Responsividade e dialogia: momentos críticos na educação permanente em saúde / Responsividad y dialogismo: momentos críticos en educación permanente en salud / Responsiveness and dialogism: critical moments in continuing education in health

RESUMO. Este artigo tem como objetivo analisar um processo de Educação Permanente em Saúde (EPS) desenvolvido com profissionais de Centros de Atenção Psicossocial. O estudo foi orientado pela perspectiva construcionista social, que considera a linguagem como forma de ação social e se interessa pelos processos interacionais e dialógicos na produção do conhecimento. Foram realizados sete encontros com um grupo de dez profissionais. As conversas foram gravadas, transcritas e analisadas qualitativamente, a partir da delimitação de momentos críticos. Exploramos a análise de dois momentos críticos, que indicam a ocorrência de transformação de sentidos relacionados à importância do trabalho desenvolvido pelas profissionais e à possibilidade de participação das famílias no cuidado. Foram nomeados como: "'O afeto é transformador": ': construindo a importância do trabalho e dos encontros de EPS, e "'Estamos prescrevendo corresponsabilização": ': transformando o sentido de participação das famílias. Por meio da análise deles, discutimos a centralidade do processo conversacional na configuração das possibilidades dialógicas, com destaque à responsividade como recurso básico de facilitação para promoção da dialogia.

RESUMEN. Este artículo tiene como objetivo analizar un proceso de Educación Permanente en Salud (EPS) desarrollado con profesionales de servicios públicos de salud mental en Brasil. El estudio se guió por la perspectiva construccionista social, que considera el lenguaje como una forma de acción social y se interesa por los procesos interaccionales y dialógicos en la producción del conocimiento. Se celebraron siete reuniones con un grupo de diez profesionales. Las conversaciones fueron grabadas, transcritas y analizadas cualitativamente, desde la definición de momentos críticos. Exploramos el análisis de dos momentos críticos, que indican la aparición de la transformación de significados relacionados con la importancia del trabajo desarrollado por profesionales y la posibilidad de la participación familiar en la atención. Fueron llamados: "'El afecto es transformador": ': construyendo la importancia del trabajo y las reuniones de EPS, y "'Estamos prescribiendo corresponsabilidad": ': transformando el sentido de participación de las famílias. A través de su análisis, discutimos la centralidad del proceso de conversación en la configuración de posibilidades dialógicas, con énfasis en la responsividad como un recurso básico de facilitación para la promoción del dialogismo.

ABSTRACT. This study aims to analyze a process of Continuing Education in Health (CEH) developed with professionals from public mental health care centers in Brazil. The research was guided by social constructionist perspective which considers language as a form of social action and is interested in interactive and dialogical processes involved in knowledge construction. Seven meetings were held with a group of ten professionals. Conversations were recorded, transcribed and analyzed qualitatively by the delimitation of critical moments. We explored the analysis of two critical moments, which indicate the occurrence of transformation of meanings related to the importance of practices developed by professionals and to the possibility of families' participation in care. They were called: "'Affection is transformative": ': building the importance of practice and CEH meetings, and "'We are prescribing co-responsibility": ': transforming the sense of participation of families. Through their analysis, we discuss the centrality of the conversational process in the configuration of dialogical possibilities, with emphasis on responsiveness as a basic facilitating resource to promote dialogue.

Codependencia: una adicción o un patrón de relación inadecuado / Codependency: addiction or inadequate relationship pattern

La codependencia es un problema que afecta a cada vez más personas, siendo esta la que caracteriza frecuentes estados de insatisfacción y sufrimiento personal, donde la persona se encuentra enfocada en atender las necesidades de su pareja y/o de otras personas, sin tomar en cuenta las propias, a partir de una necesidad de que la conducta de otra persona se desarrolle desde las propias expectativas, al tiempo que se vive la imposibilidad de expresarlo de manera clara y asertiva en el día a día. Terapéuticamente esta problemática ha sido y sigue siendo motivo de consulta en contextos de rehabilitación y procesos de recuperación en adicciones, estando representada en la naturaleza de los vínculos que se establecen al interior de una familia o de una pareja. De ahí la importancia del abordaje terapéutico de la red de apoyo del adicto, ya que esta tiende a considerar la adicción como un asunto único de la persona en rehabilitación. Desde hace algo más de 20 años, este tema ha sido motivo de investigación de terapeutas, psicólogos, psiquiatras y consejeros, quienes han propiciado discusiones a la luz de establecer un concepto de codependencia y qué elementos de esta merecen la pena tener en cuenta al momento de establecer líneas o planes de tratamientos para las personas que sufren esta condición

Codependency is a problem that affects more and more people, being this the one that characterizes frequent states of dissatisfaction and personal suffering, where the person is focused on meeting the needs of their partner and / or other people, without taking into account their own, from a need for the behavior of another person to develop from their own expectations, while experiencing the impossibility of expressing it clearly and assertively on a day-to-day basis. Therapeutically, this problem has been and continues to be a reason for consultation in the context of rehabilitation and recovery processes in addictions, being represented in the nature of the bonds that are established within a family or a couple. Hence the importance of the therapeutic approach of the addict's support network, since it tends to consider addiction as a unique issue for the person in rehabilitation. For a little over 20 years, this topic has been the subject of research by therapists, psychologists, psychiatrists and counselors, who have fostered discussions in the light of establishing a concept of codependency and what elements of it are worth taking into account at the time of establish treatment lines or plans for people who suffer from this condition

Gracias por todo: una revisión sobre la gratitud desde la neurobiología a la clínica / Thanks for everything: a review on gratitude from neurobiology to clinic

The World Health Organization (WHO) defines health not only as the absence of disease but as a state of complete physical, mental and social well-being. Gratitude is one of the concepts most commonly associated with well-being from the empirical point of view. Despite of this, we seldom use the concept, possibly due to the lack of dissemination of its scientific bases and possible clinical applications. At an anatomical level, it is related consistently with the medial prefrontal cortex and at molecular level, with the neuropeptide oxytocin. It has been associated with better physical and mental health parameters, both in healthy and sick populations. It is usually measured using scales, being the most used worldwide the Gratitude Questionnaire-6 item (GQ-6). There are exercises that can enhance gratitude and its benefits, such as the gratitude letter and the gratitude journal. Given the current state of knowledge about gratitude, and considering its potential benefits, low risks, ability to complement other treatments, the simple and cost-effectiveness of gratitude interventions, a continuing research on this topic and its practical implementation is warranted.

Dependency, mood instability, and inconsequence traits for discriminating borderline personality disorder / Traços de dependência, instabilidade de humor e inconsequência para discriminação do transtorno da personalidade borderline

Abstract Introduction Borderline personality disorder (BPD) is one of the most widely studied personality disorders (PDs). It recurrently shows traits of emotional lability, anxiety, separation insecurity, depressiveness, impulsiveness, risk exposure, and hostility, mainly affecting the domains of negative affectivity and antagonism. Objectives To investigate the most discriminant dimensions of the Dimensional Clinical Personality Inventory (Inventário Dimensional Clínico da Personalidade 2 [IDCP-2]) to distinguish people diagnosed with BPD from people without this diagnosis. Methods A total of 305 participants were included in this study: psychiatric outpatients diagnosed with BPD (n = 30), psychiatric outpatients diagnosed with other PDs (n = 75), and a community sample (n = 200). BPD traits were assessed using the dependency, mood instability, and inconsequence dimensions of the IDCP-2. Results Analysis of variance (ANOVA) comparisons indicated highest mean measures in the BPD group, and mood instability factors were the most discriminant ones when considering all groups. Applying the multiple regression analysis, we found an adjusted r 2 = 0.50, and hopelessness was the most predictive measure (β = 0.32; t = 6.19; p < 0.001). Conclusions We found discriminatory capacity for factors of all dimensions, although at different levels, and more consistent results to discriminate the BPD group from the community sample.

Resumo Introdução O transtorno da personalidade borderline (TPB) tem sido um dos transtornos de personalidade (TPs) mais estudados. O TPB recorrentemente apresenta traços de instabilidade emocional, ansiedade, insegurança de separação, depressividade, impulsividade, exposição ao risco e hostilidade, afetando principalmente os domínios relacionados à afetividade negativa e ao antagonismo. Objetivos Investigar as dimensões mais discriminativas do Inventário Dimensional Clínico da Personalidade 2 (IDCP-2) para distinguir pessoas diagnosticadas com TPB de pessoas sem esse diagnóstico. Métodos Foram incluídos no estudo 305 participantes: pacientes psiquiátricos com TPB (n = 30), pacientes psiquiátricos com outros TPs (n = 75) e amostra da população geral (n = 200). Os traços de TPB foram avaliados utilizando as dimensões dependência, instabilidade de humor e inconsequência do IDCP-2. Resultados As comparações com análise de variância (ANOVA) indicaram que o grupo TPB apresentou as maiores médias, e os fatores da dimensão instabilidade de humor foram os mais discriminativos ao se comparar os três grupos. Usando a análise de regressão múltipla, foi encontrado um r 2 ajustado = 0,50, e o fator desesperança foi o mais preditivo (β = 0,32; t = 6,19; p < 0,001). Conclusões Foi encontrada capacidade discriminativa para fatores de todas as dimensões, embora em diferentes níveis, e resultados mais consistentes quanto à discriminação foram observados para a distinção entre o grupo com TPB e a população geral.

Effect of combined training on ratings of perceived exertion and sensation of pleasure/displeasure in obese women / O efeito do treinamento combinado sobre a percepção subjetiva do esforço e sensação de prazer/desprazer em mulheres obesas

Abstract Self-selected intensities during walking and resistances training by obese subjects are below recommended guidelines to improve health-related outcomes. From this perspective, there is the possibility of combining both aerobic and resistance training in a single exercise session with the purpose of increasing training volume and optimizing physiological adaptations, while preserving positive affective responses. Until now, no study has assessed ratings of perceived exertion (RPE) and sensations of pleasure/displeasure (SPD) during a combined training session in obese women. The present study aimed to: (1) assess RPE and SPD during a combined training session in obese women; and (2) compare RPE and SPD responses during different resistance training exercises. Twelve sedentary obese women (age: 39.2 ±11.1 years; height: 160.4 ± 5.9 cm; body mass: 87.4 ± 5.8 kg; BMI: 33.6 ±1.2 kg.m-2) performed a combined aerobic and resistance training session. RPE and SPD were recorded during the session. Data were analyzed with One-way repeated measures ANOVA and Bonferroni's post hoc tests. The results revealed that, despite the increase in exercise volume, RPE responses were low and affective responses were positive. There were no significant differences in RPE and SPD values among resistance exercises. Combined aerobic and resistance training can be prescribed during the initial phase of a training program because it produces low perceived exertion and positive affective responses.

Resumo As intensidades autosselecionadas observadas tanto na caminhada como no treinamento resistido em obesos são inferiores as recomendações do ACSM, (2011) as quais, promovem melhora na aptidão cardiorrespiratória e força muscular. A partir disso, surge a hipótese de combinar os exercícios, aeróbio e resistido em uma única sessão com o intuito de aumentar o volume de treinamento otimizando os ajustes fisiológicos tentando preservar baixos níveis de percepção subjetiva do esforço (PSE) e sensações prazerosas (SPD) observadas nessa intensidade. Desta maneira, o presente estudo teve três objetivos: 1) verificar ao longo de uma sessão de treinamento combinado a PSE e a SPD em mulheres obesas; 2) analisar se ocorrerá alteração na PSE e SPD entre os diferentes exercícios resistidos; 3) investigar se existe correlação entre a PSE e SPD. Participaram doze mulheres obesas não praticantes de exercício físico com idades de 39.2±11.1 anos e IMC: 33.6±1.2 kg.m-2 as quais, foram submetidas a uma sessão de treinamento combinado com duração total de 60 minutos. Ao longo da sessão foram reportadas a PSE e SPD. Para analisar os dados foi utilizado uma ANOVA de medidas repetidas seguido de um Post Hock de Bonferroni. Os resultados demonstram que o volume aumentado produziu baixos valores de PSE (~3) e sensações prazerosas (~3) ao longo da sessão. Não foi encontrado diferença significativa da PSE e SPD entre os exercícios resistidos e foi evidenciada uma relação negativa moderada significativa (r= -0.624; p= 0.001 com 95% IC: -0.710; -0.280) entre a PSE e SPD. Sendo assim, o treinamento combinado pode ser prescrito para mulheres obesas, pois, produz baixa percepção de esforço e sensações prazerosas.

The Mood Rhythm Instrument: development and preliminary report

Objective: To describe the initial steps in the development and validation of a new self-reported instrument designed to assess daily rhythms of mood symptoms, namely, the Mood Rhythm Instrument. Methods: A multidisciplinary group of experts took part in systematic meetings to plan the construction of the instrument. Clarity of items, their relevance to evaluation of mood states, and the consistency of findings in relation to the available evidence on the biological basis of mood disorders were investigated. The internal consistency of the questionnaire was evaluated through Cronbach’s alpha. Results: All of the items proposed in a first version were well rated in terms of clarity. The items more frequently rated as “rhythmic” were related to the somatic symptoms of mood. Their peaks in 24 hours were more frequent in the morning. The items associated with affective symptoms of mood were rated as less rhythmic, and their peak in 24 hours occurred more frequently in the afternoon and evening. Males and females behaved more similarly with respect to somatic than behavioral-affective items. The second version of the Mood Rhythm Instrument had a Cronbach’s alpha of 0.73. Conclusion: The proposed Mood Rhythm Instrument may be able to detect individual rhythms of cognitive and behavioral measures associated with mood states. Validation in larger samples and against objective measures of rhythms, such as actigraphy, is warranted.

Anesthesia for EXIT procedure (ex utero intrapartum treatment) in congenital cervical malformation - a challenge to the anesthesiologist / Anestesia para procedimento EXIT (tratamento extraútero intraparto) em malformação congênita cervical - um desafio para o anestesiologista

The ex utero intrapartum treatment (EXIT) procedure consists of partial externalization of the fetus from the uterine cavity during delivery, allowing the maintenance of placental circulation. It is indicated in the presence of congenital malformation when difficulty in fetal airway access is anticipated, allowing it to be ensured by direct laryngoscopy, bronchoscopy, tracheostomy, or surgical intervention. Anesthesia for EXIT procedure has several special features, such as the appropriate uterine relaxation, maintenance of maternal blood pressure, fetal airway establishment, and maintenance of postpartum uterine contraction. The anesthesiologist should be prepared for the anesthetic particularities of this procedure in order to contribute to a favorable outcome for the mother and particularly the fetus.

O procedimento EXIT (tratamento extraútero intraparto) consiste na exteriorização parcial do feto da cavidade uterina durante o parto para permitir a manutenção da circulação fetoplacentária. Está indicado na presença de malformações congênitas em que se antecipa a dificuldade no acesso da via aérea fetal e permite que essa seja assegurada por laringoscopia direta, broncoscopia, traqueostomia ou intervenção cirúrgica. A anestesia para procedimento EXIT apresenta várias particularidades. O relaxamento uterino adequado, a manutenção da pressão arterial materna, o estabelecimento de via aérea fetal e a manutenção da contração uterina pós-parto são alguns exemplos. O anestesiologista deve estar preparado para as particularidades anestésicas desse procedimento, de modo a contribuir para um desfecho favorável para a mãe e particularmente para o feto.

Rumination in bipolar disorder: a systematic review

Objective:To conduct a systematic review of the literature about the symptom of rumination in bipolar disorder (BD).Methods:We searched the MEDLINE (PubMed), ISI Web of Knowledge, PsycINFO, and SciELO databases using the descriptors “rumination” and “bipolar disorder” and no time limits. This strategy yielded 105 references, of which 74 were selected. Inclusion criteria were studies involving patients with BD and the use of at least one validated scale for the assessment of rumination. Review articles were excluded. Seventeen articles were ultimately analyzed and included in the review.Results:Rumination is present in all BD phases, is a stable interepisodic symptom, is associated with symptoms of depression, anxiety, and hypomania, and may occur in response to both positive and negative affect. There is no research on rumination and neurobiological findings in patients with BD.Conclusions:Rumination seems to be independent of mood state, but shows close relationship with it. It is possible that rumination has a negative impact on cognitive and executive functions, particularly inhibitory control. Finally, rumination is an important symptom in both phases of BD, and, therefore, may be a useful target for further exploration as a dimensional domain and a transdiagnostic phenomenon in Research Domain Criteria (RDoC) projects.

Serum interleukin-17 levels are associated with nephritis in childhood-onset systemic lupus erythematosus

OBJECTIVES: To determine the serum interleukin-17 (IL-17) levels in childhood-onset systemic lupus erythematosus patients and to evaluate the association between IL-17 and clinical manifestations, disease activity, laboratory findings and treatment. METHODS: We included 67 consecutive childhood-onset systemic lupus erythematosus patients [61 women; median age 18 years (range 11-31)], 55 first-degree relatives [50 women; median age 40 years (range 29-52)] and 47 age- and sex-matched healthy controls [42 women; median age 19 years (range 6-30)]. The childhood-onset systemic lupus erythematosus patients were assessed for clinical and laboratory systemic lupus erythematosus manifestations, disease activity [Systemic Lupus Erythematosus Disease Activity Index (SLEDAI)], cumulative damage [Systemic Lupus International Collaborating Clinics/American College of Rheumatology (ACR) Damage Index] and current drug use. Serum IL-17 levels were measured by an enzyme-linked immunosorbent assay using commercial kits. RESULTS: The median serum IL-17 level was 36.3 (range 17.36-105.92) pg/mL in childhood-onset systemic lupus erythematosus patients and 29.47 (15.16-62.17) pg/mL in healthy controls (p=0.009). We observed an association between serum IL-17 levels and active nephritis (p=0.01) and migraines (p=0.03). Serum IL-17 levels were not associated with disease activity (p=0.32), cumulative damage (p=0.34), or medication use (p=0.63). CONCLUSION: IL-17 is increased in childhood-onset systemic lupus erythematosus and may play a role in the pathogenesis of neuropsychiatric and renal manifestations. Longitudinal studies are necessary to determine the role of IL-17 in childhood-onset systemic lupus erythematosus. .

The joint structure of major depression, anxiety disorders, and trait negative affect

Background: Dimensional models of psychopathology demonstrate that two correlated factors of fear and distress account for the covariation among depressive and anxiety disorders. Nevertheless, these models tend to exclude variables relevant to psychopathology, such as temperament traits. This study examined the joint structure of DSM-IV-based major depression and anxiety disorders along with trait negative affect in a representative sample of adult individuals residing in the cities of São Paulo and Rio de Janeiro, Brazil. Methods: The sample consisted of 3,728 individuals who were administered sections D (phobic, anxiety and panic disorders) and E (depressive disorders) of the Composite International Diagnostic Interview (CIDI) 2.1 and a validated version of the Positive and Negative Affect Schedule. Data were analyzed using correlational and structural equation modeling. Results: Lifetime prevalence ranged from 2.4% for panic disorder to 23.2% for major depression. Most target variables were moderately correlated. A two-factor model specifying correlated fear and distress factors was retained and confirmed for models including only diagnostic variables and diagnostic variables along with trait negative affect. Conclusions: This study provides support for characterization of internalizing psychopathology and trait negative affect in terms of correlated dimensions of distress and fear. These results have potential implications for psychiatric taxonomy and for understanding the relationship between temperament and psychopathology. .

Relationship between functional fitness, medication costs and mood in elderly people / Relações entre aptidão física funcional, custos com consumo de medicamentos e estados de humor em pessoas idosas

Objective: to verify if functional fitness (FF) is associated with the annual cost of medication consumption and mood states (MSt) in elderly people. Methods: a cross-sectional study with 229 elderly people aged 65 years or more at Santa Casa de Misericórdia de Coimbra, Portugal. Seniors with physical and psychological limitations were excluded, as well as those using medication that limits performance on the tests. The Senior Fitness Test was used to evaluate FF, and the Profile of Mood States - Short Form to evaluate the MSt. The statistical analysis was based on Mancova, with adjustment for age, for comparison between men and women, and adjustment for sex, for comparison between cardiorespiratory fitness quintiles. The association between the variables under study was made with partial correlation, controlling for the effects of age, sex and body mass index. Results: an inverse correlation between cardiorespiratory fitness and the annual cost of medication consumption was found (p < 0.01). FF is also inversely associated with MSt (p < 0.05). Comparisons between cardiorespiratory fitness quintiles showed higher medication consumption costs in seniors with lower aerobic endurance, as well as higher deterioration in MSt (p < 0.01). Conclusion: elderly people with better FF and, specifically, better cardiorespiratory fitness present lower medication consumption costs and a more positive MSt. .

Objetivo: verificar se a aptidão física funcional (AFF) tem associação com o custo anual de consumo de medicamentos e com os estados de humor (EH) em pessoas idosas. Métodos: estudo transversal com 229 idosos de 65 anos de idade ou mais da Instituição Santa Casa de Misericórdia de Coimbra, Portugal. Foram excluídos os idosos com limitações físicas e psicológicas e os que usavam medicamentos que condicionariam a realização dos testes. Foram utilizados a bateria Senior Fitness Test e o questionário Profile of Mood States - Short Form como instrumentos de coleta de dados. A análise estatística recorreu à Mancova, com ajuste de idade, para comparação entre homens e mulheres, e ajustada também para o sexo, para comparação entre quintis da aptidão cardiorrespiratória. A associação entre as variáveis de interesse foi feita com a correlação parcial, corrigindo o efeito da idade, do sexo e do índice de massa corpórea. Resultados: verificou-se a existência de correlação inversa entre a aptidão cardiorrespiratória e o custo anual de consumo de medicamentos (p < 0,01). A AFF associou-se também inversamente com os EH (p < 0,05). As comparações entre os quintis da aptidão cardiorrespiratória revelaram maior consumo de medicamentos em idosos com menor resistência aeróbia, assim como maior deterioração dos EH (p < 0,01). Conclusão: idosos com melhor AFF e, particularmente, melhor aptidão cardiorrespiratória apresentam menores custos com consumo de medicamentos e EH mais positivos. .

Metabolic syndrome prevalence in different affective temperament profiles in bipolar-I disorder

Objective: Temperament originates in the brain structure, and individual differences are attributable to neural and physiological function differences. It has been suggested that temperament is associated with metabolic syndrome (MetS) markers, which may be partly mediated by lifestyle and socioeconomic status. Therefore, we aim to compare MetS prevalence between different affective temperamental profiles for each season in bipolar patients. Methods: Twenty-six bipolar type-I patients of a specialized outpatient mood disorder unit were evaluated for MetS according to new definition proposed by the International Diabetes Federation in the four seasons of a year. Temperament was assessed using the Temperament Evaluation of Memphis, Pisa, Paris and San Diego - autoquestionnaire version (TEMPS-A). Results: The proportions of MetS were 19.2, 23.1, 34.6, and 38.5% in the summer, fall, spring, and winter, respectively. Only depressive temperament scores were higher (p = 0.002) during the winter in patients with MetS. Conclusion: These data suggest that depressive temperament profiles may predispose an individual to the development of MetS in the winter. .

Afectividad y conciencia: la experiencia subjetiva de los valores biológicos / Affectivity and consciousness: subjective experience of biological values

El objetivo del presente escrito es proponer un modelo teórico desde la neurociencia afectiva para abordar el problema del origen y función de experiencia consciente, para ello se parte de una pequeña discusión acerca del problema epistemológico, ontológico y metodológico que implica construir una explicación de la subjetividad, entendida esta como el atributo central y básico de la consciencia. Se continúa con la presentación de algunos de los fundamentos de la neurociencia afectiva, en especial se explora la propuesta de Jaak Panksepp, desde este punto de vista, la neurociencia afectiva resulta ser un marco conceptual relevante y actualizado para el abordaje de la naturaleza de la experiencia consciente. En este modelo se resalta el papel primordial, básico y biológico de los procesos afectivos, los cuales permiten una autoorganización de los parámetros neurodinámicos, a partir de la cual van emergiendo nuevos patrones de actividad orgánica que dan lugar a los diferentes tipos de subjetividades, estas experiencias subjetiva le permiten al organismo sentir los valores biológicos de su actuar en relación con las exigencias medioambientales. En el último apartado, se presentan algunas consideraciones, se discute sobre el uso desafortunado del concepto de inconsciente, el aporte a problemas de la bioética, y las implicaciones que esta aproximación podría tener para la sociedad en general y para la psicología en particular.

The paper aims is to propose a theoretical model from affective neuroscience to treat the problem of roots and functions of the conscious experience, the paper begins with a short discussion about the epistemological, ontological and methodological problem that implies to build a subjectivity explanation, understood this as the core and basic characteristic of the consciousness. It is continued with the presentation of some affective neuroscience principles, in especial is explored the Jaak Panksepp approach, from this point of view, the affective neuroscience result to be a relevant and updated conceptual framework to treat with the nature of conscious experience. The paper remarks the primordial, basic and biologic role of the affective process, which lets the autoorganization of the neurodynamics parameters, from which goes emerging new patrons of organic activity that result in the different subjectivities feelings, this subjective experiences lets to organism fell the biological values of its action in relation with the environmental challenges. In the last part, are presented some considerations, is discussed about the fortuneless use of unconsciousness concept, the contribution to bioethical problems, and the implications of this approximation on the society in general and the psychology in particular.

Procesamiento emocional en la vejez / Emotional processing in old age

Se cita la etimología de la palabra emoción, la evolución histórica de las diferentes teorías de esta y se profundiza en la Teoría de las emociones de A. Damasio, quien clasifica las emociones como: de fondo, primarias y secundarias, describe el procesamiento emocional, diferencia y define emoción de sentimiento. El planteo es ¿procesan igual las emociones los adultos mayores que los jóvenes?, si fuera así, ¿qué beneficios les traería? Se revisaron trabajos neurobiológicos que muestran un mejor procesamiento de las emociones positivas que de las negativas en la vejez sana a través de estudios con RMCf (Resonancia Magnética de Cerebro funcional). Se cita la Teoría de la selectividad socioemocional. En 1993, L. Carstensen postula que con el envejecimiento se produce un cambio motivacional por el cual las personas jerarquizan las metas, su significado y la optimizacion de su experiencia. Frente a eventos vitales negativos (enfermedades, pérdidas afectivas, etc. las personas mayores siguen manteniendo niveles similares o superiores de bienestar subjetivo es la Paradoja del bienestar en la vejez. Se analizan trabajos sobre emociones y enfermedad de Alzheimer.

The etymology of the word "emotion" is explained as well as its evolution throughout the years. Antonio Damasio's classification of backgrounds, primary and secondary emotions are described along with its differences in moaning with the word "feeling". Two differences in emotional Procedure between older and young adults are mentions. RMCf was shown a better positive emotional processing in old age. From Social Theories, Selectivity, Hierarchical organization of goals, paradox in the elderly, emotional balance, and subjective dimensions and shown. The relationship between these change and life quality during normal and pathological aging as well as Alzheimer's disease is also mentions.

International affective picture system (IAPS) in Chile: a cross-cultural adaptation and validation study / El sistema internacional de imágenes afectivas (International Affective Picture System-IAPS) en Chile: estudio de adaptación y validación transcultural

The International Affective Picture System (IAPS) (Lang, Ohman, & Vaitl, 1988) is a standardized set of photographs to induce emotions in the context of experimental investigations. The aim of this study was determine the psychometric behavior of the IAPS for the preparation of standards in the Chilean population and the subsequent validation of the instrument for its use in Chile. 208 university students participated (40 percent men) and had an affective experience induced using the presentation of visual stimuli extracted from sets 7 and 14 of the IAPS. In order to evaluate valence, arousal and dominance, the self-assessment manikin (SAM) was used, made up of pictographic scales for each dimension and a scale of continuous variation of emotional reactions. The IAPS showed psychometric behavior comparable to the original, with the same boomerang-shaped distribution of scores being found in the valence/arousal relationship. The IAPS is a reliable tool for inducing emotions in studies related to affectivity.

El Sistema Internacional de Imágenes Afectivas (International Affective Picture System-IAPS) (Lang, Ohman, & Vaitl, 1988) es un conjunto estandarizado de fotografías para la inducción de emociones en el contexto de investigaciones experimentales. El objetivo de este estudio fue conocer el comportamiento psicométrico del IAPS para la confección de normas en la población chilena y la validación consiguiente del instrumento para su uso en Chile. Participaron 208 estudiantes universitarios (40 por ciento hombres) a quienes se les indujo una experiencia afectiva mediante la presentación de estímulos visuales extraídos del set 1 y 14 del IAPS. Para evaluar valencia, arousal y dominancia, se utilizo el maniquí de auto-evaluación o SAM (Self - Assessment Manikin), compuesto por escalas pictográficas para cada dimensión y una escala de variación continua de reacciones emocionales. El IAPS muestran un comportamiento psicométrico comparable al original, encontrándose la dispersión de puntajes de boomerang en la relación Valencia/Arousal. El IAPS es una herramienta confiable para la inducción de emociones en estudios ligados a la afectividad.

The paradox of age: an analysis of responses by aging Brazilians to International Affective Picture System (IAPS) / Paradoxo etário: uma análise feita por idosos brasileiros sobre o International Affective Picture System(IAPS)

OBJECTIVE: To explore the possible differences in subjective analysis of the emotional stimuli from the International Affective Picture System between elderly and young samples. METHOD: 187 elderly subjects ranked the International Affective Picture System images according to the directions from the Manual of Affective Ratings. Their scores were compared to those obtained from International Affective Picture System studies with young people. RESULT: There is an age-related difference in arousal and valence in the International Affective Picture System rating. The correlation between affective valence and arousal is strong, and negative for the elderly. The expected versus the observed frequency of International Affective Picture System images between elderly and young samples show a statistical difference. CONCLUSION: This study shows an inter-age statistical dichotomy in how elderly and young people subjectively evaluate International Affective Picture System images.

OBJETIVO: Explorar as possíveis diferenças nas avaliações subjetivas dos estímulos emocionais do International Affective Picture System entre idosos e jovens. MÉTODO: 187 indivíduos idosos avaliaram as imagens do International Affective Picture System de acordo com o Manual de Aplicação do Teste. Os escores obtidos pelos idosos foram então comparados com os escores obtidos da normatização do International Affective Picture System para jovens. RESULTADOS: Há diferença nos níveis de alerta e valência afetiva entre idosos e jovens. Há uma forte e negativa correlação entre valência afetiva e nível de alerta na amostra estudada. As frequências esperadas versus observadas das imagens do International Affective Picture System entre idosos e jovens mostram diferenças estatísticas. CONCLUSÃO: Este estudo mostra uma diferença interetária na avaliação de imagens do International Affective Picture System.

Effects of Music Therapy on Mood in Stroke Patients

PURPOSE: To investigate the effects of music therapy on depressive mood and anxiety in post-stroke patients and evaluate satisfaction levels of patients and caregivers. MATERIALS AND METHODS: Eighteen post-stroke patients, within six months of onset and mini mental status examination score of over 20, participated in this study. Patients were divided into music and control groups. The experimental group participated in the music therapy program for four weeks. Psychological status was evaluated with the Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) before and after music therapy. Satisfaction with music therapy was evaluated by a questionnaire. RESULTS: BAI and BDI scores showed a greater decrease in the music group than the control group after music therapy, but only the decrease of BDI scores were statistically significant (p=0.048). Music therapy satisfaction in patients and caregivers was affirmative. CONCLUSION: Music therapy has a positive effect on mood in post-stroke patients and may be beneficial for mood improvement with stroke. These results are encouraging, but further studies are needed in this field.

Negative addiction to exercise: are there differences between genders?

INTRODUCTION: Regular physical exercise has numerous benefits. However, there is a subset of the exercising population who may develop a compulsion to exercise excessively and who may, as a consequence, display physiological and psychological changes that have a direct influence on their quality of life. OBJECTIVE: Our objective was to determine if there are differences between male and female athletes' scores on measures of negative addiction symptoms, quality of life, mood and sleep. METHODS: 144 female and 156 male athletes participated in this study by answering the following questionnaires: Negative Addiction Scale, Beck Depression Inventory, Trait Anxiety Inventory, Profile of Mood States, SF-36 Quality of Life, Pittsburgh Sleep Quality and Epworth Sleepiness Scale. RESULTS: Higher dedication to training sessions in the male group, and members of the female group with symptoms of negative addiction to exercise showed a lower score on vigor observed by the Profile of Mood States compared to the males in both situations. We also observed depression symptoms in both members of groups who had negative addiction symptoms when compared with their peers without symptoms, and these figures were even higher in females compared with the male group in the same situation. CONCLUSION: No differences were seen in the development of negative addiction exercise symptoms in males and females and there were no changes in the quality of life and mood of these athletes. Further studies of eating disorders associated with changes in body image perception could contribute to a better understanding of negative addiction to exercise.