopelessness and observing the possible correlations between psychological conditions and activity Crohn¿s disease. Casuistry and Methods: The sample was composed by 11 people sick with Crohn¿s disease of both sexes and aged from 25 to 55 years old. It was used the clinical method and the procedure consisted of treatment with TBP based on the theoretical reference of the Transpersonal Integrative Approach along with data collection before and after psychotherapy. The following instruments were used to data collection: Sociodemographic Questionnaire, Crohn¿s Disease Activity Index, Inflammatory Bowel Disease Questionnaire, General Health Questionnaire, Beck Anxiety Inventory, Beck Depression Inventory and Beck Hopelessness Scale. In order to evaluate the results it was used the descriptive analysis and the statistical methodology with Wilcoxon test. Results: The intervention turned out to be effective to all of the evaluated instruments (p<0.05), and the best result was to the decrease of depression (-76.8%), followed by anxiety (-62%) and reduction on the state of hopelessness (-61.2%); there was improvement on general health state (40.4%) and in life quality (35.3%). The disease activity, assessed by the Crohn¿s Disease Activity Index, has decreased by -38.1%. Conclusion: Conclusion: The psychotherapeutic process has brought meaningful benefits to patients with Crohn¿s disease, with decrease on anxiety levels, depression, state of hopelessness and reduction in the activity Crohn¿s disease, consequently, it has improved general health and quality of life of patients with CD. There was an improvement in the psychological status of patients with CD, demonstrating the direct correlation between psychological aspects and disease activity / Mestrado / Fisiopatologia Cirúrgica / Mestra em Ciências

Submitted by Fabiana Gonçalves Pinto (benf@ndc.uff.br) on 2015-11-26T18:03:58Z No. of bitstreams: 1 Adriana Marques dos Santos.pdf: 7651287 bytes, checksum: f7d6ef222db63fda5dde024519f21181 (MD5) / Made available in DSpace on 2015-11-26T18:03:58Z (GMT). No. of bitstreams: 1 Adriana Marques dos Santos.pdf: 7651287 bytes, checksum: f7d6ef222db63fda5dde024519f21181 (MD5) Previous issue date: 2013 / Universidade Federal Fluminense. Escola de Enfermagem Aurora de Afonso Costa / Uma parte significativa da população é acometida por Hipertensão arterial, o que demanda uma atenção acolhedora e eficaz em seu tratamento e cuidado. Muitos sujeitos desconhecem que são hipertensos e outros não se apropriam do cuidado. A dificuldade de adesão ao tratamento aponta para a necessidade de estudos acerca dos aspectos subjetivos relacionados com esta enfermidade e os cuidados inerentes. Buscando atender a esta lacuna existente na literatura, nosso objeto de estudo é a História de vida de sujeitos com Hipertensão arterial segundo a perspectiva da Psicossomática. Propomos como objetivos deste estudo descrever a História de Vida dos sujeitos com Hipertensão Arterial; identificar aspectos psicossomáticos na História de Vida dos sujeitos com Hipertensão arterial; e analisar os conteúdos emergidos na História de Vida voltados para o cuidado em saúde. Nosso referencial teórico baseia-se em conceitos adotados pela Psicossomática e autores que tratam da questão do cuidado. Nossa abordagem de pesquisa é qualitativa, de cunho descritivo e exploratório, utilizando como método a entrevista de história de vida e como instrumento para a coleta de dados a entrevista aberta ou em profundidade dirigida aos pacientes hipertensos do Ambulatório de Reparo de Feridas do Hospital Universitário Antônio Pedro. As entrevistas geraram o Discurso do Sujeito Coletivo, técnica analítica proposta por Lefevre e Lefevre, cujas ideias centrais originaram três eixos temáticos: “vida”, “aspectos psicossomáticos”, e “autocuidado”. Concluiu-se que o conhecimento da história de vida dos sujeitos com hipertensão arterial possibilita a utilização de recursos favorecedores de sua adesão ao tratamento. Acrescenta-se o fato de que a realidade demanda a formação dos profissionais de saúde baseada na visão da complexidade, observando-se a interação entre o todo (sociedade, grupos de hipertensos, cultura, dentre outros) e a parte (história de vida dos sujeitos hipertensos), como meio de promover estratégias de adesão ao tratamento adequadas. / A significant part of the population is affected by high blood pressure, What warm attention and effective demand in their treatment and care. Many individuals are unaware that others do not hypertension and appropriate care. The difficulty of adherence to treatment points to the need for studies about the subjective aspects related to this disease and care. Seeking to address this gap in the literature, our object of study is the life story of subjects with hypertension in Psychosomatic perspective. We propose this study aims to describe the life history of the subjects with hypertension; identify psychosomatic aspects in the history of life of subjects with hypertension; and analyze the contents emergency in the history of life focused on health care. Our theoretical framework is based on concepts adopted by Psychosomatic and authors that deal with the issue of care. Our approach to research is qualitative, descriptive and exploratory nature, using as method of life history interview and as a tool for collecting data in the open or in depth interview aimed at hypertensive patients of wound Repair clinic of the University Hospital Antonio Pedro. The interviews led to the collective subject discourse analytical technique proposed by Lefevre and Lefevre, whose central ideas originated three thematic axes: "life", "psychosomatic aspects", and "self-care". It was concluded that the knowledge of the life history of the subjects with hypertension makes use of potential resources of their adherence to treatment. Added the fact that reality demands the formation of health professionals based on the view of Complexity, observing the interaction between the whole (hypertensive groups, society, culture, among others) and the part (life history of hypertensive subjects), as a means to promote adequate treatment adherence strategies.

One hundred women aged 20 to 50 were asked to compare their sexual experience before diagnosis and following treatment for benign and malignant cervical disease. The subjects were divided into five groups: three groups had definite cervical intraepithelial neoplasia (CIN), (Class II or III). Two groups were treated with cryotherapy, and one with hysterectomy. One group had a provisional diagnosis of CIN I, but received no treatment. Subjects in the last group had microinvasive cervical carcinoma and were also treated with hysterectomy. All subjects had ovarian function; all were sexually active at the time of treatment. They were interviewed at least six months post-cryotherapy and 15 months post-hysterectomy. All subjects completed a variant version of the Derogatis Sexual Function Inventory (DSFI).

The purpose of this descriptive study was to determine the existence of a relationship between perceptions of global self-esteem and stress incontinence episodes in a group of older women participating in a bladder retraining protocol. A convenience sample of fifteen older women was obtained. The participants constituted a group of well older women who ranged in age from 63 years to 82 years. All participants were living in the community and experiencing urinary incontinence. The University of British Columbia Model for Nursing was the conceptual framework which guided the focus of the study. The model views the individual as a behavioural system composed of nine interrelated and interdependent subsystems. This study focused on the interrelationship of the excretory and ego-valuative subsystems. The theory of self-efficacy, as outlined by Bandura provided the method by which this study was operationalized. Self-efficacy is the product of personal efficacy—an individual's judgement of the effectiveness of an executed course of action in achieving a desired outcome. The enactive, persuasive, and emotive modes of influence were utilized to provide efficacy information. Data were collected on three occasions using four instruments. The first instrument involved collection of selected demographic variables and was completed during the initial interview. A continence assessment and the Rosenberg self-esteem scale were completed during the initial and final interviews. An interview guide was used during a telephone contact. The telephone contact occurred four days following the first interview; the final interview occurred fourteen days after the first. The data were summarized, compared and described using measures of central tendency and frequency distributions. Paired t-tests were performed on selected variables to determine if there was a difference between pre and post intervention interview score. These tests demonstrated no significant differences in scores. Study findings indicated that at the end of the two week trial 53% of the women were able to identify a change in their voiding habits. Four of the participants (26.7%) stated that they were completely continent at the completion of the two week trial and four other participants (26.7%) indicated that $ some type of positive change had occurred. Three women (20%) identified a negative change in their continence status. Global self-esteem scores, as measured by the Rosenberg self-esteem scale, remained relatively stable during the two week trial period. Scores appeared to be unaffected by a change in continence status. This may be due to the many successful normalizing strategies subjects had developed to hide the evidence of the symptom of urinary incontinence. / Applied Science, Faculty of / Nursing, School of / Graduate

This master thesis focuses on atopic eczema in children and adolescents from a psychological perspective. The aim of this text is to describe and emphasize the psychological aspects of this disease and characterize the areas it may concern and affect. Regarding the structure, the thesis is divided into three parts. The introductory theoretical part is focused on a description of the explored subject-matter, the aim was to submit a comprehensive perspective on this disease and outline a relevant psychological basis for the empirical enquiry. The second empirical part is focused on the intrinsic aspects of the experience of this disease in children and adolescents. The quantitative research was designed to map out the specific phenomena, incidence of depressive symptoms and family upbringing style. The quantitative research is complemented by a qualitative inquiry with the aim to get further into depth of the issue by means of two case studies. These were focused on the overall experience related to the diagnosis of atopic eczema. The final part reflects acquired findings and the conclusive discussion summarizes the results of the exploratory assumptions including the limits and the possibilities of future psychological work with this disease. Keywords Atopic eczema, psychosomatic approach,...

Cardiovascular disease is one of the leading causes of death in industrialized nations. Research indicates that job strain may be significantly related to cardiovascular disease in employees with little to no social support. Using the JDC-S model developed by Karasek (1979) and elaborated upon by Johnson and Hall (1988), the family-supportive supervisory behaviors (FSSB) measure created by Hammer et al., (2009), and the blood pressure wrist monitor device Omron317T, this study examined FSSB as a moderator of the relationship between job strain, job demands, job control and workers' blood pressure on work and non-work days. Sixty-nine grocery store workers from a Midwest grocery store chain participated in this study, fifty-six of which were included in the analyses. Though none of the interactions were significant at the .05 level, results indicate that FSSB is significantly related to a number of blood pressure readings at the grand centered mean of job strain, job control, and job demands.

Christian Spirituality, Church History & Missiology