RESUMO
OBJECTIVE: Negative mood regulation expectancies (NMRE) describe the expectancies of an individual regarding his or her ability to regulate or reduce negative mood states by certain cognitive or behavioral strategies. NMRE are closely associated with the actual emotion regulation and potentially buffer the negative psychological and physical health consequences of stress. In the context of chronic pain, stress plays a central role, as long-term stress can have additional negative consequences regarding pain and its progression. The present study investigated the relationship of NMRE with treatment outcome, and more importantly, its buffering role in the association between stress and treatment outcomes. METHOD: Two hundred six chronic pain inpatients (fulfilling the International Classification of Diseases, 10th Revision [ICD-10] diagnosis of F45.41) of an interdisciplinary treatment completed standardized self-report questionnaires at intake and discharge. Hierarchical linear regression analyses were used to test the main effects of the Negative Mood Regulation Scale-Short Form on pain intensity, pain-related disability, and psychological distress as treatment outcomes and its moderating role in the association of stress and the 3 outcome measures. RESULTS: A significant main effect of NMRE on treatment outcome was only found for psychological distress. However, for all 3 outcome measures, a significant moderating effect of NMRE on the association between stress level and treatment outcome was found. DISCUSSION: NMRE appear to play an important role for the outcome of inpatient treatment for chronic pain. Due to their buffering effect on the negative association between stress and therapy outcome, they should be targeted in the treatment of chronic pain.
Assuntos
Dor Crônica , Regulação Emocional , Adaptação Psicológica , Afeto/fisiologia , Dor Crônica/terapia , Feminino , Humanos , Masculino , Resultado do TratamentoRESUMO
OBJECTIVE: This study aimed to analyze the associations among depressive and anxiety and pain symptoms in patients diagnosed with chronic pain. MATERIALS AND METHODS: Four hundred fifty-four inpatients who were consecutively admitted in a multimodal 3-week treatment in a tertiary, psychosomatic university clinic completed 25 items from the Brief Pain Inventory and the Hospital Anxiety and Depression Scale at baseline and after treatment termination. Associations among symptoms were explored by network analyses using the graphical least absolute shrinkage and selection operator to estimate their partial correlations, whereas Extended Bayesian Information Criterion was used to select the best network solution for the data. We explored symptoms' centrality and expected influence within the network and the minimum spanning tree for the network. RESULTS: Besides expected associations within depressive and anxiety and pain symptoms, the estimated network showed several local associations between depressive and pain interference symptoms. The lacks of being cheerful and of laughing are 2 of the depressive symptoms that showed the greatest associations with pain interference and a strong centrality within the network. Sleep problems were associated with both anxiety and depressive symptoms and pain intensity symptoms. Although at posttreatment most of the symptoms showed a significant decrease, the strength of the associations between the symptoms within the network was significantly higher than at baseline. DISCUSSION: The results support focusing psychosocial interventions in chronic pain treatment not only on reducing pain, anxiety, and sleep symptoms but also on enhancing positive affect. Future research is needed to replicate these findings using repeated within-person measures designs.
Assuntos
Ansiedade/complicações , Dor Crônica/psicologia , Depressão/complicações , Teorema de Bayes , HumanosRESUMO
Introducción: A pesar de su obvio protagonismo, existe un escaso consenso en la forma de comprender y estudiar el cambio en psicoterapia. Objetivos y estructura: el presente trabajo ofrece una síntesis de las principales formas de conceptualizar y analizar el cambio en tratamientos psicoterapéuticos. Se describen tres conjuntos de problemas asociados con la temática, a saber: 1) los debates respecto a qué elementos debe modificar una psicoterapia, 2) los distintos esfuerzos y estrategias para medir el constructo "cambio", y 3) los diferentes criterios metodológicos para establecer si el cambio efectivamente ocurre en una psicoterapia. Se analiza cada eje tanto desde un punto de vista teórico como a la luz de los resultados de la investigación empírica. Discusión: Se presentan conclusiones del trabajo y se discuten las implicancias de la revisión efectuada para la práctica clínica y la investigación en psicoterapia.
Introduction: Although its importance in psychotherapy, there is a scarce consensus about how change must be understand and study. Aims and structure: this paper present a synthesis of the main ways of conceptualizing and analyzing change in psychotherapeutic treatments. We describe three types of challenges in this topic: 1) The debates about what its need to change by the therapy, 2) the strategies used to measure the "change" construct, & 3) the methodological criteria to establish if the change occurs. We analyze each of these axes from a theoretical point of view, and also based on the results of empirical research. Discussion: We present conclusions of the paper and discuss their implications for clinical practice and psychotherapy research.
Assuntos
Humanos , Psicoterapia , Pesquisa Empírica , Pacientes , TerapêuticaRESUMO
La siguiente investigación clasificó la conceptualización de un caso de TAG, realizada por terapeutas psicoanalíticos, utilizando los criterios del Diagnóstico Psicodinámico Operacionalizado 2 (OPD-2). Se re-analizó información proveniente de la tesis doctoral en curso del primer autor, donde 30 psicoterapeutas (15 psicoanalíticos y 15 cognitivos), en una entrevista individual, propusieron inferencias pronósticas y una conceptualización del caso para un paciente TAG. El objetivo del presente estudio fue la utilización de los criterios OPD-2 para un análisis secundario de las 15 entrevistas ya conducidas con los participantes psicoanalíticos. Se describen la justificación, los procedimientos y preguntas centrales de esta investigación. Se presenta el OPD-2 como instrumento de análisis. Según resultados preliminares, los ejes OPD-2 III y IV predominaron en la identificación del problema principal del paciente, los ejes IV y V en su diagnóstico tentativo, y el eje II en las expectativas inferidas del paciente respecto del tratamiento. Se discuten implicancias de esta investigación para la práctica clínica psicoanalítica.
The present study classified a GAD´s case conceptualization made by psychoanalytic therapists using Operationalized Psychodynamic Diagnostic 2 (OPD-2) criteria. Information from the first author´s ongoing dissertation research was re-analyzed. In that study, 30 psychotherapists (15 psychoanalytic and 15 cognitive) proposed prognostic inferences and a case conceptualization for a GAD patient. The aim of the present study was to use OPD-2´s criteria for a secondary analysis of the 15 interviews already conducted with the psychoanalytic participants. The present study`s rationale, procedures and central research questions are described. OPD-2 is presented as a data analysis` instrument. According to preliminary results, OPD-2´s axis III and IV were predominant in the patient´s main problem identification, axis IV and V were used to describe patient´s preliminary diagnosis, and axis II was observed in the patient´s inferred treatment expectations. Implications for psychoanalytic clinical practice are discussed.
