Made available in DSpace on 2016-04-04T18:27:49Z (GMT). No. of bitstreams: 1 Katia Perez Ramos.pdf: 749029 bytes, checksum: 4936cc8552dcf26b27520a4fd7750c4a (MD5) Previous issue date: 2004-11-23 / This research has as a general purpose of developing and validation na auxiliary scale of body dysmorphic disorder (BDD) for healthcare professionals. Three samples of participants took part on it: Group 1: which comprises fifteen esthetic plastic surgery patients diagnosed as having BDD; Group 2: which includes fifteen esthetic plastic surgery patients diagnosed as not having BDD; Group 3: five professionals of psychiatry and psychology which stood as judges to evaluate the items of the scale. Initially, the items of the scale were generated from the study of 4 BDD evaluation questionaries which existed already, comtemplating the diagnostic criteria of the DSM-IV (1994) and of scientific assays on the BDD field. Fifty items were, then, built (1st version) which were evaluated by the authoress regarding relevance, objectivity, clearness and precision. From this analysis ten items were discarded, resulting in a 40-item scale (2st version). The relevance of the items to the construct by means of the theoretical analysis of judges. As a result from this analysis five more items were discarded for not obtaining an agreement of at least 80% among the judges (3sd version). The third version of the scale was applied on both groups (G1 and G2). The results from this aplication were submitted to the BDD construct study by means of factorial analysis. The discriminating validity was accomplised by the application of the 3sd scale version of the clinical population (G1) and of sample the non clinical population (G2). The estimate of the U Mann-Whitney Test showed that the scale is sensitive to distinguish the individuals diagnosed as having BDD from those diagnosed as not having the disorder. Besides, the instrument was applied once more twenty days later on both groups (G1 and G2), to submit the scale to the test-retest precision. Through the application of the Pearson Test one verified an expressive correlation between the first and the second application for group 1 as well as for group 2. As a result from these quantitative analyses no item was discarded for they showed to be relevant for the BDD measurement. It was, then, proposed a pilot version of the BDD diagnosis auxiliary instrument to be used by healthcare professionals. The current instrument consists of thirty five items measured by the four-point Likert scale. / A presente pesquisa teve por objetivo geral desenvolver e validar uma escala auxiliar de diagn?stico do Transtorno Dism?rfico Corporal (TDC) para profissionais da ?rea da sa?de. Para tanto contou com tr?s amostras de participantes: Grupo I: que englobou 15 pacientes de cirurgia pl?stica est?tica diagnosticados com TDC; Grupo 2: que incluiu 15 pacientes de cirurgia pl?stica est?tica sem o diagn?stico de TDC e; Grupo 3: 5 profissionais da ?rea de Psiquiatria e Psicologia que serviram como ju?zes para avaliar os itens da escala. Inicialmente os itens da escala foram gerados por meio do estudo de quatro question?rios de avalia??o do TDC j? existentes, contemplando os crit?rios diagn?sticos do DSM-IV (1994) e de trabalhos cient?ficos na ?rea do TDC. Construiu-se, ent?o, 50 itens (P Vers?o) os quais foram avaliados pela autora em rela??o a pertin?ncia, objetividade, clareza e precis?o. A partir desta an?lise foram descartados dez itens, o que resultou em uma escala de 40 itens (2a Vers?o). Analisou-se a pertin?ncia dos itens ao construto, por meio da an?lise te?rica de ju?zes. Como resultado desta an?lise mais cinco itens foram descartados por n?o obterem uma concord?ncia de no m?nimo 80% entre os ju?zes (3a Vers?o). A terceira vers?o da escala foi aplicada nos dois grupos (G1 e G2). Os resultados dessa aplica??o foram submetidos ao estudo do construto do TOC por meio da an?lise fatorial. A validade discriminativa foi realizada por meio da aplica??o da primeira vers?o da escala em uma amostra da popula??o cl?nica (G I) e uma amostra da popula??o n?o cl?nica (G2). O c?lculo da prova U de Mann-Whitney mostrou que a escala ? sens?vel para discriminar os indiv?duos diagnosticados com TDC dos indiv?duos sem o diagn?stico do transtorno. Al?m disso, o instrumento foi reaplicado ap?s 20 dias nos dois grupos (G1 e G2), para submeter a escala ? precis?o de teste-reteste. Atrav?s da aplica??o da correla??o de Pearson verificou-se uma alta correla??o entre a primeira e a segunda aplica??o tanto do Grupo 1 como do Grupo 2. Como resultado dessas an?lises quantitativas n?o foi descartado nenhum item pois os 35 mostraram ser significativos para a mensura??o do TDC. Foi proposta ent?o, uma vers?o piloto do instrumento auxiliar de diagn?stico do TDC para a utiliza??o por profissionais da ?rea da sa?de. O instrumento ficou composto por 35 itens medidos por escalas Likert de quatro pontos.

Made available in DSpace on 2016-04-04T18:27:33Z (GMT). No. of bitstreams: 1 Josy de Souza Moriyama-1.pdf: 538769 bytes, checksum: d9c9c18d8d0776782f67a5efca7e8c1b (MD5) Previous issue date: 2003-06-17 / The Body Dysmorphic Disorder (BDD) is diagnosed when there is an exaggerated preoccupation with some minimal or imagined defect in the appearance, which brings significative impairments to the person s life. It has been sought to investigate the development and maintenance of the BDD behaviors through the functional analysis and the concept of experential avoidance proposed by Hayes, Wilson, Gifford and Follette (1996). Seven people with characteristic behaviors of the BDD, their families and four plastic surgeons participated in this study. It has been used as instruments: instructions to orient surgeons about behaviors of the BDD, enabling them to identify and invite patients to participate in the research; an identification questionnaire with the purpose to select the sample; semi-structured interviews for the participant and their families, containing questions relating to the history of the participants life, families relationship, the beginning of the concern with the appearance, behaviors of the BDD and actual contingencies which maintains them. Ten patients responded to the identification questionnaire and seven of them were selected. Individual interviews were made with each of the participants and their families, according to the necessity of collecting complementary data. From the recording and transcription of the interviews, it has been made a clinic systematical study, in which, the behaviors were described and analyzed according to probable origin and actual functioning processes. Beyond the behaviors related to the preoccupations with the appearance, typical behaviors of other disorders were found (such as: Obsessive Compulsive Disorder, Depression, Social Phobia, Hypochondria) and standards of behavior known as personality features (such as: vanity, perfectionism, aggressiveness). The results pointed similar functional processes, among all the participants. Among the origin processes there were: the cohersitive education with few positive reinforcements in the childhood, past occurrence like accidents, comparisons and comments relating to the part of the body which they worried about. These contingencies, probably, influenced the strong emphasis on discriminative stimuli related to the appearance. Among the actual processes there have been identified: negative reinforcement, lack of positive reinforcements, secondary gains and strong cultural influences of the valorization of the appearance. As particular variables to each case there have been found: low development of skilful socially behaviors, models in the childhood, extremely critical mother concerning to the appearance, among others. It has been concluded that the actual functioning of the BDD is marked by experiential avoidance where the individuals start avoiding the private aversive stimuli, like the anxiety, thoughts about their appearance and about the reaction of the people against their appearance. This avoidance prevents them from exposing themselves to the social situations, resulting in consequences such as social isolation and depressive behaviors. Functional resemblances were demonstrated for all seven cases studied although some topographic behaviors were different, indicating the necessity in considering the functionality of the behaviors and not only the arbitrariness of the psychiatric classification based on symptoms. / O Transtorno Dism?rfico Corporal (TDC) ? diagnosticado quando h? uma preocupa??o t?o exagerada com algum defeito m?nimo ou imaginado na apar?ncia, que traz preju?zos significativos ? vida da pessoa. Buscou-se investigar o desenvolvimento e manuten??o de comportamentos do TDC atrav?s de an?lises funcionais e do conceito de esquiva experencial proposto por Hayes, Wilson, Gifford e Follette (1996). Participaram do estudo sete pessoas com comportamentos caracter?sticos do TDC, seus familiares e quatro cirurgi?es pl?sticos. Foram utilizados como instrumentos: roteiros para orientar cirurgi?es sobre comportamentos do TDC, possibilitando-os identificar e convidar pacientes seus para participarem da pesquisa; uma ficha de identifica??o dos participantes, para selecionar a amostra; roteiros de entrevistas semi-estruturadas para os participantes e seus familiares, com quest?es relativas ? hist?ria de vida dos participantes, rela??es familiares, in?cio das preocupa??es com a apar?ncia, comportamentos do TDC e conting?ncias atuais que os mantinham. Dez pacientes responderam ? ficha de identifica??o e sete foram selecionados. Entrevistas individuais foram feitas com cada participante e com seus familiares, de acordo com a necessidade de se coletar dados complementares. A partir da grava??o e transcri??o das entrevistas foi feito um estudo sistem?tico cl?nico em que os comportamentos foram descritos e analisados de acordo com prov?veis processos de origem e funcionamento atual. Al?m de comportamentos relacionados ?s preocupa??es com a apar?ncia, foram encontrados comportamentos t?picos de outros transtornos (como: Transtorno Obsessivo Compulsivo, Depress?o, Fobia Social, Hipocondria) e padr?es de comportamento conhecidos como tra?os de personalidade (como: vaidade, perfeccionismo, agressividade). Os resultados apontaram processos funcionais semelhantes, entre todos os participantes.