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1.
PLoS One ; 15(2): e0229067, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32084160

RESUMO

Psilocybin, a substance mainly found in mushrooms of the genus psilocybe, has been historically used for ritualistic, recreational and, more recently, medicinal purposes. The scientific literature suggests low toxicity, low risk of addiction, overdose, or other causes of injury commonly caused by substances of abuse, with growing interest in the use of this substance for conditions such as treatment-resistant depression. However, the presence of negative outcomes linked to psilocybin use is not clear yet. The objective of this study is to investigate the negative effects of psilocybin consumption, according to the users' own perception through self-reports extracted from an online platform. 346 reports were analyzed with the assistance of the IRAMUTEQ textual analysis software, adopting the procedures of Descending Hierarchical Classification, Correspondence Factor Analysis and Specificities Analysis. The text segments were grouped in 4 main clusters, describing thinking distortions, emergencies, perceptual alterations and the administration of the substance. Bad trips were more frequent in female users, being associated with thinking distortions. The use of multiple doses of psilocybin in the same session or its combination with other substances was linked to the occurrence of long-term negative outcomes, while the use of mushrooms in single high doses was linked to medical emergencies. These results can be useful for a better understanding of the effects of psilocybin use, guiding harm-reduction initiatives.


Assuntos
Psilocibina/química , Agaricales/química , Feminino , Alucinógenos/química , Humanos , Masculino , Autorrelato , Software
2.
Int Psychogeriatr ; : 1-11, 2019 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-31647053

RESUMO

OBJECTIVES: To investigate the nature of the relationship between cognitive function, mood state, and functionality in predicting awareness in a non-clinically depressed sample of participants with mild to moderate Alzheimer's disease (AD) in Brazil. METHODS: People with AD (PwAD) aged 60 years or older were recruited from an outpatient unit at the Center of AD of the Federal University of Rio de Janeiro, Brazil. Measures of awareness of condition (Assessment Scale of the Psychosocial Impact of the Diagnosis of Dementia), cognitive function (Mini-Mental State Examination), mood state (Cornell Scale for Depression in Dementia), and functionality (Pfeffer Functional Activities Questionnaire) were applied to 264 people with mild to moderate AD and their caregivers. Hypotheses were tested statistically using SEM approach. Three competing models were compared. RESULTS: The first model, in which the influence of mood state and cognitive function on awareness was mediated by functionality, showed a very good fit to the data and a medium effect size. The competing models, in which the mediating variables were mood state and cognitive function, respectively, only showed poor model fit. CONCLUSION: Our model supports the notion that the relationship between different factors and awareness in AD is mediated by functionality and not by depressive mood state or cognitive level. The proposed direct and indirect effects on awareness are discussed, as well as the missing direct influence of mood state on awareness. The understanding of awareness in dementia is crucial and our model gives one possible explanation of its underlying structure in AD.

3.
Neuropsychol Rehabil ; : 1-35, 2019 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-31642719

RESUMO

Background: Awareness of deficit plays an important role in adjustment following a brain injury and has been noted to impact on engagement with and outcome of rehabilitation. However, there are challenges associated with the assessment of awareness. Aim: To systematically review all instruments used to assess intellectual awareness of deficits following Traumatic Brain Injury (TBI) in adults, and evaluate instrument characteristics (e.g., the format and focus of measures of awareness) and assessment methods adopted. Results: Thirty-four studies, all rated as fair to good quality, were identified and within these twenty-three different assessment tools were adopted. The most common method of assessment was patient-proxy discrepancy, with three frequently used instruments employed in a total of 22 of the 34 studies. Across studies, variability was noted regarding the type of assessment method dependent on various sample demographics (e.g., age of sample) and injury characteristics (e.g., time post injury). Conclusions: There is no consensus on the preferred instrument to assess intellectual awareness of deficits after TBI. Continued instrument development should attempt to incorporate multiple perspectives and assessment should take into account demographic and injury-related factors. An insightful avenue for future research would be to determine which factors are likely to impact awareness measurement.

4.
BMJ Open ; 9(8): e030933, 2019 08 20.
Artigo em Inglês | MEDLINE | ID: mdl-31434784

RESUMO

INTRODUCTION: In low/middle-income countries (LMICs), the prevalence of people diagnosed with dementia is expected to increase substantially and treatment options are limited, with acetylcholinesterase inhibitors not used as frequently as in high-income countries (HICs). Cognitive stimulation therapy (CST) is a group-based, brief, non-pharmacological intervention for people with dementia that significantly improves cognition and quality of life in clinical trials and is cost-effective in HIC. However, its implementation in other countries is less researched. This protocol describes CST-International; an implementation research study of CST. The aim of this research is to develop, test, refine and disseminate implementation strategies for CST for people with mild to moderate dementia in three LMICs: Brazil (upper middle-income), India (lower middle-income) and Tanzania (low-income). METHODS AND ANALYSIS: Four overlapping phases: (1) exploration of barriers to implementation in each country using meetings with stakeholders, including clinicians, policymakers, people with dementia and their families; (2) development of implementation plans for each country; (3) evaluation of implementation plans using a study of CST in each country (n=50, total n=150). Outcomes will include adherence, attendance, acceptability and attrition, agreed parameters of success, outcomes (cognition, quality of life, activities of daily living) and cost/affordability; (4) refinement and dissemination of implementation strategies, enabling ongoing pathways to practice which address barriers and facilitators to implementation. ETHICS AND DISSEMINATION: Ethical approval has been granted for each country. There are no documented adverse effects associated with CST and data held will be in accordance with relevant legislation. Train the trainer models will be developed to increase CST provision in each country and policymakers/governmental bodies will be continually engaged with to aid successful implementation. Findings will be disseminated at conferences, in peer-reviewed articles and newsletters, in collaboration with Alzheimer's Disease International, and via ongoing engagement with key policymakers.

5.
J Alzheimers Dis ; 69(4): 921-933, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31104016

RESUMO

Empathy is essential for social interaction and a crucial trait to understand the intentions and behaviors of others and to react accordingly. Alzheimer's disease (AD) affects both cognitive and emotional processes and can lead to social dysfunction. Empathy results from the interaction of four components: shared neural representation, self-awareness, mental flexibility, and emotion regulation. This review discusses the abilities and deficits of patients with AD from the perspective of subcomponents of empathy and integrates these facets into a model of human empathy. The aim was to investigate the components that are affected by AD and the ways in which patients are still able to empathize with others in their social environment. It concludes that AD patients show a pattern of relatively preserved affective aspects and impairments in cognitive components of empathy and points out specific areas with the need for further research.

6.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 41(3): 213-217, May-June 2019. tab
Artigo em Inglês | LILACS | ID: biblio-1011498

RESUMO

Objectives: To estimate the current prevalence of posttraumatic stress disorder (PTSD) and the diagnosis rate of this disorder ascertained by psychiatrists in training. Methods: We interviewed 200 adults under treatment in a university mental health outpatient clinic. The PTSD diagnoses obtained using the Structured Clinical Interview for DSM-IV (SCID-IV) were compared with the patients' medical records. Results: Forty-one patients (20.5%) were diagnosed with current PTSD, but only one of them (2.4%) had previously received this diagnosis. This study confirms that although PTSD is highly prevalent among mental health outpatients, it is remarkably underdiagnosed in teaching hospitals. Conclusions: These findings suggest that psychiatrists in training may be failing to investigate traumatic events and their consequences and strongly indicate that trauma-related issues should be given more prominence in psychiatry curricula and psychiatrist training.


Assuntos
Humanos , Masculino , Feminino , Adulto , Idoso , Adulto Jovem , Psiquiatria/educação , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Fatores Socioeconômicos , Transtornos de Estresse Pós-Traumáticos/psicologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Brasil/epidemiologia , Saúde Mental/educação , Prevalência , Inquéritos e Questionários , Assistência Ambulatorial , Hospitais Universitários , Pessoa de Meia-Idade
7.
Alzheimer Dis Assoc Disord ; 33(3): 220-225, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30958416

RESUMO

Awareness of disease is defined as the recognition of changes caused by the deficits related to the disease process. We aimed to examine the psychometric properties of the short versions of the Assessment Scale of Psychosocial Impact of the Diagnosis of Dementia (ASPIDD-s), a multidimensional awareness scale. Using a cross-sectional design, we included 201 people with dementia and their family caregivers. The creation of the short versions was based on items with higher loadings on each factor, the correlations between the short versions and demographic or clinical variables and the relevance of the item to the respondent population. Three short versions were created: version 1 and 3, with 12 items and version 2, with 16 items. The short versions correlated very strongly with the full scale and with the 4 factors of the original scale, maintaining the multidimensional nature of the ASPIDD. Loss of awareness was associated with worse quality of life, decreased functionality and cognitive level, and higher caregiver burden across the short versions. Considering the appropriateness of the items and their clinical relevance, we recommend version 3 for use. With only 12 items, the time required for the completion of the scale is short, while maintaining robust psychometric properties.

8.
Psychiatr Q ; 90(2): 385-394, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30796694

RESUMO

Insight is greatly impaired in Bipolar Disorder (BD), especially during mania. Cognitive impairment is also present in BD. Despite that, few studies have investigated a possible association between these two aspects. The main goal of the current study is to compare BD affective states regarding performance in cognitive testing and investigate clinical and cognitive predictors for insight loss in BD. The study investigated a sample of 65 patients who were evaluated in one of the BD phases (mania, euthymia or depression). All the subjects underwent neuropsychological evaluation and completed the Insight Scale for Affective Disorders (ISAD). The relationship between level of insight and clinical/cognitive variables was analyzed through multiple regression models. No significant differences were found among BD phases regarding performance on cognitive testing. Insight was more impaired in mania then in depression or euthymia. Predictors for loss of insight were: severity of manic symptoms and impairments in selective attention (Symbol search test), divided attention (Trail making test) and inhibition (Stroop test). The sample size is a potential limitation of the current study. Nevertheless, the results suggest this had limited impact, with group differences being detected for a number of variables. The results found have important clinical importance, suggesting, for example, that rehabilitation of specific cognitive skills may improve insight in BD.


Assuntos
Conscientização/fisiologia , Transtorno Bipolar/fisiopatologia , Disfunção Cognitiva/fisiopatologia , Autoavaliação Diagnóstica , Adulto , Atenção/fisiologia , Transtorno Bipolar/complicações , Disfunção Cognitiva/etiologia , Função Executiva/fisiologia , Feminino , Humanos , Inibição Psicológica , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença
9.
Braz J Psychiatry ; 41(3): 213-217, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30328959

RESUMO

OBJECTIVES: To estimate the current prevalence of posttraumatic stress disorder (PTSD) and the diagnosis rate of this disorder ascertained by psychiatrists in training. METHODS: We interviewed 200 adults under treatment in a university mental health outpatient clinic. The PTSD diagnoses obtained using the Structured Clinical Interview for DSM-IV (SCID-IV) were compared with the patients' medical records. RESULTS: Forty-one patients (20.5%) were diagnosed with current PTSD, but only one of them (2.4%) had previously received this diagnosis. This study confirms that although PTSD is highly prevalent among mental health outpatients, it is remarkably underdiagnosed in teaching hospitals. CONCLUSIONS: These findings suggest that psychiatrists in training may be failing to investigate traumatic events and their consequences and strongly indicate that trauma-related issues should be given more prominence in psychiatry curricula and psychiatrist training.


Assuntos
Psiquiatria/educação , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Adulto , Idoso , Assistência Ambulatorial , Brasil/epidemiologia , Feminino , Hospitais Universitários , Humanos , Masculino , Saúde Mental/educação , Pessoa de Meia-Idade , Prevalência , Fatores Socioeconômicos , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Inquéritos e Questionários , Adulto Jovem
10.
Aging Ment Health ; 23(10): 1400-1404, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-30444133

RESUMO

Objectives: The prevalence of dementia has been increasing particularly in developing countries. However, people with dementia (PwD) in Brazil are currently offered no psychosocial treatment upon diagnosis. Cognitive stimulation therapy (CST) that originated in the UK has proven benefits on cognition and quality of life in PwD. We investigate the possible issues for the implementation of CST for the Brazilian population and its cultural appropriateness. Method: Individual interviews and focus groups were conducted with PwD, their caregivers and health professionals (n = 37). Data were recorded and transcribed, before being analyzed using Framework Analysis. Results: Regarding the issues for implementation of CST in the Brazilian population, two main themes emerged, 'Barriers' and 'Facilitators', along with nine subthemes. Overall, the activities and materials were seen as being appropriate for use with the Brazilian population, some minor changes were suggested. Conclusions: The results indicate that CST is appropriate for use in the Brazilian population, only some cultural adaptations are necessary. In the stakeholders' opinions, CTS intervention is needed in Brazil, due to the lack of treatment options for PwD in developing countries.

11.
Psicol. clín ; 30(3): 509-540, set.-dez. 2018. ilus, tab
Artigo em Inglês | LILACS-Express | ID: biblio-976605

RESUMO

Current psychiatric nosological classifications maintain a heterogeneous categorical view of clinical presentations that contribute to overlapping symptoms across different disorders, thus influencing appropriate diagnosis and treatment. The United States National Institute of Mental Health (NIMH) proposed the Research Domain Criteria (RDoC) project as an alternative dimensional approach that comprises different units of analysis across psychopathology. Although it may represent a paradigm shift, investigations of its application for dissociative phenomena that are present in various clinical conditions are still lacking. The present review examines theoretical models of dissociation and their presence in a wide range of clinical conditions. The literature review indicated the suitability of a transdiagnostic concept of altered states of consciousness by considering dimensions of temporality, narrative, embodiment, affect, and intersubjectivity.


As classificações nosológicas psiquiátricas atuais mantêm uma visão categórica heterogênea das apresentações clínicas que contribuem para a sobreposição de sintomas entre diferentes distúrbios, influenciando, assim, o diagnóstico e o tratamento adequados. O United States National Institute of Mental Health (NIMH) propôs o projeto Research Domain Criteria (RDoC) como uma abordagem dimensional alternativa que engloba diferentes unidades de análise para a compreensão da psicopatologia. Embora essa perspectiva possa representar uma mudança de paradigma, ainda faltam investigações sobre sua aplicação para fenômenos dissociativos presentes em várias condições clínicas. A presente revisão analisa modelos teóricos de dissociação e sua presença em uma ampla gama de condições clínicas. A revisão da literatura indicou a adequação de um conceito transdiagnóstico de estados alterados de consciência, considerando dimensões de temporalidade, narrativa, corporificação, afeto e intersubjetividade.


Las clasificaciones nosológicas psiquiátricas actuales mantienen una visión categórica heterogénea de las presentaciones clínicas que contribuyen a la superposición de los síntomas en diferentes trastornos, lo que influye en el diagnóstico y el tratamiento adecuados. El United States National Institute of Mental Health (NIMH) propuso el proyecto Research Domain Criteria (RDoC) como un enfoque dimensional alternativo que comprende diferentes unidades de análisis para la comprensión de la psicopatología. Aunque esta perspectiva puede representar un cambio de paradigma, aún faltan investigaciones sobre su aplicación para los fenómenos disociativos que están presentes en diversas condiciones clínicas. La presente revisión examina modelos teóricos de disociación y su presencia en una amplia gama de condiciones clínicas. La revisión de la literatura indicó la idoneidad de un concepto trans diagnóstico de estados alterados de conciencia al considerar dimensiones de temporalidad, narrativa, corporificación, afecto e intersubjetividad.

12.
Trends Psychiatry Psychother ; 40(3): 210-215, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30304117

RESUMO

INTRODUCTION: In recent years, the association between temperament and clinical characteristics of mood disorders has been studied. Most bipolar patients show deficits in their awareness of signs and symptoms. The relationship between affective temperament and insight in bipolar patients has not been carried out in the literature so far. OBJECTIVE: To evaluate the relationship between affective temperament and insight in bipolar disorder. METHOD: A group of 65 bipolar patients were followed during a year. Patients underwent a clinical assessment and were diagnosed using criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). Insight was evaluated through the Insight Scale for Affective Disorders (ISAD), and affective temperament, through the TEMPS-Rio de Janeiro. The relationship between affective temperament and insight was explored with Spearman rho correlations between scores on each item of the ISAD and on the TEMPS-Rio de Janeiro subscales. RESULTS: In euthymic phases, bipolars with depressive temperament were associated with a higher level of insight about the consequences of the disorder; when in mania, patients showed better insight about having an affective disorder, presenting psychomotor alterations, and suffering from guilt or grandiosity. Similarly, bipolar patients with higher scores of anxious temperament, when in mania, had better insight on alterations in attention. Bipolar patients with higher scores of hyperthymic temperament, when in mania, showed the worst insight about thought disorder. CONCLUSION: In addition to being determined by the phase of the disease and several varying symptoms, the level of insight in bipolar patients is also influenced by affective temperament.


Assuntos
Afeto , Transtorno Bipolar/psicologia , Autoimagem , Adulto , Idoso , Depressão , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Metacrilatos , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Adulto Jovem
13.
Trends psychiatry psychother. (Impr.) ; 40(3): 210-215, July-Sept. 2018. tab
Artigo em Inglês | LILACS | ID: biblio-963107

RESUMO

Abstract Introduction In recent years, the association between temperament and clinical characteristics of mood disorders has been studied. Most bipolar patients show deficits in their awareness of signs and symptoms. The relationship between affective temperament and insight in bipolar patients has not been carried out in the literature so far. Objective To evaluate the relationship between affective temperament and insight in bipolar disorder. Method A group of 65 bipolar patients were followed during a year. Patients underwent a clinical assessment and were diagnosed using criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). Insight was evaluated through the Insight Scale for Affective Disorders (ISAD), and affective temperament, through the TEMPS-Rio de Janeiro. The relationship between affective temperament and insight was explored with Spearman rho correlations between scores on each item of the ISAD and on the TEMPS-Rio de Janeiro subscales. Results In euthymic phases, bipolars with depressive temperament were associated with a higher level of insight about the consequences of the disorder; when in mania, patients showed better insight about having an affective disorder, presenting psychomotor alterations, and suffering from guilt or grandiosity. Similarly, bipolar patients with higher scores of anxious temperament, when in mania, had better insight on alterations in attention. Bipolar patients with higher scores of hyperthymic temperament, when in mania, showed the worst insight about thought disorder. Conclusion In addition to being determined by the phase of the disease and several varying symptoms, the level of insight in bipolar patients is also influenced by affective temperament.


Resumo Introdução Nos últimos anos, a associação entre temperamento e características clínicas dos transtornos de humor tem sido estudada. A maioria dos pacientes bipolares apresenta déficits na consciência de sinais e sintomas. A relação entre temperamento afetivo e insight em pacientes bipolares não tem sido relatada na literatura até o momento. Objetivo Avaliar a relação entre temperamento afetivo e insight no transtorno bipolar. Métodos Um grupo de 65 pacientes bipolares foi acompanhado por um ano. Os pacientes foram submetidos a uma avaliação clínica utilizando os critérios do Manual Diagnóstico e Estatístico de Transtornos Mentais, 5ª edição (DSM-5). O insight foi avaliado através da Escala de Insight para Transtornos Afetivos (ISAD), e o temperamento afetivo, através da TEMPS-Rio de Janeiro. A relação entre temperamento afetivo e insight foi explorada usando correlações de Spearman entre os escores de cada item da ISAD e as subescalas da TEMPS-Rio de Janeiro. Resultados Nas fases eutímicas, os bipolares com temperamento depressivo relacionaram-se com maior nível de insight sobre as consequências do transtorno; quando em mania, apresentaram melhor insight sobre ter um transtorno afetivo, apresentar alterações psicomotoras e sofrer de culpa ou grandiosidade. Da mesma forma, bipolares com maiores escores de temperamento ansioso, quando em mania, tiveram melhor percepção sobre alterações na atenção. Bipolares com escores mais altos de temperamento hipertímico, quando em mania, mostraram o pior insight sobre o curso do pensamento. Conclusão O nível de insight em pacientes bipolares, além de ser determinado pela fase da doença e por diversos sintomas, é influenciado pelo temperamento afetivo.


Assuntos
Humanos , Masculino , Feminino , Adulto , Idoso , Adulto Jovem , Autoimagem , Transtorno Bipolar/psicologia , Afeto , Escalas de Graduação Psiquiátrica , Conhecimentos, Atitudes e Prática em Saúde , Depressão , Metacrilatos , Pessoa de Meia-Idade
14.
J Alzheimers Dis ; 65(3): 917-930, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30103326

RESUMO

The capacity to make decisions is an important feature of daily living, which is closely linked to proper cognitive functioning. In conditions in which cognitive functioning becomes compromised, such as in Alzheimer's disease (AD), decision-making capacity can also get affected. Especially in AD, this has important implications, since over the course of the condition many important clinical decisions have to be made. For caregivers as well as physicians, it is sometimes difficult to determine how and when to intervene in the decision-making process. The aim of this systematic literature review was to identify studies that have evaluated medical and research consent decision-making capacity in patients with AD. Studies consistently show that decision-making capabilities are impaired in patients with AD. The cognitive and neuronal correlates of this process are, however, poorly studied. The few studies that investigated correlations have shown worse cognitive performance, mainly on the MMSE, to be related to poorer decision-making capacity. As most of these correlations have been performed in groups combining patients and controls, it remains unknown if these associations are disease specific. There is a need to study more systematically the decision-making process in relation to cognitive functioning and neural correlates to be able to develop a framework of decision-making capacity in AD, ultimately aiding clinicians and caregivers to understand and evaluate those capabilities in patients.


Assuntos
Doença de Alzheimer/psicologia , Tomada de Decisões , Consentimento Livre e Esclarecido/psicologia , Doença de Alzheimer/terapia , Pesquisa Biomédica/ética , Cuidadores/psicologia , Humanos , Consentimento Livre e Esclarecido/ética , Médicos/psicologia
15.
Neuropsychology ; 32(6): 700-710, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29878837

RESUMO

OBJECTIVE: Metacognition, or the ability to accurately identify, appraise, and monitor one's deficits, is commonly impaired in Alzheimer's disease (AD). Poor metacognition prevents correct appraisal of a range of physical, cognitive, and emotional symptoms and facilitates anosognosia, which has important clinical implications for individuals (e.g., diminished treatment adherence, increased engagement in high-risk situations) and caregivers (e.g., higher burden). However, the neural correlates of metacognitive disturbance are still debated in the literature, partly because of the subjective nature of traditional awareness measures. METHOD: An objective Feeling of Knowing (FOK) task was used to measure metamemory capacity in a group of cognitively diverse older adults, including 14 with mild to moderate AD and 20 cognitively healthy older adults. The association between three different objective metamemory measures of the FOK task and regional cortical thickness (12 bilateral regions of interest [ROIs] hypothesized to support self-awareness) was analyzed using partial correlations. RESULTS: Less accurate metamemory at the local and global levels was associated with reduced right posterior cingulate cortical thickness, r = -0.42, p = .02 and reduced right medial prefrontal, r = -0.39, p = .029, respectively. CONCLUSIONS: To our knowledge, this was the first study to examine metacognition in relation to cortical thickness. Both global and local metamemory functions appear to rely on the integrity of right sided midline regions, known to be important for processing self-referential information. Findings are conceptualized with regard to the Default Mode Network, and also considered in relation to recent findings pointing to the right insula as a region critical for self-awareness. (PsycINFO Database Record


Assuntos
Envelhecimento/fisiologia , Doença de Alzheimer/fisiopatologia , Córtex Cerebral/diagnóstico por imagem , Memória/fisiologia , Metacognição/fisiologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade
16.
Cortex ; 103: 385-386, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29731103
17.
Trends Psychiatry Psychother ; 40(1): 21-28, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29668823

RESUMO

Introduction Beliefs about the unacceptability of expression and experience of emotion are present in the general population but seem to be more prevalent in patients with a number of health conditions. Such beliefs, which may be viewed as a form of perfectionism about emotions, may have a deleterious effect on symptomatology as well as on treatment adherence and outcome. Nevertheless, few questionnaires have been developed to measure such beliefs about emotions, and no instrument has been validated in a developing country. The current study adapted and validated the Beliefs about Emotions Scale in a Brazilian sample. Methods The adaptation procedure included translation, back-translation and analysis of the content, with the final Brazilian Portuguese version of the scale being tested online in a sample of 645 participants. Internal consistency of the scale was very high and results of a principal axis factoring analysis indicated a two-factor solution. Results Respondents with high fatigue levels showed more perfectionist beliefs, and the scale correlated positively with questionnaires measuring anxiety, depression and fear of negative evaluation, confirming cross-cultural associations reported before. Finally, men, non-Caucasians and participants with lower educational achievement gave greater endorsement to such beliefs than women, Caucasian individuals and participants with higher educational level. Conclusions The study confirms previous clinical findings reported in the literature, but indicates novel associations with demographic variables. The latter may reflect cultural differences related to beliefs about emotions in Brazil.


Assuntos
Emoções , Testes Psicológicos , Pensamento , Adolescente , Adulto , Idoso , Comparação Transcultural , Estudos Transversais , Escolaridade , Inteligência Emocional , Análise Fatorial , Fadiga/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Perfeccionismo , Fatores Sexuais , Inquéritos e Questionários , Tradução , Adulto Jovem
18.
J Diabetes ; 10(11): 835-846, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29665283

RESUMO

BACKGROUND: The aim of the present study was to determine trajectories of cognitive and cortical changes over time in middle-aged patients with type 1 diabetes mellitus (T1DM) and proliferative retinopathy. METHODS: Twenty-five patients and 25 controls underwent neuropsychological assessment and neuroimaging twice in a mean (±SD) of 3.56 ± 0.65 and 3.94 ± 0.91 years, respectively (P = 0.098). Cognitive assessment included the domains of general cognitive ability, memory, information processing speed, executive functions, attention, and motor and psychomotor speed. Symmetrized percentage change in local cortical thickness, surface area, and volume was determined using the FreeSurfer 6 vertex-wise general linear model method. Analyses were performed uncorrected and corrected for baseline systolic blood pressure and depressive symptoms. RESULTS: In patients versus controls, accelerated executive function decline was accompanied by, but not related to, lower left frontal and temporal surface area, left parietal and right frontal thickness, and bilateral frontal and right posterior cingulate volume (family-wise error [FWE]-corrected P < 0.05 for all). In patients, lower executive performance was related to loss of right precuneus surface area (PFWE = 0.005). Higher HbA1c during follow-up was related to executive function decline (r = -0.509, P = 0.016) and loss of left hemisphere surface area (rcorrected analysis = -0.555, P = 0.007). CONCLUSIONS: After 3.5 years of follow-up, middle-aged T1DM patients with proliferative retinopathy, mild focal changes in executive functions, and cortical structure were found, which may indicate accelerated aging.


Assuntos
Encefalopatias/etiologia , Transtornos Cognitivos/etiologia , Cognição , Diabetes Mellitus Tipo 1/complicações , Retinopatia Diabética/etiologia , Função Executiva , Substância Cinzenta/fisiopatologia , Substância Branca/fisiopatologia , Adulto , Glicemia/efeitos dos fármacos , Glicemia/metabolismo , Encefalopatias/diagnóstico por imagem , Encefalopatias/fisiopatologia , Encefalopatias/psicologia , Estudos de Casos e Controles , Transtornos Cognitivos/diagnóstico por imagem , Transtornos Cognitivos/fisiopatologia , Transtornos Cognitivos/psicologia , Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 1/diagnóstico , Diabetes Mellitus Tipo 1/tratamento farmacológico , Retinopatia Diabética/diagnóstico , Progressão da Doença , Hemoglobina A Glicada/metabolismo , Substância Cinzenta/diagnóstico por imagem , Humanos , Hipoglicemiantes/uso terapêutico , Pessoa de Meia-Idade , Fatores de Risco , Fatores de Tempo , Substância Branca/diagnóstico por imagem
19.
Cogn Behav Neurol ; 31(1): 2-12, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29561313

RESUMO

BACKGROUND AND OBJECTIVE: Lack of awareness about impairments is commonly found in Alzheimer disease (AD), but recent evidence suggests that patients may respond to the experience of illness despite limited awareness. In this study, we explored whether implicit emotional responses to experiences of failure in cognitive tasks would result in longer-term change in behavior. METHODS: Twenty-two patients with AD were seen 1 week after a previous session in which they performed computer tasks that had been manipulated to be either too difficult (failure condition) or very easy (success condition) for them. At the second session, both types of tasks were set to have medium difficulty and were administered so that the participants decided how long to persist on each task. Task persistence was determined by relative time spent doing the tasks, considering that participants would be more likely to stop performing tasks in which they had experienced failure during the first session. RESULTS: Task persistence in the second session was not affected by performance in the first session. However, when participants' awareness of performance in the first session was taken into account, differences were found in persistence between tasks in the second session. During the second session, participants stopped performing tasks after a sequence of errors. There were no self-reported changes in motivation or enjoyment in response to task failure. CONCLUSIONS: These findings suggest that implicit learning of task valence may be compromised in AD, but that initial moments of awareness of performance may influence long-term adaptation in unaware patients.


Assuntos
Doença de Alzheimer/fisiopatologia , Emoções/fisiologia , Transtornos Mentais/fisiopatologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino
20.
Trends psychiatry psychother. (Impr.) ; 40(1): 21-28, Jan.-Mar. 2018. tab
Artigo em Inglês | LILACS | ID: biblio-904607

RESUMO

Abstract Introduction Beliefs about the unacceptability of expression and experience of emotion are present in the general population but seem to be more prevalent in patients with a number of health conditions. Such beliefs, which may be viewed as a form of perfectionism about emotions, may have a deleterious effect on symptomatology as well as on treatment adherence and outcome. Nevertheless, few questionnaires have been developed to measure such beliefs about emotions, and no instrument has been validated in a developing country. The current study adapted and validated the Beliefs about Emotions Scale in a Brazilian sample. Methods The adaptation procedure included translation, back-translation and analysis of the content, with the final Brazilian Portuguese version of the scale being tested online in a sample of 645 participants. Internal consistency of the scale was very high and results of a principal axis factoring analysis indicated a two-factor solution. Results Respondents with high fatigue levels showed more perfectionist beliefs, and the scale correlated positively with questionnaires measuring anxiety, depression and fear of negative evaluation, confirming cross-cultural associations reported before. Finally, men, non-Caucasians and participants with lower educational achievement gave greater endorsement to such beliefs than women, Caucasian individuals and participants with higher educational level. Conclusions The study confirms previous clinical findings reported in the literature, but indicates novel associations with demographic variables. The latter may reflect cultural differences related to beliefs about emotions in Brazil.


Resumo Introdução Crenças sobre a inaceitabilidade da expressão e experiência de emoção estão presentes na população em geral, mas parecem ser mais prevalentes em pacientes com uma série de problemas de saúde. Tais crenças, que podem ser vistas como uma forma de perfeccionismo sobre as emoções, podem ter um efeito deletério na sintomatologia, bem como na adesão ao tratamento e nos seus resultados. No entanto, poucos questionários foram desenvolvidos para medir tais crenças sobre emoções, e nenhum instrumento foi validado em um país em desenvolvimento. O presente estudo adaptou e validou a Escala de Crenças sobre Emoções (Beliefs about Emotions Scale) em uma amostra brasileira. Métodos O procedimento de adaptação incluiu tradução, retrotradução e análise do conteúdo, com a versão final brasileira da escala sendo testada online em uma amostra de 645 participantes. A consistência interna da escala foi muito alta e os resultados da análise fatorial de eixo principal indicaram uma solução de dois fatores. Resultados Os respondentes com altos níveis de fadiga mostraram crenças mais perfeccionistas, e a escala se correlacionou positivamente com questionários medindo ansiedade, depressão e medo de avaliação negativa, confirmando associações transculturais relatadas anteriormente. Finalmente, homens, não caucasianos e participantes com baixo nível de escolaridade endossaram mais tais crenças do que mulheres, indivíduos caucasianos e participantes com maior nível de escolaridade. Conclusões O estudo confirma achados clínicos anteriores relatados na literatura, mas indica novas associações com variáveis demográficas. O último pode refletir diferenças culturais relacionadas às crenças sobre emoções no Brasil.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Idoso , Adulto Jovem , Testes Psicológicos , Pensamento , Emoções , Tradução , Fatores Sexuais , Comparação Transcultural , Estudos Transversais , Inquéritos e Questionários , Análise Fatorial , Escolaridade , Fadiga/psicologia , Inteligência Emocional , Perfeccionismo , Pessoa de Meia-Idade
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