RESUMO
OBJECTIVE: The knowledge about the consequences of state doping in the GDR is limited. It is assumed that the precarious training conditions had a great influence on the mental health of the former competitive athletes. The aim of this study was to assess the psychological symptoms of former GDR competitive athletes. METHOD: A case-control study was conducted using questionnaires on psychological symptoms and possible risk or protective factors. RESULTS: Significant differences were found on scales. The major part of the affected athletes showed a clinically relevant psychological stress. Exemplary for this is a pronounced depressive symptomatology in 65,19% of the probands. CONCLUSION: Presumably, the negative experiences in competitive sports led to an increase in psychological symptoms and vulnerability.
Assuntos
Depressão , Transtornos Mentais , Humanos , Depressão/epidemiologia , Estudos de Casos e Controles , Alemanha , Atletas/psicologia , Transtornos Mentais/epidemiologiaRESUMO
BACKGROUND AND AIMS: Existing evidence suggests that text message interventions can help people to reduce their alcohol consumption. However, studies with alcohol-dependent patients are lacking. In this study a 1-year automatic mobile phone-based short messaging service (SMS) intervention on alcohol consumption in patients after alcohol detoxification in hospital was compared with treatment as usual. DESIGN: Multi-center, randomized, controlled, two parallel-group, observer-blinded trial. SETTING AND PARTICIPANTS: Primary and secondary care: four hospitals and community (1 million residents, 7600 km2 area in Germany). A total of 462 patients with alcohol dependence (ICD-10) were included during inpatient detoxification treatment. Patients were randomly assigned (1 : 1) to an SMS intervention and treatment as usual (SMS + TAU; n = 230; mean age: 45.4 years; 22.6% women) or TAU alone (n = 232 mean age: 44.5 years; 22.8% women). Planned, automated messages were sent to patients over 1 year to record assistance needs. A 'yes' or missing response triggered a telephone call from a hospital therapist. Outcome was assessed by an independent survey center. MEASUREMENTS: The primary end-point was a three-category alcohol consumption measure covering months 10-12 after discharge: abstinence, non-heavy drinking, heavy drinking [men > 60 g/day; women > 40 g/day equal to World Health Organization (WHO) criteria: high risk and very high risk, mean consumption]. Secondary end-points were number of abstinent days over 12 months and frequency of abstinence. RESULTS: The arms differed primarily in the heavy drinking category (intervention group 22.2%, TAU-only group 32.3%) in months 9-12. This is reflected by an odds ratio (OR) = 1.68, 95% confidence interval (CI) = 1.11-2.54, P = 0.015 for heavy drinking versus non-heavy drinking/abstinence. No difference between treatments was found with respect to any drinking versus abstinence (OR = 1.13). These results were confirmed by models adjusting for randomization strata. CONCLUSIONS: In Germany, a 12-month mobile phone short messaging service-based intervention enhanced the reduction in heavy drinking for 1 year in routine care among adults with alcohol dependence discharged from inpatient alcohol detoxification.
Assuntos
Alcoolismo , Telefone Celular , Envio de Mensagens de Texto , Adulto , Consumo de Bebidas Alcoólicas , Alcoolismo/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos de PesquisaRESUMO
OBJECTIVE: Students with specialization preferences in psychiatry, neurology, or psychosomatic medicine were retrospectively compared with regard to aspects of motivation to choose medicine as their field of study. METHODS: To identify early predictors of specialization preferences, a nationwide online survey was conducted with 9079 medical students. The statements of those with a preference for neurology, psychiatry, or psychosomatic medicine were evaluated using analysis of variance (ANOVA). RESULTS: Prospective neurologists were motivated by scientific interest variables and less by the aspects of life management. On the other hand, students with preferences for one of the psychological disciplines reported comparatively higher degrees of desire to actively provide help and of the importance of their own medical history. There were no significant differences between future psychiatrists and psychosomatic professionals. CONCLUSION: The reported motives point to thematic orientations that might be useful in the subject-specific acquisition of young academics.
Assuntos
Escolha da Profissão , Neurologia , Psiquiatria , Medicina Psicossomática , Estudantes de Medicina , Adulto , Feminino , Alemanha , Humanos , Masculino , Estudos Prospectivos , Estudos Retrospectivos , Especialização , Inquéritos e QuestionáriosAssuntos
Transtornos de Adaptação/diagnóstico , Luto , Família/psicologia , Pesar , Militares/psicologia , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/epidemiologia , II Guerra Mundial , Transtornos de Adaptação/epidemiologia , Transtornos de Adaptação/psicologia , Adulto , Idoso , Estudos Transversais , Alemanha , Humanos , Pessoa de Meia-Idade , Psicometria , Transtornos de Estresse Pós-Traumáticos/psicologia , Inquéritos e QuestionáriosRESUMO
BACKGROUND: In public health settings, short message service (SMS) appears to be a promising low-cost modality for reducing alcohol consumption. Here, we test a simple interactive SMS-based helpline with detoxified alcohol-dependent patients to extend findings to curative settings. METHODS: This controlled, prospective, 2-group before-after block-assignment, open pilot study tested the feasibility and efficacy of an 8-week outpatient interactive mobile phone SMS intervention (n = 42) against treatment as usual (TAU; n = 38) after inpatient detoxification. Patients were asked whether they needed any help via an automatically generated text message twice a week. A therapist called the individual back when notified. Alcohol consumption was assessed using the telephone version of Form-90 4 and 8 weeks after discharge from inpatient detoxification. The primary end point was defined as attaining low-risk consumption (males ≤30 g or 3.75 units per drinking day (DDD); females ≤20 g or 2.5 units per DDD) 8 weeks after discharge. Missing data were replaced by multiple imputation. RESULTS: Among all messages sent, 20.5% were followed by a phone call. Feasibility and acceptability were good, as indicated by successful implementation of the SMS procedure and the rapid inclusion of patients. Adherence was satisfactory with 57.14% of the participants replying to at least 50% of the prompts. Patients reported a typical preadmission DDD of 281.25 ± 244.61 g. In the SMS group, 55.7% of 42 patients, and 40% of 38 patients in the TAU group, achieved low-risk consumption (risk diff: 0.16; 95% CI -0.06 to 0.37; p = 0.122). CONCLUSIONS: In detoxified alcohol-dependent patients, relapse prevention based on SMS was well received and implemented efficiently and rapidly. An adequately powered multicenter study is currently being conducted to test the nonsignificant but encouraging findings of this exploratory study with more rigorous trial methods (ISRCTN78350716).
Assuntos
Consumo de Bebidas Alcoólicas/prevenção & controle , Alcoolismo/prevenção & controle , Telefone Celular , Envio de Mensagens de Texto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Vigilância da População/métodos , Estudos ProspectivosRESUMO
The aim of the study was to compare the long-term effects of conflict-related sexual violence experienced at the end of World War II (WWII) with non-sexual WWII trauma (e.g., being exposed to shell shock or physical violence). A total of 27 elderly wartime rape survivors were compared to age- and gender-matched control subjects who were drawn from a larger sample of subjects over 70 years of age who had experienced WWII-related trauma. A modified version of the Posttraumatic Diagnostic Scale was used to assess trauma characteristics and posttraumatic stress disorder (PTSD) symptoms and the Brief Symptom Inventory-18 was used to assess current psychopathology. Additionally, measures of posttraumatic growth (Posttraumatic Growth Inventory) and social acknowledgement as a trauma survivor (Social Acknowledgement Questionnaire) were used to assess two mediating variables in post-trauma conditions of rape victims. Women exposed to conflict-related sexual violence reported greater severity of PTSD-related avoidance and hyperarousal symptoms, as well as anxiety, compared with female long-term survivors of non-sexual WWII trauma. The vast majority (80.9 %) of these women also reported severe sexual problems during their lifetimes relative to 19.0 % of women who experienced non-sexual war trauma. Women exposed to conflict-related sexual violence also reported greater posttraumatic growth, but less social acknowledgement as trauma survivors, compared to survivors of non-sexual war trauma. The results were consistent with emerging neurobiological research, which suggests that different traumas may be differentially associated with long-term posttraumatic sequelae in sexual assault survivors than in other survivor groups and highlights the need to treat (or better prevent) deleterious effects of conflict-related sexual violence in current worldwide crisis zones.
Assuntos
Estupro/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Sobreviventes/psicologia , Crimes de Guerra/psicologia , II Guerra Mundial , Idoso , Idoso de 80 Anos ou mais , Transtornos de Ansiedade/psicologia , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Transtornos de Estresse Pós-Traumáticos/etiologia , Inquéritos e QuestionáriosRESUMO
OBJECTIVES: Myofascial trigger points (MTPs) are extremely frequent in the human musculoskeletal system. Despite this, little is known about their etiology. Increased muscular tension in the trigger point area could be a major factor for the development of MTPs. To investigate the impact of muscular tension in the taut band with an MTP and thereby, the spinal excitability of associated segmental neurons, we objectively measured the tissue tension in MTPs before and during the administration of anesthesia using a transducer. METHODS: Three target muscles (m. temporalis, upper part of m. trapezius, and m. extensor carpi radialis longus) with an MTP and 1 control muscle without an MTP were examined in 62 patients scheduled for an operation. RESULTS: We found significant 2-way interactions (ANOVA, P<0.05) between the analyzed regions of the target muscles dependent on the time of measurement, that is, before and during a complete blocking of neuromuscular transmission. These effects could be demonstrated for each target muscle separately. DISCUSSION: An increased muscle tension in MTPs, and not a primary local inflammation with enhanced viscoelasticity, was the main result of our investigation. We interpret this increased muscular tension in the taut band with an MTP as increased spinal segmental excitability. In line with this, we assume a predominant, but not unique, impact of increased spinal excitability resulting in an augmented tension of segmental-associated muscle fibers for the etiology of MTP. Consequently, postisometric relaxation might be a promising therapeutic option for MTPs.
Assuntos
Tono Muscular/efeitos dos fármacos , Músculo Esquelético/efeitos dos fármacos , Músculo Esquelético/fisiopatologia , Síndromes da Dor Miofascial/fisiopatologia , Bloqueio Neuromuscular , Pontos-Gatilho/fisiopatologia , Análise de Variância , Fenômenos Biomecânicos/efeitos dos fármacos , Feminino , Humanos , Inflamação/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Síndromes da Dor Miofascial/tratamento farmacológico , Síndromes da Dor Miofascial/cirurgia , Músculos Superficiais do Dorso/efeitos dos fármacos , Músculos Superficiais do Dorso/fisiologia , Fatores de Tempo , TransdutoresRESUMO
OBJECTIVES: Despite today's extensive research on the psychosocial consequences of World War II, the group of wives and children whose husbands or fathers went "missing in action" during the Second World War, has yet to be studied systematically in Germany. The present review article shows the special role the wives, and in particular the children, of missing German soldiers played in society and discusses the impact of their loved ones being unaccounted has had on the mental health of this group. METHODS: An overview of current research on the psychosocial status of the war generation is given following a short historical introduction to the theme. Subsequently, we discuss the legal and social situation of the families of missing German soldiers during the postwar decades. Finally, two psychological concepts drawn from the US research show that specific disorders, such as complicated grief or "boundary ambiguity," can occur in the relatives of missing persons and blur the line between hope and grief occurring as a result of ambiguous loss. RESULTS AND CONCLUSION: The psychosocial impact of having a relative go missing has hardly been noticed in the German research tradition after World War II. Particularly in light of the age structure of those directly affected and the experiences of transgenerational transmission this neglected psychosocial research subject urgently needs further scientific investigation, inasmuch as the age of the family members still allows it.
Assuntos
Filhos Adultos/psicologia , Pai/história , Pai/psicologia , Pesar , Militares/história , Militares/psicologia , Transtornos de Estresse Pós-Traumáticos/história , Transtornos de Estresse Pós-Traumáticos/psicologia , Viuvez/história , Viuvez/psicologia , II Guerra Mundial , Adulto , Criança , Alemanha , História do Século XX , História do Século XXI , Humanos , Transtornos de Estresse Pós-Traumáticos/diagnósticoRESUMO
To explain the phenomenological overlap between dissociation and schizophrenia, a dissociative subtype of schizophrenia has been proposed as a possibility. Dissociation is often believed to be organized on a continuum, although 2 qualitatively different phenomena can be distinguished in theory, research, and clinical practice: (a) states of separation from self or environment (detachment dissociation) and (b) inaccessibility of normally accessible mental contents (compartmentalization dissociation). This study used the Positive and Negative Syndrome Scale (PANSS) and the Association for Methodology and Documentation in Psychiatry module for the interview assessment of dissociation to investigate the relationships between PANSS subscales, detachment dissociation, and compartmentalization dissociation in a sample of 72 patients with schizophrenia. A confirmatory factor analysis sustained the bipartite model, yielding factors that grouped dissociative items around amnesia and depersonalization/derealization. The latter factor also contained identity disturbances and was therefore not entirely consistent with the theoretical formulations of detachment dissociation. It is important to note that the structure of those factors may be influenced by the symptoms of schizophrenia to which they were specifically linked: The factor containing depersonalization/derealization was connected to the positive symptoms subscale of the PANSS, whereas the factor containing amnesia was associated with the negative subscale. Hence, a dichotomy of dissociation is confirmed inasmuch as its subtypes are as distinguishable as PANSS subscales. This has implications on theoretical and clinical levels.
Assuntos
Despersonalização/psicologia , Transtornos Dissociativos/psicologia , Escalas de Graduação Psiquiátrica , Teoria Psicológica , Psicologia do Esquizofrênico , Adulto , Feminino , Humanos , Entrevista Psicológica , MasculinoRESUMO
OBJECTIVE: The aim of the study was to document perceived social support in a sample of German war-raped women in World War II. Furthermore the impact of this potential resource on today's posttraumatic symptoms should be pointed out. METHODS: 27 women (M = 80.3 years, SD = 3.1 years) answered each a semi-structured interview and several questionnaires. RESULTS: Perceived social support shows clearly lower values than in the comparative samples. The measured degree of the variable in the present sample bears negative relationship to the actual posttraumatic symptoms of the women. CONCLUSIONS: In World War II sexually traumatized women could profit only few from the examined resource. The found negative relationship between perceived social support and posttraumatic symptoms shows additionally the potentially long-lasting impact of these form of coping on psychological health in trauma victims.
Assuntos
Adaptação Psicológica , Estupro/psicologia , Apoio Social , Sobreviventes/psicologia , Crimes de Guerra/psicologia , II Guerra Mundial , Idoso , Idoso de 80 Anos ou mais , Mecanismos de Defesa , Feminino , Alemanha , Humanos , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/psicologiaRESUMO
A sample of 74 male bodybuilders was analyzed for relationships between steroid abuse (abuse n=31; no abuse n=43) and self-esteem (Multidimensionale Selbstwertskala MSWS), body-image (Body-Image Questionnaire FK-ASA) as well as teasing (Physical Appearance Related Teasing Scale PARTS). In a logistic regression analysis age (p=0.001), low values for body expression (p=0.036) and high self-esteem (p=0.024) predicted steroid intake; training frequency or teasing experiences showed no effect. Contrary to earlier findings high and not low self-esteem was associated with steroid abuse. Because of the overlap between constructs narcissism and self-esteem further studies should disentangle the role of narcissism and self-esteem for steroid abuse in bodybuilders.
Assuntos
Esteroides/efeitos adversos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Levantamento de Peso , Adulto , Imagem Corporal , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Narcisismo , Psicometria , Autoimagem , Inquéritos e QuestionáriosRESUMO
Dissociation, though understood as a response to trauma, lacks a proven etiology. The assumption of a dose-response relationship between trauma, dissociation and Schneiderian symptoms led to the proposal of a dissociative subtype of schizophrenia characterized by severe child maltreatment, dissociation and psychosis. Child maltreatment and dissociation are common features of neurotic disorders as well, and the link between trauma, dissociation, and hallucinations is not specific for schizophrenia. This study compares childhood abuse and neglect, posttraumatic distress and adult dissociation in patients with psychotic vs. non-psychotic disorder. Thirty-five participants with non-psychotic disorder and twenty-five with schizophrenia were analyzed using the Scale for the Assessment of Positive Symptoms (SAPS), the Scale for the Assessment of Negative Symptoms (SANS), the Montgomery-Åsberg Depression Rating Scale (MADRS), the Posttraumatic Stress Diagnostic Scale PDS (PDS), the Childhood Trauma Questionnaire (CTO) and the Arbeitsgemeinschaft Methodik und Dokumentation in der Psychiatrie (AMDP)-module on dissociation. Trauma and clinical syndromes were compared by means of T-testing and logistic regression between 1) the diagnoses and 2) groups with and without post-traumatic stress disorder (PTSD), marked dissociation and psychotic symptoms. While non-psychotic disorder was related to abuse, schizophrenia showed an association with neglect. Childhood trauma predicted posttraumatic symptomatology and negative symptoms. Childhood abuse and neglect may effectuate different outcomes in neurotic and psychotic disorder. The underlying mechanisms, including dissociation, dovetail with cognitive, emotional and behavioural changes involved in depression, posttraumatic distress and chronic schizophrenia symptoms rather than being directly linked to trauma.
Assuntos
Maus-Tratos Infantis , Transtornos Neuróticos/etiologia , Transtornos Neuróticos/psicologia , Esquizofrenia/etiologia , Adulto , Distribuição de Qui-Quadrado , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Transtornos Neuróticos/diagnóstico , Escalas de Graduação Psiquiátrica , Psicometria , Esquizofrenia/diagnóstico , Psicologia do Esquizofrênico , Inquéritos e Questionários , Adulto JovemRESUMO
BACKGROUND: Public stigma and self-stigma are two facets of mental illness stigma. Self-stigma denotes the internalization of negative public perceptions by persons with mental illness and has been shown to decrease general self-efficacy. To date, self-stigma has not been examined in people suffering from alcohol dependence, a particularly severely stigmatized mental disorder. METHODS: By adopting the Self-Stigma in Mental Illness Scale (SSMI), we developed the Self-Stigma in Alcohol Dependence Scale (SSAD). The scale is based on a focus-group derived list of 16 negative stereotypes about alcohol dependent persons. It consists of four 16-item subscales measuring four hypothetical stages of self-stigma, stereotype awareness (aware), stereotype agreement (agree), self-concurrence (apply), and self-esteem decrement (harm). We employed the SSAD in a cross-sectional study of 153 patients hospitalized for alcohol detoxification to examine its reliability and validity. RESULTS: The four stages of self-stigma could be reliably measured with the SSAD (Cronbach's alpha, 0.86-0.93). Each step in the process of self-stigmatization was most closely associated with its preceding step. Other significantly related independent variables in multiple regression analyses included desire for social distance (associated with agree), duration of drinking problems (associated with apply) and depressive symptoms (associated with apply and harm). Both apply and harm were significantly related to reduced drinking-refusal self-efficacy in analyses controlling for depressive symptoms and variables related to duration and severity of the drinking problem. DISCUSSION: The SSAD showed good validity and reliability measuring the stages of self-stigma in this group. Self-stigma appears to be associated with lower drinking-refusal self-efficacy.
Assuntos
Alcoolismo/psicologia , Autoeficácia , Estigma Social , Estereotipagem , Adulto , Alcoolismo/diagnóstico , Alcoolismo/terapia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos/normas , Reprodutibilidade dos TestesRESUMO
The aim of this study was to determine the persistent trauma impact and significant posttraumatic stress symptoms in a sample of very elderly German women who survived the mass rapes committed by soldiers at the end of World War II. A total of 27 women were recruited, interviewed, and then administered a modified Posttraumatic Diagnostic Scale. They all reported a very severe degree of trauma exposure in 1945; 19% reported significant current posttraumatic stress symptoms indicating a possible posttraumatic stress disorder at the time of the study, and 30% fulfilled the criteria of a current partial posttraumatic stress disorder. The results highlight the necessity for prevention and treatment programs for women exposed to wartime rapes in current conflict settings worldwide, and the need to identify and treat posttraumatic conditions in the elderly generation of all countries exposed to World War II trauma.
Assuntos
Acontecimentos que Mudam a Vida , Estupro/psicologia , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Sobreviventes/psicologia , II Guerra Mundial , Idoso , Idoso de 80 Anos ou mais , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Avaliação Geriátrica/estatística & dados numéricos , Alemanha/epidemiologia , Humanos , Estudos Longitudinais , Masculino , Militares/psicologia , Militares/estatística & dados numéricos , Prevalência , Escalas de Graduação Psiquiátrica , Estupro/estatística & dados numéricos , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Inquéritos e Questionários , Sobreviventes/estatística & dados numéricos , VeteranosRESUMO
The multiaxial system of operational psychodynamic diagnosis (OPD) is based on five axes covering illness experience and prerequisites for treatment, interpersonal relations, conflict, structure and symptomatology following ICD-10, Chapter V (F). The new version, OPD-2, has developed from a purely diagnostic system into one including a set of tools and procedures for treatment planning and for measuring change, as well as for determining the appropriate main focuses of treatment and developing appropriate treatment strategies. Focusing on axis I of the system, the concept and content of OPD are introduced and data concerning aspects of reliability and validity are discussed.
Assuntos
Transtornos Mentais/psicologia , Transtornos Mentais/terapia , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Psicoterapia/métodos , Adaptação Psicológica , Conflito Psicológico , Mecanismos de Defesa , Diagnóstico Diferencial , Emoções , Humanos , Classificação Internacional de Doenças , Relações Interpessoais , Transtornos Mentais/diagnóstico , Prognóstico , Reprodutibilidade dos Testes , Inquéritos e Questionários , Inconsciente PsicológicoRESUMO
With the availability of disease-modifying, immunomodulatory therapies (DMT) for multiple sclerosis (MS) and the first long-term studies, it became obvious that problems of compliance to complex treatment regimens under chronic conditions would also apply to these approaches. In a selective overview, problems and findings of adherence research are depicted. Based on a discussion of basic concepts, issues of operationally defining and measuring adherence are outlined. Descriptive findings on adherence to DMTs and empirical predictors of nonadherence are then discussed. Referring to theoretical models of treatment motivation, selected problems (e. g., indication) and strategies of promoting adherence are described. Finally, implications of modern concepts of the patient-therapist relationship for the issue of patient adherence are considered.
Assuntos
Imunoterapia/métodos , Adesão à Medicação/psicologia , Esclerose Múltipla/psicologia , Esclerose Múltipla/terapia , Humanos , Imunoterapia/psicologia , Satisfação do PacienteRESUMO
BACKGROUND: Previous investigations using transcranial magnetic stimulation (TMS) have shown that neural inhibitory motor circuits are disturbed in ADHD children. We sought to investigate the influence of methylphenidate (MPH) on inhibitory and facilitatory motor circuits of ADHD children with TMS paired pulse protocols using surplus long interval inter-stimulus intervals (ISI) not investigated so far. METHODS: Motorcortical modulation was tested with TMS paired pulse protocols employing ISI of 3, 13, 50, 100, 200, and 300 msec in 18 ADHD children before and on treatment with MPH. Clinical improvement by MPH was measured by the Conners score. RESULTS: Analysis of variance (ANOVA) revealed a significant three-way interaction "Group x Amplitude x ISI," p = .001. Subsequent two-factorial ANOVAs and t-tests showed group specific differences of motor evoked potential (MEP) amplitudes for inhibitory ISIs of 3 and 100 msec, and for facilitatory ISIs of 13 and 50 msec. Compared to controls, an adjustment of these parameters by MPH could be shown. On MPH, a significant bivariate correlation was found between the Conners score reduction and averaged MEP amplitude changes only for inhibitory ISIs (3 and 100 msec). CONCLUSIONS: In ADHD children, MPH modulates disturbed facilitatory and inhibitory motor circuits, which for the latter is associated with clinical improvement.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Estimulantes do Sistema Nervoso Central/uso terapêutico , Metilfenidato/uso terapêutico , Córtex Motor/fisiopatologia , Inibição Neural/efeitos dos fármacos , Adolescente , Estudos de Casos e Controles , Criança , Estimulação Elétrica/métodos , Feminino , Humanos , Masculino , Córtex Motor/efeitos dos fármacos , Córtex Motor/efeitos da radiação , Inibição Neural/fisiologia , Inibição Neural/efeitos da radiação , Fatores de Tempo , Estimulação Magnética Transcraniana/métodosRESUMO
Although there is little doubt about a considerable need for psychosocial support in patients with severe neuroimmunological diseases, the theoretical elaboration of stressful illness consequences as well as the development of standardised intervention programs are still in their beginnings. In the present paper, models of coping with chronic illness are characterised as a suitable framework. After a short overview of psychological dimensions of physical illness, concepts from the coping literature that seem to meet these demands are briefly introduced. Furthermore, recent results of coping research especially in multiple sclerosis (MS) are outlined in an overview which also includes findings from evaluation studies. Moreover, aims and techniques, which constitute necessary elements of coping skills training for patients with neuroimmunological disease, are described. Questions of suitability of coping interventions for subgroups of patients with multiple sclerosis are finally discussed.
Assuntos
Adaptação Psicológica , Doenças do Sistema Imunitário/psicologia , Doenças do Sistema Nervoso/psicologia , Humanos , Doenças do Sistema Imunitário/reabilitação , Esclerose Múltipla/psicologia , Esclerose Múltipla/reabilitação , Doenças do Sistema Nervoso/imunologia , Doenças do Sistema Nervoso/reabilitaçãoRESUMO
Although pathological dissociation (PD) has received increasing scientific attention in Anglo-American countries, European research on the frequency, clinical and demographic correlates of this discontinuous construct are lacking. An 8-item subscale of the Dissociative Experiences Scale, called the DES-Taxon, was administered to five samples comprising a non-clinical population, students, unselected psychiatric inpatients, eating-disordered inpatients and psychosomatic outpatients with a total of 1,759 adult participants. In the two non-clinical samples, the frequency of PD ranged between 0.3 and 1.8%. Its prevalence was highest in the psychiatric inpatients (5.4%) followed by the eating disorders (4.8%) and the psychosomatic outpatients (2.2%). PD was seen in all diagnostic groups and it was associated with more psychopathological distress and younger age. PD is frequently found in clinical populations in European countries, too. However, methodological problems relating to its empirical determination might obscure the clinical and scientific value of the construct.