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1.
J Clin Psychol ; 80(1): 144-157, 2024 01.
Artigo em Inglês | MEDLINE | ID: mdl-37830404

RESUMO

OBJECTIVE: Relationship obsessive-compulsive disorder (ROCD) symptoms, which include obsessive preoccupation, doubts, and compulsive behaviors focusing on the suitability of the relationship and/or partner, have been receiving increasing clinical, theoretical, and empirical attention. This clinical variant of OCD is associated with significant functional, personal, and dyadic consequences. ROCD symptoms have also been linked to several cognitive vulnerability factors, such as maladaptive relationship catastrophization. However, little is known about the connection between ROCD symptoms and specific personality traits. In this study, we examine whether vulnerable narcissistic personality traits may constitute a general vulnerability factor for ROCD symptoms. Specifically, we assess whether partner value self-contingencies moderate the association between vulnerable narcissistic traits and obsessive preoccupation with a romantic partner's perceived flaws. METHOD: A total of 310 individuals self-reporting ROCD symptoms completed questionnaires assessing narcissistic personality traits, ROCD symptoms and cognitions, and partner value self-contingencies. RESULTS: Vulnerable narcissistic traits were uniquely associated with ROCD symptoms over and above ROCD-related cognitions. Self-worth contingent on the partner's perceived value partially mediated the effect of vulnerable narcissistic traits on ROCD symptoms. CONCLUSION: Results supported the role of vulnerable narcissistic traits and domain-relevant self-vulnerabilities on obsessive preoccupation with romantic partners' perceived flaws. Further research is needed to explore the susceptibility of vulnerable individuals to the development and maintenance of ROCD symptoms.


Assuntos
Narcisismo , Transtorno Obsessivo-Compulsivo , Humanos , Emoções , Inquéritos e Questionários , Autorrelato
2.
PLoS Comput Biol ; 17(2): e1007831, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33556070

RESUMO

The stimulation of a single neuron in the rat somatosensory cortex can elicit a behavioral response. The probability of a behavioral response does not depend appreciably on the duration or intensity of a constant stimulation, whereas the response probability increases significantly upon injection of an irregular current. Biological mechanisms that can potentially suppress a constant input signal are present in the dynamics of both neurons and synapses and seem ideal candidates to explain these experimental findings. Here, we study a large network of integrate-and-fire neurons with several salient features of neuronal populations in the rat barrel cortex. The model includes cellular spike-frequency adaptation, experimentally constrained numbers and types of chemical synapses endowed with short-term plasticity, and gap junctions. Numerical simulations of this model indicate that cellular and synaptic adaptation mechanisms alone may not suffice to account for the experimental results if the local network activity is read out by an integrator. However, a circuit that approximates a differentiator can detect the single-cell stimulation with a reliability that barely depends on the length or intensity of the stimulus, but that increases when an irregular signal is used. This finding is in accordance with the experimental results obtained for the stimulation of a regularly-spiking excitatory cell.


Assuntos
Modelos Neurológicos , Córtex Somatossensorial/citologia , Córtex Somatossensorial/fisiologia , Potenciais de Ação/fisiologia , Animais , Biologia Computacional , Simulação por Computador , Estimulação Elétrica , Fenômenos Eletrofisiológicos , Junções Comunicantes/fisiologia , Rede Nervosa/citologia , Rede Nervosa/fisiologia , Redes Neurais de Computação , Neurônios/fisiologia , Ratos , Sinapses/fisiologia
3.
Dev Psychopathol ; 34(2): 607-620, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-34924083

RESUMO

Being able to control oneself in emotionally upsetting situations is essential for good relationship functioning. According to life history theory, childhood exposure to harshness and unpredictability should forecast diminished emotional control and lower relationship quality. We examined this in three studies. In Studies 1 and 2, greater childhood unpredictability (frequent financial, residential, and familial changes), but not harshness (low SES), was associated with lower emotional control in adolescents (N = 1041) and adults (N = 327). These effects were stronger during the participants' reproductive years. Moreover, in Study 2, greater childhood unpredictability was indirectly associated with lower relationship quality through lower emotional control. In study 3, we leveraged the Minnesota Longitudinal Study of Risk and Adaptation (N = 160). Greater early-life unpredictability (ages 0-4) prospectively predicted lower relationship quality at age 32 via lower emotional control at the same age. This relation was serially mediated by less supportive observed early maternal care (ages 1.5-3.5) and insecure attachment representations (ages 19 and 26). Early unpredictability also predicted greater observed emotional distress during conflict interactions with romantic partners (ages 19-36). These findings point to the role of emotional control in mediating the effects of unpredictable childhood environments on relationship functioning in adulthood.


Assuntos
Emoções , Adulto , Adolescente , Humanos , Recém-Nascido , Lactente , Pré-Escolar , Adulto Jovem , Estudos Longitudinais , Minnesota
4.
J Med Internet Res ; 23(11): e29201, 2021 11 12.
Artigo em Inglês | MEDLINE | ID: mdl-34766913

RESUMO

BACKGROUND: People with serious mental illness (SMI) have significant unmet mental health needs. Development and testing of digital interventions that can alleviate the suffering of people with SMI is a public health priority. OBJECTIVE: The aim of this study is to conduct a fully remote randomized waitlist-controlled trial of CORE, a smartphone intervention that comprises daily exercises designed to promote reassessment of dysfunctional beliefs in multiple domains. METHODS: Individuals were recruited via the web using Google and Facebook advertisements. Enrolled participants were randomized into either active intervention or waitlist control groups. Participants completed the Beck Depression Inventory-Second Edition (BDI-II), Generalized Anxiety Disorder-7 (GAD-7), Hamilton Program for Schizophrenia Voices, Green Paranoid Thought Scale, Recovery Assessment Scale (RAS), Rosenberg Self-Esteem Scale (RSES), Friendship Scale, and Sheehan Disability Scale (SDS) at baseline (T1), 30-day (T2), and 60-day (T3) assessment points. Participants in the active group used CORE from T1 to T2, and participants in the waitlist group used CORE from T2 to T3. Both groups completed usability and accessibility measures after they concluded their intervention periods. RESULTS: Overall, 315 individuals from 45 states participated in this study. The sample comprised individuals with self-reported bipolar disorder (111/315, 35.2%), major depressive disorder (136/315, 43.2%), and schizophrenia or schizoaffective disorder (68/315, 21.6%) who displayed moderate to severe symptoms and disability levels at baseline. Participants rated CORE as highly usable and acceptable. Intent-to-treat analyses showed significant treatment×time interactions for the BDI-II (F1,313=13.38; P<.001), GAD-7 (F1,313=5.87; P=.01), RAS (F1,313=23.42; P<.001), RSES (F1,313=19.28; P<.001), and SDS (F1,313=10.73; P=.001). Large effects were observed for the BDI-II (d=0.58), RAS (d=0.61), and RSES (d=0.64); a moderate effect size was observed for the SDS (d=0.44), and a small effect size was observed for the GAD-7 (d=0.20). Similar changes in outcome measures were later observed in the waitlist control group participants following crossover after they received CORE (T2 to T3). Approximately 41.5% (64/154) of participants in the active group and 60.2% (97/161) of participants in the waitlist group were retained at T2, and 33.1% (51/154) of participants in the active group and 40.3% (65/161) of participants in the waitlist group were retained at T3. CONCLUSIONS: We successfully recruited, screened, randomized, treated, and assessed a geographically dispersed sample of participants with SMI entirely via the web, demonstrating that fully remote clinical trials are feasible in this population; however, study retention remains challenging. CORE showed promise as a usable, acceptable, and effective tool for reducing the severity of psychiatric symptoms and disability while improving recovery and self-esteem. Rapid adoption and real-world dissemination of evidence-based mobile health interventions such as CORE are needed if we are to shorten the science-to-service gap and address the significant unmet mental health needs of people with SMI during the COVID-19 pandemic and beyond. TRIAL REGISTRATION: ClinicalTrials.gov NCT04068467; https://clinicaltrials.gov/ct2/show/NCT04068467.


Assuntos
COVID-19 , Transtorno Depressivo Maior , Transtornos Mentais , Humanos , Transtornos Mentais/terapia , Pandemias , SARS-CoV-2 , Smartphone , Resultado do Tratamento
5.
Clin Psychol Psychother ; 25(1): e19-e29, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28791792

RESUMO

Increasingly, cognitive-behavioural models have been considering the role of beliefs about the self in the development and maintenance of obsessive-compulsive disorder (OCD), including sensitive domains of self-concept and feared self-perceptions. This has led to the development of the Fear of Self Questionnaire (FSQ; Aardema et al., ), which has shown strong internal consistency, divergent and convergent validity, and found to be a major predictor of unwanted thoughts and impulses (i.e., repugnant obsessions). The current study aimed to investigate fear of self-perceptions using the FSQ in an OCD sample (n = 144) and related psychological disorders (eating disorders, n = 57; body dysmorphic disorder, n = 33) in comparison to a non-clinical (n = 141) and clinical comparison group (anxiety/depressive disorders, n = 27). Following an exploratory factor analysis of the scale in the OCD sample, the results showed that participants with OCD in general did not score significantly higher on fear of self-perceptions than did the clinical comparison participants. However, consistent with previous findings, fear of self was highly characteristic among OCD patients with unwanted repugnant thoughts and impulses. In addition, fear of self-perceptions were significantly more elevated in those with eating or body dysmorphic disorders relative to the other non-clinical and clinical groups. The construct of a "feared possible self" may be particularly relevant in disorders where negative self-perception is a dominant theme, either involving concerns about one's inner self or concerns related to perceived bodily faults.


Assuntos
Cognição , Ego , Medo/psicologia , Transtorno Obsessivo-Compulsivo/psicologia , Autoimagem , Adulto , Feminino , Humanos , Masculino , Psicometria , Inquéritos e Questionários
6.
J Neurosci ; 36(43): 11120-11132, 2016 10 26.
Artigo em Inglês | MEDLINE | ID: mdl-27798191

RESUMO

Single cells in the motor and somatosensory cortex of rats were stimulated in vivo with broadband fluctuating currents applied juxtacellularly. Unlike the DC current steps used previously, fluctuating stimulation currents reliably evoked spike trains with precise timing of individual spikes. Fluctuating currents resulted in strong cellular responses at stimulation frequencies beyond the inverse membrane time constant and the mean firing rate of the neuron. Neuronal firing was associated with high rates of information transmission, even for the high-frequency components of the stimulus. Such response characteristics were also revealed in additional experiments with sinusoidal juxtacellular stimulation. For selected cells, we could reproduce these statistics with compartmental models of varying complexity. We also developed a method to generate Gaussian stimuli that evoke spike trains with prescribed spike times (under the constraint of a certain rate and coefficient of variation) and exemplify its ability to achieve precise and reliable spiking in cortical neurons in vivo Our results demonstrate a novel method for precise control of spike timing by juxtacellular stimulation, confirm and extend earlier conclusions from ex vivo work about the capacity of cortical neurons to generate precise discharges, and contribute to the understanding of the biophysics of information transfer of single neurons in vivo at high frequencies. SIGNIFICANCE STATEMENT: Nanostimulation of single identified neurons in vivo can control spike frequency parametrically and, surprisingly, can even bias the animal's behavioral response. Here, we extend this stimulation protocol to time-dependent broadband noise stimulation in sensory and motor cortices of rat. In response to such stimuli, we found increased temporal spike-time reliability. The information transmission properties reveal, both experimentally and theoretically, that the neurons support high-frequency stimulation beyond the inverse membrane time. Generating a stimulus using the neuron's response properties, we could evoke prescribed spike times with high precision. Our work helps to establish a novel method for precise temporal control of single-cell spiking and provides a simplified biophysical description of single-neuron spiking under time-dependent in vivo-like stimulation.


Assuntos
Potenciais de Ação/fisiologia , Córtex Cerebral/fisiologia , Estimulação Elétrica/métodos , Modelos Neurológicos , Neurônios/fisiologia , Animais , Simulação por Computador , Feminino , Masculino , Modelos Estatísticos , Ratos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Razão Sinal-Ruído
7.
J Sex Marital Ther ; 42(7): 648-58, 2016 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-26571053

RESUMO

Schema therapy is an integrative approach of psychotherapy developed by Jeffrey E. Young. Its aim is to help clients explore and understand their deep emotional needs and meet them in a healthy manner. It is suitable for complex pathologies, such as comorbidities and personality disorders. In sex therapy, schema therapy can serve as a method for a deep, evidence-based, integrative conceptualization of a client's difficulties and needs. However, its principles have never been demonstrated in sex therapy. In this paper, we briefly review schema therapy and introduce schema domains. We bring a case study of a couple undergoing sex therapy from the cognitive-behavioral perspective. We then return to the same case study, in order to demonstrate the usefulness of a schema therapy conceptualization.


Assuntos
Terapia Cognitivo-Comportamental/métodos , Transtornos da Personalidade/terapia , Disfunções Sexuais Psicogênicas/terapia , Pesquisa Biomédica/normas , Feminino , Humanos , Masculino , Modelos Psicológicos , Psicoterapia Breve
8.
Clin Psychol Psychother ; 22(6): 570-9, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25196782

RESUMO

UNLABELLED: Previous research has shown a robust link between emotional abuse and neglect with social anxiety symptoms. However, the mechanisms through which these links operate are less clear. We hypothesized a model in which early experiences of abuse and neglect create aversive shame states, internalized into a stable shame-based cognitive-affective schema. Self-criticism is conceptualized as a safety strategy designed to conceal flaws and prevent further experiences of shame. However, self-criticism maintains negative self-perceptions and insecurity in social situations. To provide preliminary, cross-sectional support for this model, a nonclinical community sample of 219 adults from Israel (110 females, mean age = 38.7) completed measures of childhood trauma, shame-proneness, self-criticism and social anxiety symptoms. A sequential mediational model showed that emotional abuse, but not emotional neglect, predicted shame-proneness, which in turn predicted self-criticism, which in turn predicted social anxiety symptoms. These results provide initial evidence supporting the role of shame and self-criticism in the development and maintenance of social anxiety disorder. The clinical implications of these findings are discussed. KEY PRACTITIONER MESSAGE: Previous research has shown that histories of emotional abuse and emotional neglect predict social anxiety symptoms, but the mechanisms that underlie these associations are not clear. Using psycho-evolutionary and emotion-focused perspectives, the findings of the current study suggest that shame and self-criticism play an important role in social anxiety and may mediate the link between emotional abuse and symptoms. These findings also suggest that therapeutic interventions specifically targeting shame and self-criticism should be incorporated into treatments for social anxiety, especially with socially anxious patients with abuse histories.


Assuntos
Maus-Tratos Infantis/psicologia , Transtornos Fóbicos/epidemiologia , Transtornos Fóbicos/psicologia , Autoimagem , Vergonha , Adulto , Criança , Maus-Tratos Infantis/estatística & dados numéricos , Mecanismos de Defesa , Feminino , Humanos , Israel/epidemiologia , Masculino , Pessoa de Meia-Idade , Modelos Psicológicos , Inquéritos e Questionários , Adulto Jovem
9.
J Sex Med ; 11(9): 2218-24, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24903281

RESUMO

INTRODUCTION: Relationship obsessive-compulsive disorder (ROCD) is marked by the presence of obsessions and compulsions focusing on romantic relationships. ROCD symptoms were previously linked with decreased relationship quality and might interfere with sexual functioning. AIM: The study aims to examine the association between ROCD symptoms and sexual satisfaction. METHODS: Participants completed an online survey assessing ROCD symptoms and relationship and sexual satisfaction levels. Depression, general worry, obsessive-compulsive disorder (OCD) symptoms, and attachment orientation were also measured. MAIN OUTCOME MEASURE: The main outcome measures were self reported relationship satisfaction and sexual satisfaction. RESULTS: ROCD symptoms were associated with decreased sexual satisfaction over and above symptoms of depression, general worry, OCD, and attachment orientation. The link between ROCD symptoms and sexual satisfaction was mediated by relationship satisfaction. CONCLUSIONS: Identifying and addressing ROCD symptoms may be important for treatment of sexual functioning.


Assuntos
Relações Interpessoais , Transtorno Obsessivo-Compulsivo/psicologia , Satisfação Pessoal , Parceiros Sexuais , Adulto , Depressão , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
10.
Cyberpsychol Behav Soc Netw ; 27(2): 119-126, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38190274

RESUMO

Relationship Obsessive Compulsive Disorder (ROCD) is a form of obsessive-compulsive disorder that manifests in the relationship domain, such as romantic relationships. Within romantic relationship, ROCD symptoms could be focused on flaws perceived on the relationship itself (ROCD relationship-centered) or on the partners' quality (ROCD partner-focused). These symptoms are associated with negative relationship outcomes, such as low relationship satisfaction. However, no studies have yet addressed the role of relationship quality in the context of ROCD. Furthermore, previous studies have shown the detrimental role of social media use and maximization style in obsessive-compulsive symptoms and the romantic relational domain; however, the associations with ROCD symptoms have not yet been explored. Thus, this study aimed to close this gap examining the associations between ROCD symptoms (relationship-centered and partner-focused) and relationship quality, social media addiction, and maximization style. A total of 211 participants currently involved in a romantic relationship (71.1 percent female, mean age = 30.4 ± 11.54 years) participated in the study. Multiple hierarchical regression analyses revealed that relationship quality, social media addiction, and maximization style emerged as being significantly associated with relationship-centered and partner-focused ROCD symptoms. The results highlighted potential risk factors for ROCD symptoms in romantic relationships, namely relationship quality, social media addiction, and maximization style. These psychological dimensions could be identified as possible targets in the assessment and treatment of ROCD symptoms.


Assuntos
Relações Interpessoais , Transtorno Obsessivo-Compulsivo , Humanos , Feminino , Adolescente , Adulto Jovem , Adulto , Transtorno de Adição à Internet , Transtorno Obsessivo-Compulsivo/diagnóstico , Satisfação Pessoal , Análise de Regressão
11.
Heliyon ; 9(11): e21673, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-38027836

RESUMO

Relationship Obsessive Compulsive Disorder (ROCD) is a disabling form of obsessive-compulsive disorder (OCD) centering on interpersonal relationships. Previous findings suggest ROCD symptoms are particularly detrimental to romantic relationships. In this randomized controlled trial (RCT), we assessed influence a CBT-based mobile application used by both partners on resilience to ROCD symptoms, cognitions, and relationship dissatisfaction. The app consists of brief, daily exercises targeting OCD symptoms, related cognitions and attachment insecurities. Heterosexual couples (Ncouples = 103; Mage = 26.15) were randomly assigned to individually use a mobile application for 15 days (n = 49 couples) or to a control group (n = 54 couples). All participants completed questionnaires at baseline (T1), 15 days from baseline (T2), and 45 days from baseline (T3). All couples also underwent an ROCD resilience task at T2. Intention-to-treat analyses revealed that, in contrast to the control group, couples who used the app exhibited enhanced resilience in the resilience task, as well as measures of ROCD symptoms, cognitions, and relationship dissatisfaction. These observed effects persisted even at the 1-month follow-up. Concurrent use of brief mobile delivered cognitive training by both romantic partners may foster resilience in romantic couples.

12.
Health Informatics J ; 28(1): 14604582221083483, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35349777

RESUMO

BACKGROUND: Tinnitus may be a disabling, distressing disorder whereby patients report of sounds, in the absence of external stimulus. Recent evidence supports the effectiveness of psychological interventions, particularly, cognitive behavioral therapy (CBT) based intervention for the reduction of tinnitus-related distress and disability. This study assessed the effectiveness of mobile delivered cognitive training exercises to reduce tinnitus-related distress. MATERIALS AND METHODS: Out of 26 patients diagnosed with tinnitus, 14 participants completed all 48 levels of the app. Levels of pre-post intervention tinnitus intrusiveness and handicap were evaluated using the short Hebrew version of the Tinnitus Handicap Inventory (H-THI). Mood was assessed using a Visual Analogue Scale (VAS). Participants were instructed to complete 3-4 min of daily training for 14 days. RESULTS: Repeated-measures ANOVA of completers showed a significant large-effect size reduction on H-THI scores. 50% of completers have shown reliable change (indicated by their Reliable Change Index [RCI] scores). No significant change was found in mood. DISCUSSION: Several minutes a day of training using a CBT-based app targeting maladaptive believes may decreased patients' tinnitus intrusiveness and handicap. CONCLUSIONS: Mobile apps can provide access to CBT-based interventions, using an efficient, inviting and simple platform, addressing the ramifications of tinnitus symptoms.


Assuntos
Terapia Cognitivo-Comportamental , Aplicativos Móveis , Zumbido , Cognição , Exercício Físico , Humanos , Zumbido/psicologia , Zumbido/terapia
13.
J Affect Disord ; 311: 604-613, 2022 08 15.
Artigo em Inglês | MEDLINE | ID: mdl-35636516

RESUMO

BACKGROUND: The COVID-19 pandemic has been suggested to constitute a broad base stressor with severe mental health consequences. mHealth applications are accessible self-help tools that can be used to reduce psychological distress during the pandemic. This randomized controlled trial evaluated the effects of mobile-based cognitive training exercises on COVID-19 related distress and maladaptive cognitions. METHODS: Following initial screening (n = 924), participants scoring 1 standard deviations above the mean of the COVID-19 Distress Scale were randomized into two groups. Participants in the immediate-app group (iApp; n = 25) started using the application at baseline (T0) for 12 days (from T0 to T1). Participants in the delayed-app group (dApp; n = 22) started using the mobile application at T1 (crossover) and used it for the following 12 days (T1 to T2). RESULTS: Intention to treat analyses indicated that the iApp group exhibited lower COVID-19 distress, lower depression, fewer intolerance of uncertainty and obsessive beliefs than the dApp group at T1. In addition, using the app for 12 consecutive days was associated with large effect-size reductions (Cohen's d ranging from 0.81 to 2.35) in COVID-19 distress and related maladaptive cognitions in the iApp group (from T0 to T1) and the dApp group (from T1 to T2). Moreover, these reductions were maintained at the follow-up. LIMITATIONS: This study was a crossover trial with a relatively limited sample size and mainly female participants. CONCLUSION: Our findings underscore the usefulness of brief, low-intensity, portable interventions in alleviating the negative effects of the pandemic on mental health.


Assuntos
COVID-19 , Aplicativos Móveis , Adaptação Psicológica , Cognição , Estudos Cross-Over , Feminino , Humanos , Pandemias
14.
Drug Saf ; 45(5): 583-596, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35579820

RESUMO

INTRODUCTION: Signal validation in pharmacovigilance is the process of evaluating data to decide whether evidence is sufficient to justify further assessment of a detected signal. During the signal validation process, safety experts in our organization are required to review signals of disproportionate reporting (SDRs) and classify them into one of six predefined categories. OBJECTIVE: This experiment explored the extent to which predictive machine learning (ML) models can support the decision making of safety experts by accurately identifying the most appropriate predefined signal validation category. METHODS: We extracted cumulative data for six medicinal products, consisting of historic SDR validations and Individual Case Safety Reports, from the company's safety database for training and testing of the ML model. We implemented a decision tree-based supervised multiclass classifier model termed Gradient Boosted Trees followed by a SHapley Additive exPlanations (SHAP) analysis to mitigate the "black box" effect of the ensemble model by identifying the key predicting features in the model. Following a retrospective analysis, a prospective experiment was conducted to test the model accuracy and user acceptance in a real-life setting. RESULTS: The prediction accuracy of our ML model ranged from 83 to 86% over 3 months for the six medicinal products. The applicability of the model was confirmed by the company's safety experts. Additionally, the systematic predictions provided valuable information to the safety experts and assisted them in reviewing the SDRs efficiently and consistently. CONCLUSIONS: This experiment demonstrated that it is possible to train a multiclass classification model to accurately predict signal validation categories for SDRs. More importantly, the transparency of the predictions provided by the SHAP analysis led to high acceptance by the safety experts.


Assuntos
Aprendizado de Máquina , Aprendizado de Máquina Supervisionado , Humanos , Farmacovigilância , Estudos Prospectivos , Estudos Retrospectivos
15.
Behav Ther ; 53(5): 776-792, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35987538

RESUMO

Obsessive-compulsive disorder (OCD) is a persistent psychiatric disorder causing significant impairment in functioning. The COVID-19 pandemic has exacerbated OCD-related symptoms and interrupted access to treatment. Recent research suggests mHealth apps are promising tools for coping with OCD symptoms. This randomized controlled trial evaluated the effects of a CBT-based mobile application designed to reduce OCD symptoms and cognitions in community participants considered at high risk of developing OCD symptoms. Following initial screening (n = 924), fifty-five community participants scoring 2 standard deviations above the OCI-R mean were randomized into two groups. In the immediate-app use group (iApp; n = 25), participants started using the application at baseline (T0), 4 min a day, for 12 days (T0-T1). Participants in the delayed-app group (dApp; n = 20) started using the mobile application at T1 (crossover) and used the app for the following 12 consecutive days (T1-T2). Intention to treat analyses indicated that using the app for 12 consecutive days was associated with large effect-size reductions (Cohen's d ranging from .87 to 2.73) in OCD symptoms and maladaptive cognitions in the iApp group (from T0 to T1) and dApp group (from T1 to T2). These reductions were maintained at follow-up. Our findings underscore the usefulness of brief, low-intensity, portable interventions in reducing OCD symptoms and cognitions during the pandemic.


Assuntos
COVID-19 , Terapia Cognitivo-Comportamental , Aplicativos Móveis , Transtorno Obsessivo-Compulsivo , Cognição , Humanos , Transtorno Obsessivo-Compulsivo/psicologia , Transtorno Obsessivo-Compulsivo/terapia , Pandemias
16.
Body Image ; 42: 297-306, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35908296

RESUMO

Body dissatisfaction has been related to Body Image Disorders (BIDs) such as Eating Disorders (EDs) and Body Dysmorphic Disorder (BDD). This study investigates the efficacy of a mHealth app in reducing body dissatisfaction, BDD/ED symptoms and related features. Ninety-five women who were identified as high-risk of developing BIDs (using the Structured Clinical Interview for DSM-5) were randomized into: immediate-use App (iApp group; n = 47) and delayed-use App (dApp group; n = 48). The iApp group started using the app at baseline for 16 days (T1). The dApp group started using the app at T1 for 16 days. Participants completed questionnaires at baseline (T0), 16 days from baseline (T1), and 32 days from baseline (T2). Repeated measure Multivariate Analysis of Variance (MANOVA) showed Group (iApp vs. dApp) × Time (T0 vs. T1) interactions indicating decrease in BDD symptoms and body dissatisfaction related to EDs in the iApp group at T1. The Reliable Change Index indicated changes on extreme body dissatisfaction/BDD symptoms for 34.74% of participants. Although preliminary, these findings highlight that a mHeatlh app might reduce BDD symptoms and body dissatisfaction related to EDs in women at high-risk for BIDs. Effects on ED symptoms and associated features seem more limited.


Assuntos
Insatisfação Corporal , Transtornos Dismórficos Corporais , Transtornos da Alimentação e da Ingestão de Alimentos , Aplicativos Móveis , Transtornos Dismórficos Corporais/diagnóstico , Transtornos Dismórficos Corporais/psicologia , Transtornos Dismórficos Corporais/terapia , Imagem Corporal/psicologia , Cognição , Transtornos da Alimentação e da Ingestão de Alimentos/prevenção & controle , Feminino , Humanos
17.
Int J Clin Health Psychol ; 22(1): 100275, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34703466

RESUMO

BACKGROUND/OBJECTIVE: Unwanted mental intrusions (UMIs) with contents related to Obsessive-Compulsive Disorder (OCD), Body Dysmorphic Disorder (BDD), Illness Anxiety Disorder (IAD), and Eating Disorders (EDs) are highly prevalent, independently of the cultural and/or social context. Cognitive-behavioral explanations for these disorders postulates that the escalation from common UMIs to clinically relevant symptoms depends on the maladaptive consequences (i.e., emotions, appraisals, and control strategies) of experiencing UMIs. This study examines, from a cross-cultural perspective, the cognitive-behavioral postulates of the maladaptive consequences of having UMIs. METHOD: Non-clinical 1,473 participants from Europe, the Middle-East, and South America completed the Questionnaire of Unpleasant Intrusive Thoughts to assess the maladaptive consequences of experiencing highly disturbing OCD, BDD, IAD, and EDs-related UMIs. RESULTS: Findings revealed main effects for both the country and the consequences associated with the four UMI contents. Interaction effects between the consequences of each UMI content and the sample location were also observed. CONCLUSIONS: Cognitive-Behavioral models for OCD, BDD, IAD, and EDs should be implemented along with socio-cultural variables that increase the understanding of the role of these variables in the phenomenology of UMIs and their associated consequences.


INTRODUCCIÓN/OBJETIVO: Las intrusiones mentales no deseadas (IM) de contenidos relacionados con el Trastorno Obsesivo-Compulsivo (TOC), el Trastorno Dismórfico Corporal (TDC), la Ansiedad por la Enfermedad (AE), y los Trastornos Alimentarios (TAs) son muy prevalentes, independientemente de la cultura y/o el contexto social. Las explicaciones cognitivo-conductuales de esos trastornos postulan que la escalada de IM normales a síntomas clínicamente relevantes depende de las consecuencias desadaptativas (i.e., emociones, valoraciones y estrategias de control) de las IM. Este estudio examina los planteamientos sobre dichas consecuencias desde una perspectiva transcultural. MÉTODO: 1.473 participantes de Europa, Oriente Medio y Suramérica completaron el Inventario de Pensamientos Intrusos Desagradables para evaluar las consecuencias desadaptativas de experimentar IM muy molestas con contenidos de TOC, TDC, AE y TAs. RESULTADOS: Se obtuvieron efectos principales tanto para el país como para las consecuencias asociadas con los cuatro contenidos de IM, así como efectos de interacción entre las consecuencias de cada modalidad de IM y la localización de la muestra. CONCLUSIONES: Los modelos cognitivo-conductuales sobre el TOC, el TDC, la AE y los TAs deben complementarse con variables socioculturales que aumenten la comprensión del papel de esas variables en la fenomenología de las IM y sus consecuencias asociadas.

18.
Attach Hum Dev ; 13(6): 597-610, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-22011102

RESUMO

This study explored the relation between mothers' and their children's secure base scripts in two samples of school-aged children: a community sample (N = 29; mean age 8.9) and a sample of children diagnosed with ADHD (N = 50; mean age 8.9). Using the Attachment Script Representation Task, mothers and children were asked to construct narratives using word prompt outlines. In addition, mothers and children completed questionnaires focusing on symptoms. The results revealed that while the link between mothers' and children's scriptedness was significant in the community, no significant association was found in the ADHD sample. In the ADHD group, maternal reports of children's symptoms were negatively linked to children's secure-base scriptedness. Implications of these findings for theory and intervention are discussed.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Relações Mãe-Filho , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Criança , Estudos de Coortes , Feminino , Humanos , Masculino , Inquéritos e Questionários , Estados Unidos
19.
Science ; 374(6567): 538-539, 2021 Oct 29.
Artigo em Inglês | MEDLINE | ID: mdl-34709915
20.
Front Psychiatry ; 12: 589949, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34603090

RESUMO

Infant socioemotional development and underlying brain maturation occur primarily within the context of early caregiver-infant relationships. Perinatal research demonstrates detrimental impact of postpartum pathology, including postnatal onset of maternal OCD-on the mother-infant relationship. The present study is the first to examine postnatal onset of a particular dimension of OCD symptoms focusing on close interpersonal relationships (relationship-OCD, i.e., ROCD) within a general population sample. Specifically, we assessed whether symptoms of Parent-Child ROCD (PC-ROCD), may onset postnatally, thus yielding symptoms of Parent-Infant ROCD (PI-ROCD). We adapted the previously validated Parent-Child ROCD measure for use during infancy to assess symptoms of PI-ROCD. The adapted measure, Parent-Infant Relationship Obsessive Compulsive Symptoms Inventory (PI-PROCSI), was administered to 143 mothers from the general population at 4-months postpartum. We investigated concurrent associations between postnatal onset of PI-ROCD, maternal depression and bonding, as well as longitudinal predictive associations with observed maternal and infant behaviors in dyadic interactions at 10 months. Due to dropout across the 1st year postpartum, the subsample with longitudinal data was substantially reduced compared to the full sample. PI-PROCSI scores explained unique variance in concurrent maternal depression over and above concurrent anxiety. PI-PROCSI scores also associated with concurrent impairments of maternal bonding. Moreover, unique associations emerged between maternal PI-ROCD scores and perturbations in both maternal and infant observable behaviors at 10-months. Specifically, observable perturbations in maternal behaviors mediated associations between symptoms of PI-ROCD at 4-months and observable infant avoidance of social engagement behaviors at 10-months. Findings suggest that parent-child ROCD symptoms may onset during the postnatal period, and that such symptoms may play a significant role in shaping quality of reciprocal caregiver-infant interactions. Theoretical and clinical implications are discussed.

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