Effectiveness of a self-makeup program for Brazilian women with breast cancer.

PURPOSE: We aim to evaluate the effectiveness of a self-makeup program for Brazilian women with breast cancer by measuring different psychological variables and coping strategies. DESIGN: A quasi-experimental, longitudinal, within-group study. SAMPLE: One hundred fifty-two women undergoing treatment for breast cancer. METHODS: Indicators of anxiety, depression, self-esteem, body image, and coping strategies were evaluated before the workshop (baseline), immediately after the workshop (Time 1) and one month after the workshop (Time 2). FINDINGS: The self-makeup program was effective at Times 1 and 2. At Time 1, only a decrease in the anxiety score was observed (Cohen's d= -0.41; p < 0.001). At Time 2, the results were stronger and statistically significant (p ≤ 0.001), showing decreased anxiety (d = -0.62) and depression (d = -0.46) and improved self-esteem (d = 0.61) and satisfaction with the body (d = 0.46) and appearance (d = 0.48). No significant changes were observed in coping strategies, except for denial (d = -0.26). IMPLICATION FOR PSYCHOSOCIAL PROVIDERS OR POLICY: The self-makeup program effectively improved psychological variables, especially one month after the intervention. This program can be used as an adjuvant to treatment to promote mental health and humanize the hospital environment.

Increased body sway in phobic patients exposed to images of spiders

Objective: The aim of the present study was to analyze the body sway response in specific phobia (SP) patients and healthy controls while viewing neutral, phobic, and disgusting images. Methods: The participants' heart rate (HR) and skin conductance were also recorded during the procedure. Nineteen patients with arachnophobia and 19 healthy volunteers matched by age, gender, and years of education underwent a postural control test on a stabilometric platform. Results: The platform recorded increased body sway in the SP group when exposed to spider images (SPI). The SP group presented increases in most parameters (SD, velocity, frequency, area, p ≤ 0.05) when viewing pictures of the SPI category. Psychometric measures of subjective anxiety (State-Trait Anxiety Inventory, STAI) and physiological states (HR; skin conductance responses; spontaneous fluctuations in skin conductance) showed increased anxiety (p ≤ 0.05) in the SP group compared to healthy volunteers. High anxiety levels were observed throughout the assessment, including the task of exposure to SPI (p ≤ 0.05). No significant effect or correlation was found between skin conductance and body sway measures (p > 0.05). Conclusions: The results of the postural control test suggest the occurrence of a defensive escape response in SP, in agreement with previous evidence.

Personality Inventory for DSM-5 (PID-5): cross-cultural adaptation and content validity in the Brazilian context / Inventário de Personalidade para o DSM-5 (PID-5): adaptação transcultural e validade de conteúdo para o contexto brasileiro

Abstract Objective To describe the process of cross-cultural adaptation of the Personality Inventory for DSM-5 (PID-5) to the Brazilian context. Methods Cross-cultural adaptation involved the steps of independent translation of the instrument, synthesis version, and back-translation. Analysis of content validity was conducted by a multidisciplinary expert committee and consisted of quantitative assessment of agreement indicators. The test was then applied to a target population. Results All the steps required for a cross-cultural adaptation were followed and satisfactory agreement values (≥ 4.75) were reached for most of the structures assessed. Most of the changes suggested by the experts were followed; these changes consisted primarily of adjustments to verb tense and agreement and the inclusion of letters and words to allow gender inflection. In the pre-test, no suggestions were made and the instrument was considered comprehensible. Conclusion The Brazilian version of the PID-5 was found to be adequate to the Brazilian context from semantic, idiomatic, cultural, and conceptual perspectives. The Brazilian version assessed here can be freely used, was approved by the publishers who hold the copyright on the instrument, and is considered the official version of the instrument. New studies are underway to determine the validity and reliability of the PID-5.

Resumo Objetivo Apresentar o processo de adaptação transcultural do Personality Inventory for DSM-5 (PID-5) para o contexto brasileiro. Métodos A adaptação transcultural envolveu as etapas de tradução independente, versão síntese e retrotradução. A validade de conteúdo foi realizada por um comitê multidisciplinar de especialistas, com avaliação quantitativa dos índices de concordância. Por fim, o pré-teste foi conduzido com a população-alvo. Resultados Todos os estágios da adaptação transcultural foram seguidos, e na maioria das estruturas avaliadas, os valores de concordância foram satisfatórios (≥ 4.75). Grande parte das sugestões de modificações feitas pelos especialistas foram acatadas, sendo as principais relacionadas a ajustes no tempo e concordância verbal e a inclusão de letras e palavras para permitir a flexão de gênero. No pré-teste nenhuma sugestão foi apresentada e o instrumento foi considerado compreensível. Conclusão A versão brasileira do PID-5 mostrou-se adequada ao contexto brasileiro sob as perspectivas semântica, idiomática, cultural e conceitual. A versão brasileira avaliada é de uso livre, foi aprovada pelas editoras responsáveis pelos direitos autorais do instrumento e é considerada oficial. Novos estudos estão sendo conduzidos para aprimorar a busca por evidencias de validade e confiabilidade.

Impact of an animal-assisted therapy programme on physiological and psychosocial variables of paediatric oncology patients.

The objective of this study was to propose an intervention and safety protocol for performing animal-assisted therapy (AAT) and evaluating its efficacy in children under outpatient oncological treatment based on psychological, physiological, and quality of life indicators for the children and caregivers. The sample consisted of 24 children diagnosed with leukaemia and solid tumours (58% girls with a mean age of 8.0 years) who underwent an AAT programme consisting of three 30-min sessions in an open group. Two dogs (one Labrador retriever and one golden retriever) were used, and activities such as sensory stimulation, gait training, and socialization were conducted. The exclusion criteria were severe mental problems, inability to answer the questions included in the instruments used, allergy to animals, unavailability/lack of interest, isolation precaution, surgical wound, use of invasive devices, ostomy, no current blood count for evaluation, neutropaenia, infection, fever, diarrhoea, vomiting, respiratory symptoms at the beginning of the intervention or 1 week before the intervention, hospitalization or scheduled surgery, and non-completion of the AAT programme. The variables analysed using validated self or other evaluations were stress, pain, mood, anxiety, depression, quality of life, heart rate, and blood pressure. A quasi-experimental study design was used. We observed a decrease in pain (p = 0.046, d = -0.894), irritation (p = 0.041, d = -0.917), and stress (p = 0.005; d = -1.404) and a tendency towards improvement of depressive symptoms (p = 0.069; d = -0.801). Among the caregivers, an improvement was observed in anxiety (p = 0.007, d = -1.312), mental confusion (p = 0.006, d = -1.350), and tension (p = 0.006, d = -1.361). Therefore, the selection criteria and care protocols used for the AAT programme in the oncological context were adequate, and the programme was effective.

Borderline personality disorder and bias in the recognition of facial expressions of emotion: a pathway to understand the psychopathology

Abstract Background The identification of facial emotions is a key skill as it promotes rapid and accurate recognition of emotions and enables better communication and greater social adaptation. More recent studies have suggested that impaired social interactions may be related to deficits in social cognition and therefore in the recognition of facial expressions, contributing to social disturbance among individuals with borderline personality disorder (BPD). Objective To present the results of an empirical study assessing the recognition of facial emotion expressions in women with BPD, having as reference a group of healthy women from the general population. Methods The subjects (40 female with BPD and 40 controls) were assessed with a dynamic task on a computer screen for recognition of facial expressions of emotion. Results The BPD group had a lower accuracy in perceiving emotions of fear and surprise and slowness in recognising happiness. Logistic regression analyses also identified an association between BPD and higher sensitivity in the recognition of anger. Discussion Women with BPD made more mistakes in the recognition of negative emotions, which can bias the behaviour and regulation of affective states, favouring in turn the emergence of some typical symptoms associated with BPD.

Music performance anxiety: a critical review of etiological aspects, perceived causes, coping strategies and treatment

Abstract Background Music performance anxiety (MPA) is understood as a sub-type of social anxiety and is characterised by fears of a musical presentation. Objective To carry out a critical literature review on clinical and etiological aspects, perceived causes, coping strategies and treatment of MPA. Methods Electronic databases PubMed, PsycINFO and Lilacs as well as specific periodicals were used based on the key-words symptoms, diagnosis, aetiology, perceived causes, coping strategies and treatment. Results MPA is highly prevalent among musicians (> 16%), regardless of culture and formation. Cognitive, behavioural and physiological factors are associated with the aetiology of MPA, including biological and psychological predispositions. In addition, one should highlight factors related to the individual, aspects related to tasks and musical situation as perceived causes and/or predictor variables of MPA. As for the coping strategies, one can also highlight the use of breathing/relaxing techniques, increased musical practice, use of homeopathy and substances without medical prescription. Discussion MPA is impacting in the musician's life. Despite the increasing interest in its study, it is necessary to better understand this complex phenomenon, mainly in the therapeutic context, in addition to the publicising and offering of services for prevention and treatment of MPA.

Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5): transcultural adaptation of the Brazilian version

Abstract Background DSM-5 introduced some modifications on Posttraumatic Stress Disorder (PTSD) criteria. The instruments developed for the assessment of aspects related to PTSD needed a reformulation, as was the case of the Posttraumatic Stress Disorder Checklist (PCL). Objectives To present the process of transcultural adaptation of the three forms of the PCL-5 to Brazilian Portuguese, as well as its face validity. Methods The procedure involved independent translations, a synthesis version, back translation by an independent translator, evaluation by the original author, analysis by an expert committee, and a pretesting study (10 subjects with/without experience of a traumatic situation). The last two steps formed the face validity procedure. Results The synthesis version was approved by the original author and the agreement percentage by the expert committee was excellent, with only two items showing < 90%. The pretesting study showed that the Brazilian version was well understood and linguistically and culturally accepted by the participants, which did not make significant suggestions for changes. Discussion Transcultural adaptation of the PCL-5 for Brazilian Portuguese followed a rigid and standardized procedure. Therefore, after having its face validity assessed by an expert committee and by the target population, it is apt to be used.

Antidepressive, anxiolytic, and antiaddictive effects of ayahuasca, psilocybin and lysergic acid diethylamide (LSD): a systematic review of clinical trials published in the last 25 years.

To date, pharmacological treatments for mood and anxiety disorders and for drug dependence show limited efficacy, leaving a large number of patients suffering severe and persistent symptoms. Preliminary studies in animals and humans suggest that ayahuasca, psilocybin and lysergic acid diethylamide (LSD) may have antidepressive, anxiolytic, and antiaddictive properties. Thus, we conducted a systematic review of clinical trials published from 1990 until 2015, assessing these therapeutic properties. Electronic searches were performed using the PubMed, LILACS, and SciELO databases. Only clinical trials published in peer-reviewed journals were included. Of these, 151 studies were identified, of which six met the established criteria. Reviewed studies suggest beneficial effects for treatment-resistant depression, anxiety and depression associated with life-threatening diseases, and tobacco and alcohol dependence. All drugs were well tolerated. In conclusion, ayahuasca, psilocybin and LSD may be useful pharmacological tools for the treatment of drug dependence, and anxiety and mood disorders, especially in treatment-resistant patients. These drugs may also be useful pharmacological tools to understand psychiatric disorders and to develop new therapeutic agents. However, all studies reviewed had small sample sizes, and half of them were open-label, proof-of-concept studies. Randomized, double-blind, placebo-controlled studies with more patients are needed to replicate these preliminary findings.

Predictor Variables and Screening Protocol for Depressive and Anxiety Disorders in Cancer Outpatients.

BACKGROUND: Cancer patients are at increased risk of persistent depressive and anxiety symptoms and disorders compared to the general population. However, these issues are not always identified, which may worsen the prognosis and increase morbidity and mortality. Therefore, the objectives of this study are to identify predictor variables (demographic and clinical) for the development of mood and anxiety disorders in cancer outpatients and to propose a probabilistic screening protocol considering these variables and certain standardized screening instruments. METHODS: A total of 1,385 adults, of both genders, receiving outpatient cancer care were evaluated using a questionnaire and screening instruments. Thereafter, 400 of these subjects responded to the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID-IV) by telephone to confirm or rule out the presence of a Current Major Depressive Episode (CMDE) or Anxiety Disorder (AD). RESULTS: Of the patients surveyed, 64% met the criteria for CMDE and 41% for AD. Female gender was found to be a risk factor for both disorders, and the presence of previous psychiatric history and marital status (divorced and widowed) were risk factors for anxiety disorders. When scoring above the recommended cutoff score, the screening instruments also indicated a risk of the studied disorders. Based on these findings, a screening protocol and nomograms were created for the quantification, combination and probabilistic estimate of risk, with accuracy indicators >0.68. CONCLUSION: The prevalence rates for the disorders under study are extremely high in cancer patients. The use of the proposed protocol and nomogram can facilitate rapid and wide screening, thus refining triage and supporting the establishment of criteria for referral to mental health professionals, so that patients can be properly diagnosed and treated.

Antidepressive and anxiolytic effects of ayahuasca: a systematic literature review of animal and human studies

Objective: To conduct a systematic literature review of animal and human studies reporting anxiolytic or antidepressive effects of ayahuasca or some of its isolated alkaloids (dimethyltryptamine, harmine, tetrahydroharmine, and harmaline). Methods: Papers published until 3 April 2015 were retrieved from the PubMed, LILACS and SciELO databases following a comprehensive search strategy and using a predetermined set of criteria for article selection. Results: Five hundred and fourteen studies were identified, of which 21 met the established criteria. Studies in animals have shown anxiolytic and antidepressive effects of ayahuasca, harmine, and harmaline, and experimental studies in humans and mental health assessments of experienced ayahuasca consumers also suggest that ayahuasca is associated with reductions in anxiety and depressive symptoms. A pilot study reported rapid antidepressive effects of a single ayahuasca dose in six patients with recurrent depression. Conclusion: Considering the need for new drugs that produce fewer adverse effects and are more effective in reducing anxiety and depression symptomatology, the described effects of ayahuasca and its alkaloids should be further investigated.

Assessment and screening of panic disorder in cancer patients: performance of the PHQ-PD.

OBJECTIVE: This study's objective was to promote the transcultural adaptation of the Patient Health Questionnaire-Panic Disorder Module (PHQ-PD) for Brazilian Portuguese and to evaluate the discriminative validity of this scale in detecting PD among cancer patients. METHODS: Adult cancer outpatients (n=400) from a specialized cancer hospital (61.50% female; 68.40% married; 56% incomplete elementary education or elementary school as the highest educational level) were assessed with the Structured Clinical Interview for DSM-IV and PHQ-PD. Using receiver operating characteristic (ROC) analyses, we determined the sensitivity and specificity values for the original PD algorithm and the PD screening. RESULTS: The prevalence of PD in cancer patients (8.75%) was higher than the prevalence of PD for the general population. The original PD algorithm demonstrated an accuracy of 0.66, sensitivity of 0.31 and specificity of 0.94. The PD screening question in the PHQ-PD had a sensitivity of 0.66 and a specificity of 0.75 (accuracy=0.80). CONCLUSION: PD screening questions in the PHQ-PD may be useful for identifying cancer patients with PD because of the high prevalence of PD in this population and because the questionnaire's sensitivity is greater than that of the original PD algorithm. Nevertheless, researchers and clinical practitioners should consider the original PD algorithm (five items) in the PHQ-PD when they investigate PD in patients because of the algorithm's high specificity. Individuals who are found to be positive for PD on screening should be referred for assessment and a thorough psychiatric interview that focuses on the differential diagnosis of an anxiety disorder relating to cancer.

Coping, psychopathology, and quality of life in cancer patients under palliative care.

OBJECTIVE: To assess hopelessness, anxiety, depression, and quality of life in cancer patients undergoing palliative treatment by comparing their scores at the onset of treatment and one month later and by assessing possible correlations with coping strategies. METHOD: Participants included 85 patients of both genders (56.5% female) diagnosed with advanced cancer who did not have curative therapeutic options who were assessed with self-applied instruments (the Beck Hopelessness Scale, the European Organization for the Research and Treatment of Cancer Quality of Life Core Questionnaire-Cancer 30, the Hospital Anxiety and Depression Scale, and the Coping Strategies Inventory by Folkman and Lazarus) at two timepoints: first before their appointment with doctors and other professionals in their first visit to the palliative care outpatient clinic (PCOC) and then as soon as patients arrived at the PCOC for their first medical follow-up visit (approximately 30 days after the first appointment). RESULTS: The scores for hopelessness, anxiety, and depression remained stable (p = 0.24). The results were the same for the quality-of-life (QoL) variables, except for the fatigue and pain scores, which decreased (p = 0.01), and social impairment, which increased (p = 0.03). Analysis of the correlations between the coping mechanisms used after the onset of palliative treatment showed that confronting coping, seeking social support, and positive reappraisal were inversely correlated with hopelessness. Seeking social support, planful problem solving, and positive reappraisal were inversely correlated with indicators of depression. In contrast, use of the escape-avoidance strategy and reduced use of the planful problem-solving strategy were associated with increased anxiety. SIGNIFICANCE OF RESULTS: The employment of problem-focused coping strategies exerted a positive impact on the end-of-life process and, above all, protected patients from the negative experiences associated with psychiatric symptoms, thus enabling them to look for alternative solutions for experiencing the end-of-life process in a more well-adjusted manner.

Parameters for screening music performance anxiety

Objective: To assess the discriminative capacity of the Kenny Music Performance Anxiety Inventory (K-MPAI), in its version adapted for Brazil, in a sample of 230 Brazilian adult musicians. Method: The Social Phobia Inventory (SPIN) was used to assess the presence of social anxiety indicators, adopting it as the gold standard. The Mann-Whitney U test and the receiver operating characteristic (ROC) curve were used for statistical analysis, with p ≤ 0.05 set as the significance level. Results: Subjects with social anxiety indicators exhibited higher mean total K-MPAI scores, as well as higher individual scores on 62% of its items. The area under the ROC curve was 0.734 (p = 0.001), and considered appropriate. Within the possible cutoff scores presented, the score -15 had the best balance of sensitivity and specificity values. However, the score -7 had greater specificity and accuracy. Conclusion: The K-MPAI showed appropriate discriminant validity, with a marked association between music performance anxiety and social anxiety. The cutoff scores presented in the study have both clinical and research value, allowing screening for music performance anxiety and identification of possible cases. .

Indicators of psychiatric disorders in different oncology specialties: a prevalence study.

Objective. This study evaluated the prevalence of various indicators of psychiatric disorders in Brazilian outpatients with cancer and assessed possible associations with sociodemographic indicators. Materials and Methods. A total of 1,385 patients were evaluated using the following instruments: Patient Health Questionnaire-4 (PHQ-4), Generalized Anxiety Disorder (GAD-7), Fagerström Test for Nicotine Dependence (FTND), and Fast Alcohol Screening Test (FAST). Results. The sample was composed of both genders with a slight predominance of women (55.8%), subjects with incomplete/completed elementary school (59%), married (67.4%), with children (94%), not active from a labor viewpoint (61.6%), and following some type of religion (79.5%). The prevalence of anxiety for the total sample varied between 21.5 and 27.4%. The prevalence of depression was 21.1%, tobacco abuse/dependence was 40.2%, and alcohol was 20.3%. Women had significantly higher levels of anxiety and depression than men. Men had higher levels of substance abuse/dependence indicators than women. Conclusion. These results are consistent with the literature, which attests to the high prevalence of psychiatric disorder indicators in cancer patients, especially compared to the general population.

Quality of life in patients with Charcot-Marie-Tooth disease type 1A / Análise da qualidade de vida de pacientes com a doença de Charcot-Marie-Tooth tipo 1A

We assessed the functional impairment in Charcot-Marie-Tooth resulting from 17p11.2-p12 duplication (CMT1A) patients using the Short-Form Health Survey (SF-36), which is a quality of life questionnaire. Twenty-five patients of both genders aged ≥10 years with a positive molecular diagnosis of CMT1A were selected. Age- and gender-matched Control Group (without family history of neuropathy), and the sociodemographic and professional conditions similar to the patients' group were selected to compare the SF-36 results between them. The results showed that the majority quality of life impairments in CMT1A patients occurred in the social and emotional domains. Functional capacity also tended to be significantly affected; other indicators of physical impairment were preserved. In conclusion, social and emotional aspects are mostly neglected in the assistance provided to CMT1A Brazilian patients, and they should be better understood in order to offer global health assistance with adequate quality of life as a result.

Avaliou-se o comprometimento funcional de pacientes com Charcot-Marie-Tooth provenientes da duplicação 17p11.2-p12 (CMT1A), utilizando o SF-36, que é um questionário para medir a qualidade de vida. Vinte e cinco pacientes de ambos os sexos com idades ≥10 anos e diagnóstico molecular de CMT1A foram selecionados. Idade, sexo, condições sociodemográficas e profissionais foram pareados com o Grupo Controle (sem histórico familiar de neuropatia). Os resultados mostraram que o maior impacto da CMT1A na qualidade de vida ocorreu nos domínios social e emocional dos pacientes avaliados. A capacidade funcional também tende a ser significativamente afetada, enquanto outros indicadores de deficiência física foram preservados. Por fim, os aspectos sociais e emocionais dos pacientes acometidos por CMT1A costumam ser negligenciados na assistência médica prestada aos pacientes brasileiros, e devem ser melhor compreendidos a fim de oferecer uma assistência global à saúde, resultando em adequada qualidade de vida.

Validation of the state version of the Self-Statement during Public Speaking Scale

OBJECTIVE: To adapt the trait version of the Self Statements during Public Speaking (SSPS) scale to a state version (SSPS-S) and to assess its discriminative validity for use in the Simulated Public Speaking Test (SPST). METHOD: Subjects with and without social anxiety disorder (n = 45) were assessed while performing the SPST, a clinical-experimental model of anxiety with seven different phases. RESULTS: Alterations in negative self-assessment occurred with significant changes throughout the different phases of the procedure (p = .05). Non-cases presented significantly higher mean values of the SSPS-S in all phases of the procedure than cases (p < .01). CONCLUSION: Cases assessed themselves in a less positive and more negative manner during the SPST than did non-cases. SSPS-S is adequate for this assessment, especially its negative subscale, and shows good psychometric qualities.

O psicólogo interconsultor, na enfermaria de pneumologia, de um hospital escola: caracterização das solicitações de atendimento psicológico / The psychologist as an interconsultant on the pneumology ward of teaching hospital: characterization of the requests for psychological care

Objetiva-se caracterizar as solicitações de atendimento psicológico feitas a um Serviço de Psicologia em Interconsulta, numa Enfermaria de Pneumologia de um Hospital-Escola, por meio da análise dos formulários de solicitação de interconsulta (PI). Analisaram-se os Pls enviados no período de três semestres, caracterizando-se o número total de pacientes, distribuição quanto ao sexo, idade, motivo de solicitação e encaminhamento dado ao caso. Quanto aos resultados obtidos, detectou-se que, para 11,3 por cento dos pacientes internados na enfermaria, no citado período, foi solicitada interconsulta psicológica. Desses pacientes, predominaram os de sexo masculino, na faixa etária dos 50-69 anos. Quanto aos motivos de solicitação, predominaram referências às seguintes categorias: doença neoplásica pulmonar, sintomatologia depressiva, falta de colaboração no tratamento, sintomatologia ansiosa, quadros de somatização, dificuldade de adaptação hospitalar e presença de doença crônica prévia. Quanto ao encaminhamento dos casos, predominou a indicação de atendimento psicoterápico de apoio, seguido de orientação familiar. Percebe-se que a demanda para atendimento psicológico, na Enfermaria de pneumologia, é adequadamente percebida pela equipe médica, principalmente frente a doenças em que o componente emocional é relevante, tanto no aparecimento como no enfrentamento, e em situações em que sintomas de maior fragilidade psíquica, como a depressão, já se fazem presentes. Conclui-se que, em tal contexto hospitalar, o psicólogo tem um campo de atuação configurado: melhorar a qualidade da assistência ao paciente, provendo cuidados aos aspectos psicossociais, envolvidos na situação de a pessoa estar doente e hospitalizada