Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 152
Filtrar
1.
J Sex Marital Ther ; 50(2): 123-136, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-37822263

RESUMO

We investigated distinct profiles in emotion regulation strategies (reappraisal and suppression) and their associations with sexual function and mental health. The online survey sample consisted of 5436 adult participants. The gender stratified cluster analysis resulted in a four-cluster solution for both men and women. Better sexual function and mental health scores were found for participants with high cognitive reappraisal and low expressive suppression. High expressive suppression was associated with higher anxiety and depression and worse sexual function. Sexological care should take into account the assessment of emotion regulation abilities and emotion regulation training interventions to support reappraisal strategies.


Assuntos
Regulação Emocional , Adulto , Masculino , Humanos , Feminino , Saúde Mental , Ansiedade/psicologia , Inquéritos e Questionários , Emoções
2.
Dev Psychopathol ; : 1-14, 2024 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-38654405

RESUMO

Early-life adversity as neglect or low socioeconomic status is associated with negative physical/mental health outcomes and plays an important role in health trajectories through life. The early-life environment has been shown to be encoded as changes in epigenetic markers that are retained for many years.We investigated the effect of maternal major financial problems (MFP) and material deprivation (MD) on their children's epigenome in the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort. Epigenetic aging, measured with epigenetic clocks, was weakly accelerated with increased MFP. In subsequent EWAS, MFP, and MD showed strong, independent programing effects on children's genomes. MFP in the period from birth to age seven was associated with genome-wide epigenetic modifications on children's genome visible at age 7 and partially remaining at age 15.These results support the hypothesis that physiological processes at least partially explain associations between early-life adversity and health problems later in life. Both maternal stressors (MFP/MD) had similar effects on biological pathways, providing preliminary evidence for the mechanisms underlying the effects of low socioeconomic status in early life and disease outcomes later in life. Understanding these associations is essential to explain disease susceptibility, overall life trajectories and the transition from health to disease.

3.
Addict Biol ; 29(3): e13389, 2024 03.
Artigo em Inglês | MEDLINE | ID: mdl-38516877

RESUMO

With the advent of digital technologies, online sports betting is spurring a fast-growing expansion. In this study, we examined how sports betting availability modulates the brain connectivity of frequent sports bettors with [problem bettors (PB)] or without [non-problem bettors (NPB)] problematic sports betting. We conducted functional connectivity analyses centred on the ventral anterior insular cortex (vAI), a brain region playing a key role in the dynamic interplay between reward-based processes. We re-analysed a dataset on sports betting availability undertaken in PB (n = 30) and NPB (n = 35). Across all participants, we observed that sports betting availability elicited positive vAI coupling with extended clusters of brain activation (encompassing the putamen, cerebellum, occipital, temporal, precentral and central operculum regions) and negative vAI coupling with the orbitofrontal cortex. Between-group analyses showed increased positive vAI coupling in the PB group, as compared with the NPB group, in the left lateral occipital cortex, extending to the left inferior frontal gyrus, the anterior cingulate gyrus and the right frontal pole. Taken together, these results are in line with the central assumptions of triadic models of addictions, which posit that the insular cortex plays a pivotal role in promoting the drive and motivation to get a reward by 'hijacking' goal-oriented processes toward addiction-related cues. Taken together, these findings showed that vAI functional connectivity is sensitive not only to gambling availability but also to the status of problematic sport betting.


Assuntos
Jogo de Azar , Esportes , Humanos , Córtex Insular , Encéfalo , Motivação
4.
Health Econ ; 32(8): 1659-1669, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37146156

RESUMO

We here investigate the role of risk aversion in COVID-19 vaccine hesitancy. The theoretical effect is ambiguous, as both COVID-19 infection and vaccination side-effects involve probabilistic elements. In large-scale data covering five European countries, we find that vaccine hesitancy falls with risk aversion, so that COVID-19 infection is perceived as involving greater risk than is vaccination.


Assuntos
COVID-19 , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Humanos , Vacinas contra COVID-19 , COVID-19/prevenção & controle , Europa (Continente)/epidemiologia , Vacinação
5.
Health Qual Life Outcomes ; 20(1): 122, 2022 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-35974393

RESUMO

BACKGROUND: In recent years, more importance is being given to the assessment of quality of life (QoL) among diabetic patients as a measure of their health and the goal of all health interventions. Other studies have reported a high prevalence of diabetes-related effects on; however, there is a knowledge gap in the region of Sub-Saharan Africa, as is the case for Rwanda, where the prevalence of diabetes is expected to rise over the next decade. The aim of this study is to report on the translation and cultural adaptation of the Diabetes-39 (D-39) questionnaire into the Kinyarwanda and its psychometric properties among diabetic patients in Rwanda. METHODS: The D-39 questionnaire-a five-scale, disease-specific QoL questionnaire-was translated from English to Kinyarwanda, then back-translated to English. A consensus meeting discussed discrepancies and agreed on changes. Interviews were conducted with 26 participants before producing a final version. For the psychometric evaluation, the adapted version was administered to 309 patients with diabetes mellitus. Participants either came from a separate cluster-randomised controlled trial or were recruited ad hoc for this study. The evaluation included testing internal consistency, known group validity, and construct validity. RESULTS: Participants' mean age was 51 ± 12.7 years with a predominance of women (64%) in the sample. All five scales of the questionnaire showed a good internal consistency, with composite reliability of above 0.7. The five-factor model of the questionnaire was fitted to the 39 items. Although the fit was not exact, there was a satisfactory approximate fit (CFI = 0.93, TLI = 0.92, RMSEA = 0.05). There was a good discriminant validity except for the "social burden" and "anxiety and worry" scales (inter-factor correlation = 0.80). CONCLUSIONS: Diabetes-39 is a questionnaire developed in English that was adapted and translated into Kinyarwanda. The Kinyarwanda version of D-39 is a reliable and valid instrument to measure QoL among diabetic patients in Rwanda. The questionnaire can be helpful in research and clinical practice improving health outcomes for patients with diabetes in Rwanda and other Kinyarwanda-competent areas in the sub-region. However, certain cross-cultural differences should be considered.


Assuntos
Diabetes Mellitus , Qualidade de Vida , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários
6.
Dev Psychopathol ; 34(1): 431-445, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-33349279

RESUMO

The current study examined the effects of attachment on autonomy, relatedness, and emotion regulation during an attachment interview (Friends and Family Interview; FFI) and a Parent×Child Conflict interaction (Family Interaction Task; FIT) in 49 adolescents (11 to 17 years old). Disorganized adolescents displayed behaviors promoting autonomy and relatedness less frequently and at a lower extent than organized ones in the FIT with mothers but not with fathers. Disorganized adolescents also showed a steeper decrease in heart rate variability (HRV) than organized ones, during both the FFI and the FITs. Moreover, disorganized adolescents responded with a more marked increase in skin conductance level to the FIT with mothers than organized individuals. Dismissing adolescents showed behaviors promoting autonomy and relatedness less frequently and to a lesser extent than secure ones, while displaying more often behaviors undermining autonomy and relatedness in the FITs. Dismissing adolescents also showed a more pronounced decrease in HRV during the FFI than secure and preoccupied individuals; no differences were found between these groups in HRV during the FITs. The results suggest that disorganized adolescents had more difficulties in regulating their emotions during both the FFI and the FITs, whereas dismissing individuals seemed effectively challenged only during the interview.


Assuntos
Emoções , Apego ao Objeto , Relações Pais-Filho , Autonomia Pessoal , Adolescente , Criança , Pai , Feminino , Frequência Cardíaca , Humanos , Masculino , Mães
7.
Dev Psychopathol ; 34(3): 1013-1024, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-33446284

RESUMO

Acute stress affects interoception, but it remains unclear if this is due to activation of the sympatho-adreno-medullary (SAM) or hypothalamic-pituitary-adrenocortical axis. This study aimed to investigate the effect of SAM axis activation on interoceptive accuracy (IAcc). Central alpha2-adrenergic receptors represent a negative feedback mechanism of the SAM axis. Major depressive disorder and adverse childhood experiences (ACE) are associated with alterations in the biological stress systems, including central alpha2-adrenergic receptors. Here, healthy individuals with and without ACE as well as depressive patients with and without ACE (n = 114; all without antidepressant medication) were tested after yohimbine (alpha2-adrenergic antagonist) and placebo. We assessed IAcc and sensibility in a heartbeat counting task. Increases in systolic and diastolic blood pressure after yohimbine confirmed successful SAM axis activation. IAcc decreased after yohimbine only in the healthy group with ACE, but remained unchanged in all other groups (Group × Drug interaction). This effect may be due to selective upregulation of alpha2-adrenergic receptors after childhood trauma, which reduces capacity for attention focus on heartbeats. The sympathetic neural pathway including alpha2-adrenergic circuitries may be essential for mediating interoceptive signal transmission. Suppressed processing of physical sensations in stressful situations may represent an adaptive response in healthy individuals who experienced ACE.


Assuntos
Experiências Adversas da Infância , Transtorno Depressivo Maior , Interocepção , Humanos , Interocepção/fisiologia , Receptores Adrenérgicos , Ioimbina/farmacologia
8.
BMC Public Health ; 22(1): 1108, 2022 06 03.
Artigo em Inglês | MEDLINE | ID: mdl-35658847

RESUMO

AIM: To identify the impact of COVID-19 measures on sexual behaviors and sexual satisfaction in Luxembourg residents. METHODS: We conducted a cross-sectional online survey of adults (> 18 years of age) residing in Luxembourg, while COVID-19 restrictions were in place. The survey was available from January 15 to February 12, 2021 in four languages (French, German, English and Portuguese). Survey questions focused on masturbation, cuddling, condom use, sex frequency, sexting, cybersex, watching porn, and sexual satisfaction. RESULTS: 557 volunteers completed the survey (35.5% men, 64.3% women). Sexual satisfaction and sexual problems variables were assessed on 4-point Likert scales (0 = not at all/never to 3 = very/often). Sexual problems increased during the COVID-19 measures while sexual satisfaction decreased compared to before the introduction of COVID-19 restrictions (assessed retrospectively). Factors associated with increased odds of sexual satisfaction included having a steady relationship before COVID-19 restrictions, engaging in sexting, reporting good mental health and not altering alcohol intake. CONCLUSIONS: The context of the COVID-19 pandemic and the measures implemented in Luxembourg affected sexual behaviors and sexual satisfaction. Sexual and reproductive health care centers and health professionals in general should take these results into consideration when providing care. Recommendations on the importance of sexual health for general wellbeing and behaviors associated with sexual satisfaction should be offered and possibilities to experience sexuality while reducing contamination risks be discussed.


Assuntos
COVID-19 , Saúde Sexual , Adulto , COVID-19/epidemiologia , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Luxemburgo/epidemiologia , Masculino , Orgasmo , Pandemias , Saúde Reprodutiva , Estudos Retrospectivos , Comportamento Sexual
9.
Appl Psychophysiol Biofeedback ; 47(3): 199-212, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35641719

RESUMO

Models of social anxiety disorder (SAD) stress the relevance of physiological arousal. So far, limited research has been conducted in children with SAD in experimental stress designs. Thus, examining autonomic arousal, children with and without SAD completed a standardized social stressor (Trier Social Stress Test for Children-C; TSST-C). Pre-existing differences to healthy controls (HC) were expected to decrease after receiving cognitive behavior therapy (CBT). Children with SAD (n = 64) and HC children (n = 55) completed a TSST-C. Children with SAD participated in a second TSST-C after either cognitive-behavioral treatment or a waitlist-control period (WLC). As expected, children with SAD showed blunted heart rate reactivity compared to HC children. Further, children with SAD had elevated levels of tonic sympathetic arousal as indexed by skin conductance level compared to HC. Children with SAD showed lower parasympathetic arousal during the baseline compared to HC. Children receiving treatment did not differ from children in the WLC condition in a repeated social stress test. Psychophysiological differences between children with SAD and HC children could be confirmed as indicated by previous research. The lack of physiological effects of the intervention as an experimental manipulation might be related to slower changes in physiology compared to e.g. cognition.


Assuntos
Terapia Cognitivo-Comportamental , Fobia Social , Ansiedade/psicologia , Nível de Alerta/fisiologia , Sistema Nervoso Autônomo , Criança , Humanos , Fobia Social/terapia , Projetos de Pesquisa
10.
Health Qual Life Outcomes ; 19(1): 183, 2021 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-34294101

RESUMO

BACKGROUND: High prevalence rates in diabetes-related distress have been observed in several studies; however, in the region of Sub-Saharan Africa evidence is lacking as is, for example, the case for Rwanda, where diabetes prevalence is expected to increase over the next decade. The aim of this study is to report on the translation and cultural adaption of the problem areas in diabetes (PAID) questionnaire into Kinyarwanda and its psychometric properties. METHODS: The questionnaire was translated following a standard procedure. Interviews were conducted with 29 participants before producing a final version. For the psychometric evaluation, a sample of 266 patients with diabetes mellitus, aged 21-64 years old were examined. Participants either came from a separate cluster-randomised controlled trial or were recruited ad-hoc for this study. The evaluation included testing internal consistency, known groups validity, and construct validity. A series of confirmatory factor analysis were conducted investigating seven previously established factorial structures. An exploratory factor analysis (EFA) was also carried out to examine the structure further. RESULTS: The full scale showed good internal reliability (Cronbach's α = 0.88). A four-factor solution previously tested in Spain with subdimensions of emotional, treatment, food-related and social-support problems demonstrated adequate approximate fit (RMSEA = 0.056; CFI = 0.951; TLI = 0.943). The EFA revealed a four-factor structure; however, two of these factors were not as homogeneous and easily interpretable as those of the Spanish model. CONCLUSIONS: The psychometric properties of the Kinyarwanda version of PAID are acceptable. The questionnaire can be helpful in research and clinical practice in Rwanda, however certain cross-cultural differences should be taken into account.


Assuntos
Diabetes Mellitus/psicologia , Inquéritos e Questionários , Adulto , Comparação Transcultural , Análise Fatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria , Reprodutibilidade dos Testes , Ruanda , Traduções , Adulto Jovem
11.
Int J Eat Disord ; 54(7): 1106-1115, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-32400920

RESUMO

OBJECTIVE: Identifying factors that control food intake is crucial to the understanding and treatment of eating disorders characterized by binge eating. In healthy individuals, stomach distension plays an important role in the development of satiation, but gastric sensations might be overridden in binge eating. The present study investigated the perception of gastric signals (i.e., gastric interoception) and gastric motility in patients experiencing binge-eating episodes, that is, bulimia nervosa (BN) and binge-eating disorder (BED). METHOD: Twenty-nine patients with BN or BED (ED group) and 32 age-, sex-, and BMI-matched healthy controls (HC group) participated in the study. The onset of satiation and stomach fullness were assessed using a novel 2-step water load test (WLT-II). Gastric myoelectrical activity (GMA) was measured by electrogastrography (EGG) before and after ingestion of noncaloric water. RESULTS: Individuals in the ED group drank significantly more water until reporting satiation during the WLT-II. The percentage of normal gastric myoelectrical power was significantly smaller in the ED group compared to HC, and negatively related to the number of objective binge-eating episodes per week in patients with BN or BED. Power in the bradygastria range was greater in ED than in HC participants. DISCUSSION: Patients with EDs have a delayed response to satiation compared to HC participants, together with abnormal GMA. Repeated binge-eating episodes may induce disturbances to gastric motor function.


Assuntos
Transtorno da Compulsão Alimentar , Bulimia Nervosa , Interocepção , Humanos , Saciação , Estômago
12.
Addict Biol ; 26(4): e12996, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-35394691

RESUMO

The unprecedented development and ubiquity of sports betting constitute an emerging public health concern. It is crucial to provide markers that could help to better identify people experiencing sports betting-related harms. The current study investigated whether problem gambling status, sports betting passion, and trait-self-control modulate brain reactivity to sports betting cues. Sixty-five frequent sports bettors (35 "nonproblem bettors" and 30 "problem bettors") were exposed to cues representing real upcoming sport events (with varying levels of winning confidence) that were made available or blocked for betting, during functional magnetic resonance imaging (fMRI) recording. Sports betting passion and trait-self-control were assessed using self-report scales. Sport events nonavailable for betting elicited higher insular and striatal activation in problem bettors, as compared with nonproblem bettors. Within a large cluster encompassing the ventral striatum, hippocampus, and amygdala, lower trait-self-control was associated with increased brain reactivity to sport events with high levels of winning confidence that were nonavailable for betting. No significant effect of sports betting passion was observed. These findings suggest that sports bettors' brain reactivity to gambling unavailability might be a relevant marker of sports betting-related harms, as well as of blunted trait-self-control.


Assuntos
Jogo de Azar , Esportes , Encéfalo/diagnóstico por imagem , Emoções , Jogo de Azar/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética
13.
Dev Psychopathol ; 32(3): 853-863, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-31407649

RESUMO

Early life adversity (ELA) has been associated with inflammation and immunosenescence, as well as hyporeactivity of the HPA axis. Because the immune system and the HPA axis are tightly intertwined around the glucocorticoid receptor (GR), we examined peripheral GR functionality in the EpiPath cohort among participants who either had been exposed to ELA (separation from parents and/or institutionalization followed by adoption; n = 40) or had been reared by their biological parents (n = 72).Expression of the strict GR target genes FKBP5 and GILZ as well as total and 1F and 1H GR transcripts were similar between groups. Furthermore, there were no differences in GR sensitivity, examined by the effects of dexamethasone on IL6 production in LPS-stimulated whole blood. Although we did not find differences in methylation at the GR 1F exon or promoter region, we identified a region of the GR 1H promoter (CpG 1-9) that showed lower methylation levels in ELA.Our results suggest that peripheral GR signaling was unperturbed in our cohort and the observed immune phenotype does not appear to be secondary to an altered GR response to the perturbed HPA axis and glucocorticoid (GC) profile, although we are limited in our measures of GR activity and time points.


Assuntos
Sistema Hipotálamo-Hipofisário , Receptores de Glucocorticoides , Metilação de DNA , Humanos , Sistema Hipotálamo-Hipofisário/metabolismo , Leucócitos/metabolismo , Sistema Hipófise-Suprarrenal/metabolismo , Receptores de Glucocorticoides/genética , Receptores de Glucocorticoides/metabolismo
14.
Int J Mol Sci ; 21(9)2020 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-32365612

RESUMO

The role of twins in research is evolving as we move further into the post-genomic era. With the re-definition of what a gene is, it is becoming clear that biological family members who share a specific genetic variant may well not have a similar risk for future disease. This has somewhat invalidated the prior rationale for twin studies. Case co-twin study designs, however, are slowly emerging as the ideal tool to identify both environmentally induced epigenetic marks and epigenetic disease-associated processes. Here, we propose that twin lives are not as identical as commonly assumed and that the case co-twin study design can be used to investigate the effects of the adult social environment. We present the elements in the (social) environment that are likely to affect the epigenome and measures in which twins may diverge. Using data from the German TwinLife registry, we confirm divergence in both the events that occur and the salience for the individual start as early as age 11. Case co-twin studies allow for the exploitation of these divergences, permitting the investigation of the role of not only the adult social environment, but also the salience of an event or environment for the individual, in determining lifelong health trajectories. In cases like social adversity where it is clearly not possible to perform a randomised-controlled trial, we propose that the case co-twin study design is the most rigorous manner with which to investigate epigenetic mechanisms encoding environmental exposure. The role of the case co-twin design will continue to evolve, as we argue that it will permit causal inference from observational data.


Assuntos
Doenças em Gêmeos/genética , Pesquisa em Genética , Genética Médica , Genômica , Gêmeos/genética , Suscetibilidade a Doenças , Epigênese Genética , Predisposição Genética para Doença , Genética Médica/métodos , Genômica/métodos , Humanos , Meio Social , Gêmeos Dizigóticos/genética , Gêmeos Monozigóticos/genética
15.
J Immunol ; 199(12): 4046-4055, 2017 12 15.
Artigo em Inglês | MEDLINE | ID: mdl-29133294

RESUMO

Early life adversity (ELA) has been associated with an increased risk for diseases in which the immune system plays a critical role. The ELA immune phenotype is characterized by inflammation, impaired cellular immunity, and immunosenescence. However, data on cell-specific immune effects are largely absent. Additionally, stress systems and health behaviors are altered in ELA, which may contribute to the generation of the ELA immune phenotype. The present investigation tested cell-specific immune differences in relationship to the ELA immune phenotype, altered stress parameters, and health behaviors in individuals with ELA (n = 42) and those without a history of ELA (control, n = 73). Relative number and activation status (CD25, CD69, HLA-DR, CD11a, CD11b) of monocytes, NK cells, B cells, T cells, and their main subsets were assessed by flow cytometry. ELA was associated with significantly reduced numbers of CD69+CD8+ T cells (p = 0.022), increased numbers of HLA-DR+ CD4 and HLA-DR+ CD8 T cells (p < 0.001), as well as increased numbers of CD25+CD8+ T cells (p = 0.036). ELA also showed a trend toward higher numbers of CCR4+CXCR3-CCR6+ CD4 T cells. Taken together, our data suggest an elevated state of immune activation in ELA, in which particularly T cells are affected. Although several aspects of the ELA immune phenotype were related to increased activation markers, neither stress nor health-risk behaviors explained the observed group differences. Thus, the state of immune activation in ELA does not seem to be secondary to alterations in the stress system or health-risk behaviors, but rather a primary effect of early life programming on immune cells.


Assuntos
Criança Adotada , Inflamação/etiologia , Acontecimentos que Mudam a Vida , Subpopulações de Linfócitos T/imunologia , Adolescente , Adulto , Estudos de Casos e Controles , Senescência Celular , Criança Institucionalizada , Exercício Físico , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Síndromes de Imunodeficiência/etiologia , Síndromes de Imunodeficiência/imunologia , Imunofenotipagem , Inflamação/imunologia , Interleucina-6/sangue , Luxemburgo , Ativação Linfocitária , Contagem de Linfócitos , Masculino , Obesidade/epidemiologia , Fumar/epidemiologia , Estresse Psicológico/epidemiologia , Estresse Psicológico/imunologia , Homeostase do Telômero/imunologia , Adulto Jovem
16.
Cochrane Database Syst Rev ; (5): CD008646, 2016 May 26.
Artigo em Inglês | MEDLINE | ID: mdl-27228096

RESUMO

BACKGROUND: In a review and meta-analysis conducted in 1993, psychological preparation was found to be beneficial for a range of outcome variables including pain, behavioural recovery, length of stay and negative affect. Since this review, more detailed bibliographic searching has become possible, additional studies testing psychological preparation for surgery have been completed and hospital procedures have changed. The present review examines whether psychological preparation (procedural information, sensory information, cognitive intervention, relaxation, hypnosis and emotion-focused intervention) has impact on the outcomes of postoperative pain, behavioural recovery, length of stay and negative affect. OBJECTIVES: To review the effects of psychological preparation on postoperative outcomes in adults undergoing elective surgery under general anaesthetic. SEARCH METHODS: We searched the Cochrane Register of Controlled Trials (CENTRAL 2014, Issue 5), MEDLINE (OVID SP) (1950 to May 2014), EMBASE (OVID SP) (1982 to May 2014), PsycINFO (OVID SP) (1982 to May 2014), CINAHL (EBESCOhost) (1980 to May 2014), Dissertation Abstracts (to May 2014) and Web of Science (1946 to May 2014). We searched reference lists of relevant studies and contacted authors to identify unpublished studies. We reran the searches in July 2015 and placed the 38 studies of interest in the `awaiting classification' section of this review. SELECTION CRITERIA: We included randomized controlled trials of adult participants (aged 16 or older) undergoing elective surgery under general anaesthesia. We excluded studies focusing on patient groups with clinically diagnosed psychological morbidity. We did not limit the search by language or publication status. We included studies testing a preoperative psychological intervention that included at least one of these seven techniques: procedural information; sensory information; behavioural instruction; cognitive intervention; relaxation techniques; hypnosis; emotion-focused intervention. We included studies that examined any one of our postoperative outcome measures (pain, behavioural recovery, length of stay, negative affect) within one month post-surgery. DATA COLLECTION AND ANALYSIS: One author checked titles and abstracts to exclude obviously irrelevant studies. We obtained full reports of apparently relevant studies; two authors fully screened these. Two authors independently extracted data and resolved discrepancies by discussion.Where possible we used random-effects meta-analyses to combine the results from individual studies. For length of stay we pooled mean differences. For pain and negative affect we used a standardized effect size (the standardized mean difference (SMD), or Hedges' g) to combine data from different outcome measures. If data were not available in a form suitable for meta-analysis we performed a narrative review. MAIN RESULTS: Searches identified 5116 unique papers; we retrieved 827 for full screening. In this review, we included 105 studies from 115 papers, in which 10,302 participants were randomized. Mainly as a result of updating the search in July 2015, 38 papers are awaiting classification. Sixty-one of the 105 studies measured the outcome pain, 14 behavioural recovery, 58 length of stay and 49 negative affect. Participants underwent a wide range of surgical procedures, and a range of psychological components were used in interventions, frequently in combination. In the 105 studies, appropriate data were provided for the meta-analysis of 38 studies measuring the outcome postoperative pain (2713 participants), 36 for length of stay (3313 participants) and 31 for negative affect (2496 participants). We narratively reviewed the remaining studies (including the 14 studies with 1441 participants addressing behavioural recovery). When pooling the results for all types of intervention there was low quality evidence that psychological preparation techniques were associated with lower postoperative pain (SMD -0.20, 95% confidence interval (CI) -0.35 to -0.06), length of stay (mean difference -0.52 days, 95% CI -0.82 to -0.22) and negative affect (SMD -0.35, 95% CI -0.54 to -0.16) compared with controls. Results tended to be similar for all categories of intervention, although there was no evidence that behavioural instruction reduced the outcome pain. However, caution must be exercised when interpreting the results because of heterogeneity in the types of surgery, interventions and outcomes. Narratively reviewed evidence for the outcome behavioural recovery provided very low quality evidence that psychological preparation, in particular behavioural instruction, may have potential to improve behavioural recovery outcomes, but no clear conclusions could be reached.Generally, the evidence suffered from poor reporting, meaning that few studies could be classified as having low risk of bias. Overall,we rated the quality of evidence for each outcome as 'low' because of the high level of heterogeneity in meta-analysed studies and the unclear risk of bias. In addition, for the outcome behavioural recovery, too few studies used robust measures and reported suitable data for meta-analysis, so we rated the quality of evidence as `very low'. AUTHORS' CONCLUSIONS: The evidence suggested that psychological preparation may be beneficial for the outcomes postoperative pain, behavioural recovery, negative affect and length of stay, and is unlikely to be harmful. However, at present, the strength of evidence is insufficient to reach firm conclusions on the role of psychological preparation for surgery. Further analyses are needed to explore the heterogeneity in the data, to identify more specifically when intervention techniques are of benefit. As the current evidence quality is low or very low, there is a need for well-conducted and clearly reported research.


Assuntos
Afeto , Procedimentos Cirúrgicos Eletivos/psicologia , Tempo de Internação/estatística & dados numéricos , Dor Pós-Operatória/prevenção & controle , Educação de Pacientes como Assunto/métodos , Cuidados Pré-Operatórios/psicologia , Adulto , Anestesia Geral , Ansiedade/terapia , Humanos , Cuidados Pré-Operatórios/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto , Terapia de Relaxamento , Sensação , Pensamento , Resultado do Tratamento
18.
Appetite ; 105: 798-807, 2016 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-27426620

RESUMO

Intuitive eating has been described to represent an adaptive eating behaviour that is characterised by eating in response to physiological hunger and satiety cues, rather than situational and emotional stimuli. The Intuitive Eating Scale-2 (IES-2) has been developed to measure such attitudes and behaviours on four subscales: unconditional permission to eat (UPE), eating for physical rather than emotional reasons (EPR), reliance on internal hunger and satiety cues (RHSC), and body-food choice congruence (B-FCC). The present study aimed at validating the psychometric properties of the German translation of the IES-2 in a large German-speaking sample. A second objective was to assess levels of intuitive eating in participants with an eating disorder diagnosis (anorexia nervosa, bulimia nervosa, or binge eating disorder). The proposed factor structure of the IES-2 could be confirmed for the German translation of the questionnaire. The total score and most subscale scores were negatively related to eating disorder symptomatology, problems in appetite and emotional awareness, body dissatisfaction, and self-objectification. Women with eating disorders had significantly lower values on all IES-2 subscale scores and the total score than women without an eating disorder diagnosis. Women with a binge eating disorder (BED) diagnosis had higher scores on the UPE subscale compared to participants with anorexia nervosa (AN) or bulimia nervosa (BN), and those diagnosed with AN had higher scores on the EPR subscale than individuals with BN or BED. We conclude that the German IES-2 constitutes a useful self-report instrument for the assessment of intuitive eating in German-speaking samples. Further studies are warranted to evaluate psychometric properties of the IES-2 in different samples, and to investigate its application in a clinical setting.


Assuntos
Ingestão de Alimentos/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Psicometria , Adolescente , Adulto , Idoso , Índice de Massa Corporal , Comportamento de Escolha , Sinais (Psicologia) , Emoções , Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Feminino , Preferências Alimentares/psicologia , Alemanha , Humanos , Fome , Idioma , Masculino , Pessoa de Meia-Idade , Saciação , Inquéritos e Questionários , Adulto Jovem
19.
Cult Health Sex ; 18(4): 391-404, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26466524

RESUMO

Young people live in an environment that sexualises them, particularly women, along traditional gender roles. This, in parallel with a silence about positive sexuality in policy development, means that sexual double standards prevail in young people's lives. The aim of this study was to explore the discourses young women and men from two European countries, Germany and England, draw on when making sense of sexual relationships and how these are steeped in the local cultural climate and messages. The study used Q methodology and included 65 German and English young people between 16 and 19 years of age. Six accounts emerged: sex as responsible, intimate and shared experience; sex as joint fun; ideal versus reality; sex has to be responsible, consensual and shared; caring relationships offer the perfect context for fulfilling sex; and equality between partners. The importance of cultural context in the availability of specific dominant and alternative discourses is discussed with a focus on how this influences young people's sense-making with regard to sexuality and sexual relationships. Future directions for research are highlighted.


Assuntos
Relações Interpessoais , Comportamento Sexual , Parceiros Sexuais/psicologia , Socialização , Adolescente , Estudos Transversais , Inglaterra , Feminino , Alemanha , Humanos , Masculino , Q-Sort , Adulto Jovem
20.
Eur Child Adolesc Psychiatry ; 25(11): 1267-1269, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27460656

RESUMO

Increasing divorce rates leave more and more children to deal with the separation of their parents. Recent research suggests that children of divorced parents more often experience psychological and physical symptoms than children of non-divorced parents. The processes that mediate the relationship between parental divorce and ill-health, however, are still elusive. This study investigated the mediating role of psychological factors such as resilience and rejection sensitivity on the long-term consequences of parental divorce in young adults. One hundred and ninety-nine participants (mean age 22.3 years) completed an online survey, including measures of mental health, childhood trauma, resilience, and rejection sensitivity. Participants with divorced parents (33 %) reported increased levels of psychological symptoms, childhood trauma, rejection sensitivity, and lower levels of resilience. The association between parental divorce and mental health was fully mediated by resilience, rejection sensitivity, and childhood trauma. The mediation model explained up to 44 % of the total variance in mental health symptoms. Resilience and rejection sensitivity are crucial factors for successful coping with the experience of parental separation. Prevention programs that help to boost children's resilience might help to reduce the long-term effects of parental divorce on their attachment style (e.g., rejection sensitivity), thereby improving their mental health on the long run. Furthermore, the results call for parental awareness and counseling to target and reduce the observed increased level of childhood trauma. Limitations concern the cross-sectional and retrospective design of the study.


Assuntos
Adultos Sobreviventes de Eventos Adversos na Infância/psicologia , Divórcio/psicologia , Pais/psicologia , Distância Psicológica , Trauma Psicológico/psicologia , Resiliência Psicológica , Adulto , Feminino , Humanos , Masculino , Adulto Jovem
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA