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Previous issue date: 2012-01-13 / Addiction to crack cocaine has been a constant subject of discussion in public policy as well as scientific and clinical settings. Although the spread of crack is a serious public health problem, there is a paucity of scientific data on the impact caused by exposure to the substance and the vulnerability factors that interfere in the course of this exposure. This reinforces the need for more investment in theoretical and empirical research on the subject. This dissertation is one of the first to result from "The Cohort Study on Vulnerability Factors Associated with Craving in Women Crack Cocaine Addiction: Impact of Childhood Neglect on Cognition, Behavior and neuroendocrine response." This work was divided into two sections: theoretical and empirical. Because of the need to organize and expand the understanding of a comprehensive model of the motivational factors that culminate in addiction, the first section of this paper is a review on the subject. The theoretical article "Stress and Motivated Behavior: Impulse and Compulsion in Addiction" combines a theoretical overview to describe the associations between the dysregulation of motivated behavior and the neurobiological changes resulting from drug abuse. It also discusses the influence of early stress on neurodevelopmental disorders and changes in volition (compulsive and impulsive behaviors). Furthermore, this section addresses the behavioral concept of the reward system and the anti-reward system, as well as their neurobiological basis in the context of addiction. The theoretical study focused on literature that contributes to the understanding of addiction as a dysregulation of the innate motivational system essential to survival. The second section of this study provides the empirical article "Childhood Neglect: Impact on the Severity of Abstinence and Depressive Symptoms in Women Dependent on Crack Cocaine." This study was conducted on the first 96 subjects drawn from the cohort study; 16 subjects were removed from the analysis because they fulfilled the exclusion criteria. The sample was monitored during the period of detoxification in a specialized hospital unit. The purpose of the research was to investigate the role of physical neglect (PN) as a vulnerability factor with respect to symptoms that arise during the period of detoxification. These measures, the severity of withdrawal symptoms and depressed mood are considered as the most likely to contribute to a potential relapse. Thus, the empirical study has shown that women with PN (n=38) had more severe withdrawn syndrome, exacerbated symptoms of depressed mood and lower remission of symptoms during the entire period of hospitalization when compared with women without PN (n=42). Finally, this dissertation intends to contribute data, theoretical and empirical, about the impact of childhood neglect on the system that regulates motivated behaviors, and the repercussions of this "scar" on the exacerbation of depressive symptoms and perceived craving during the period of crack detoxification. / A depend?ncia qu?mica (DQ) da coca?na tipo crack tem sido constante alvo de discuss?es no cen?rio cient?fico, de pol?ticas p?blicas e no ?mbito cl?nico. Embora a propaga??o do crack seja um problema grave de sa?de p?blica, h? uma relativa escassez de dados cient?ficos sobre o impacto decorrente da exposi??o ? subst?ncia, bem como os fatores de vulnerabilidade que interferem no decorrer dessa exposi??o. Isso refor?a a necessidade de mais investimentos na produ??o te?rica e emp?rica sobre o tema. Nesse sentido, a presente disserta??o ? um dos primeiros frutos do projeto Estudo de Coorte sobre Fatores de Vulnerabilidade Associados ao Craving em Dependentes de Crack: Impacto da Neglig?ncia na Inf?ncia na Cogni??o, Comportamento e Resposta Neuroend?crina. Assim, este trabalho foi dividido em duas se??es: te?rica e emp?rica. Frente ? necessidade de organizar e expandir o entendimento sobre um modelo compreensivo dos fatores motivacionais que culminam na DQ, a primeira se??o desta disserta??o faz uma revis?o deste tema. O artigo: Comportamentos Motivados e Estresse: Impulso e Compuls?o na Depend?ncia Qu?mica re?ne um apanhado te?rico a fim de descrever as associa??es entre a desregula??o dos comportamentos motivados e as altera??es neurobiol?gicas decorrente do abuso de drogas. Discute a influ?ncia do estresse precoce sobre as altera??es do neurodesenvolvimento e as altera??es da voli??o (comportamentos compulsivos e impulsivos). Tamb?m traz o conceito comportamental do sistema de recompensa e sistema anti-recompensa e suas bases neurobiol?gicas no contexto da DQ. O estudo I concentrou um aporte bibliogr?fico que leva ao entendimento da DQ como uma desregula??o do sistema motivacional inato, ou seja, indispens?vel ? sobreviv?ncia. A segunda se??o deste estudo traz o artigo: "Neglig?ncia na Inf?ncia: Impacto na Gravidade da Abstin?ncia e Sintomas Depressivos de Mulheres Dependentes de Crack". O estudo foi realizado a partir dos primeiros 96 sujeitos extra?dos do estudo de coorte e 16 foram retirados da an?lise por preencherem crit?rios de exclus?o. A amostra foi acompanhada durante o per?odo de desintoxica??o, em uma unidade hospitalar especializada. O objetivo da pesquisa foi investigar o papel da neglig?ncia f?sica (NF) como fator de vulnerabilidade no que tange a sintomas que surgem durante o per?odo de desintoxica??o. Essas medidas, da gravidade dos sintomas de abstin?ncia e do humor deprimido, s?o apontados como os que mais interferem para uma poss?vel reca?da. Assim, no estudo emp?rico foi demonstrado que as mulheres com NF (n=38) tiveram mais intensidade dos sintomas de abstin?ncia, sintomas de humor deprimido exacerbados e menor remiss?o da sintomatologia durante todo o per?odo de interna??o quando comparadas a mulheres sem NF (n=42). Enfim, esta disserta??o pretende contribuir com dados, te?ricos e emp?ricos, a respeito do impacto da neglig?ncia na inf?ncia sobre o sistema que regula os comportamentos motivados, e as repercuss?es dessa cicatriz diante da exacerba??o dos sintomas de abstin?ncia e depressivos percebidos durante o per?odo de desintoxica??o do crack.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/779 |
| Date | 13 January 2012 |
| Creators | Francke, Ingrid D'Avila |
| Contributors | Grassi-oliveira, Rodrigo |
| Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Psicologia, PUCRS, BR, Faculdade de Psicologia |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 2588426296948062698, 500, 600, 2599381623216554467 |
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