The Role of Vaginal Penetration Skills and Vaginal Penetration Behavior in Genito-Pelvic Pain/Penetration Disorder.

Vaginal penetration skills and behavior are considered different aspects of vaginal penetration. Nevertheless, these terms are used interchangeably in most genito-pelvic pain/penetration disorder (GPPPD) intervention studies, possibly impacting the assessment and selection of intervention outcomes. This is the first theoretical essay on the relevance of nonsexual vaginal penetration skills in understanding and treating GPPPD symptoms, mainly for patients with vaginismus complaints. We aim to provide avenues for further empirical research and new perspectives for assessing, preventing, and treating GPPPD symptoms. We highlight the conceptual boundaries, overlaps, and commonalities between vaginal penetration skills and vaginal penetration behavior and the implications for measuring and selecting GPPPD treatment outcomes. We then briefly explain vaginal penetration skills as a self-learning process and review the impact of fear, anxiety, and cognitive factors on GPPPD symptoms. We also outline the role of the nonsexual genital self-exploration skills in later penetration behavior and offer implications for a new GPPPD patient-centered treatment approach.

Impairment of Sexual Desire in Treatment-Resistant Depression: Prevalence and Correlates.

Objective: To assess sexual desire in patients with treatment-resistant depression (TRD).Methods: Baseline data were analyzed from an ongoing cohort study at an outpatient clinic specializing in TRD treatment in Brazil. The cohort comprised consecutive patients with the diagnosis of TRD who sought treatment at this center between November 2015 and January 2021. The Hamilton Depression Rating Scale (HDRS) genital symptoms item (item 14) was used as a proxy to assess sexual desire.Results: Sixty-five participants with TRD were included. There was sexual desire impairment in 67.7% of patients. Men (87.5%) were more affected than women (61.2%), and this difference was statistically significant (P = .05). Depression severity was associated with greater complaints of this aspect of sexual function (P < .01).Conclusions: Participants with TRD had a high prevalence of sexual desire impairment, which was associated with greater depressive symptom severity and male sex. The findings suggest that health care professionals should systematically assess sexual desire in patients with TRD in daily clinical practice. Further longitudinal studies are needed in larger samples using specific instruments for assessing sexual dysfunction and comparing TRD and non-TRD populations.

Percepção de profissionais da Atenção Básica acerca da atenção a idosos com perda de peso não intencional / Primary Health Care professionals perception regarding care for elderly people with unintentional weight loss

Introdução. O processo de envelhecimento cursa com alterações biológicas como a perda de peso não intencional. Essa condição associa-se a um aumento de morbidade e mortalidade em pessoas idosas, requerendo cuidado por equipe interprofissional da Atenção Básica, além do nutricionista. Embora a atenção a saúde dessa população esteja pautada em políticas e documentos norteadores de saúde, o cuidado aos idosos tem se mostrado desafiador, devido à necessidade de cumprimento de metas de produtividade na Atenção Básica, como número elevado de atendimentos e agendas pouco flexíveis. Objetivo. Conhecer a percepção de profissionais da Atenção Básica sobre o estado nutricional de idosos usuários de Unidades Básicas de Saúde, com ênfase para perda de peso não intencional e, identificar possibilidades de intervenção a essa problemática pela equipe interprofissional. Metodologia. Pesquisa qualitativa, exploratória e descritiva, realizada em duas etapas: entrevistas individuais com roteiro semiestruturado e grupo focal com profissionais de nível superior da Atenção Básica das UBS da Região Centro do Município de São Paulo. Os dados das duas etapas foram transcritos na íntegra e submetidos à Análise Temática de Conteúdo, sendo discutidos conjuntamente, por meio de triangulação. Resultados. Dezessete profissionais foram entrevistados, e doze destes participaram do grupo focal. Os profissionais referiram dificuldade em identificar idosos com perda de peso não intencional, embora a Avaliação Multidimensional da Pessoa Idosa na Atenção Básica, usualmente utilizada, contenha pergunta específica sobre essa temática. Os desafios identificados para o cuidado a essa condição foram a insuficiência financeira e de suporte familiar, o isolamento social, a não adesão às ofertas de cuidado, a vulnerabilidade social, incluindo insegurança alimentar, além dos desafios do processo de trabalho, como a burocracia dos serviços, as dificuldades com a estrutura física das UBS, além do pouco tempo destinado às consultas. Quanto às possibilidades de cuidado, foram consideradas as abordagens grupais, as consultas e reuniões de discussão de casos, além do trabalho em equipe interprofissional, compartilhado com a Rede de Atenção à Saúde e intersetorial. A atenção nutricional e o nutricionista são fundamentais para o manejo da condição. O uso de Suplementos Nutricionais Orais foi observado, porém esses têm custo elevado e não são disponibilizados no SUS. O acesso a serviços de refeições domiciliares ou a restaurantes populares é fundamental para a garantia da Segurança Alimentar e Nutricional. Conclusão. A perda de peso não intencional ainda é condição pouco identificada pelos profissionais da Atenção Básica, embora esses compreendam suas possíveis causas e implicações à saúde da população idosa, assim como observado em pesquisas internacionais. A atenção nutricional e interprofissional, a prática colaborativa, a Educação Permanente e o apoio da Rede de Atenção à Saúde da Pessoa Idosa e da rede de serviços Intersetorial configuram-se como possibilidade de enfrentamento.

Instruments for assessing sexual dysfunction in Arabic: A systematic literature review.

Sexual health is relevant throughout a person's life; however, studying human sexuality is complex and requires particular care when working with individuals from different cultural and social backgrounds. Much of the research addressing this subject has been conducted in Western countries, and that in non-Western countries is generally based on small sample sizes. The biopsychosocial nature of sexuality and its dysfunctions should be taken into consideration given that it is indispensable when conducting and assessing sexual studies in different countries and cultures. Therefore, culturally sensitive studies that consider cultural contexts and determinants as well as social markers are needed. The topic of sexuality in Arab culture is still enigmatic. This enigma has impacted the advancement of sexual science and limited researchers, health care practitioners, and patients. Thus, the aim of this systematic literature review was to find and assemble all scales and questionnaires regarding human sexual health that have been translated into Arabic and validated in order to promote a critical analysis of the methods used in each instrument and to inform readers and researchers of the limits and potential of each scale. Electronic databases were systematically searched, and eight instruments were selected for inclusion: the Arabic Index of Premature Ejaculation (AIPE), the Sexual Health Inventory for Men (SHIM), the Arabic Female Sexual Function Index (ArFSFI), the Female Genital Self-Image Scale (AVFGSIS), the Arabic Arizona Sexual Experiences Scale (ASEX), the Egyptian Pelvic Organ Prolapse/Incontinence Sexual Questionnaire (PISQ-IR), the Saudi Arabian Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire in Arabic (PSIQ-IR), and the Arabic Female Sexual Distress Scale (FSDS). All included instruments showed good validity and reliability for the target population. Future studies are needed to develop culturally sensitive instruments.

Sexuality Assessment of the Brazilian Population: An Integrative Review of the Available Instruments.

This paper provides an integrative review of psychometric instruments targeting sexual function and clinical measures of sexuality available to the Brazilian population. Our aim was to summarize the existing measures, indicating current development needs related to the quality of psychometric evidence, research design and untapped theoretical ground that could be relevant for clinical practice and research in sexuality. Electronic databases were searched. Additional records were found through a manual search. The general search terms and operators were (scale OR inventory OR questionnaire) AND (validation) AND (sexual beliefs OR sexuality OR sexual behavior OR sexual function OR sexual satisfaction) AND (Brazil or Brazilian). The results indicate a total of 18 developed or transculturally adapted and/or validated scales and questionnaires available in Brazilian Portuguese, covering sexual dysfunctions and clinical measures. Despite development, adaptation and validation efforts, there is a critical need for better psychometric and sampling strategies as well as norms for the clinical interpretation of test results. Ecological validity is also a challenge. At present, sexual assessments in Brazil offer some useful information, but reaching the applied clinical field remains a challenge.Supplemental data for this article is available online at https://doi.org/10.1080/0092623X.2022.2035869 .

Intervenções Preventivas com Casais: O que Podemos Aprender com a Experiência Internacional? / Preventive Interventions with Couples: What Can we Learn from the International Experience?

Resumo A dissolução da unidade conjugal é um desafio familiar e para os diversos sistemas sociais a esta relacionados. O objetivo deste artigo é revisar a literatura sobre programas preventivos com casais, visando a identificar os formatos de sucesso, as lacunas existentes no que é oferecido no Brasil e o que podemos aprender com a experiência internacional. Os dados são apresentados e discutidos privilegiando os estudos que se mostraram teórica e empiricamente relevantes para o desenvolvimento de um programa adaptado à realidade brasileira. Os estudos encontrados apontam para a eficácia das intervenções preventivas na promoção de habilidades relacionadas à resiliência conjugal. Entretanto, os mecanismos de mudança implicados nesse processo e sua repercussão na qualidade conjugal ainda não foram esclarecidos.

Abstract The dissolution of a marital unit challenges not only the family but also a great range of social systems related to it. The article aimed to review the literature on preventive programs with couples, willing to identify the elements of success, the gaps in the interventions offered in Brazil, and summarize what we should learn from the international experience. Data will be presented and discussed, highlighting the studies found to be theoretically and empirically relevant to the development of a program targeting the prevention of crisis and the promotion of marital resilience adapted to the Brazilian reality. Results point to the efficacy of preventive interventions in promoting relational skills associated with marital resilience. However, the mechanisms of change implicated in this process, as well as its impact on marital quality, are still to be further clarified.

O papel preditivo da habilidade empática sobre o perdão interpessoal / The predictive role of empathic skill on interpersonal forgiveness / El papel predictivo de la capacidad empática sobre el perdón interpersonal

Pesquisas associam benefícios pessoais e interpessoais à empatia, uma habilidade de interação social que abrange aspectos cognitivos, afetivos e comportamentais. A empatia envolve a capacidade para adotar a perspectiva afetiva e cognitiva do outro (tomada de perspectiva), para importar-se genuinamente com o bem-estar alheio (sensibilidade afetiva) e para comportar-se de forma congruente, expressando ao interlocutor que o compreende e se preocupa com o mesmo. Estudos recentes têm relacionado esta habilidade ao perdão interpessoal, o qual caracteriza-se pela mudança cognitiva, afetiva e comportamental em relação a um ofensor específico, de uma polaridade negativa a outra positiva. Neste estudo, objetivou-se avaliar o valor preditivo da empatia sobre o perdão, a partir de medidas de autorrelato multidimensionais. O Inventário de Empatia e o Enright Forgiveness Inventory foram aplicados a uma amostra brasileira, composta por 172 participantes. Análises de regressão indicaram que três fatores empáticos - Tomada de Perspectiva, Sensibilidade Afetiva e Altruísmo - foram preditores do perdão, nas dimensões afetiva e comportamental. Os resultados encontrados apoiam a importância da empatia para a ocorrência do perdão e sugerem que investir nesta habilidade seja um meio promissor de promoção do perdão em intervenções para superação da mágoa.(AU)

Current research point to personal and interpersonal benefits associated to empathy, a social interaction ability that includes cognitive, affective and behavioral aspects. Empathy involves the ability to adopt the other's affective and cognitive perspective (perspective taking), to care genuinely with the welfare of others (affective sensitivity) and to behave in a consistent manner, expressing understanding and concern to the one whom you are talking to. Recent studies have linked this ability to interpersonal forgiveness, which is characterized by cognitive, affective and behavioral change in relation to a specific offender, from a negative polarity to a positive one. This study aimed to evaluate the predictive power of empathy on forgiveness, using self-report multidimensional instruments. The Empathy Inventory and the Enright Forgiveness Inventory were applied to a Brazilian sample composed of 172 participants. Regression analysis indicated three dimensions of empathy - Perspective Taking, Affective Sensitivity and Altruism - as predictors of affective and behavioral aspects of forgiveness. Results support the important role of empathy for the occurrence of forgiveness and they suggest investing in this ability is a promising means of promoting forgiveness in interventions to overcome grief.(AU)

Investigaciones han asociado beneficios personales e interpersonales a empatía, una habilidad de interacción social que incluye aspectos cognitivos, afectivos y conductuales. Empatía implica capacidad de adoptar el punto de vista afectivo y cognitivo de los otros (toma de perspectiva), de preocuparse con el bienestar de los demás (sensibilidad afectiva) y de comportarse de manera consistente, expresando al otro comprensión y que el mismo le importa. Estudios recientes han relacionado esta capacidad al perdón interpersonal, que se caracteriza por el cambio cognitivo, afectivo y de comportamiento en relación con un agresor específico, de una polaridad negativa a otra positiva. Este estudio tuvo como objetivo evaluar el valor predictivo de la empatía sobre el perdón, usando medidas multidimensionales de autorreporte. Se aplicaron el Inventario de Empatía y el Enright Forgiveness Inventory a una muestra brasileña de 172 participantes. Los análisis de regresión indicaron que tres factores de la empatía - Toma de Perspectiva, Sensibilidad Afectiva y Altruismo - fueron predictores del perdón en sus dimensiones afectivas y conductuales. Los resultados apoyan la importancia de la empatía para la ocurrencia del perdón y sugieren que la inversión en esta habilidad es un medio prometedor para promover perdón en intervenciones para superar el dolor.(AU)

O papel preditivo da habilidade empática sobre o perdão interpessoal / The predictive role of empathic skill on interpersonal forgiveness / El papel predictivo de la capacidad empática sobre el perdón interpersonal

Pesquisas associam benefícios pessoais e interpessoais à empatia, uma habilidade de interação social que abrange aspectos cognitivos, afetivos e comportamentais. A empatia envolve a capacidade para adotar a perspectiva afetiva e cognitiva do outro (tomada de perspectiva), para importar-se genuinamente com o bem-estar alheio (sensibilidade afetiva) e para comportar-se de forma congruente, expressando ao interlocutor que o compreende e se preocupa com o mesmo. Estudos recentes têm relacionado esta habilidade ao perdão interpessoal, o qual caracteriza-se pela mudança cognitiva, afetiva e comportamental em relação a um ofensor específico, de uma polaridade negativa a outra positiva. Neste estudo, objetivou-se avaliar o valor preditivo da empatia sobre o perdão, a partir de medidas de autorrelato multidimensionais. O Inventário de Empatia e o Enright Forgiveness Inventory foram aplicados a uma amostra brasileira, composta por 172 participantes. Análises de regressão indicaram que três fatores empáticos - Tomada de Perspectiva, Sensibilidade Afetiva e Altruísmo - foram preditores do perdão, nas dimensões afetiva e comportamental. Os resultados encontrados apoiam a importância da empatia para a ocorrência do perdão e sugerem que investir nesta habilidade seja um meio promissor de promoção do perdão em intervenções para superação da mágoa.

Current research point to personal and interpersonal benefits associated to empathy, a social interaction ability that includes cognitive, affective and behavioral aspects. Empathy involves the ability to adopt the other's affective and cognitive perspective (perspective taking), to care genuinely with the welfare of others (affective sensitivity) and to behave in a consistent manner, expressing understanding and concern to the one whom you are talking to. Recent studies have linked this ability to interpersonal forgiveness, which is characterized by cognitive, affective and behavioral change in relation to a specific offender, from a negative polarity to a positive one. This study aimed to evaluate the predictive power of empathy on forgiveness, using self-report multidimensional instruments. The Empathy Inventory and the Enright Forgiveness Inventory were applied to a Brazilian sample composed of 172 participants. Regression analysis indicated three dimensions of empathy - Perspective Taking, Affective Sensitivity and Altruism - as predictors of affective and behavioral aspects of forgiveness. Results support the important role of empathy for the occurrence of forgiveness and they suggest investing in this ability is a promising means of promoting forgiveness in interventions to overcome grief.

Investigaciones han asociado beneficios personales e interpersonales a empatía, una habilidad de interacción social que incluye aspectos cognitivos, afectivos y conductuales. Empatía implica capacidad de adoptar el punto de vista afectivo y cognitivo de los otros (toma de perspectiva), de preocuparse con el bienestar de los demás (sensibilidad afectiva) y de comportarse de manera consistente, expresando al otro comprensión y que el mismo le importa. Estudios recientes han relacionado esta capacidad al perdón interpersonal, que se caracteriza por el cambio cognitivo, afectivo y de comportamiento en relación con un agresor específico, de una polaridad negativa a otra positiva. Este estudio tuvo como objetivo evaluar el valor predictivo de la empatía sobre el perdón, usando medidas multidimensionales de autorreporte. Se aplicaron el Inventario de Empatía y el Enright Forgiveness Inventory a una muestra brasileña de 172 participantes. Los análisis de regresión indicaron que tres factores de la empatía - Toma de Perspectiva, Sensibilidad Afectiva y Altruismo - fueron predictores del perdón en sus dimensiones afectivas y conductuales. Los resultados apoyan la importancia de la empatía para la ocurrencia del perdón y sugieren que la inversión en esta habilidad es un medio prometedor para promover perdón en intervenciones para superar el dolor.

Agoraphobia Related to Unassertiveness in Panic Disorder.

Despite developments in panic disorder (PD) research, a significant percentage of patients do not benefit from conventional treatments. Interpersonal factors have been identified as potential predictors of treatment failures. We aimed to evaluate assertiveness in a sample of patients with PD and its implications for treatment. Forty-six symptomatic patients with PD and 46 college students responded to assessment scales regarding assertiveness and clinical data. Seventy-five percent of the patients had a secondary diagnosis of agoraphobia. We found that the PD group was characterized as nonassertive and slightly less assertive than control subjects. Furthermore, the deficit in the level of assertiveness correlated with the severity of the PD. The diagnosis of agoraphobia was correlated with unassertiveness (p < 0.05). Agoraphobia predisposes individuals to dependency and insecurity about their ability to overcome anxiogenic situations. These data demonstrate the importance of managing assertiveness in patients with PD accompanied by agoraphobia.

Sexual Activity and Heart Patients: A Contemporary Perspective.

Sexual activity (SA) encompasses several behaviors such as kissing (Ki), touching (T), oral (O) stimulation, masturbation (M), and vaginal/anal intercourse (I). The acronym KiTOMI is proposed here to represent these behaviors. SA, particularly coitus, is a major aspect of health-related quality of life and is often considered the most pleasant and rewarding exercise performed during an entire lifetime. Although several studies have been conducted on sexuality, relatively limited information is available regarding SA in patients with heart disease. Moreover, the level of evidence of this limited information is nearly always B or C. This article provides a comprehensive and updated review of the relevant literature and offers evidence and expert-based practical messages regarding SA in patients with heart disease. Considering the rationale for exercise prescription, SA is typically well tolerated by most clinically stable patients with heart disease. Even in more debilitated and sicker individuals, KiT activities would most likely be feasible and desirable. The absolute risk of major adverse cardiovascular events during SA is typically very low. Even lower death rates have been reported for specific groups, such as women in general, aerobically fit men, and asymptomatic young adults with congenital heart disease. Finally, we emphasize the relevance of sexual counselling for patients and their partners, including the proper use of medications to treat erectile dysfunction. Counselled patients will be reassured and adequately informed regarding how to gradually resume habitual SA after a major cardiac event or procedure, starting with KiT and progressively advancing to KiTOM until all KiTOMI activities are allowed.

Cardiorespiratory optimal point: a submaximal exercise variable to assess panic disorder patients.

Panic disorder (PD) patients often report respiratory symptoms and tend to perform poorly during maximal cardiopulmonary exercise testing (CPX), at least partially, due to phobic anxiety. Thus, we hypothesized that a submaximal exercise variable, minimum VE/VO2 - hereafter named cardiorespiratory optimal point (COP) -, may be useful in their clinical assessment. Data from 2,338 subjects were retrospectively analyzed and 52 (2.2%) patients diagnosed with PD (PDG) (70% women; aged 48±13 years). PD patients were compared with a healthy control group (CG) precisely matched to number of cases, age and gender profiles. PDG was further divided into two subgroups, based on having achieved a maximal or a submaximal CPX (unwilling to continue until exhaustion). We compared COP, VO2 max, maximum heart rate (HR max) between PDG and CG, and also COP between maximal and submaximal PD subgroups. COP was similar between PDG and CG (21.9±0.5 vs. 23.4±0.6; p = 0.07), as well as, for PD subgroups of maximal and submaximal CPX (22.0±0.5 vs. 21.6±1.3; p = 0.746). Additionally, PD patients completing a maximal CPX obtained VO2 max (mL x kg-1 x min-1) (32.9±1.57 vs 29.6±1.48; p = 0.145) and HR max (bpm) similar to controls (173±2.0 vs 168±2.7; p = 0.178). No adverse complications occurred during CPX. Although clinically safe, it is sometimes difficult to obtain a true maximal CPX in PD patients. Normalcy of cardiorespiratory interaction at submaximal effort as assessed by COP may contribute to reassure both patients and physicians that there is no physiological substrate for exercise-related respiratory symptoms often reported by PD patients.

Terapia cognitivo-comportamental e coaching cognitivo-comportamental: como as duas práticas se integram e se diferenciam / Cognitive-behavioural therapy and cognitive-behavioural coaching: differences and similarities between the two approaches

O coaching cognitivo-comportamental (CCC) é um processo estruturado de estabelecimento e alcance de metas que se fundamenta sobre o princípio cognitivo-comportamental, que pressupõe que não são os eventos em si que deflagram respostas emocionais e comportamentais, mas a interpretação que os indivíduos apresentam sobre eles. Nesse sentido, o CCC é um processo de identificação e desbloqueio de padrões cognitivos que dificultam a realização e o alcance de objetivos vinculado a planos de ação para a mudança comportamental, tendo sido descrito como método eficaz para o alcance de resultados na vida profissional e pessoal. No entanto, a interface dessa prática com a terapia cognitivo-comportamental (TCC) tem sido pouco investigada no Brasil. Assim, este artigo tem como objetivo discutir algumas das principais semelhanças e diferenças entre essas duas práticas. Pretende-se, com essa discussão, contribuir para o fortalecimento da prática profissional fundamentada sobre a abordagem cognitivo-comportamental para além do contexto clínico no nosso país, tendo em vista que o CCC visa atuar com clientes que não preencham critérios diagnósticos para transtornos mentais ou que simplesmente almejam alcançar uma experiência de viver mais plena e dotada de significado(AU)

Cognitive-behavioral coaching (CBC) is a structured process of goal establishment and attainment that is grounded on the cognitive-behavioral principle that emotional and behavioral responses are not triggered by events per se but by the individual's interpretation of them. In this respect, the CBC is a process of identifying and unblocking cognitive patterns that difficult goal achievement, tagged to action plans targeting behavioral change. CBC has been described as an effective method for achieving results in both professional and personal dimensions of life. However, the interface of this practice with CBT has been little investigated in Brazil. Thus, the present article aims at attempting to bridge this gap by presenting and discussing some of the main similarities and differences between these two practices. It is intended that this discussion will contribute towards the strengthening of cognitive-behavioral-grounded practices beyond the clinical context in our country, with patients who do not fulfill diagnostic criteria for mental disorders or with those who simply aim at developing a more purposeful experience of living(AU)

Dietary sources of fiber intake in Brazil.

The objective of this study was to estimate the household availability of fibers in Brazil and to identify the dietary sources of this nutrient. Data from the 2008-2009 Household Budget Survey were used to estimate national household availability and density of fibers and also according to stratifications defined by income level, five regions and area (rural or urban). The contribution of the different food groups, classified by the nature, extent and purpose of processing, to total fibers available in Brazilian households was also determined. The mean density of per capita fibers was 7.6 g/1000 kcal. Higher availability and density of fibers was observed in households situated in rural areas and among low-income families. The main dietary sources of fiber were beans, bread, rice, fruit, vegetables and manioc flour. Fiber intake was found to be insufficient. Therefore, actions promoting a healthy diet are needed to improve the dietary quality of the Brazilian population.

Validação da versão brasileira do questionário de ansiedade cardíaca / Brazilian portuguese validated version of the cardiac anxiety questionnaire

FUNDAMENTOS: A ansiedade cardíaca (AC) é o medo de sensações cardíacas, caracterizado por sintomas recorrentes de ansiedade em pacientes com ou sem doença cardiovascular. O Questionário de Ansiedade Cardíaca (QAC) é uma ferramenta para avaliar a AC, já adaptado, mas não validado em português. OBJETIVO: Este trabalho apresenta as três fases dos estudos de validação do QAC brasileiro. MÉTODOS: Foram recrutados 98 pacientes com doença arterial coronária, a fim de extrair a estrutura fatorial e avaliar a confiabilidade do QAC (fase 1). O objetivo da fase 2 foi explorar a validade convergente e divergente. Cinquenta e seis pacientes completaram o QAC, juntamente com o Escala de sensações corporais (ESC) e o Versão brasileira do Social Phobia Inventory (SPIN). Para determinar a validade discriminante (fase 3), comparamos os escores do QAC de dois subgrupos formados por pacientes da fase 1 (n = 98), de acordo com os diagnósticos de transtorno do pânico e agorafobia obtidos com o MINI - Mini International Neuropsychiatric Interview (Mini Entrevista Neuropsiquiátrica Internacional). RESULTADOS: A solução de dois fatores foi a mais interpretável (46,4% da variância). As subescalas foram denominadas de "Medo e Hipervigilância" (n = 9; alfa = 0,88) e "Evitação" (n = 5; alfa = 0,82). Foi encontrada correlação significativa do fator 1 com o escore total do ESC (p < 0,01), mas não com o fator 2. Os fatores do SPIN apresentaram correlações significativas com as subescalas do QAC (p < 0,01). Na fase 3, os escores dos pacientes "Cardíacos com pânico" foram significativamente maiores no fator 1 do QAC (t = -3,42; p < 0,01, IC = -1,02 a -0,27), e maiores, mas não significativamente diferentes, no fator 2 (t = -1,98; p = 0,51, IC = -0.87 a 0,00). CONCLUSÕES: Os presentes resultados fornecem uma versão final brasileira validada do QAC adequada aos contextos clínicos e de pesquisa.

BACKGROUND: Cardiac Anxiety (CA) is the fear of cardiac sensations, characterized by recurrent anxiety symptoms, in patients with or without cardiovascular disease. The Cardiac Anxiety Questionnaire (CAQ) is a tool to assess CA, already adapted but not validated to Portuguese. OBJECTIVE: This paper presents the three phases of the validation studies of the Brazilian CAQ. METHODS: To extract the factor structure and assess the reliability of the CAQ (phase 1), 98 patients with coronary artery disease were recruited. The aim of phase 2 was to explore the convergent and divergent validity. Fifty-six patients completed the CAQ, along with the Body Sensations Questionnaire (BSQ) and the Social Phobia Inventory (SPIN). To determine the discriminative validity (phase 3), we compared the CAQ scores of two subgroups formed with patients from phase 1 (n = 98), according to the diagnoses of panic disorder and agoraphobia, obtained with the MINI - Mini International Neuropsychiatric Interview. RESULTS: A 2-factor solution was the most interpretable (46.4% of the variance). Subscales were named "Fear and Hypervigilance" (n=9; alpha = 0.88), and "Avoidance", (n = 5; alpha = 0.82). Significant correlation was found between factor 1 and the BSQ total score (p<0.01), but not with factor 2. SPIN factors showed significant correlations with CAQ subscales (p < 0.01). In phase 3, "Cardiac with panic" patients scored significantly higher in CAQ factor 1 (t = -3.42; p < 0.01, CI = -1.02 to -0.27), and higher, but not significantly different, in factor 2 (t = -1.98; p = 0.51, CI = -0.87 to 0.00). CONCLUSIONS: These results provide a definite Brazilian validated version of the CAQ, adequate to clinical and research settings.

Brazilian Portuguese validated version of the Cardiac Anxiety Questionnaire.

BACKGROUND: Cardiac Anxiety (CA) is the fear of cardiac sensations, characterized by recurrent anxiety symptoms, in patients with or without cardiovascular disease. The Cardiac Anxiety Questionnaire (CAQ) is a tool to assess CA, already adapted but not validated to Portuguese. OBJECTIVE: This paper presents the three phases of the validation studies of the Brazilian CAQ. METHODS: To extract the factor structure and assess the reliability of the CAQ (phase 1), 98 patients with coronary artery disease were recruited. The aim of phase 2 was to explore the convergent and divergent validity. Fifty-six patients completed the CAQ, along with the Body Sensations Questionnaire (BSQ) and the Social Phobia Inventory (SPIN). To determine the discriminative validity (phase 3), we compared the CAQ scores of two subgroups formed with patients from phase 1 (n = 98), according to the diagnoses of panic disorder and agoraphobia, obtained with the MINI - Mini International Neuropsychiatric Interview. RESULTS: A 2-factor solution was the most interpretable (46.4% of the variance). Subscales were named "Fear and Hypervigilance" (n=9; alpha = 0.88), and "Avoidance", (n = 5; alpha = 0.82). Significant correlation was found between factor 1 and the BSQ total score (p<0.01), but not with factor 2. SPIN factors showed significant correlations with CAQ subscales (p < 0.01). In phase 3, "Cardiac with panic" patients scored significantly higher in CAQ factor 1 (t = -3.42; p < 0.01, CI = -1.02 to -0.27), and higher, but not significantly different, in factor 2 (t = -1.98; p = 0.51, CI = -0.87 to 0.00). CONCLUSIONS: These results provide a definite Brazilian validated version of the CAQ, adequate to clinical and research settings.

Entrevista com Dr. Stephen Palmer: o desenvolvimento do coaching cognitivo comportamental / Interview with Stephen Palmer: the development of cognitive behavioural coaching

Stephen Palmer, PhD, é diretor do Centre for Coaching e do Centre for Stress Management em Londres, Inglaterra. Ele é diretor da Unidade de Psicologia do Coaching da City University London e do adSapiens, Gothenburg, Suécia. É também diretor honorário da Unidade de Psicologia do Coaching do Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro. Tem formação clínica em Terapia Cognitivo Comportamental e atua como Supervisor em coaching, com certificação pela International Society for Coaching Psychology (ISCP), da qual é atualmente presidente. Dr. Palmer escreveu/editou mais de 40 livros. O coaching cognitivo comportamental é uma abordagem de coaching baseada nos princípios teóricos da Terapia Cognitivo Comportamental, desenvolvendo técnicas específicas para promover e facilitar processos de mudança e a obtenção de metas específicas. Diversas evidências científicas demonstram a eficácia da abordagem do Coaching Cognitivo Comportamental (CCC) nas diversas esferas de aplicação do coaching, como o coaching pessoal, coorporativo, de saúde etc. A presente entrevista tem como objetivo familiarizar o leitor da Revista Brasileira de Terapias Cognitivas com os princípios e aplicações do CCC e divulgar esta área do conhecimento no país(AU)

Stephen Palmer PhD is Director of the Centre for Coaching, and the Centre for Stress Management, London, UK. He is Director of the Coaching Psychology Unit at City University London and a Director of adSapiens, Gothenburg, Sweden. He is also Honorary Consultant Director of the Coaching Psychology Unit at the Federal University of Rio de Janeiro, Brazil. He is an Accredited Cognitive Behavioural Therapist and Coach. He is President of the International Society for Coaching Psychology and former President of the Association for Coaching. He has written/edited 40 books. The Cognitive Behavioral Coaching (CBC) is based on the theoretical principles of Cognitive Behavioral Therapy, developing specific techniques to promote and facilitate change processes and specific goals achievement. Abounding scientific evidence currently demonstrate the efficacy of the Cognitive Behavioural Coaching (CCC) approach in the various spheres of application of coaching, as life coaching, as well as executive and health coaching. This interview aims to familiarize the reader with the principles and applications of CBC and disseminate this possible application of cognitive behavioral principles in Brazil(AU)

Deficiências em habilidades sociais na depressão: estudo comparativo / Las deficiencias en las habilidades sociales en la depressión: un estudio comparativo / Social skills deficts in depression: a comparative study

O objetivo deste trabalho foi verificar a relação entre déficits em habilidades sociais e níveis de depressão. Participaram da amostra 46 indivíduos de ambos os sexos. Dos participantes, 23 eram pacientes de psicoterapia (grupo clínico) que preencheram os critérios do DSM-IV-TR para o diagnóstico de depressão e apresentaram escores compatíveis com esse diagnóstico no inventário Beck de depressão (BDI). Os outros 23 indivíduos (grupo de comparação) apresentaram escores no self report questionnaire (SRQ) compatíveis com baixa probabilidade de desenvolver quadro psiquiátrico. Ambos os grupos responderam ainda ao inventário de habilidades sociais (IHS-Del Prette) e ao inventário de empatia (IE). Os terapeutas do grupo clínico forneceram informações sobre seus pacientes por meio de um questionário. A análise estatística mostrou diferenças significativas entre os grupos. Uma análise qualitativa indicou relação entre sintomas depressivos e períodos de estresse interpessoal. Os resultados confirmam estudos anteriores e sugerem que déficits em habilidades sociais podem constituir um fator de vulnerabilidade para a depressão.(AU)

Objective: To investigate the relationship between deficits in social skills and depression levels. Method: The sample consisted of 46 participants of both sexes were 23 patients in psychotherapy (clinical group) met the DSM-IV-TR for the diagnosis of depression, and had scores compatible with this diagnosis in the Beck depression (BDI). The other 23 subjects (comparison group) had scores in the self report questionnaire (SRQ) compatible with a low probability of developing psychiatric disorder. Yet responded to the Social Skills Inventory (IHS-Del Prette) and Empathy Inventory (IE). Therapists Clinical Group provided information on their patients through a questionnaire. Results: Statistical analysis showed significant differences between groups. A qualitative analysis indicated the relationship between depressive symptoms and interpersonal stress periods. Conclusion: The results confirm previous studies and suggest that deficits in social skills may be a vulnerability factor for depression.(AU)

Objetivo: Investigar la relación entre los déficits en habilidades sociales y los niveles de depresión. Método: La muestra constó de 46 participantes de ambos sexos fueron 23 pacientes en psicoterapia (grupo clínico) se reunió con el DSM-IV-TR para el diagnóstico de depresión, y tuvo resultados compatibles con este diagnóstico en el Beck depresión (BDI). Los otros 23 sujetos (grupo de comparación) tuvieron puntuaciones en el self report questionnaire (SRQ) compatible con una baja probabilidad de desarrollar trastornos psiquiátricos. Sin embargo, respondieron al inventario de habilidades sociales (IHS-Del Prette) y el inventario de empatía (IE). Grupo de terapeutas clínicos proporcionaron información sobre sus pacientes a través de un cuestionario. Resultados: El análisis estadístico mostró diferencias significativas entre los grupos. Un análisis cualitativo se indica la relación entre síntomas depresivos y los períodos de estrés interpersonal. Conclusión: Los resultados confirman estudios previos y sugieren que los déficits en habilidades sociales puede ser un factor de vulnerabilidad para la depresión.(AU)