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Previous issue date: 2017-01-25 / Overweight and its consequences cause several physical and mental health
problems. A reduction of caloric ingestion and an increase in physical activity are
recommended to weight adequacy. However, the adhesion and maintenance of
these practices continue being a limitation in the care of overweight and obese
people. There are evidences of the effectiveness of therapies that involve the
incentive to lifestyle changes through topographic alterations of behavior and
thought. Unlike these interventions, the Acceptance and Commitment Therapy (ACT)
does not focus on the topographic modification of behavior, but on the alteration of its
function. It is aimed, with this thesis, to evaluate the effect of the use of an intensive
psychological intervention, based in ACT, in comparison to a Psychoeducational and
CBT intervention in overweight and obese people. This thesis, is divided in three
studies. The first one aimed to identify the processes of psychological inflexibility (PI)
associated to the body mass index (BMI), depression, anxiety and stress symptoms
and binge eating in overweight and obese people. A cross-sectional study was
conducted in 243 people with BMI 25 and higher and ages 18 to 60 years. The data
was analysed through a One-Way ANOVA and t test. There were no differences
found in the PI mediums in relation to BMI. There were significant differences found
in PI in relation to binge eating and depression, anxiety and stress symptoms, being
that the most severe the symptom, the higher the PI medium. The second study
aimed to evaluate the predictive factors of the participation of overweight and obese
people in an intensive psychosocial program, of 8 hours of duration in one day. This
is a cross-sectional quantitative study in which 82 people (77 of them, women) with
BMI 25 and higher and ages from 18 and 60 years answered to a recruiting and
confirmed participation. A multivariate binary logistic regression was conducted. The
variables with some degree of prediction in the adhesion to the intervention were the
ones of behavior related to diet and physical activity (OR: 1,342; IC: 95%: 0,970-
1,857), psychological flexibility (OR:1,078; IC 95%: 1,009-1,152) and, more
specifically, the psychological process of cognitive fusion (OR: 1,078; IC: 95%: 0,969
- 1,069). The last study aimed to investigate the effects of an intervention based in
ACT, in comparison to one based in Psychoeducation and CBT, in the objective
measures (weight and BMI) and in the ones of self-repot (depression, anxiety and
stress symptoms, binge eating and psychological flexibility) in overweight and obese
people. 72 people were randomly assigned to one of the groups. The ACT group
showed differences in the development of cognitive defusion and eating conscience -
emotional response, as well as it helped more in the modification of binge eating
intensity. Other results did not present a significant difference between the groups.
Considering that the Psychoeducational/CBT intervention is the chosen intervention
nowadays, the results of this thesis show that an intervention in ACT can have at
least the same outcomes as the intervention of choice. / O excesso de peso e suas consequ?ncias causam diversos problemas ? sa?de
f?sica e mental. Redu??o da ingesta cal?rica e aumento das atividades f?sicas s?o
recomendados para adequa??o do peso. Por?m, a ades?o e a manuten??o dessas
pr?ticas seguem sendo um limitador no aux?lio ?s pessoas com sobrepeso ou
obesidade. H? evid?ncias de efetividade em terapias que envolvem o est?mulo ?
mudan?a do estilo de vida atrav?s da altera??es topogr?ficas do comportamento e
do pensamento. Diferente da interven??o anterior, a Terapia de Aceita??o e
Compromisso (ACT) n?o foca na modifica??o topogr?fica do comportamento, mas
na altera??o da fun??o dele. Objetiva-se, com essa tese, avaliar o efeito da
utiliza??o de uma interven??o psicol?gica intensiva, baseada na ACT, em
compara??o a uma interven??o Psicoeducativa e TCC em pessoas com sobrepeso e
obesidade. Essa tese ? dividida em tr?s estudos. O primeiro objetivou identificar os
processos de inflexibilidade psicol?gica (IP) associados ao ?ndice de massa corporal
(IMC), sintomas de depress?o, ansiedade, estresse e comer compulsivo em pessoas
com sobrepeso e obesidade. Realizou-se um estudo transversal em 243 pessoas
com IMC a partir de 25 e idade entre 18 e 60 anos. Analisou-se os dados com
ANOVA one-way e teste t. N?o foram encontradas diferen?as entres as m?dias de IP
em rela??o ao IMC. Foram encontradas diferen?as significativas na IP em rela??o ao
comer compulsivo e aos sintomas de depress?o, ansiedade e estresse, sendo que
quanto mais grave o sintoma, maior a m?dia de IP. O segundo estudo objetivou
avaliar os fatores preditivos da participa??o de pessoas com sobrepeso e obesidade
em um programa psicossocial intensivo, de 8h de dura??o em um dia. Este ? um
estudo quantitativo transversal em que 82 pessoas (77 delas, mulheres) com IMC a
partir de 25 e idade entre 18 e 60 anos responderam ao recrutamento e confirmaram
a participa??o. Realizou-se uma regress?o log?stica bin?ria. As vari?veis com algum
grau de predi??o na ades?o ? interven??o foram as de comportamento relacionados
? dieta e atividade f?sica (OR: 1,342; IC 95%: 0,970-1,857), flexibilidade psicol?gica
(OR: 1,078; IC 95%: 1,009-1,152) e, mais espec?fico, o processo psicol?gico de
fus?o cognitiva (OR: 1,018; IC 95%: 0,969-1,069). O ?ltimo estudo objetivou
investigar os efeitos de uma interven??o baseada na ACT, em compara??o a uma
baseada em Psicoeduca??o e TCC, nas medidas objetivas (peso e ?ndice de massa
corporal - IMC) e de auto-relato (sintomas depressivos, ansiosos e de estresse,
compuls?o alimentar e flexibilidade psicol?gica) em pessoas com sobrepeso ou
obesidade. 72 pessoas foram designadas aleatoriamente para um dos grupos. O
grupo ACT apresentou diferen?a no desenvolvimento da desfus?o cognitiva e
consci?ncia alimentar ? resposta emocional, bem como auxiliou mais na modifica??o
da intensidade da compuls?o alimentar. Os demais resultados n?o apresentaram
diferen?a significativa entre os grupos. Considerando-se que a interven??o
Psicoeducativa/TCC ? a interven??o de escolha atualmente, os resultados dessa
tese mostram que uma interven??o em ACT pode ter, no m?nimo, os mesmos
desfechos que a interven??o de escolha.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/7446 |
| Date | 25 January 2017 |
| Creators | Finger, Igor da Rosa |
| Contributors | Oliveira, Margareth da Silva |
| Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Psicologia, PUCRS, Brasil, Escola de Humanidades |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| 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, 600, 600, 600, -6557531471218110192, 3411867255817377423 |
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