Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 35
Filtrar
Más filtros

Banco de datos
País/Región como asunto
Tipo del documento
Intervalo de año de publicación
1.
Eur Eat Disord Rev ; 31(1): 121-134, 2023 01.
Artículo en Inglés | MEDLINE | ID: mdl-35951630

RESUMEN

OBJECTIVE: Family dysfunction and self-esteem play an important role in the development of eating disorders (EDs), but this role has not been sufficiently examined regarding eating pathology and psychosocial quality of life (QoL), which often remains unchanged even after ED symptoms reduce. The purpose of this study was to therefore assess the mediating role of self-esteem between family dysfunction and both eating pathology and psychosocial QoL in ED patients and controls. METHOD: One hundred and fifty four female adult ED patients and 154 female healthy adult controls were recruited from Athens, Greece, and self-reported measures were used to assess family dysfunction, eating pathology, self-esteem, and psychosocial QoL. Structural equation modelling (SEM) was employed to test the mediation hypotheses. RESULTS: For both the ED and control groups, family dysfunction levels did impact eating pathology, but only through self-esteem. Family dysfunction, self-esteem, and eating pathology had a direct effect on both groups' psychosocial QoL. CONCLUSION: Self-esteem's important role in EDs was confirmed in both groups, along with its sensitivity to family dysfunction. We propose a parsimonious yet comprehensive theoretical model of the role of family dysfunction and self-esteem in EDs which future studies should further investigate longitudinally and in other population groups.


Asunto(s)
Calidad de Vida , Femenino , Humanos , Grecia
2.
J Clin Psychol ; 78(2): 105-121, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-34252977

RESUMEN

OBJECTIVES: This study aimed to understand therapists' lived experiences of delivering mentalisation-based therapy (MBT), including their experiences of service user change. METHOD: One-to-one semi-structured interviews or focus groups were conducted with 14 MBT therapists and analysed using interpretative phenomenological analysis (IPA). RESULTS: Four superordinate themes were identified: (1) experiencing the challenges and complexities of being with service users during MBT; (2) being on a journey of discovery and change; (3) being an MBT therapist: a new way of working and developing a new therapeutic identity; and (4) being a therapist in the group: seeing it all come together. CONCLUSION: Our findings highlight the complexity, challenges and individualised experience of working therapeutically with service users with a diagnosis of BPD. The study provides a perspective of service use change that is enriched by idiosyncrasies within the therapeutic encounter. We conclude with a consideration of implications for MBT research and clinical practice.


Asunto(s)
Trastorno de Personalidad Limítrofe , Terapia Basada en la Mentalización , Trastorno de Personalidad Limítrofe/terapia , Humanos , Aprendizaje , Resultado del Tratamiento
3.
Nature ; 512(7515): 453-6, 2014 Aug 28.
Artículo en Inglés | MEDLINE | ID: mdl-25164757

RESUMEN

Despite the large evolutionary distances between metazoan species, they can show remarkable commonalities in their biology, and this has helped to establish fly and worm as model organisms for human biology. Although studies of individual elements and factors have explored similarities in gene regulation, a large-scale comparative analysis of basic principles of transcriptional regulatory features is lacking. Here we map the genome-wide binding locations of 165 human, 93 worm and 52 fly transcription regulatory factors, generating a total of 1,019 data sets from diverse cell types, developmental stages, or conditions in the three species, of which 498 (48.9%) are presented here for the first time. We find that structural properties of regulatory networks are remarkably conserved and that orthologous regulatory factor families recognize similar binding motifs in vivo and show some similar co-associations. Our results suggest that gene-regulatory properties previously observed for individual factors are general principles of metazoan regulation that are remarkably well-preserved despite extensive functional divergence of individual network connections. The comparative maps of regulatory circuitry provided here will drive an improved understanding of the regulatory underpinnings of model organism biology and how these relate to human biology, development and disease.


Asunto(s)
Caenorhabditis elegans/genética , Drosophila melanogaster/genética , Evolución Molecular , Regulación de la Expresión Génica/genética , Redes Reguladoras de Genes/genética , Factores de Transcripción/metabolismo , Animales , Sitios de Unión , Caenorhabditis elegans/crecimiento & desarrollo , Inmunoprecipitación de Cromatina , Secuencia Conservada/genética , Drosophila melanogaster/crecimiento & desarrollo , Regulación del Desarrollo de la Expresión Génica/genética , Genoma/genética , Humanos , Anotación de Secuencia Molecular , Motivos de Nucleótidos/genética , Especificidad de Órganos/genética , Factores de Transcripción/genética
4.
Aggress Behav ; 41(2): 109-22, 2015 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-27539933

RESUMEN

In the current prospective study, we investigated (1) whether high and low BMI in early childhood puts a child at risk of victimization by their peers, and (2) whether being victimized increases BMI over the short- and long-term, independent of the effect of BMI on victimization. We also examined whether gender moderated these prospective associations. Participants were 1,344 children who were assessed yearly from ages 3 to 10 years as part of the Québec Longitudinal Study of Child Development (QLSCD). BMI predicted annual increases in victimization for girls aged 6 years and over; for boys aged 7 and 8 years of age, higher BMI reduced victimization over the school year. Further, victimization predicted annual increases in BMI for girls after age 6 years. When these short-term effects were held constant, victimization was also shown to have a three and 5-year influence on annual BMI changes for girls from age 3 years. These short- and long-term cross-lagged effects were evident when the effects of family adversity were controlled. The findings support those from previous prospective research showing a link between higher BMI and victimization, but only for girls. Further, being victimized increased the likelihood that girls would put on weight over time, which then increased future victimization. The implications of these prospective findings for interventions are considered. Aggr. Behav. 42:109-122, 2015. © 2015 Wiley Periodicals, Inc.


Asunto(s)
Índice de Masa Corporal , Acoso Escolar , Víctimas de Crimen/psicología , Grupo Paritario , Niño , Preescolar , Femenino , Humanos , Masculino , Estudios Prospectivos
5.
Child Abuse Negl ; 149: 106661, 2024 03.
Artículo en Inglés | MEDLINE | ID: mdl-38295605

RESUMEN

BACKGROUND: The ED literature has focused on the physical forms of childhood abuse with respect to eating disorders, overlooking non-physical abuse even though eating disorder patients report the latter either as primary experiences or as a revival of their childhood experiences. Additionally, there is no literature exploring whether adult eating disorder patients who have experienced childhood non-physical abuse continue to experience abuse as adults, and if they do, how well-being is impacted or linked with eating pathology. OBJECTIVE: This study explored the lived experiences of eating disorders patients who have experienced non-physical childhood abuse in childhood and adulthood. PARTICIPANTS AND SETTINGS: Six adult female eating disorder outpatients each took part in a semi-structured interview. METHODS: This study used the Interpretative Phenomenological Analysis framework. RESULTS: Three master themes and eleven superordinate themes were drawn from the analysis, addressing the research question: continuation of non-physical abuse across a lifetime, developmental factors and non-physical abuse, and non-physical abuse and eating pathology. CONCLUSIONS: The participants' accounts indicate that childhood non-physical abuse is related to eating disorder onset, and abuse continuation in adulthood contributes to the disorder's maintenance. Moreover, the lifelong consequences of non-physical childhood abuse impact psychological factors, such as self-esteem, attachment and emotion regulation, affecting the individuals' adult lives and keeping participants inside a vicious cycle of trauma re-enactment. Low self-esteem is considered by the participants as the key factor for their disturbed relationship with food.


Asunto(s)
Maltrato a los Niños , Trastornos de Alimentación y de la Ingestión de Alimentos , Adulto , Humanos , Niño , Femenino , Adolescente , Adulto Joven , Maltrato a los Niños/psicología , Autoimagen , Trastornos de la Personalidad , Pacientes Ambulatorios
6.
Psychiatr Serv ; 75(5): 500-503, 2024 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-38369884

RESUMEN

Previous evaluations of interventions for borderline personality disorder have focused on psychotherapies. This study (N=42 patients), conducted in Liverpool, United Kingdom, reviewed the effect on out-of-area treatments (OATs) and hospital admissions of establishing a local case management team and a combined day treatment and crisis service for patients who are too dysregulated to access typical office-based psychotherapy. Data from 12, 24, and 36 months postintervention were compared with baseline data. All patients in OATs were repatriated to the local community. No new patients were sent to OATs. Admissions decreased (at 12 months, 49%; 24 months, 64%; 36 months, 74%), achieving savings in hospitalization costs. Moderate increases in the use and costs of some other services were observed.


Asunto(s)
Trastorno de Personalidad Limítrofe , Servicios Comunitarios de Salud Mental , Hospitalización , Humanos , Trastorno de Personalidad Limítrofe/terapia , Adulto , Femenino , Masculino , Hospitalización/estadística & datos numéricos , Reino Unido , Adulto Joven , Persona de Mediana Edad , Manejo de Caso/organización & administración
7.
Syst Rev ; 12(1): 194, 2023 10 13.
Artículo en Inglés | MEDLINE | ID: mdl-37833785

RESUMEN

BACKGROUND: Establishing and maintaining relationships and ways of connecting and being with others is an important component of health and wellbeing. Harnessing the relational within caring, supportive, educational, or carceral settings as a systems response has been referred to as relational practice. Practitioners, people with lived experience, academics and policy makers, do not yet share a well-defined common understanding of relational practice. Consequently, there is potential for interdisciplinary and interagency miscommunication, as well as the risk of policy and practice being increasingly disconnected. Comprehensive reviews are needed to support the development of a coherent shared understanding of relational practice. METHOD: This study uses a scoping review design providing a scope and synthesis of extant literature relating to relational practice focussing on organisational and systemic practice. The review aimed to map how relational practice is used, defined and understood across health, criminal justice, education and social work, noting any impacts and benefits reported. Searches were conducted on 8 bibliographic databases on 27 October 2021. English language articles were included that involve/discuss practice and/or intervention/s that prioritise interpersonal relationships in service provision, in both external (organisational contexts) and internal (how this is received by workers and service users) aspects. RESULTS: A total of 8010 relevant articles were identified, of which 158 met the eligibility criteria and were included in the synthesis. Most were opinion-based or theoretical argument papers (n = 61, 38.60%), with 6 (3.80%) critical or narrative reviews. A further 27 (17.09%) were categorised as case studies, focussing on explaining relational practice being used in an organisation or a specific intervention and its components, rather than conducting an evaluation or examination of the effectiveness of the service, with only 11 including any empirical data. Of the included empirical studies, 45 were qualitative, 6 were quantitative, and 9 mixed methods studies. There were differences in the use of terminology and definitions of relational practice within and across sectors. CONCLUSION: Although there may be implicit knowledge of what relational practice is the research field lacks coherent and comprehensive models. Despite definitional ambiguities, a number of benefits are attributed to relational practices. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42021295958.


Asunto(s)
Derecho Penal , Apoyo Social , Humanos , Relaciones Interpersonales , Actitud
8.
Nat Struct Mol Biol ; 14(3): 243-5, 2007 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-17310254

RESUMEN

Histone methylation is important in regulating chromatin structure and function. In budding yeast, methylation of histone H3 at Lys4 (H3-K4) is associated with active transcription and is enriched at the 5' regions of transcribed genes. Here we identify a novel budding yeast JmjC domain-containing H3-K4 demethylase, Jhd2p, that antagonizes the trimethyl modification state and contributes to regulation of telomeric silencing.


Asunto(s)
N-Metiltransferasa de Histona-Lisina/metabolismo , Histonas/metabolismo , Lisina/metabolismo , Oxidorreductasas O-Demetilantes/metabolismo , Proteínas de Saccharomyces cerevisiae/metabolismo , Saccharomyces cerevisiae/enzimología , Silenciador del Gen , Histona Demetilasas con Dominio de Jumonji , Saccharomyces cerevisiae/citología , Telómero/metabolismo
9.
Aggress Behav ; 38(5): 403-13, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-22711314

RESUMEN

The aim of this study was to identify associations between borderline personality (BP) traits and reactive and proactive aggression, and to compare the meditational effects of maladaptive coping in samples of older adolescents (n = 133) and young adults (n = 93), which has not hitherto been explored. This was a cross-sectional study that used self-report measures to assess BP traits on a continuum, trait-based reactive and proactive aggression, and coping strategies. In adults, maladaptive emotional coping significantly mediated the relationship between BP and reactive aggression, and maladaptive avoidant coping mediated the relationship between BP and proactive aggression; no significant mediational effects were found for adolescents. These findings highlight potential explanations for associations between BP traits and reactive and proactive aggression in young adults, and indicate that reactive aggression in adult BPs could be decreased by reducing emotional coping, and proactive aggression by reducing avoidant coping.


Asunto(s)
Adaptación Psicológica/fisiología , Agresión/psicología , Trastorno de Personalidad Limítrofe/psicología , Personalidad/fisiología , Adolescente , Adulto , Factores de Edad , Estudios Transversales , Femenino , Humanos , Masculino , Escalas de Valoración Psiquiátrica , Encuestas y Cuestionarios , Adulto Joven
10.
Acta Diabetol ; 59(12): 1575-1587, 2022 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-36038781

RESUMEN

AIMS: Type 1 and 2 diabetes mellitus (T1DM and T2DM) can lead to emotional distress and cognitive impairments, often caused by psychological factors such as low mood or anxiety; yet, few studies have explored the theoretical mechanisms underlying these relationships and within one study. This study explored the relationships between psychological states (anxiety/worry, fatigue) and diabetes outcomes (diabetes distress, cognitive dysfunction), and whether resilience mediated the association between these in T1DM and T2DM. METHODS: A sample of 307 UK adults with a clinical diagnosis of diabetes (T1DM = 129; T2DM = 178) completed a cross-sectional online survey, composed of six questionnaires. Associations between variables were investigated using Pearson's correlations and Structural Equation Modelling (SEM). RESULTS: Psychological states were significantly correlated with diabetes outcomes, and resilience was significantly related to both psychological states and diabetes outcomes. The SEM model achieved an acceptable model fit with a significant mediating effect of resilience between psychological states (anxiety/worry, fatigue) and diabetes outcomes (diabetes distress, cognitive dysfunction), with no significant differences between diabetes type. CONCLUSIONS: We propose a new theoretical model of T1DM and T2DM that could be used to provide guidance for those designing interventions. These findings help to understand the complex nature of diabetes management, suggesting resilience could be a key factor in managing psychological states and diabetes outcomes.


Asunto(s)
Diabetes Mellitus Tipo 1 , Diabetes Mellitus Tipo 2 , Adulto , Humanos , Diabetes Mellitus Tipo 1/complicaciones , Estudios Transversales , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/psicología , Modelos Teóricos , Fatiga
11.
Crisis ; 43(1): 35-45, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33475010

RESUMEN

Background: Understanding and effectively managing self-harm and suicide require collaborative research between stakeholders focused on shared priorities. Aims: We aimed to develop a consensus about suicide and self-harm research priorities in the North West of England using the Delphi method. Method: Items for the Delphi survey were generated through group discussions at a workshop with 88 stakeholders and subsequent thematic analysis of key themes. A total of 44 participants who were experts-by-experience, researchers, and clinicians based within health services including third-sector organizations completed the Delphi survey. Results: A three-round survey reached consensus on 55 research priority items identifying key priorities in each of the following groups: offenders, children and young people, self-harm in community settings, and crisis care in the community. Limitations: The pool of delegates at the workshop and subsequent self-selection into the Delphi may have introduced bias into the study. Conclusion: The current paper highlights specific actionable priorities were identified in four areas that can be used to inform research efforts and future policy and practice, based on shared areas of perceived importance and concern. Future work is needed to confirm the significance of these priority areas, including the use of evidence synthesis approaches to ascertain the extent to which these priorities have already been investigated and where gaps in understanding remain.


Asunto(s)
Prevención del Suicidio , Adolescente , Niño , Consenso , Técnica Delphi , Humanos , Investigación , Encuestas y Cuestionarios
12.
Prim Health Care Res Dev ; 23: e61, 2022 09 29.
Artículo en Inglés | MEDLINE | ID: mdl-36172708

RESUMEN

BACKGROUND: The deployment of (Trainee) Associate Psychological Practitioners (T/APPs) to deliver brief psychological interventions focusing on preventing mental health deterioration and promoting emotional wellbeing in General Practice settings is a novel development in the North West of England. As the need and demand for psychological practitioners increases, new workforce supply routes are required to meet this growth. AIMS: To evaluate the clinical impact and efficacy of the mental health prevention and promotion service, provided by the T/APPs and the acceptability of the role from the perspective of the workforce and the role to T/APPs, patients and services. METHODS: A mixed-methods design was used. To evaluate clinical outcomes, patients completed measures of wellbeing (WEMWBS), depression (PHQ-9), anxiety (GAD-7) and resilience (BRS) at the first session, final session and at a 4-6 week follow-up. Paired-samples t-tests were conducted comparing scores from session 1 and session 4, and session 1 and follow-up for each of the four outcome measures. To evaluate acceptability, questionnaires were sent to General Practice staff, T/APPs and patients to gather qualitative and quantitative feedback on their views of the T/APP role. Quantitative responses were collated and summarised. Qualitative responses were analysed using inductive summative content analysis to identify themes. RESULTS: T-test analysis revealed clinically and statistically significant reductions in depression and anxiety and elevations in wellbeing and resiliency between session 1 and session 4, and at follow-up. Moderate-large effect sizes were recorded. Acceptability of the T/APP role was established across General Practice staff, T/APPs and patients. Content analysis revealed two main themes: positive feedback and constructive feedback. Positive sub-themes included accessibility of support, type of support, patient benefit and primary care network benefit. Constructive sub-themes included integration of the role and limitations to the support. CONCLUSIONS: The introduction of T/APPs into General Practice settings to deliver brief mental health prevention and promotion interventions is both clinically effective and acceptable to patients, General Practice staff and psychology graduates.


Asunto(s)
Medicina General , Salud Mental , Inglaterra , Humanos , Encuestas y Cuestionarios
13.
Gastroenterol Nurs ; 34(2): 93-100, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-21455041

RESUMEN

Nurses are taught to place patients on their left-side postcolonoscopy to facilitate passing of flatus and relief of bloating, but there was no research evidence found to substantiate the use of that position. This study's purpose was to determine which position (left lateral, right lateral, or supine) was the most effective to encourage passing the insufflated room air and provide patient comfort after a colonoscopy. Sequential selection was used to assign one of three positions (168-174 patients per position) to 512 postcolonoscopy patients. Immediately following the procedure, the nurse placed the patient in the selected position. The patient's position, pain, bloating, vital signs, and passage of flatus were assessed every 15 minutes. A numerical rating scale of 1-10 was used to assess abdominal pain and bloating. Significant differences indicate that after colonoscopy, left lateral was the optimal position for facilitating passage of flatus and relieving bloating. The patients who were placed on their left side passed air more quickly than the patients in the other positions. The data show that after 30 minutes, most patients, regardless of which position they were in, passed the insufflated room air and were comfortable.


Asunto(s)
Colonoscopía/enfermería , Posicionamiento del Paciente/enfermería , Satisfacción del Paciente , Dolor Abdominal , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Flatulencia , Humanos , Insuflación , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Muestreo , Encuestas y Cuestionarios
14.
Front Psychol ; 12: 688472, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34349705

RESUMEN

Background: Research has identified functions of non-suicidal self-harm/self-injury (NSSH) but whether functions change over time, from adolescence to early adulthood, or predict the continuation of the behavior prospectively remains unclear. This study aimed to prospectively explore whether intrapersonal and interpersonal NSSH functions in adolescence predict repetition of self-harm (regardless of suicidal intent) and incident suicide attempts in early adulthood. Methods: Participants were 528 individuals with NSSH at age 16 years from the Avon Longitudinal Study of Parents and Children (ALSPAC), a population-based birth cohort in the UK. Descriptive statistics were used to explore changes in functions over time from age 16 to 21, and logistic regression used to examine associations between NSSH functions and repeat self-harm and suicide attempts at age 21, 24, and 25 years. Findings: The majority of 16-year-olds with NSSH endorsed intrapersonal (e.g., affect regulatory) functions only (73% at 16 years and 64% at 21 years). Just under half of adolescents (42%) and three quarters of 21 years olds reported more than one function simultaneously. A greater number of intrapersonal functions at 16 years independently predicted future repetition of self-harm at ages 21-25 years, over and above interpersonal functions (OR = 1.46, 95% CI 1.06-2.01). Interpersonal functions during adolescence did not predict repeat self-harm or suicide attempts in adulthood. Discussion: Our findings suggest that intrapersonal but not interpersonal NSSH functions are a prospective risk factor for future self-harm and might also predict incident suicide attempts. The results highlight the central role of underlying affective difficulties and motivations in self-harm maintenance.

15.
Mol Cell Biol ; 27(11): 3951-61, 2007 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-17371840

RESUMEN

Histone methylation is an important posttranslational modification that contributes to chromatin-based processes including transcriptional regulation, DNA repair, and epigenetic inheritance. In the budding yeast Saccharomyces cerevisiae, histone lysine methylation occurs on histone H3 lysines 4, 36, and 79, and its deposition is coupled mainly to transcription. Until recently, histone methylation was considered to be irreversible, but the identification of histone demethylase enzymes has revealed that this modification can be dynamically regulated. In budding yeast, there are five proteins that contain the JmjC domain, a signature motif found in a large family of histone demethylases spanning many organisms. One JmjC-domain-containing protein in budding yeast, Jhd1, has recently been identified as being a histone demethylase that targets H3K36 modified in the di- and monomethyl state. Here, we identify a second JmjC-domain-containing histone demethylase, Rph1, which can specifically demethylate H3K36 tri- and dimethyl modification states. Surprisingly, Rph1 can remove H3K9 methylation, a histone modification not found in budding yeast chromatin. The capacity of Rph1 to demethylate H3K9 provides the first indication that S. cerevisiae may have once encoded an H3K9 methylation system and suggests that Rph1 is a functional vestige of this modification system.


Asunto(s)
Histonas/metabolismo , Lisina/metabolismo , Proteínas Represoras/metabolismo , Proteínas de Saccharomyces cerevisiae/metabolismo , Saccharomyces cerevisiae/metabolismo , Histona Demetilasas , Metilación , Fenotipo , Estructura Terciaria de Proteína , Proteínas Recombinantes/genética , Proteínas Recombinantes/metabolismo , Proteínas Represoras/genética , Saccharomyces cerevisiae/genética , Proteínas de Saccharomyces cerevisiae/genética
16.
Psychiatry Res ; 176(2-3): 208-12, 2010 Apr 30.
Artículo en Inglés | MEDLINE | ID: mdl-20199812

RESUMEN

Relatively few studies have evaluated the emotional functioning of individuals with borderline personality disorder traits, especially in nonclinical populations. This study therefore sought to understand further the emotional skills and subjective emotional experiences of adults with borderline traits in a community sample. Adult volunteers (N=523) were recruited from community and student populations, and borderline personality was determined via three self-report measures. Close to one in six respondents (17.2%) self-reported borderline personality traits above the threshold on the three instruments. Poor skills in managing and understanding emotion were characteristic of these individuals. They also possessed significantly poorer subjective perception of emotion, management of their own emotions and management of others' emotions, relative to the non-borderline personality controls. Skills in managing and understanding emotion and the subjective experience of managing one's own emotions were significant multivariate predictors of borderline personality trait status. We conclude that persons with borderline personality traits have pronounced deficits in emotional understanding and management. Interventions targeting these deficits are needed, given the high prevalence of borderline traits in the community.


Asunto(s)
Trastorno de Personalidad Limítrofe/fisiopatología , Trastorno de Personalidad Limítrofe/psicología , Emociones/fisiología , Adolescente , Adulto , Anciano , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Inventario de Personalidad , Escalas de Valoración Psiquiátrica , Autoimagen , Encuestas y Cuestionarios , Adulto Joven
17.
J Affect Disord ; 266: 603-609, 2020 04 01.
Artículo en Inglés | MEDLINE | ID: mdl-32056933

RESUMEN

BACKGROUND: Self-cutting in young people is associated with high risk of repetition and suicide. It is important, therefore, to identify characteristics of self-cutting that might impact on repetition and aspects of care by staff. This study aimed to explore differences in clinical (e.g., previous self-harm) and psychological characteristics (intent, mental state, precipitants) of self-cutting in young people based on whether site of cut was visible or concealed. METHODS: Data were from a large prospective self-harm monitoring database that collected data on hospital emergency department presentations for self-harm in the City of Manchester, UK, between 2005 and 2011. Clinical and psychological characteristics, as well as onward referral/clinical management from the emergency department, of 799 young people (totalling 1,196 episodes) age 15-24 who self-cut in visible or concealed areas were compared using logistic regression. RESULTS: During the study period 500 (40%) episodes were in a concealed location. Concealed self-cutting was more likely to be precipitated by specific self-reported precipitants such as abuse and characterised by the following: previous self-harm, current psychiatric treatment, premeditation, and greater risk of repetition within the study period. Receiving a psychosocial assessment and referral to psychiatric services from the emergency department were less likely, however. Repetition and referral to psychiatric treatment were not significantly associated with site of injury when adjusting for other factors. CONCLUSIONS: There are meaningful differences in characteristics associated with location of cut. We recommend that all young people who present to hospital following self-harm receive a psychosocial assessment, in line with NICE guidance.


Asunto(s)
Conducta Autodestructiva , Suicidio , Adolescente , Adulto , Servicio de Urgencia en Hospital , Humanos , Estudios Prospectivos , Derivación y Consulta , Conducta Autodestructiva/epidemiología , Adulto Joven
18.
Psychol Psychother ; 93(3): 572-586, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-31301159

RESUMEN

OBJECTIVES: Studies of lived experiences are important for improving treatment effectiveness, but most studies of mentalization-based therapy (MBT) are quantitative. This qualitative study aimed to better understand service users' lived experiences of MBT, including their experiences of change. DESIGN: This is a qualitative study that used one-to-one semi-structured interviews. METHOD: Semi-structured interviews were conducted with eight MBT service users recruited via four NHS trusts. Interviews were analysed using interpretative phenomenological analysis (IPA). FINDINGS: Three superordinate themes were identified: being borderline, being in the group, and being on a journey. 'Experiences of diagnosis' and 'the group' are salient topics in the lived experiences of service users' during the MBT journey, as is the nature/type of 'change' that can create symptom reduction albeit alongside a negative felt experience. CONCLUSION: Our research aligns with current thought regarding the complexity and challenges of treating BPD via psychotherapy and adds a further dimension, that of experiencing MBT and changes during therapy. The participants' experiences of BPD and of experiencing MBT are discussed. PRACTITIONER POINTS: Therapists are observant of how each client gives meaning to their experience of diagnosis, the group, and change, particularly since the experience of recovery is not all positive. Service users' emerging and ongoing construction of their experience of diagnosis is closely monitored and additional appropriate strategies implemented where necessary. The impact of joining MBT, especially the group, becomes a process for formal regular review. Therapists undertake an in-depth exploration of service users' felt experiences to capture less quantifiable dimensions of change.


Asunto(s)
Trastorno de Personalidad Limítrofe/terapia , Mentalización , Psicoterapia de Grupo/métodos , Adulto , Femenino , Humanos , Entrevistas como Asunto , Persona de Mediana Edad , Investigación Cualitativa , Calidad de Vida , Resultado del Tratamiento , Adulto Joven
19.
J Gen Intern Med ; 24(2): 198-204, 2009 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-19089507

RESUMEN

BACKGROUND: Effective physician-nurse collaboration is an important, but incompletely understood determinant of patient and nurse satisfaction, and patient safety. Its impact on physicians has not been described. This study was undertaken to develop a fuller understanding of the collaboration experience and its outcomes. METHODS: Twenty-five medical residents, 32 staff nurses, 5 physician and 5 nurse faculty wrote narratives about successful collaboration; the narratives were then qualitatively analyzed. Narrative analysis was the initial qualitative method iteratively employed to identify themes. A phenomenological approach was subsequently used to develop a framework for collaborative competence. RESULTS: Collaboration triggers, facilitative behaviors, outcomes and collaborative competence were the themes identified. Affect was identified in the triggers leading to collaboration and in its outcomes. Practioners typically entered a care episode feeling worried, uncertain or inadequate and finished the interaction feeling satisfied, understood and grateful to their colleagues. The frequency of affective experience was not altered by gender, profession, or ethnicity. These experiences were particularly powerful for novice practioners of both disciplines and appear to have both formative and transformative potential. Collaborative competence was characterized by a series of graduated skills in clinical and relational domains. Many stories took place in the ICU and afterhours settings. CONCLUSIONS: Despite the prevailing wisdom that nursing and medicine are qualitatively different, the stories from this study illuminate surprising commonalities in the collaboration experience, regardless of gender, age, experience, or profession. Collaborative competence can be defined and its component skills identified. Contexts of care can be identified that offer particularly rich opportunities to foster interprofessional collaboration.


Asunto(s)
Conducta Cooperativa , Estudios de Evaluación como Asunto , Relaciones Médico-Enfermero , Adulto , Actitud del Personal de Salud , Competencia Clínica/normas , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven
20.
Arch Suicide Res ; 20(4): 614-34, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-26953689

RESUMEN

The presented study aimed to advance understanding of the reasons for non-suicidal self-harm (NSSH) in adult male offenders, with and without borderline personality traits. 179 offenders completed self-report measures of NSSH and other clinical constructs, with 42 being identified as having self-harmed. Results were consistent with past research and supported the relative importance of intrapersonal over interpersonal functions, but also highlight that self-harm is performed rarely for one type of reason. The results also show that the presence of borderline personality traits increases the likelihood of endorsing a range of interpersonal reasons. These findings highlight the importance of understanding the range of reasons for engaging in NSSH to help manage the behaviour within the prison.


Asunto(s)
Control de la Conducta , Trastorno de Personalidad Limítrofe , Criminales/psicología , Relaciones Interpersonales , Adulto , Control de la Conducta/métodos , Control de la Conducta/psicología , Trastorno de Personalidad Limítrofe/diagnóstico , Trastorno de Personalidad Limítrofe/psicología , Humanos , Masculino , Aislamiento Social/psicología
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA