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1.
Prax Kinderpsychol Kinderpsychiatr ; 68(4): 253-270, 2019 May.
Artigo em Alemão | MEDLINE | ID: mdl-31044679

RESUMO

"I Would Never have done it Without Coercion …" - Experiences with Coercion and Compulsion in a Family Psychiatric and Psychotherapeutic Day Clinic Coercion and compulsion have negative connotations, especially in psychiatric therapy. But in families, children are always also affected if parents do not want or are not able to make use of therapy. The avoidance of therapy can be a symptom of illness, e. g. separation anxiety. Perceived or real external coercion, e. g. from the youth welfare office or school, can be used to initially open up access to therapy and to allow parents to become capable of acting again. Coercion can initially reduce the ambivalence of the parents. The Family Therapeutic Centre (FaTZ) is a psychiatric and psychotherapeutic day clinic for parents and children. Family constellations are described in which initial coercion was a door-opener to therapy. During courses of treatment therapeutic alliances could be established, hope for positive change emerged, and the outcome was favourable. School avoidance of the child (e. g. due to separation anxiety) in combination with mentally ill parents is an exemplary constellation in which initial coercion can pave the way to therapy for families that otherwise wouldn't get access. Afterwards, voluntary cooperation should be intended, as the overriding objective is to reduce coercive measures to a minimum.


Assuntos
Coerção , Centros Comunitários de Saúde Mental , Terapia Familiar/métodos , Tratamento Psiquiátrico Involuntário/métodos , Transtornos Mentais/terapia , Pais/psicologia , Psicoterapia/métodos , Recusa do Paciente ao Tratamento/psicologia , Adolescente , Ansiedade de Separação , Criança , Filho de Pais com Deficiência/psicologia , Terapia Familiar/ética , Humanos , Tratamento Psiquiátrico Involuntário/ética , Transtornos Mentais/psicologia , Cooperação do Paciente/psicologia , Psicoterapia/ética
2.
Brain Behav Immun ; 77: 141-149, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30590109

RESUMO

Maternal care is crucial for infants and profoundly affects their responses to different kinds of stressors. Here, we examined how maternal separation affects inflammatory gene expression and the corticosterone response to an acute immune challenge induced by lipopolysaccharide (LPS; 40 µg/kg ip) in mouse pups, 8-9 days old. Maternal separation initially attenuated LPS-induced hypothalamic pro-inflammatory gene expression, but later, at 3 h after immune challenge, robustly augmented such gene expression and increased serum corticosterone levels. Providing the pups with a warm and soft object prevented the separation-induced augmented hypothalamic-pituitary-adrenal (HPA)-axis response. It also prevented the potentiated induction of some, but not all, inflammatory genes to a similar extent as did the dam. Our results show that maternal separation potentiates the inflammatory response and the resulting HPA-axis activation, which may have detrimental effects if separation is prolonged or repeated.


Assuntos
Ansiedade de Separação/genética , Inflamação/metabolismo , Privação Materna , Animais , Animais Recém-Nascidos , Ansiedade de Separação/fisiopatologia , Corticosterona/sangue , Corticosterona/metabolismo , Hormônio Liberador da Corticotropina/metabolismo , Feminino , Expressão Gênica/efeitos dos fármacos , Expressão Gênica/genética , Regulação da Expressão Gênica/genética , Sistema Hipotálamo-Hipofisário/metabolismo , Hipotálamo/metabolismo , Inflamação/genética , Lipopolissacarídeos/farmacologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Sistema Hipófise-Suprarrenal/metabolismo
3.
São Paulo; s.n; s. l; 2019. 36 p. tab.
Tese em Português | HomeoIndex | ID: biblio-998231

RESUMO

Através do relato de um caso clínico de transtorno delirante em adolescente, o autor procura demonstrar a eficácia do tratamento homeopático, respeitada a individualidade de cada paciente. Comenta a restrita bibliografia referente ao tema e discute o resultado obtido por tratamento homeopático. Conclui pelo sucesso obtido com a abordagem homeopática, que inclui minuciosa anamnese e individualização. (AU)


Assuntos
Humanos , Feminino , Criança , Ansiedade de Separação , Arsenicum Album/uso terapêutico , Homeopatia
4.
São Paulo; s.n; s. l; 2019. 35 p.
Tese em Português | HomeoIndex | ID: biblio-999551

RESUMO

Transtornos de ansiedade estão entre as psicopatologias mais comuns na juventude, com prevalência estimada variando de 5% a 25% mundialmente, sendo que apenas uma porcentagem pequena recebe tratamento. O Transtorno de Ansiedade de Separação (TAS) é caracterizado como uma reação anormal a uma separação de um ente próximo, sendo que esta que pode ser real ou imaginária, vindo a interferir significativamente nas atividades diárias e no desenvolvimento do indivíduo. Relata se aqui um caso clínico de uma adolescente de 12 anos com quadro de TAS que não conseguia frequentar a escola e que, após tratamento homeopático com Natrum Muriaticum, voltou a sua rotina de aulas normalmente, concluindo se que a homeopatia pode ser usada como terapia complementar aos tratamentos convencionais para o TAS. (AU)


Assuntos
Humanos , Feminino , Criança , Ansiedade de Separação , Natrium Muriaticum/uso terapêutico , Homeopatia
5.
J Affect Disord ; 232: 349-357, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29510352

RESUMO

BACKGROUND: Saffron has antidepressant and anxiolytic effects in adults with mild-to-moderate depression. However, this is the first study examining its mood-related effects in teenagers. METHODS: In this 8-week, randomised, double-blind, placebo-controlled study, youth aged 12-16 years, with mild-to-moderate anxiety or depressive symptoms were given tablets containing placebo or a saffron extract (affron®, 14 mg b.i.d). The youth and parent versions of the Revised Child Anxiety and Depression Scale (RCADS) were used as outcome measures. RESULTS: 80 participants were enrolled and 68 completed the study. Based on youth self-reports, affron® was associated with greater improvements in overall internalising symptoms (p = 0.049), separation anxiety (p = 0.003), social phobia (p = 0.023), and depression (p = 0.016). Total internalising scores decreased by an average of 33% compared to 17% in the placebo group (p = 0.029). However, parental reports of improvements were inconsistent as mean improvements in RCADS scores were greater in the saffron group (40% vs 26%) (p = 0.026), although no other significant differences were identified. affron® was well-tolerated and there was a trend of reduced headaches in participants on the active treatment. LIMITATIONS: The use of a self-report instrument, limited study duration, single treatment dose, and non-clinical sample used in this study limit the generalisability of study findings. CONCLUSION: The administration of a standardised saffron extract (affron®) for 8 weeks improved anxiety and depressive symptoms in youth with mild-to-moderate symptoms, at least from the perspective of the adolescent. However, these beneficial effects were inconsistently corroborated by parents.


Assuntos
Ansiedade/tratamento farmacológico , Crocus , Depressão/tratamento farmacológico , Fitoterapia , Extratos Vegetais/uso terapêutico , Adolescente , Antidepressivos/uso terapêutico , Ansiedade/complicações , Ansiedade de Separação/complicações , Ansiedade de Separação/tratamento farmacológico , Criança , Depressão/complicações , Método Duplo-Cego , Feminino , Humanos , Masculino , Pais/psicologia , Fobia Social/complicações , Fobia Social/tratamento farmacológico , Autorrelato , Resultado do Tratamento
6.
J Spec Oper Med ; 17(3): 109-113, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28910478

RESUMO

Within the Department of Defense over the past decade, a focus on enhancing Warfighter resilience and readiness has increased. For Special Operation Forces (SOF), who bear unique burdens for training and deployment, programs like the Preservation of the Force and Family have been created to help support SOF and their family members in sustaining capabilities and enhancing resilience in the face of prolonged warfare. In this review, we describe the shift in focus from resilience to human performance optimization (HPO) and the benefits of human performance initiatives that include holistic fitness. We then describe strategies for advancing the application of HPO for future initiatives through tailoring and cultural adaptation, as well as advancing methods for measurement. By striving toward specificity and precision performance, SOF human performance programs can impact individual and team capabilities to a greater extent than in the past, as well as maintaining the well-being of SOF and their families across their careers and beyond.


Assuntos
Relações Familiares/psicologia , Saúde Holística , Militares/psicologia , Resiliência Psicológica , Adaptação Psicológica , Ansiedade de Separação , Humanos , Militares/educação , Aptidão Física , Estresse Psicológico , Estados Unidos , Guerra
7.
Psychotherapy (Chic) ; 54(2): 207-219, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28581329

RESUMO

Literature has shown the importance of mentalizing techniques in symptom remission and emotional understanding; however, no study to date has looked at the dynamic relations between mental state talk and affect regulation in the psychotherapy process. From a psychodynamic perspective, the emergence of the child's capacity to regulate affect through the therapist's reflection on the child's mental states is a core aspect of treatment. In an empirical investigation of 2 single cases with separation anxiety disorder, who were treated in long-term psychodynamic play therapy informed with mentalization principles, the effect of therapists' and children's use of mental state talk on children's subsequent capacity to regulate affect in play was assessed. One case was a positive outcome case, whereas the other did not show symptomatic improvement at the end of treatment. Children's and therapists' utterances in the sessions were coded using the Coding System for Mental State Talk in Narratives, and children's play was coded by Children's Play Therapy Instrument, which generated an index of children's "affect regulation." Time-series Granger Causality tests showed that even though both therapists' use of mental state talk significantly predicted children's subsequent affect regulation, the association between child's mental state talk and affect regulation was only supported for the child who showed clinically significant symptom reduction. This study provided preliminary support that mental state talk in psychodynamic psychotherapy facilitates emotion regulation in play. (PsycINFO Database Record


Assuntos
Afeto , Ansiedade de Separação/terapia , Ludoterapia/métodos , Psicoterapia Psicodinâmica/métodos , Teoria da Mente , Ansiedade de Separação/psicologia , Criança , Feminino , Humanos , Resultado do Tratamento , Turquia
8.
Indian J Pharmacol ; 48(4): 430-433, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27756956

RESUMO

AIM: The aim of this study was to analyze the ethyl acetate extract of Nerium indicum (NIE) flower for its antioxidant effect in anxious Sprague-Dawley rats. MATERIALS AND METHODS: Animals were divided into six groups (n = 6) and treated with 200 mg/kg and 400 mg/kg p.o. of NIE for 21 days to assess its preventive and curative effects. Anxiety was induced by isolating animals socially for 21 days. Elevated plus maze (EPM) and light and dark model were used for measuring anxiety in animals. Oxidative stress parameters such as lipid peroxidation (LPO), superoxide dismutase (SOD), catalase (CAT), and reduced glutathione (GSH) in blood and brain tissue homogenate were monitored after 21 days of social isolation in animals. RESULTS: Rats were treated with NIE 200 mg/kg and 400 mg/kg p.o. Both the treatments showed a significant (P < 0.001) increase in the number of open arm entries and time spent in open arm in EPM when compared with the negative control. Results also demonstrated that there was a significant (P < 0.001) increase in the number of lightbox entries and time spent in light box in light and dark model when compared with negative control. There was a significant (P < 0.001) improvement in endogenous anti-oxidants such as SOD, CAT, reduced GSH, and decreased levels of LPO in blood and brain tissue when compared with the negative control. CONCLUSION: The present study suggests the role of NIE in the treatment of anxiety, possibly by modulating the oxidative stress.


Assuntos
Ansiolíticos/uso terapêutico , Antioxidantes/uso terapêutico , Ansiedade de Separação/tratamento farmacológico , Nerium/química , Estresse Oxidativo/efeitos dos fármacos , Extratos Vegetais/uso terapêutico , Animais , Ansiolíticos/isolamento & purificação , Antioxidantes/administração & dosagem , Ansiedade de Separação/metabolismo , Encéfalo/efeitos dos fármacos , Encéfalo/enzimologia , Encéfalo/metabolismo , Modelos Animais de Doenças , Flores/química , Peroxidação de Lipídeos/efeitos dos fármacos , Masculino , Aprendizagem em Labirinto/efeitos dos fármacos , Extratos Vegetais/isolamento & purificação , Ratos Sprague-Dawley
9.
J Vet Sci ; 17(2): 153-8, 2016 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-26645334

RESUMO

Separation anxiety (SA) is a serious behavioral problem in dogs. In this study, salivary cortisol was studied to determine if the owner's odor or voice could reduce SA in dogs. Twenty-eight dogs with SA were divided into three groups: group 1 (control), group 2 (with owner's clothes during the separation period; SP) and group 3 (a recording of the owner's voice was played during SP). The dog's saliva was collected after the owner and their dog were in the experimental room for 5 min (PRE). The dog was then separated from the owner for 20 min and saliva collected four times at intervals of 5 min (SP1-4). Finally, the owner was allowed back into the room to calm the dog for 5 min, after which saliva was collected (POST). Evaluation of salivary cortisol concentrations by ELISA revealed that the ratios of SP1 concentration to PRE or POST concentrations were significantly higher in group 1 than in group 2 or 3. Additionally, the concentrations of SP1-PRE and SP1-POST among groups differed significantly. These findings indicate that the owner's odor or voice may be helpful to managing stress in dogs with SA.


Assuntos
Estimulação Acústica/veterinária , Ansiedade de Separação/prevenção & controle , Doenças do Cão/prevenção & controle , Hidrocortisona/metabolismo , Olfatometria/veterinária , Animais , Biomarcadores/análise , Cães , Feminino , Masculino , Saliva/química , Estresse Fisiológico
10.
BMC Psychiatry ; 15: 237, 2015 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-26446496

RESUMO

BACKGROUND: Studies have found higher levels of insecure attachment in individuals with schizophrenia. Attachment theory provides a framework necessary for conceptualizing the development of interpersonal functioning. Some aspects of the attachment of the believer to his/her spiritual figure are similar to those between the child and his/her parents. The correspondence hypothesis suggests that early child-parent interactions correspond to a person's relation to a spiritual figure. The compensation hypothesis suggests that an insecure attachment history would lead to a strong religiousness/spirituality as a compensation for the lack of felt security. The aim of this study is to explore attachment models in psychosis vs. healthy controls, the relationships between attachment and psychopathology and the attachment processes related to spiritual figures. METHODS: Attachment models were measured in 30 patients with psychosis and 18 controls with the AAI (Adult Attachment interview) in relationship with psychopathology. Beliefs and practices related to a spiritual figure were investigated by qualitative and quantitative analyses. RESULTS: Patients with psychosis showed a high prevalence of insecure avoidant attachment. Spiritual entities functioned like attachment figures in two thirds of cases. Interviews revealed the transformation of internal working models within relation to a spiritual figure: a compensation process was found in 7 of the 32 subjects who showed a significant attachment to a spiritual figure. CONCLUSIONS: Attachment theory allows us to highlight one of the underlying dimensions of spiritual coping in patients with psychosis.


Assuntos
Adaptação Psicológica , Apego ao Objeto , Transtornos Psicóticos/psicologia , Espiritualidade , Adolescente , Adulto , Idoso , Ansiedade de Separação/psicologia , Atitude Frente a Saúde , Cuidadores/psicologia , Estudos de Casos e Controles , Feminino , Humanos , Relações Interpessoais , Masculino , Pessoa de Meia-Idade , Relações Pais-Filho , Psicologia do Esquizofrênico , Estresse Psicológico/psicologia , Adulto Jovem
11.
World J Gastroenterol ; 21(10): 2912-7, 2015 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-25780288

RESUMO

AIM: To investigate the pharmacological effect of TongXie-YaoFang (TXYF) formula and its underlying mechanisms. METHODS: A neonatal maternal separation plus restraint stress (NMS + RS) model of diarrhea-predominant irritable bowel syndrome was developed by subjecting male Sprague-Dawley rats to daily maternal separation from postnatal days 2 to 21 plus restraint stress from days 50 to 59. Rats were randomly divided into two groups (NMS + RS and TXYF formula), and rats with no handling or separation were used as normal controls. Starting from postnatal day 60, rats were administered TXYF formula (9.84 g/100 g body weight) orally twice daily for 14 consecutive days, while the normal and NMS + RS groups were given distilled water. The distinctions of movement index (MI, area under the curve of contraction intensity/min, mg/min) and contraction frequency (CF, number of contractions/min, times/min) of isolated colonic longitudinal smooth muscle strips (CLSMs) in the three groups before and after treatment were observed with a Power Lab system. Different inhibitors were applied, and then 10(-4) mol/L acetylcholine chloride (Ach) was added to CLSMs to induce muscle contraction. RESULTS: Before treatment, the MI of CLSMs in the NMS + RS and TXYF formula groups was similar and both higher than that in the normal group (545.49 ± 73.66 mg/min vs 245.76 ± 34.44 mg/min and 551.09 ± 54.29 mg/min vs 245.76 ± 34.44 mg/min, P < 0.01, respectively). After treatment, the MI in the TXYF formula group was lower than that in the NMS + RS group (261.39 ± 38.59 mg/min vs 533.9 ± 61.63 mg/min, P < 0.01). In the same way, the CF of CLSMs in the NMS + RS and TXYF formula groups was similar and both higher than that in the normal group (3.42 ± 0.25 times/min and 3.31 ± 0.21 vs 1.1 ± 0.17 times/min, P < 0.01) before treatment. After treatment, the CF in the TXYF formula group was lower than that in the NMS + RS group (1.42 ± 0.87 times/min vs 3.11 ± 0.82 times/min, P < 0.01) and similar to that in the normal group (1.42 ± 0.87 times/min vs 1.09 ± 0.13 times/min). When 8-(N,N-diethylamino)octyl 3,4,5-trimethoxybenzoate hydrochloride and 4-aminopyridine were added to the bath and equilibrated for 30 min, respectively, and 10(-4) mol/L Ach was added to CLSMs to induce muscle contraction, MI of the CLSMs in the TXYF formula group was lower than that in the normal group (666 ± 36.32 mg/min vs 747.77 ± 49.47 mg/min, and 686.53 ± 39.17 mg/min vs 750.45 ± 29.39 mg/min; P < 0.01, respectively). The MI of CLSMs in the TXYF formula group was lower than that in the normal group after treatment with nifedipine (689.48 ± 30.84 mg/min vs 741.65 ± 32.41 mg/min; P < 0.05). CONCLUSION: TXYF formula inhibits colon contraction in rats. This may be related to activation of specific potassium channels and inhibition of extracellular calcium internal flow.


Assuntos
Antidiarreicos/farmacologia , Colo/efeitos dos fármacos , Diarreia/tratamento farmacológico , Medicamentos de Ervas Chinesas/farmacologia , Motilidade Gastrointestinal/efeitos dos fármacos , Síndrome do Intestino Irritável/tratamento farmacológico , Contração Muscular/efeitos dos fármacos , Músculo Liso/efeitos dos fármacos , Fatores Etários , Animais , Animais Recém-Nascidos , Ansiedade de Separação/complicações , Canais de Cálcio/efeitos dos fármacos , Canais de Cálcio/metabolismo , Colo/metabolismo , Colo/fisiopatologia , Diarreia/metabolismo , Diarreia/fisiopatologia , Diarreia/psicologia , Modelos Animais de Doenças , Feminino , Imobilização , Síndrome do Intestino Irritável/metabolismo , Síndrome do Intestino Irritável/fisiopatologia , Síndrome do Intestino Irritável/psicologia , Masculino , Músculo Liso/metabolismo , Músculo Liso/fisiopatologia , Canais de Potássio/agonistas , Canais de Potássio/metabolismo , Ratos Sprague-Dawley , Transdução de Sinais/efeitos dos fármacos
12.
Psychotherapy (Chic) ; 51(1): 148-158, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24635002

RESUMO

Few studies report treatment outcome for early childhood internalizing disorders following psychotherapy, especially psychodynamic techniques. We aimed to investigate effectiveness of a novel, developmentally appropriate, short-term psychodynamic treatment program for 4- to 10-year-olds with anxiety disorders in an outpatient setting. We conducted a quasi-experimental wait-list controlled study. Thirty children (12 females) with Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) anxiety disorders and their families received 20-25 sessions of manualized short-term Psychoanalytic Child Therapy (PaCT). We assessed outcome with standardized diagnostic interviews and parent reports of internalizing and total problems at all time points. Child puppet interviews and teacher reports were also available for pre-post treatment and follow-up analyses. While 18 families entered treatment immediately, 12 families were first wait-listed before receiving treatment. Analyses of symptom improvement were based on comparisons between groups (treatment vs. wait-list) as well as pre-post and 6-month follow-up data across all families (including wait-listed families). Among the 27 completers, 66.67% (n = 18) no longer met criteria for any anxiety disorder (59.88% in intent-to-treat analysis) while no children remitted across the wait-list interval. Parent-reported child internalizing and total problems significantly declined during treatment relative to wait-list. Child and teacher reports also revealed significant pre-post symptom reductions on internalizing and total problems. Diagnostic and symptom remission rates were maintained at 6-month follow-up except on child reports. This preliminary study adds to a growing database showing that psychodynamic treatments may offer an effective line of treatment for childhood internalizing symptoms and disorders in the eyes of clinicians, children, parents, and teachers.


Assuntos
Transtornos de Ansiedade/terapia , Terapia Psicanalítica/métodos , Psicoterapia Breve/métodos , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/psicologia , Ansiedade de Separação/diagnóstico , Ansiedade de Separação/psicologia , Ansiedade de Separação/terapia , Criança , Transtornos do Comportamento Infantil/diagnóstico , Transtornos do Comportamento Infantil/psicologia , Transtornos do Comportamento Infantil/terapia , Pré-Escolar , Conflito Familiar/psicologia , Relações Pai-Filho , Feminino , Alemanha , Humanos , Individuação , Controle Interno-Externo , Entrevista Psicológica , Masculino , Relações Mãe-Filho , Determinação da Personalidade , Transtornos Fóbicos/diagnóstico , Transtornos Fóbicos/psicologia , Transtornos Fóbicos/terapia , Projetos Piloto , Ludoterapia/métodos , Psicoterapia Psicodinâmica/métodos
13.
J Nerv Ment Dis ; 201(12): 1060-5, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24284641

RESUMO

Anxiety disorders (ADs) are common in youths with bipolar disorder (BD). We examine psychiatric comorbidity, hospitalization, and treatment in youths with versus without AD and rapid cycling (four or more cycles per year). Data from the Integrated Healthcare Information Services cohort were used and included 8129 youths (ages ≤18 years). Prevalence of AD, demographic, type of AD, hospitalization, and use of psychotropics were compared between rapid and nonrapid cycling. Overall, 51% of the youths met criteria for at least one comorbid AD; they were predominantly female and were between 12 and 17 years of age. The most common comorbid ADs were generalized ADs and separation ADs. In the patients with rapid cycling, 65.5% met criteria for comorbid AD. The BD youths with AD were more likely to have major depressive disorders and other comorbid ADs, to be given more psychotropics, and to be hospitalized for depression and medical conditions more often than were those without AD.


Assuntos
Transtornos de Ansiedade/psicologia , Transtorno Bipolar/psicologia , Adolescente , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/terapia , Ansiedade de Separação/epidemiologia , Ansiedade de Separação/psicologia , Transtorno Bipolar/epidemiologia , Transtorno Bipolar/terapia , Criança , Comorbidade , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/psicologia , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Masculino
14.
Pediatr Emerg Care ; 29(10): 1098-101, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24076612

RESUMO

OBJECTIVES: Procedures are common in pediatric emergency departments and frequently cause distress from pain and/or anxiety. The objective of this study was to describe the incidence, types, and magnitude of long-term behavior changes after procedures in the emergency setting. METHODS: This is a descriptive pilot study to determine if children display negative behavioral changes after a minor emergency department procedure (abscess drainage or laceration repair). Behavior change was measured at 1 week by telephone follow-up using the 27-item Post Hospitalization Behavior Questionnaire, a well-validated instrument that measures behavior changes across 6 categories: general anxiety, separation anxiety, anxiety about sleep, eating disturbances, aggression toward authority, and apathy/withdrawal. Significant behavior change was defined as 5 or more negative behavior changes on the 27-item questionnaire. RESULTS: Twenty percent of children who underwent abscess drainage (n = 30) and 20% who underwent laceration repair (n = 30) displayed significant negative behavior change at 1 week. Children who displayed significant negative behavior change tended to be younger (3.6 vs 5.9 years) and trended toward being more likely to have received anxiolysis or sedation (16.7% vs 8.3%). Separation anxiety, sleep difficulties, and aggression toward authority were the most common behavior changes. CONCLUSIONS: In this pilot study, a significant percentage of children undergoing common emergency procedures exhibited an appreciable burden of negative behavior change at 1 week; these results demonstrate the need for further rigorous investigation of predictors of these changes and interventions, which can ameliorate these changes.


Assuntos
Abscesso/cirurgia , Transtornos do Comportamento Infantil/etiologia , Comportamento Infantil , Lacerações/terapia , Estresse Psicológico/etiologia , Técnicas de Fechamento de Ferimentos/psicologia , Anestesia Local , Ansiolíticos/uso terapêutico , Ansiedade de Separação/epidemiologia , Ansiedade de Separação/etiologia , Criança , Transtornos do Comportamento Infantil/epidemiologia , Transtornos do Comportamento Infantil/prevenção & controle , Pré-Escolar , Drenagem/efeitos adversos , Drenagem/psicologia , Serviço Hospitalar de Emergência , Emoções , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Transtornos da Alimentação e da Ingestão de Alimentos/etiologia , Feminino , Humanos , Hipnóticos e Sedativos/uso terapêutico , Masculino , Dor/etiologia , Dor/prevenção & controle , Dor/psicologia , Projetos Piloto , Estudos Prospectivos , Transtornos do Sono-Vigília/epidemiologia , Transtornos do Sono-Vigília/etiologia , Estresse Psicológico/epidemiologia , Inquéritos e Questionários , Técnicas de Fechamento de Ferimentos/efeitos adversos
15.
Bull Menninger Clin ; 77(3): 250-68, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-24020610

RESUMO

Caregiver-child attachment results in a cognitive-emotional schema of self, other, and self-other relationships. Significantly disrupted attachments may lead to pathogenic internal working models, which may have deleterious consequences; this indicates the need for early attachment intervention. The authors consider the therapy of a 3-year-old boy with aggressive behaviors who had lacked consistent caregiving. Attachment theory can account for the child's psychotherapeutic gains, despite his insecure attachment style. The authors discuss discrepancies between treatment and current research trends.


Assuntos
Agressão/psicologia , Ansiedade de Separação/terapia , Apego ao Objeto , Ludoterapia/métodos , Pré-Escolar , Humanos , Masculino , Relações Pais-Filho , Resultado do Tratamento
16.
J Pers Disord ; 27(6): 764-82, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23795759

RESUMO

Due to the higher diagnostic prevalence of borderline personality disorder (BPD) in females, there exists a dearth of literature on the manifestations of BPD in men and minimal information on male developmental trajectories to the disorder. To identify precursors of BPD in males, surveys were administered to parents about their BPD male offspring and non-BPD male siblings. Questions covered aspects of probands' lives from infancy to late adolescence. BPD offspring were identified through self-reported clinical diagnoses and standardized diagnostic criteria embedded within the survey. A total of 263 male offspring (97 meeting strict criteria for BPD and 166 non-BPD siblings) were studied. The authors found that parents describe the early emergence of a constellation of symptoms in their BPD sons that include separation anxiety starting in infancy, body image concerns in childhood, and impulsivity, emptiness, and odd thinking in adolescence. This trajectory differs from the developmental course found in females diagnosed with BPD.


Assuntos
Desenvolvimento do Adolescente , Transtorno da Personalidade Borderline/psicologia , Desenvolvimento Infantil , Comportamento Impulsivo , Pais , Adolescente , Adulto , Ansiedade de Separação , Transtorno da Personalidade Borderline/diagnóstico , Transtorno da Personalidade Borderline/epidemiologia , Criança , Pré-Escolar , Família , Feminino , Humanos , Lactente , Masculino , Prevalência , Autorrelato , Fatores Sexuais , Inquéritos e Questionários
17.
PLoS One ; 7(11): e48159, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-23185248

RESUMO

The aim of this study was to compare the impact of dietary supplementation with a Bifidobacterium breve strain together with linoleic acid & α-linolenic acid, for 7 weeks, on colonic sensitivity and fatty acid metabolism in rats. Maternally separated and non-maternally separated Sprague Dawley rats (n = 15) were orally gavaged with either B. breve DPC6330 (10(9) microorganisms/day) alone or in combination with 0.5% (w/w) linoleic acid & 0.5% (w/w) α-linolenic acid, daily for 7 weeks and compared with trehalose and bovine serum albumin. Tissue fatty acid composition was assessed by gas-liquid chromatography and visceral hypersensitivity was assessed by colorectal distension. Significant differences in the fatty acid profiles of the non-separated controls and maternally separated controls were observed for α-linolenic acid and arachidonic acid in the liver, oleic acid and eicosenoic acid (c11) in adipose tissue, and for palmitoleic acid and docosahexaenoic acid in serum (p<0.05). Administration of B. breve DPC6330 to MS rats significantly increased palmitoleic acid, arachidonic acid and docosahexaenoic acid in the liver, eicosenoic acid (c11) in adipose tissue and palmitoleic acid in the prefrontal cortex (p<0.05), whereas feeding B. breve DPC6330 to non separated rats significantly increased eicosapentaenoic acid and docosapentaenoic acid in serum (p<0.05) compared with the NS un-supplemented controls. Administration of B. breve DPC6330 in combination with linoleic acid and α-linolenic acid to maternally separated rats significantly increased docosapentaenoic acid in the serum (p<0.01) and α-linolenic acid in adipose tissue (p<0.001), whereas feeding B. breve DPC6330 with fatty acid supplementation to non-separated rats significantly increased liver and serum docosapentaenoic acid (p<0.05), and α-linolenic acid in adipose tissue (p<0.001). B. breve DPC6330 influenced host fatty acid metabolism. Administration of B. breve DPC6330 to maternally separated rats significantly modified the palmitoleic acid, arachidonic acid and docosahexaenoic acid contents in tissues. The effect was not observed in non-separated animals.


Assuntos
Ansiedade de Separação/metabolismo , Bifidobacterium/metabolismo , Síndrome do Intestino Irritável/metabolismo , Metabolismo dos Lipídeos/efeitos dos fármacos , Ácido alfa-Linolênico/farmacologia , Tecido Adiposo/efeitos dos fármacos , Tecido Adiposo/metabolismo , Tecido Adiposo/patologia , Animais , Ansiedade de Separação/sangue , Ansiedade de Separação/complicações , Ansiedade de Separação/patologia , Suplementos Nutricionais , Modelos Animais de Doenças , Feminino , Hipersensibilidade/sangue , Hipersensibilidade/complicações , Hipersensibilidade/metabolismo , Hipersensibilidade/patologia , Síndrome do Intestino Irritável/sangue , Síndrome do Intestino Irritável/patologia , Fígado/efeitos dos fármacos , Fígado/metabolismo , Fígado/patologia , Córtex Pré-Frontal/efeitos dos fármacos , Córtex Pré-Frontal/metabolismo , Córtex Pré-Frontal/patologia , Ratos , Ratos Sprague-Dawley , Vísceras/efeitos dos fármacos , Vísceras/metabolismo , Vísceras/patologia , Ácido alfa-Linolênico/administração & dosagem
18.
Breastfeed Rev ; 20(1): 25-31, 2012 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22724310

RESUMO

The study took place in a 10-bed neonatal ward in a hospital in the south of Sweden and includes mothers having given birth to a preterm infant born before the 37th week of gestation. The aim of the study was to illuminate mothers' experiences of breastfeeding a preterm infant in a neonatal ward. Data collection includes written protocols from twelve mothers. These protocols were analysed thematically. The results indicate that the mothers should be offered a private place where they can breastfeed or express breastmilk, and that the breastmilk should not be placed in a shared area. The mothers described that they did not want to be separated from their preterm infant during the night. Finally, they also pointed out the importance of support from the health professionals for establishing an exclusive breastfeeding regime.


Assuntos
Ansiedade de Separação/prevenção & controle , Aleitamento Materno/psicologia , Recém-Nascido Prematuro , Mães/psicologia , Apego ao Objeto , Satisfação Pessoal , Adaptação Psicológica , Adulto , Anedotas como Assunto , Comportamento Alimentar/psicologia , Feminino , Humanos , Fenômenos Fisiológicos da Nutrição do Lactente , Recém-Nascido , Unidades de Terapia Intensiva Neonatal , Tocologia/métodos , Relações Mãe-Filho , Suécia , Adulto Jovem
19.
Am J Physiol Gastrointest Liver Physiol ; 302(7): G702-11, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22241856

RESUMO

Exposure to early life stress causes increased stress responsiveness and permanent changes in the central nervous system. We recently showed that delayed gastric emptying (GE) and accelerated colonic transit (CT) in response to acute restraint stress (ARS) were completely restored following chronic homotypic stress (CHS) in rats via upregulation of hypothalamic oxytocin (OXT) expression. However, it is unknown whether early life stress affects hypothalamic OXT circuits and gastrointestinal motor function. Neonatal rats were subjected to maternal separation (MS) for 180 min/day for 2 wk. Anxiety-like behaviors were evaluated by the elevated-plus-maze test. GE and CT were measured under nonstressed (NS), ARS, and CHS conditions. Expression of corticotropin-releasing factor (CRF) and OXT in the paraventricular nucleus (PVN) of the hypothalamus was evaluated by real time RT-PCR and immunohistochemistry. MS increased anxiety-like behaviors. ARS delayed GE and accelerated CT in control and MS rats. After CHS, delayed GE and accelerated CT were restored in control, but not MS, rats. CRF mRNA expression was significantly increased in response to ARS in control and MS rats. Increased CRF mRNA expression was still observed following CHS in MS, but not control, rats. In response to CHS, OXT mRNA expression was significantly increased in control, but not MS, rats. The number of OXT-immunoreactive cells was increased following CHS in the magnocellular part of the PVN in control, but not MS, rats. MS impairs the adaptation response of gastrointestinal motility following CHS. The mechanism of the impaired adaptation involves downregulation of OXT and upregulation of CRF in the hypothalamus in MS rats.


Assuntos
Adaptação Fisiológica/fisiologia , Ansiedade de Separação/fisiopatologia , Motilidade Gastrointestinal/fisiologia , Estresse Psicológico/fisiopatologia , Animais , Animais Recém-Nascidos , Doença Crônica , Feminino , Regulação da Expressão Gênica/fisiologia , Hipotálamo/metabolismo , Masculino , Ocitocina/genética , Ocitocina/metabolismo , Ratos , Ratos Sprague-Dawley
20.
Phytomedicine ; 19(5): 402-8, 2012 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-22230486

RESUMO

Visceral hypersensitivity is an important characteristic feature of functional gastrointestinal disorders, such as irritable bowel syndrome (IBS). This study evaluated the effect of Schisandra chinensis on visceral hyperalgesia induced by neonatal maternal separation (NMS) in an IBS rat model. The visceromotor responses to colorectal balloon distension (CRD) were measured by abdominal withdrawal reflex (AWR) and electromyographic (EMG) activities. NMS control rats (receiving vehicle) underwent aggravated visceral pain in response to CRD as compared to normal rats, evidenced by the reduced pain threshold, enhanced AWR scores and EMG responses. Treatment with a 70% ethanol extract of S. chinensis (0.3g/kg and 1.5g/kg/day) for 7 days resulted in an increase in the pain threshold (NMS control: 19.1±1.0mmHg vs low-dose: 24.8±1.3mmHg and high-dose: 25.2±1.8mmHg, p<0.01), and abolished the elevated AWR and EMG responses to CRD in NMS rats (AUC values of EMG response curve were: 1952±202 in NMS control group vs 1074±90 in low-dose group and 1145±92 in high-dose group, p<0.001), indicating that S. chinensis could reverse the visceral hypersensitivity induced by early-life stress event. The result of ELSA measurement shows that the elevated serotonin (5-HT) level in the distal colon of NMS rats returned to normal level after treatment with S. chinensis. Moreover, the increase in pain threshold in rats treated with S. chinensis was associated with a decline of the mRNA level of 5-HT(3) receptor in the distal colon. All available results demonstrate that S. chinensis can reverse visceral hypersensitivity induced by neonatal-maternal separation, and the effect may be mediated through colonic 5-HT pathway in the rat.


Assuntos
Analgésicos/uso terapêutico , Ansiedade de Separação/complicações , Síndrome do Intestino Irritável/tratamento farmacológico , Fitoterapia , Schisandra/química , Dor Visceral/tratamento farmacológico , Analgésicos/farmacologia , Animais , Animais Recém-Nascidos , Ansiedade de Separação/psicologia , Colo/efeitos dos fármacos , Colo/metabolismo , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , Feminino , Frutas/química , Síndrome do Intestino Irritável/complicações , Masculino , Privação Materna , Limiar da Dor/efeitos dos fármacos , Extratos Vegetais/farmacologia , Extratos Vegetais/uso terapêutico , Distribuição Aleatória , Ratos , Ratos Sprague-Dawley , Serotonina/metabolismo , Estresse Psicológico , Dor Visceral/complicações , Dor Visceral/metabolismo , Dor Visceral/psicologia
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