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1.
J Psychopathol Clin Sci ; 133(1): 76-89, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38059936

RESUMEN

Dissociative symptoms, such as depersonalization and derealization, are experienced by about half of individuals with posttraumatic stress disorder (PTSD). Theoretical models propose that acute dissociation is accompanied by specific behavioral, physiological, and experiential alterations and contributes to unfavorable PTSD symptom course. Yet, empirical evidence is scarce. Here, we explored associations between dissociative and behavioral, physiological, and experiential threat responses as well as effects of dissociative responding on PTSD symptom course. Individuals with PTSD (N = 71) participated in a preregistered script-driven imagery study including exposure to standardized, detail-enriched trauma, and neutral scripts. Stabilometry, eye-tracking, facial electromyography, autonomic psychophysiology, and self-report data were collected. Moreover, PTSD symptoms were assessed before and 3 months after testing. Analyses did not link acute dissociation to bodily and facial immobility or staring in response to trauma scripts. However, dissociation displayed an inverted U-shaped relationship with heart rate and was linked to higher nonspecific skin conductance fluctuation and higher high-frequency heart rate variability in response to trauma scripts. Moreover, acute dissociation was linked to higher self-reported negative affect responses to trauma scripts and displayed a U-shaped relationship with unfavorable PTSD symptom course. While results did not confirm hypothesized behavioral markers of dissociation, they do support defense-cascade model assumptions of an inverted U-shaped relationship between dissociation and psychophysiological arousal resulting from a progression of parasympathetic versus sympathetic dominance with increasing dissociation. On an experiential level, results did not confirm posttraumatic dissociation-induced emotional numbing, questioning theoretical notions. The observed nonlinear associations may help explain the heterogeneity of prior findings and might inform an updated conceptualization of posttraumatic dissociation. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Asunto(s)
Trastornos por Estrés Postraumático , Humanos , Trastornos por Estrés Postraumático/diagnóstico , Trastornos por Estrés Postraumático/psicología , Emociones , Trastornos Disociativos/diagnóstico , Trastornos Disociativos/psicología , Sistema Nervioso Autónomo , Autoinforme
2.
Span J Psychiatry Ment Health ; 16(2): 102-108, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-33359120

RESUMEN

INTRODUCTION: Dissociative symptoms are a type of phenomenon which is present in a wide variety of psychopathological disorders. It is therefore necessary to develop scales that measure this type of experience for therapy and research. Starting out from the bipartite model of dissociation, this study intended to adapt and validate the Detachment and Compartmentalization Inventory (DCI) in Spanish. MATERIAL AND METHODS: For this, 308 participants (268 from the community population and 40 with psychiatric pathology) completed the DCI, the Dissociative Experiences Scale (DES-II), the Somatoform Dissociation Questionnaire (SDQ20) and the Mindfulness Attention Awareness Scale (MAAS). RESULTS: The results showed that the Spanish version has a two-factor structure similar to the original version and was invariant across participants. The reliability of DCI scores was adequate and acquired evidence of validity related to other instruments. CONCLUSIONS: It is concluded that the DCI is a valid scale for detecting detachment and compartmentalization dissociative experiences, both in the clinic and research.


Asunto(s)
Trastornos Disociativos , Atención Plena , Humanos , Reproducibilidad de los Resultados , Trastornos Disociativos/diagnóstico , Encuestas y Cuestionarios , Instituciones de Atención Ambulatoria
3.
Int J Soc Psychiatry ; 68(7): 1507-1515, 2022 11.
Artículo en Inglés | MEDLINE | ID: mdl-34387515

RESUMEN

Dissociative/conversion disorders affect almost 31% of children and adolescents in a clinical setting. These children experience significant impairments in their academics, and daily functioning, with high chances of developing other psychiatric comorbidities such as anxiety and depression. However, there are no studies that explore the experiences of suffering from dissociative/conversion disorders from perspective of the sufferer. Therefore, the paper has aimed at exploring the subjective experiences of dissociative and conversion disorders among adolescents in the Indian context by examining their understanding about the illness and the reason they ascribe to the cause of their illness. The study used a qualitative semi-structured interview to understand their illness. In total, 10 adolescents of age group between 12 and 16 years participated. Eight out of the 10 participants were female and the mean age was 12 years. All of them were in-patients in the department of Child and Adolescent Psychiatry, NIMHANS, which is the tertiary mental health care Institute India and pioneer Institute of mental health in Asia. All participants have had at least one or more consultation history either with a traditional healer or/and physician. Thematic analysis identified vital themes such as (1) Adolescents' attributing factors of the illness, (2) Cognitive and emotional appraisal of stressful situation/s, (3) Adolescents' appraisal of different explanatory model, (4) Living with the Impact of the illness. This analysis about dissociative/conversion disorders from adolescents' perspective has a major contribution in enhancing the clinical knowledge and practice in planning and managing children/adolescents diagnosed with dissociative/conversion disorders.


Asunto(s)
Trastornos de Conversión , Trastornos Disociativos , Adolescente , Psiquiatría del Adolescente , Trastornos de Ansiedad , Niño , Comorbilidad , Trastornos de Conversión/diagnóstico , Trastornos de Conversión/epidemiología , Trastornos Disociativos/diagnóstico , Trastornos Disociativos/epidemiología , Femenino , Humanos , Masculino
4.
Cogn Neuropsychiatry ; 25(3): 179-189, 2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-31955650

RESUMEN

Introduction: Predictive coding models propose that high hypnotic suggestibility confers a predisposition to hallucinate due to an elevated propensity to weight perceptual beliefs (priors) over sensory evidence. Multiple lines of research corroborate this prediction and demonstrate a link between hypnotic suggestibility and proneness to anomalous perceptual states. However, such effects might be moderated by dissociative tendencies, which seem to account for heterogeneity in high hypnotic suggestibility. We tested the prediction that the prevalence of anomalous experiences would be greater among highly suggestible individuals who are also highly dissociative.Methods: We compared high and low dissociative highly suggestible participants and low suggestible controls on multiple psychometric measures of anomalous experiences.Results: High dissociative highly suggestible participants reliably reported greater anomalous experiences than low dissociative highly suggestible participants and low suggestible controls, who did not significantly differ from each other.Conclusions: These results suggest a greater predisposition to experience anomalous perceptual states among high dissociative highly suggestible individuals.


Asunto(s)
Trastornos Disociativos/diagnóstico , Trastornos Disociativos/psicología , Psicometría/métodos , Sugestión , Adulto , Cognición/fisiología , Trastornos Disociativos/epidemiología , Femenino , Humanos , Masculino , Prevalencia , Adulto Joven
5.
Cogn Neuropsychiatry ; 24(3): 191-207, 2019 05.
Artículo en Inglés | MEDLINE | ID: mdl-30987544

RESUMEN

INTRODUCTION: Hypnotic suggestibility is elevated in the dissociative disorders but the relationship between dissociative tendencies and suggestibility in the general population seems to be constrained by additional factors. The diathesis-stress (DS) model stipulates that suggestibility interacts with trauma exposure to augment the propensity for dissociative states whereas the dual pathway to suggestibility (DPS) model proposes two developmental routes involving either dissociation preceded by trauma, or a healthy cognitive profile characterised by superior imagination. METHODS: This study sought to discriminate between these partially competing accounts and further considered the moderating role of anxious attachment. 209 participants completed psychometric measures of dissociative tendencies, trauma, and attachment, and a behavioural measure of suggestibility. RESULTS: In support of the DS model, trauma moderated the relationship between suggestibility and dissociation and, as predicted by the DPS model, dissociation moderated the relationship between trauma and suggestibility. Anxious attachment additionally moderated both effects. Model comparisons indicated that the DS model consistently provided a superior fit to the data. Further analyses showed that secure attachment independently predicted suggestibility, thereby supporting the non-dissociative pathway in the DPS model. CONCLUSIONS: These results suggest that high suggestibility confers vulnerability to dissociative states in individuals exposed to trauma and displaying an anxious attachment style.


Asunto(s)
Ansiedad/psicología , Trastornos Disociativos/psicología , Trauma Psicológico/psicología , Sugestión , Adolescente , Adulto , Ansiedad/diagnóstico , Trastornos Disociativos/diagnóstico , Femenino , Humanos , Imaginación/fisiología , Masculino , Persona de Mediana Edad , Trauma Psicológico/diagnóstico , Autoinforme , Adulto Joven
6.
Psychiatry Res ; 233(3): 339-51, 2015 Sep 30.
Artículo en Inglés | MEDLINE | ID: mdl-26254542

RESUMEN

Evidence is heterogeneous regarding whether patients with borderline personality disorder (BPD) display disturbed emotional inhibition in the emotional Stroop task. Previous findings suggest that state dissociation may influence cognitive inhibition of task-irrelevant material, particularly with negative content. Our aim was to examine performance in an emotional Stroop task including negative, neutral, and positive words in BPD patients and healthy controls during functional magnetic resonance imaging. In advance, half of the BPD patients underwent a dissociation induction using script-driven imagery. BPD patients without dissociation induction showed behavioural performance comparable to that of healthy controls but displayed stronger neural responses, especially to positive stimuli, in the superior temporal gyrus, dorsomedial prefrontal cortex, and anterior cingulate cortex. BPD patients with dissociation induction showed overall slower and less accurate responses as well as increased reaction times for negative versus neutral words compared with BPD patients without dissociation induction. Moreover, they showed comparatively decreased neuronal activity in the fusiform gyrus and parietal cortices independent of valence, but elevated activity in the left inferior frontal gyrus in response to negative versus neutral words. In conclusion, experimentally induced dissociation in BPD was associated with inefficient cognitive inhibition, particularly of negative stimuli, in the emotional Stroop task.


Asunto(s)
Trastorno de Personalidad Limítrofe/metabolismo , Trastornos del Conocimiento/metabolismo , Trastornos Disociativos/metabolismo , Emociones , Lóbulo Frontal/metabolismo , Inhibición Psicológica , Adulto , Trastorno de Personalidad Limítrofe/diagnóstico , Trastorno de Personalidad Limítrofe/psicología , Trastornos del Conocimiento/diagnóstico , Trastornos del Conocimiento/psicología , Trastornos Disociativos/diagnóstico , Trastornos Disociativos/psicología , Emociones/fisiología , Femenino , Lóbulo Frontal/patología , Giro del Cíngulo/metabolismo , Giro del Cíngulo/patología , Humanos , Imagen por Resonancia Magnética/métodos , Masculino , Red Nerviosa/metabolismo , Red Nerviosa/patología , Tiempo de Reacción/fisiología , Adulto Joven
7.
Int J Clin Exp Hypn ; 62(2): 231-50, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24568329

RESUMEN

The author developed a new scale aimed at measuring beliefs about "hypnotic states" and investigated the influence of such beliefs and attitudes on hypnotic responses in a large sample of Japanese undergraduate students. Exploratory factor analysis of this new questionnaire examining beliefs about hypnotic states yielded four factors: Dissociative or Depersonalized Experience, Loss of Self-Control, Therapeutic Expectation, and Arousing Extraordinary Ability. The results of structural equation modeling showed that Therapeutic Expectation and Arousing Extraordinary Ability influenced hypnotizability through attitudes toward hypnosis, while also directly affecting subjective experiences without mediating attitudes. Present findings suggest that it is more effective to enhance therapeutic expectations than to correct misconceptions about hypnotic states in modification of patients' beliefs before initiating treatment.


Asunto(s)
Actitud Frente a la Salud , Cultura , Hipnosis , Modelos Psicológicos , Aptitud , Despersonalización/diagnóstico , Despersonalización/psicología , Trastornos Disociativos/diagnóstico , Trastornos Disociativos/psicología , Femenino , Humanos , Japón , Masculino , Psicometría/estadística & datos numéricos , Reproducibilidad de los Resultados , Estudiantes/psicología , Sugestión , Encuestas y Cuestionarios , Adulto Joven
8.
J Trauma Dissociation ; 15(1): 35-51, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24377971

RESUMEN

The purpose of this study was to examine the relationship between childhood traumas, mindfulness, and dissociation (more specifically, absorption and depersonalization) in healthy subjects with and without hallucination proneness. A sample of 318 subjects was given the Launay-Slade Hallucination Scale-Revised (R. P. Bentall & P. Slade, 1985). From this sample, 2 groups were formed: one with high and the other with low hallucination proneness. Furthermore, all participants were given the Tellegen Absorption Scale (A. Tellegen & G. Atkinson, 1974), the Cambridge Depersonalization Scale (M. Sierra & G. E. Berrios, 2000), the Southampton Mindfulness Questionnaire (P. D. J. Chadwick et al., 2008), and the Trauma Questionnaire (J. R. E. Davidson, D. Hughes, & D. G. Blazer, 1990). The results showed that in the group with high hallucination proneness, there were significantly more subjects with traumatic experiences than in the group with low predisposition, although no significant difference in the mean number of traumatic experiences undergone in childhood was found between the 2 groups, although there was a trend toward significance. A correlation analysis showed a significant negative association between mindfulness on the one hand and absorption and depersonalization on the other. A positive relationship was also found between childhood traumas and absorption and depersonalization. Finally, multiple mediation analysis showed that the absorption and depersonalization variables acted as mediators between childhood traumas and hallucination proneness. We discuss the importance of the relationship between the variables studied and hallucination proneness and suggest some approaches for their treatment.


Asunto(s)
Trastornos Disociativos/diagnóstico , Trastornos Disociativos/psicología , Alucinaciones/diagnóstico , Alucinaciones/psicología , Acontecimientos que Cambian la Vida , Atención Plena , Trastornos por Estrés Postraumático/diagnóstico , Trastornos por Estrés Postraumático/psicología , Adolescente , Adulto , Niño , Femenino , Humanos , Masculino , Inventario de Personalidad/estadística & datos numéricos , Psicometría/estadística & datos numéricos , Reproducibilidad de los Resultados , Estadística como Asunto , Encuestas y Cuestionarios , Adulto Joven
9.
J Trauma Dissociation ; 14(2): 224-35, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-23406226

RESUMEN

The aim of this study was to determine whether classical culture-bound syndromes occur among psychiatric inpatients with dissociative disorders in North America. The Dissociative Trance Disorder Interview Schedule, the Dissociative Experiences Scale, and the Dissociative Disorders Interview Schedule were administered to 100 predominantly Caucasian, American, English-speaking trauma program inpatients at a hospital in the United States. The participants reported high rates of childhood physical and/or sexual abuse (87%), dissociative disorders (73%), and membership in the dissociative taxon (78%). They also reported a wide range of possession experiences and exorcism rituals, as well as the classical culture-bound syndromes of latah, bebainan, amok, and pibloktoq. Our data are consistent with the view that possession and classical culture-bound syndromes are predominantly dissociative in nature and not really culture-bound from the perspective of Caucasian, English-speaking America.


Asunto(s)
Comparación Transcultural , Trastornos Disociativos/psicología , Acontecimientos que Cambian la Vida , Trastornos Somatomorfos/psicología , Trastornos por Estrés Postraumático/psicología , Adulto , Conducta Ceremonial , Niño , Maltrato a los Niños/diagnóstico , Maltrato a los Niños/etnología , Maltrato a los Niños/psicología , Abuso Sexual Infantil/diagnóstico , Abuso Sexual Infantil/etnología , Abuso Sexual Infantil/psicología , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Trastornos Disociativos/diagnóstico , Trastornos Disociativos/etnología , Femenino , Humanos , Entrevista Psicológica , Magia/psicología , Masculino , Persona de Mediana Edad , Determinación de la Personalidad/estadística & datos numéricos , Psicometría , Religión y Psicología , Trastornos Somatomorfos/diagnóstico , Trastornos Somatomorfos/etnología , Trastornos por Estrés Postraumático/diagnóstico , Trastornos por Estrés Postraumático/etnología , Síndrome , Población Blanca/psicología , Hechicería/psicología
10.
Psychiatr Hung ; 27(4): 255-62, 2012.
Artículo en Húngaro | MEDLINE | ID: mdl-22987767

RESUMEN

INTRODUCTION: In spite of the fact that acting makes great demands on the personality, there is lack of research dealing with the psychological status of actors. Resulted from their profession actors often experience dissociation, since absorption and changing of their identity is a routine task for them. They are acting on the stage, and they are acting in private. METHOD: 36 theatrical actors completed the DISQ-H version of the Dissociation Questionnaire measuring four subscales: Identity Confusion, Amnesia, Loss of Control and Absorption. In order to understand their experiences deeper, nine actors were interviewed. The sample consisted of 21 men and 15 women and their ages ranged from 23 to 60. Higher ages implied longer career as an actor, thus the youngest subject had been working for 2 years, while the oldest one had been working for 39 years. RESULTS: DISQ-H total score results of the actors were significantly higher compared to the Hungarian standard scores. As we expected, the two non-pathological subscales (Loss of Control and Absorption) showed significant differences compared to the standard scores of the subscales. In the case of Identity Confusion subscale we found no significant differences, however the results indicate that the tendency observed emphasizes the importance of further research of this phenomenon. CONCLUSION: To sum up, dissociative experiences proved to be important elements of acting.


Asunto(s)
Arte , Trastornos Disociativos , Ocupaciones , Desempeño de Papel , Autoimagen , Adulto , Amnesia , Confusión , Trastornos Disociativos/diagnóstico , Trastornos Disociativos/psicología , Femenino , Humanos , Hungría , Control Interno-Externo , Masculino , Persona de Mediana Edad , Narración , Identificación Social , Encuestas y Cuestionarios
11.
J Trauma Dissociation ; 13(4): 387-96, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-22651673

RESUMEN

In this editorial, I briefly review research design issues and the current treatment research for dissociative disorders (DD), discuss the limitations and challenges of conducting treatment studies for patients with DD, and conclude by describing what I see as the first wave and second wave in the field of dissociation. Insurers and federally funded programs are increasingly requiring that treatment be empirically supported in order for treatment to be reimbursed. For example, psychoanalysis will no longer be reimbursed in The Netherlands because of what is perceived as a lack of empirical support. Other countries have also established standards about the treatments that have sufficient empirical support to merit government payment. I believe it is only a matter of time before it is common for patients with DD to be required to seek out empirically supported treatment if they want treatment to be reimbursed. We need to financially support treatment studies in order to develop a more solid empirical basis for the treatment of DD.


Asunto(s)
Trastornos Disociativos/psicología , Trastornos Disociativos/terapia , Investigación Biomédica , Ensayos Clínicos como Asunto , Trastornos Disociativos/diagnóstico , Empirismo , Práctica Clínica Basada en la Evidencia , Estudios de Seguimiento , Humanos , Cobertura del Seguro , Programas Nacionales de Salud , Psicoterapia/economía , Psicoterapia/métodos , Resultado del Tratamiento
12.
An. psicol ; 28(1): 274-280, ene.-abr. 2012. graf, tab
Artículo en Inglés | IBECS | ID: ibc-96431

RESUMEN

La popularidad de los videojuegos ha aumentado considerablemente en los últimos años, convirtiéndose en uno de los mayores productos de ocio siendo los Juegos de Rol Online (MMORPGs) uno de los mayores exponentes; sin embargo, también ha aumentado la sospecha y alarma social de que puedan poseer cierto potencial adictivo enmarcado en el contexto de las adicciones conductuales o que los usuarios puedan desarrollar conductas desadaptativas entorno a esta tecnología. El objetivo del presente estudio evalúa las motivaciones psicológicas para jugar al al World of Warcraft (WoW) y las relaciona con variables sociodemográficas y estilos de juego. Se aplicó un cuestionario para evaluar diferentes motivaciones online a un colectivo de jugadores de WoW. A partir de una muestra final de 253 jugadores españoles (hombres jóvenes) el análisis factorial mostró la presencia de cuatro motivos de juego: socialización, exploración, logro y disociación. Además, los jugadores españoles, preferían el entorno Jugador contar Jugador, un aspecto que parece prevenir las potenciales consecuencias negativas al impedir el juego solitario. Los resultados indican que una de las motivaciones más importantes es la socialización y el estilo de Jugador contra Jugador, lo cual indica en gran parte el uso de este juego se hace de forma psicológicamente adaptativo (AU)


The popularity of playing videogames has increased considerably during the last few decades, and has become one of the most popular leisure activities worldwide. Some of the most popular game types are the Massively Multiplayer Online Role-Playing Games (MMORPGs). However, there has also been increased suspicion and social alarm that these games may possess an addictive potential, similar to other behavioural addictions, and that the user may develop maladaptive behaviours with respect to these games. The purpose of the present study was to assess the psychological motivations of playing World of Warcraft (WoW) and to relate them to sociodemographic variables and gaming styles. A questionnaire for assessing these motivations was developed and applied online to a collective of games. The final sample comprised 253 Spanish WoW players (all young males). Factor analysis of the questionnaire scores showed the presence of four motivations for gaming: socialisation, exploration, achievement, and dissociation. Results indicated that socialisation was one of the main motivational factors and that the gamers preferred the Player-versus-Player environment. Both of these aspects appear to be factors that may prevent potentially negative outcomes by inhibiting solitary play (AU)


Asunto(s)
Humanos , Masculino , Femenino , Síntomas Conductuales/diagnóstico , Síntomas Conductuales/patología , Trastornos Disociativos/diagnóstico , Trastornos Disociativos/patología , Internet , Juego e Implementos de Juego/psicología , Juegos de Video/psicología , Motivación/fisiología , Síntomas Conductuales/etiología , Síntomas Conductuales/psicología , Síntomas Conductuales/terapia , Trastornos Disociativos/etiología , Trastornos Disociativos/prevención & control , Trastornos Disociativos/terapia , Ludoterapia/métodos , Ludoterapia/tendencias
13.
Nebr Symp Motiv ; 58: 193-242, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-22303768

RESUMEN

Individuals are sometimes exposed to information that may endanger their well-being. In such cases, forgetting or misremembering may be adaptive. Childhood abuse perpetrated by a caregiver is an example. Betrayal trauma theory (BTT) proposes that the way in which events are processed and remembered will be related to the degree to which a negative event represents a betrayal by a trusted, needed other. Full awareness of such abuse may only increase the victim's risk by motivating withdrawal or confrontation with the perpetrator, thus risking a relationship vital to the victim's survival. In such situations, minimizing awareness of the betrayal trauma may be adaptive. BTT has implications for the larger memory and trauma field, particularly with regard to forgetting and misremembering events. This chapter reviews conceptual and empirical issues central to the literature on memory for trauma and BTT as well as identifies future research directions derived from BTT.


Asunto(s)
Abuso Sexual Infantil/psicología , Memoria Episódica , Motivación , Represión Psicológica , Trastornos por Estrés Postraumático/psicología , Confianza , Adaptación Psicológica , Factores de Edad , Concienciación , Niño , Abuso Sexual Infantil/diagnóstico , Abuso Sexual Infantil/legislación & jurisprudencia , Preescolar , Trastornos Disociativos/diagnóstico , Trastornos Disociativos/psicología , Relaciones Familiares , Humanos , Recuerdo Mental , Teoría Psicológica , Psicoterapia , Trastornos por Estrés Postraumático/diagnóstico , Sugestión
14.
J Trauma Dissociation ; 13(1): 69-87, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-22211442

RESUMEN

In the present study we surveyed 131 adults seeking psychotherapy and pastoral care in an intensive outpatient psychotherapy program for full-time religious workers. We sought to determine whether dissociation and alexithymia are associated with spiritual well-being. We utilized the Dissociative Experiences Scale-II (DES-II), the Toronto Alexithymia Scale (TAS-20), the Spiritual Well-Being Scale (SWB) as well as the subscales of these instruments in a series of linear multiple regression analyses. DES-II total scores were inversely related to SWB total scores. No association was found between alexithymia and SWB, nor did alexithymia moderate the relationship between dissociation and SWB. Subscale analyses revealed that lower SWB and Existential Well-Being (EWB) were associated with greater nonpathological dissociation (DES-NP), which was unrelated to Religious Well-Being (RWB). By contrast, lower RWB was predicted by higher pathological dissociation (DES-T), which displayed no relationship to SWB or EWB. We conclude with a discussion of some implications of these findings.


Asunto(s)
Síntomas Afectivos/psicología , Trastornos Disociativos/psicología , Espiritualidad , Adulto , Síntomas Afectivos/diagnóstico , Trastornos Disociativos/diagnóstico , Femenino , Humanos , Modelos Lineales , Masculino , Cuidado Pastoral , Escalas de Valoración Psiquiátrica
15.
Stress ; 15(1): 85-96, 2012 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-21790446

RESUMEN

Dehydroepiandrosterone (DHEA) and DHEA sulfate (DHEAS) are anabolic prehormones involved in the synthesis of testosterone. Both have been shown to exert neuroprotective effects during stress. In this randomized, controlled, double-blind field study, we examined the effects of a 12-day DHEA regimen on stress indices in military men undergoing survival training. Forty-eight men were randomized to either a DHEA treatment group or placebo control group. The treatment group received 50 mg of oral DHEA supplementation daily for 5 days during classroom training followed by 7 days of 75 mg during stressful field operations. Control subjects received identical placebo pills. Salivary assays (DHEA[S], testosterone, and cortisol) were conducted at four time points: distal pre-stress (T1), proximal pre-stress (T2), mock-captivity stress (T3), and 24 h recovery (T4). Subjective distress was also assessed at T1, T3, and T4. As expected, DHEA treatment resulted in higher salivary concentrations of DHEA and DHEAS during daily living, mock-captivity stress, and recovery. Similar patterns were observed for salivary markers of anabolic balance: DHEA/cortisol, DHEAS/cortisol, and testosterone/cortisol concentration ratios. Despite notable time effects, no group differences emerged for subjective distress. A brief, low dose DHEA regimen yielded large increases in salivary DHEA(S) concentrations and enhanced anabolic balance throughout sustained military stress. These physiological changes did not extrapolate to subjective distress.


Asunto(s)
Deshidroepiandrosterona/administración & dosificación , Personal Militar , Estrés Psicológico/fisiopatología , Adulto , Suplementos Dietéticos , Trastornos Disociativos/diagnóstico , Método Doble Ciego , Humanos , Hidrocortisona/metabolismo , Masculino , Saliva/química , Estrés Psicológico/tratamiento farmacológico , Sobrevida/psicología , Testosterona/metabolismo
16.
Arch. Clin. Psychiatry (Impr.) ; 39(6): 203-207, 2012. tab
Artículo en Portugués | LILACS | ID: lil-661090

RESUMEN

CONTEXTO: Vivências psicóticas e dissociativas não patológicas são comuns na população geral, especialmente em grupos religiosos. Há poucos estudos sobre o perfil da população não clínica com essas vivências, bem como há dúvidas sobre critérios para o diagnóstico diferencial dessas experiências.OBJETIVOS: Identificar o perfil sociodemográfico e de experiências anômalas (EA) entre pessoas que buscaram ajuda em centros espíritas.MÉTODOS: Foram entrevistadas 115 pessoas que procuraram auxílio em seis centros espíritas de Juiz de Fora/MG por causa de vivências psicóticas e/ou dissociativas. Entrevista semiestruturada investigou dados sociodemográficos, experiências anômalas apresentadas e a presença de critérios propostos para identificar experiências espirituais não patológicas.RESULTADOS: Predomínio de mulheres (70%), de meia-idade, com alta escolaridade, ativas ocupacionalmente e cujas EA começaram na infância (65%) ou adolescência (23%). As EA mais frequentes foram alucinações visuais (63%), auditivas (54%), "percepção espiritual" (53%), "sonhos paranormais" (38%) e experiências fora do corpo (31%). Para a maioria da amostra, essas EA não traziam prejuízos sócio-ocupacionais, eram curtas, episódicas e benéficas; entretanto referiram sofrimento emocional e falta de controle sobre elas.CONCLUSÃO: A alta frequência e diversidade de EA encontradas, bem como suas implicações teóricas, clínicas e de saúde pública, indicam a urgência de maior atenção a esse tópico.


BACKGROUND: Non-pathological psychotic and dissociative experiences are frequent in the general population, particularly in religious groups. There are few studies on the profile of non-clinical populations with these experiences, and on criteria for differential diagnosis.OBJECTIVES: To identify the sociodemographic profile and anomalous experiences (AE) among people who sought help in spiritualist groups.METHODS: We interviewed 115 people who sought assistance in six spiritualist groups in the city of Juiz de Fora/MG due to psychotic and/or dissociative experiences. Semi-structured interviews investigated sociodemographic data, AEs reported and presence of criteria that have been proposed to identify non-pathological spiritual experiences.RESULTS: sample was mostly composed by women (70%), middle age, high educational level, whose AEs started in childhood (65%) and adolescence (23%). The most frequent AEs were visual (63%) and auditory (54%) hallucinations, "spiritual perception" (53%), "paranormal dreams" (38%) and out-of-body experiences (31%). Most of the sample reported that these AEs were not related to socio-occupational impairments, were short, episodic, and beneficial; however, reported emotional distress and lack of control over the experiences.DISCUSSION: The high frequency and diversity of AEs reported, as well as their theoretical, clinical, and public health implications point to the urgency need of more attention to this topic.


Asunto(s)
Acontecimientos que Cambian la Vida , Espiritualidad , Religión y Psicología , Trastornos Disociativos/diagnóstico , Trastornos Psicóticos/diagnóstico
17.
Depress Anxiety ; 28(9): 783-801, 2011 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-21910185

RESUMEN

BACKGROUND: There is considerable debate about the cross-cultural applicability of the posttraumatic stress disorder (PTSD) category as currently specified. Concerns include the possible status of PTSD as a Western culture-bound disorder and the validity of individual items and criteria thresholds. This review examines various types of cross-cultural validity of the PTSD criteria as defined in DSM-IV-TR, and presents options and preliminary recommendations to be considered for DSM-5. METHODS: Searches were conducted of the mental health literature, particularly since 1994, regarding cultural-, race-, or ethnicity-related factors that might limit the universal applicability of the diagnostic criteria of PTSD in DSM-IV-TR and the possible criteria for DSM-5. RESULTS: Substantial evidence of the cross-cultural validity of PTSD was found. However, evidence of cross-cultural variability in certain areas suggests the need for further research: the relative salience of avoidance/numbing symptoms, the role of the interpretation of trauma-caused symptoms in shaping symptomatology, and the prevalence of somatic symptoms. This review also indicates the need to modify certain criteria, such as the items on distressing dreams and on foreshortened future, to increase their cross-cultural applicability. Text additions are suggested to increase the applicability of the manual across cultural contexts: specifying that cultural syndromes-such as those indicated in the DSM-IV-TR Glossary-may be a prominent part of the trauma response in certain cultures, and that those syndromes may influence PTSD symptom salience and comorbidity. CONCLUSIONS: The DSM-IV-TR PTSD category demonstrates various types of validity. Criteria modification and textual clarifications are suggested to further improve its cross-cultural applicability.


Asunto(s)
Comparación Transcultural , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Trastornos por Estrés Postraumático/diagnóstico , Trastornos por Estrés Postraumático/etnología , Nivel de Alerta , Diversidad Cultural , Cultura , Desastres , Trastornos Disociativos/clasificación , Trastornos Disociativos/diagnóstico , Trastornos Disociativos/etnología , Trastornos Disociativos/psicología , Sueños , Humanos , Acontecimientos que Cambian la Vida , Psicometría/estadística & datos numéricos , Reproducibilidad de los Resultados , Valores Sociales , Espiritualidad , Trastornos por Estrés Postraumático/clasificación , Trastornos por Estrés Postraumático/psicología
18.
J Trauma Dissociation ; 11(4): 444-57, 2010.
Artículo en Inglés | MEDLINE | ID: mdl-20938868

RESUMEN

Cognitive avoidance is a common response to sexual assault and reminders of trauma, but there is a paucity of research regarding predictors of automatic and conscious cognitive avoidance in response to trauma-related stimuli. The present study examined whether posttraumatic stress disorder (PTSD) and depression symptoms, physiological responses, and subjective emotional responses predicted peritraumatic dissociation and thought suppression in a sample of 86 female sexual assault victims. Participants provided information about their current symptoms of PTSD and depression as well as their emotional reactions and physiological responses to hearing a personalized sexual assault narrative. PTSD and self-reported anger predicted thought suppression; peritraumatic dissociation was predicted by PTSD symptoms, changes in skin conductance, and self-reported arousal. Heart rate failed to predict either cognitive avoidance response. The results suggest that peritraumatic dissociation and thought suppression are associated with different physiological and emotional responses to trauma cues, perhaps because they tap different memory systems. Limitations and suggestions for future research are discussed.


Asunto(s)
Adaptación Psicológica , Mecanismos de Defensa , Trastornos Disociativos/psicología , Delitos Sexuales/psicología , Trastornos por Estrés Postraumático/psicología , Trastornos Disociativos/diagnóstico , Trastornos Disociativos/fisiopatología , Femenino , Humanos , Imágenes en Psicoterapia , Control Interno-Externo , Escalas de Valoración Psiquiátrica , Trastornos por Estrés Postraumático/diagnóstico , Trastornos por Estrés Postraumático/fisiopatología , Adulto Joven
19.
J Trauma Stress ; 23(4): 421-9, 2010 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-20648564

RESUMEN

This study examined the efficacy of dialectical behavior therapy (DBT) in reducing behaviors commonly used as exclusion criteria for posttraumatic stress disorder (PTSD) treatment. The sample included 51 suicidal and/or self-injuring women with borderline personality disorder (BPD), 26 (51%) of whom met criteria for PTSD. BPD clients with and without PTSD were equally likely to eliminate the exclusionary behaviors during 1 year of DBT. By posttreatment, 50-68% of the BPD clients with PTSD would have been suitable candidates for PTSD treatment. Borderline personality disorder clients with PTSD who began treatment with a greater number of recent suicide attempts and more severe PTSD were significantly less likely to become eligible for PTSD treatment.


Asunto(s)
Trastorno de Personalidad Limítrofe/terapia , Terapia Cognitivo-Conductual/métodos , Meditación/métodos , Conducta Autodestructiva/terapia , Trastornos por Estrés Postraumático/terapia , Intento de Suicidio/prevención & control , Adulto , Trastorno de Personalidad Limítrofe/diagnóstico , Trastorno de Personalidad Limítrofe/psicología , Comorbilidad , Trastornos Disociativos/diagnóstico , Trastornos Disociativos/psicología , Trastornos Disociativos/terapia , Femenino , Estudios de Seguimiento , Humanos , Meditación/psicología , Inventario de Personalidad , Conducta Autodestructiva/diagnóstico , Conducta Autodestructiva/psicología , Trastornos por Estrés Postraumático/diagnóstico , Trastornos por Estrés Postraumático/psicología , Trastornos Relacionados con Sustancias/diagnóstico , Trastornos Relacionados con Sustancias/psicología , Trastornos Relacionados con Sustancias/terapia , Intento de Suicidio/psicología , Resultado del Tratamiento , Adulto Joven
20.
J Trauma Dissociation ; 11(3): 308-21, 2010.
Artículo en Inglés | MEDLINE | ID: mdl-20603765

RESUMEN

A total of 15 clinically referred adolescents who had been sexually or physically abused participated in this pilot study of the use of symboldrama psychotherapy. Symboldrama is a psychotherapeutic method that uses imagery as the major psychotherapeutic tool. All adolescents reported to be suffering from a high level of dissociative symptoms and other symptoms such as anxiety, depression, posttraumatic stress, and anger after their traumas. The objective of the study was to test the hypothesis that symboldrama psychotherapy in addition to psycho-education of the non-offending parent would significantly reduce the reported symptoms. Before treatment, the participants answered three questionnaires: (a) the Life Incidence of Traumatic Events Scale, (b) the Trauma Symptom Checklist for Children, and (c) the Dissociation Questionnaire-Swedish version. After treatment, the participants once again filled out the Trauma Symptom Checklist for Children and the Dissociation Questionnaire-Swedish version. The scores from before and after treatment were compared, and the results showed that the symptoms had been statistically significantly reduced.


Asunto(s)
Trastornos Disociativos/terapia , Imágenes en Psicoterapia/métodos , Trastornos por Estrés Postraumático/terapia , Adolescente , Maltrato a los Niños/psicología , Abuso Sexual Infantil/psicología , Comparación Transcultural , Trastornos Disociativos/diagnóstico , Trastornos Disociativos/psicología , Fantasía , Femenino , Humanos , Hipnosis/métodos , Acontecimientos que Cambian la Vida , Masculino , Proyectos Piloto , Trastornos por Estrés Postraumático/diagnóstico , Trastornos por Estrés Postraumático/psicología , Encuestas y Cuestionarios , Suecia , Traducción
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