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1.
Trends Psychiatry Psychother ; 40(1): 47-52, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29668821

RESUMO

Introduction Intrusive thoughts may cause a significant level of distress, since some individuals evaluate the content of those thoughts as aversive. Suppression of intrusive thoughts is one of the strategies adopted by these individuals, which increases the level of distress. Suppression of thoughts may be present as one of the factors that maintain different psychological disorders. Objective To describe the translation and adaptation into Brazilian Portuguese of the White Bear Suppression Inventory (WBSI), which measures thought suppression. Methods Three translations and back-translations were conducted by independent evaluators. Semantic equivalence was assessed and the three versions were evaluated to produce a synthesized version. Comments from participants on the preliminary version of the questionnaire were examined. Results We developed a preliminary Brazilian Portuguese version of the WBSI. It was found that most participants understood the descriptions of cognitions given in the translated questionnaire. Conclusion The use of three different versions of translations and back-translations, discussion of the synthetic version and interaction with the target population have conferred viability to the process of semantic equivalence of the Brazilian Portuguese final version of the WBSI.


Assuntos
Testes Psicológicos , Autocontrole , Pensamento , Adulto , Comparação Transcultural , Função Executiva , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Semântica , Inquéritos e Questionários , Tradução , Adulto Jovem
2.
Trends psychiatry psychother. (Impr.) ; 40(1): 47-52, Jan.-Mar. 2018. tab
Artigo em Inglês | LILACS | ID: biblio-904603

RESUMO

Abstract Introduction Intrusive thoughts may cause a significant level of distress, since some individuals evaluate the content of those thoughts as aversive. Suppression of intrusive thoughts is one of the strategies adopted by these individuals, which increases the level of distress. Suppression of thoughts may be present as one of the factors that maintain different psychological disorders. Objective To describe the translation and adaptation into Brazilian Portuguese of the White Bear Suppression Inventory (WBSI), which measures thought suppression. Methods Three translations and back-translations were conducted by independent evaluators. Semantic equivalence was assessed and the three versions were evaluated to produce a synthesized version. Comments from participants on the preliminary version of the questionnaire were examined. Results We developed a preliminary Brazilian Portuguese version of the WBSI. It was found that most participants understood the descriptions of cognitions given in the translated questionnaire. Conclusion The use of three different versions of translations and back-translations, discussion of the synthetic version and interaction with the target population have conferred viability to the process of semantic equivalence of the Brazilian Portuguese final version of the WBSI.


Resumo Introdução Pensamentos intrusivos podem causar um nível significativo de desconforto, uma vez que alguns indivíduos avaliam o conteúdo desses pensamentos como aversivos. A supressão dos pensamentos intrusivos é uma das estratégias adotadas por esses indivíduos, resultando no aumento do nível de desconforto. Supressão de pensamentos pode estar presente como um dos fatores de manutenção de diferentes transtornos psicológicos. Objetivos Descrever a tradução e adaptação para o português brasileiro do White Bear Suppression Inventory (WBSI), que avalia a supressão de pensamentos. Métodos Três traduções e retrotraduções foram conduzidas por avaliadores independentes. A equivalência semântica foi analisada e as três versões foram avaliadas para produzir uma versão preliminar. Os comentários dos participantes sobre a versão preliminar do questionário foram examinados. Resultados Foi desenvolvida uma versão final em português brasileiro do WBSI. Verificou-se que a maioria dos participantes entendeu as descrições das cognições apresentadas no questionário traduzido. Conclusão O uso de três versões diferentes de traduções e retrotraduções, discussão da versão preliminar e interação com a população-alvo conferiu viabilidade ao processo de equivalência semântica da versão final brasileira da WBSI.


Assuntos
Humanos , Masculino , Feminino , Adulto , Adulto Jovem , Testes Psicológicos , Pensamento , Autocontrole , Semântica , Tradução , Projetos Piloto , Comparação Transcultural , Inquéritos e Questionários , Função Executiva , Pessoa de Meia-Idade
3.
J Psychiatr Res ; 95: 238-246, 2017 12.
Artigo em Inglês | MEDLINE | ID: mdl-28918162

RESUMO

Panic disorder (PD) is characterized by repeated and unexpected attacks of intense anxiety, which are not restricted to a determined situation or circumstance. The coherence function has been used to investigate the communication among brain structures through the quantitative EEG (qEEG). The objective of this study is to analyze if there is a difference in frontoparietal gamma coherence (GC) between panic disorder patients (PDP) and healthy controls (HC) during the Visual oddball paradigm; and verify if high levels of anxiety (produced by a computer simulation) affect PDP's working memory. Nine PDP (9 female with average age of 48.8, SD: 11.16) and ten HC (1 male and 9 female with average age of 38.2, SD: 13.69) were enrolled in this study. The subjects performed the visual oddball paradigm simultaneously to the EEG record before and after the presentation of computer simulation (CS). A two-way ANOVA was applied to analyze the factors Group and the Moment for each pair of electrodes separately, and another one to analyze the reaction time variable. We verified a F3-P3 GC increased after the CS movie, demonstrating the left hemisphere participation during the anxiety processing. The greater GC in HC observed in the frontal and parietal areas (P3-Pz, F4-F8 and Fp2-F4) points to the participation of these areas with the expected behavior. The greater GC in PDP for F7-F3 and F4-P4 pairs of electrodes assumes that it produces a prejudicial "noise" during information processing, and can be associated to interference on the communication between frontal and parietal areas. This "noise" during information processing is related to PD symptoms, which should be better known in order to develop effective treatment strategies.


Assuntos
Disfunção Cognitiva/fisiopatologia , Eletroencefalografia/métodos , Lobo Frontal/fisiopatologia , Ritmo Gama/fisiologia , Memória de Curto Prazo/fisiologia , Transtorno de Pânico/fisiopatologia , Osso Parietal/fisiopatologia , Adulto , Disfunção Cognitiva/etiologia , Simulação por Computador , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtorno de Pânico/complicações
4.
Behav Sci (Basel) ; 7(3)2017 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-28698483

RESUMO

Several lines of evidence suggest that Virtual Reality (VR) has a potential utility in eating disorders. The objective of this study is to review the literature on the use of VR in bulimia nervosa (BN) and binge eating disorder (BED). Using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement for reporting systematic reviews, we performed a PubMed, Web of Knowledge and SCOPUS search to identify studies employing VR in the assessment and treatment of BN and BED. The following search terms were used: "virtual reality", "eating disorders", "binge eating", and "bulimia nervosa". From the 420 articles identified, 19 were selected, nine investigated VR in assessment and 10 were treatment studies (one case-report, two non-controlled and six randomized controlled trials). The studies using VR in BN and BED are at an early stage. However, considering the available evidence, the use of VR in the assessment of those conditions showed some promise in identifying: (1) how those patients experienced their body image; and (2) environments or specific kinds of foods that may trigger binge-purging cycle. Some studies using VR-based environments associated to cognitive behavioral techniques showed their potential utility in improving motivation for change, self-esteem, body image disturbances and in reducing binge eating and purging behavior.

5.
Rev. bras. psiquiatr ; 38(4): 338-346, Oct.-Dec. 2016. tab, graf
Artigo em Inglês | LILACS | ID: lil-798094

RESUMO

Objective: Major depressive disorder (MDD) is a prevalent psychiatric condition characterized by multiple symptoms that cause great distress. Uncovering the brain areas involved in MDD is essential for improving therapeutic strategies and predicting response to interventions. This systematic review discusses recent findings regarding cortical alterations in depressed patients during emotional or cognitive tasks, as measured by electroencephalography (EEG). Methods: A search of the MEDLINE/PubMed and Cochrane databases was carried out using the keywords EEG and depression, confined to article title. Results: The studies identified reveal the frontal cortex as an important brain structure involved in the complex neural processes associated with MDD. Findings point to disorganization of right-hemisphere activity and deficient cognitive processing in MDD. Depressed individuals tend to ruminate on negative information and respond with a pattern of relatively higher right frontal activity to emotional stimuli associated with withdrawal and isolation. Conclusion: Patients with MDD may have altered dynamic patterns of activity in several neuroanatomical structures, especially in prefrontal and limbic areas involved in affective regulation. Identification of these alterations might help predict the response of patients to different interventions more effectively and thus maximize the effects both of pharmacotherapeutic and of psychotherapeutic strategies.


Assuntos
Humanos , Encéfalo/fisiopatologia , Cognição/fisiologia , Transtorno Depressivo Maior/fisiopatologia , Eletroencefalografia , Emoções/fisiologia , Mapeamento Encefálico , Córtex Cerebral/fisiopatologia , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/psicologia
6.
Braz J Psychiatry ; 38(4): 338-346, 2016 Aug 04.
Artigo em Inglês | MEDLINE | ID: mdl-27508396

RESUMO

Objective:: Major depressive disorder (MDD) is a prevalent psychiatric condition characterized by multiple symptoms that cause great distress. Uncovering the brain areas involved in MDD is essential for improving therapeutic strategies and predicting response to interventions. This systematic review discusses recent findings regarding cortical alterations in depressed patients during emotional or cognitive tasks, as measured by electroencephalography (EEG). Methods:: A search of the MEDLINE/PubMed and Cochrane databases was carried out using the keywords EEG and depression, confined to article title. Results:: The studies identified reveal the frontal cortex as an important brain structure involved in the complex neural processes associated with MDD. Findings point to disorganization of right-hemisphere activity and deficient cognitive processing in MDD. Depressed individuals tend to ruminate on negative information and respond with a pattern of relatively higher right frontal activity to emotional stimuli associated with withdrawal and isolation. Conclusion:: Patients with MDD may have altered dynamic patterns of activity in several neuroanatomical structures, especially in prefrontal and limbic areas involved in affective regulation. Identification of these alterations might help predict the response of patients to different interventions more effectively and thus maximize the effects both of pharmacotherapeutic and of psychotherapeutic strategies.


Assuntos
Encéfalo/fisiopatologia , Cognição/fisiologia , Transtorno Depressivo Maior/fisiopatologia , Eletroencefalografia , Emoções/fisiologia , Mapeamento Encefálico , Córtex Cerebral/fisiopatologia , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/psicologia , Humanos
7.
J Affect Disord ; 184: 176-81, 2015 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-26093831

RESUMO

UNLABELLED: Panic disorder patients are hypervigilant to danger cues and highly sensitive to unpredictable aversive events, what leads to anticipatory anxiety, that is one key component of the disorder maintenance. Prefrontal cortex seems to be involved in these processes and beta band activity may be related to the involvement of top-down processing, whose function is supposed to be disrupted in pathological anxiety. The objective of this study was to measure frontal absolute beta-power (ABP) with qEEG in panic disorder and agoraphobia (PDA) patients compared to healthy controls. METHODS: qEEG data were acquired while participants (24 PDA patients and 21 controls) watched a computer simulation (CS), consisting of moments classified as "high anxiety" (HAM) and "low anxiety" (LAM). qEEG data were also acquired during two rest conditions, before and after the computer simulation display. The statistical analysis was performed by means of a repeated measure analysis of variance (two-way ANOVA) and ABP was the dependent variable of interest. The main hypothesis was that a higher ABP in PDA patients would be found related to controls. Moreover, in HAM the ABP would be different than in LAM. RESULTS: the main finding was an interaction between the moment and group for the electrodes F7, F8, Fp1 and Fp2. We observed a higher ABP in PDA patients when compared to controls while watching the CS. The higher beta-power in the frontal cortex for the PDA group may reflect a state of high excitability, together with anticipatory anxiety and maintenance of hypervigilant cognitive state. CONCLUSIONS: our results suggest a possible deficiency in top-down processing reflected by a higher ABP in the PDA group while watching the CS and they highlight the recruitment of prefrontal regions during the exposure to anxiogenic stimuli. LIMITATIONS: the small sample, the wide age range of participants and the use of psychotropic medications by most of the PDA patients.


Assuntos
Agorafobia/fisiopatologia , Ritmo beta , Transtorno de Pânico/fisiopatologia , Córtex Pré-Frontal/fisiopatologia , Adulto , Agorafobia/psicologia , Ansiedade/fisiopatologia , Ansiedade/psicologia , Nível de Alerta , Mapeamento Encefálico , Simulação por Computador , Interpretação Estatística de Dados , Eletroencefalografia , Feminino , Lateralidade Funcional , Humanos , Masculino , Pessoa de Meia-Idade , Transtorno de Pânico/psicologia
8.
Compr Psychiatry ; 60: 156-60, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25799464

RESUMO

This paper examined the psychometric data obtained by the Brazilian version DCQ (Driving Cognitions Questionnaire) and its convergence with DBS (Driving Behavior Survey). The research included 187 participants of both genders, aged between 19 and 79years (mean 34years), with driving license in category 'B' (cars). The internal consistency obtained by research (Cronbach's alpha) was α=0.96 for full DCQ; α=0.89 for the subscale panic in the direction, α=0.91 for the subscale of concern in causing accidents and α=0.92 for the subscale of social concern. Psychometrically the results are positive and confirm the relevance of using the instrument. The survey also found positive convergence (although less pronounced) with the DBS, which is another instrument that comes to difficulties when driving or dealing with traffic or driving a car. Thus, this article demonstrates psychometric results that point to the profitable use of the Brazilian version of DCQ as an adjunct in the diagnosis of difficulty in driving.


Assuntos
Condução de Veículo/psicologia , Cognição , Psicometria , Inquéritos e Questionários/normas , Brasil , Feminino , Humanos , Masculino , Traduções
9.
CNS Neurol Disord Drug Targets ; 14(7): 863-71, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25106626

RESUMO

Researchers have been using the electroencephalogram to better understand the cognitive and neurobiological bases of panic disorder (PD) through the P300 component; this is an electric potential of the cerebral cortex that is generated in response to external sensorial stimuli and which involves more complex neurophysiological processes related to stimulus interpretation; it is then used to investigate possible alterations in the information processing and attention of patients suffering from this disorder. Aiming to verify the results found by experimental articles already published about P300 in PD patients and the information processing differences between PD patients and healthy controls, a systematic review of the PubMed and Institute for Scientific Information databases was conducted. The selection criterion involved those articles, written in English, which referred to an experimental research that focused on the P300 component, with a sample composed of PD (or panic attacks) patients. Seven articles were found that fit the selected criteria. Most of the articles show that these patients suffer from: impaired information processing and attention, an inability to automatically respond to new stimuli, and impaired interpretation of internal and external stimuli related to the disorder. Such impairment may be related to an unspecified dysfunction in the limbic-reticular structures, which would affect: active, focused and short-term attention, working and short-term memory, recognition and decision making. Some limitations were highlighted, such as the use of small samples and possible comorbidity with other disorders, which did not allow clearer results. This research can contribute to understand the neurobiological differences of PD patients and develop treatments based on such evidence.


Assuntos
Encéfalo/fisiopatologia , Potencial Evocado P300 , Transtorno de Pânico/fisiopatologia , Atenção/fisiologia , Eletroencefalografia , Humanos , Memória/fisiologia
10.
J Affect Disord ; 151(1): 259-64, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23820098

RESUMO

BACKGROUND: Panic attacks are thought to be a result from a dysfunctional coordination of cortical and brainstem sensory information leading to heightened amygdala activity with subsequent neuroendocrine, autonomic and behavioral activation. Prefrontal areas may be responsible for inhibitory top-down control processes and alpha synchronization seems to reflect this modulation. The objective of this study was to measure frontal absolute alpha-power with qEEG in 24 subjects with panic disorder and agoraphobia (PDA) compared to 21 healthy controls. METHODS: qEEG data were acquired while participants watched a computer simulation, consisting of moments classified as "high anxiety"(HAM) and "low anxiety" (LAM). qEEG data were also acquired during two rest conditions, before and after the computer simulation display. RESULTS: We observed a higher absolute alpha-power in controls when compared to the PDA patients while watching the computer simulation. The main finding was an interaction between the moment and group factors on frontal cortex. Our findings suggest that the decreased alpha-power in the frontal cortex for the PDA group may reflect a state of high excitability. CONCLUSIONS: Our results suggest a possible deficiency in top-down control processes of anxiety reflected by a low absolute alpha-power in the PDA group while watching the computer simulation and they highlight that prefrontal regions and frontal region nearby the temporal area are recruited during the exposure to anxiogenic stimuli.


Assuntos
Agorafobia/fisiopatologia , Encéfalo/fisiopatologia , Transtorno de Pânico/fisiopatologia , Adulto , Agorafobia/complicações , Mapeamento Encefálico , Estudos de Casos e Controles , Eletroencefalografia , Feminino , Lobo Frontal/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Transtorno de Pânico/etiologia , Lobo Temporal/fisiopatologia , Adulto Jovem
11.
Neurosci Lett ; 538: 20-5, 2013 Mar 22.
Artigo em Inglês | MEDLINE | ID: mdl-23287521

RESUMO

This study aimed to elucidate electrophysiological and cortical mechanisms involved when 15 healthy right-handed subjects executed an index finger flexion and extension task before and after hand immobilization, using qEEG beta band (13-30Hz) asymmetry. This beta band is involved in motor activity and sensorial factors. Our hypothesis is that an increase in beta band asymmetry in pre-frontal, motor and parietal areas will occur in post-hand immobilization, because these areas need to reorganize for new planning, preparation and voluntary motor control. We found increase in beta band asymmetry during post-treatment task. We concluded that beta band asymmetry plays an important role in the analysis of cortical changes in several brain areas when associated to motor task. Furthermore, we assume that 48h of hand immobilization change cortical functioning.


Assuntos
Córtex Cerebral/fisiologia , Mãos/fisiologia , Imobilização , Adaptação Fisiológica , Adulto , Ritmo beta , Feminino , Lateralidade Funcional , Humanos , Masculino , Córtex Motor/fisiologia , Movimento , Lobo Parietal/fisiologia , Córtex Pré-Frontal/fisiologia , Adulto Jovem
12.
Expert Rev Neurother ; 10(7): 1089-99, 2010 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-20586690

RESUMO

Bipolar disorder is one of the most serious and prevalent psychiatric disorders. The aim of the present article is to review the efficiency of cognitive-behavioral therapy (CBT) for bipolar patients. Some studies show consistent evidence that cognitive therapy, concomitant to psycho-education and pharmacological treatment, offers efficacy in different phases of the disease. In most of the studies, patients undergoing CBT showed improvements in quality of life, with a reduction in both frequency and duration of mood episodes, as well as higher degrees of compliance and fewer hospitalizations. More studies are required to prove the effectiveness of CBT for bipolar disorder in the context of standardizing diagnostic criteria and measuring instruments to evaluate the disorder's different phases and severity.


Assuntos
Transtorno Bipolar/terapia , Terapia Cognitivo-Comportamental , Ensaios Clínicos como Assunto , Humanos
13.
World J Biol Psychiatry ; 11(2 Pt 2): 220-30, 2010 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-20218785

RESUMO

Virtual reality (VR) is as effective in inducing emotional responses as reality and its application is extremely valuable in exposure treatment. In virtual environments, the patients experience similar physiological symptoms and fear as they do in real life situations, thereby facilitating the habituation process. Our goal is to offer an overview of the current panorama of VR and psychotherapy, underlining the (virtual) exposure technique and the studies that focus on panic disorder treatment through the use of VR. The literature was revised through consultation to the ISI and PubMed databases. Virtual exposure treatment offers good results and great patient acceptability. However, despite the importance of this data for the evaluation of treatment efficacy, only a few studies measure physiological responses during exposure. Lack of controlled studies and standardized treatment protocols were observed. Despite the great advance of VR use in psychotherapy, a great deal of its potential is still unknown, therefore requiring the creation of new virtual environments so that controlled studies regarding its clinical application can be conducted. Throughout the process of elaboration and investigation, clinical experiences in virtual environments must be related to real experiences in a flexible context that combines relevant cultural, physical and cognitive aspects.


Assuntos
Simulação por Computador , Terapia Implosiva/métodos , Agorafobia/terapia , Transtornos de Ansiedade/terapia , Terapia Cognitivo-Comportamental/métodos , Medo/psicologia , Habituação Psicofisiológica , Humanos , Transtorno de Pânico/terapia , Transtornos Fóbicos/terapia
14.
Expert Rev Neurother ; 10(2): 291-303, 2010 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-20136384

RESUMO

Thanks to brain imaging great advances have been made concerning the comprehension of neural substrates related to panic disorder (PD). This article aims to: review the recent functional MRI (fMRI) studies concerning PD; correlate the PD fMRI neurobiological findings with the fear neurocircuitry hypothesis; discuss the fear neurocircuitry hypothesis and link it to cognitive-behavior therapy findings; and comment on fMRI study limitations and suggest methodological changes for future research. As a whole, there is increasing evidence that brain structures such as the prefrontal cortex, the anterior cingulate cortex and limbic areas (hippocampus and amygdala) might play a major role in the panic response.


Assuntos
Encéfalo/patologia , Encéfalo/fisiopatologia , Imagem por Ressonância Magnética , Transtorno de Pânico/patologia , Transtorno de Pânico/fisiopatologia , Humanos
15.
World J Biol Psychiatry ; 11(2 Pt 2): 188-98, 2010 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19707958

RESUMO

Panic disorder (PD) is a multidimensional anxiety disorder that involves the activation of a complex brain fear-network. The goals of this systematic review are to pinpoint some working functions of the most important neuroanatomical structures of fear and panic neurocircuitry and to raise hypotheses about how cognitive-behaviour therapy (CBT) may work on modulating the neurocircuitry of fear. The bibliographical search was carried out using mainly the PubMed database. Fifty-six articles were selected. A number of studies regarding several brain sites that participate in fear and anxiety circuitry were found and each region was described with its functionalities within the circuitry. Among the structures chosen were: the amygdala, the hippocampus and the prefrontal cortex, which play a special role. Study hypotheses showed that CBT may operate upstream from the amygdala and exert inhibitory effects on a variety of learned responses. It may work by strengthening the medial prefrontal cortex ability to inhibit firing of amygdala neurons, under the modulation of the hippocampus. Only two studies examined the modulation of fear neurocircuitry with CBT in PD. The results indicate that CBT has the potential to modify the dysfunctional neural circuitry associated with PD, but there is insufficient evidence to support the preliminary hypothesis.


Assuntos
Terapia Cognitivo-Comportamental , Medo/fisiologia , Transtorno de Pânico/terapia , Tonsila do Cerebelo/fisiopatologia , Ansiedade/fisiopatologia , Hipocampo/fisiopatologia , Humanos , Vias Neurais/fisiopatologia , Transtorno de Pânico/fisiopatologia , Substância Cinzenta Periaquedutal/fisiopatologia , Córtex Pré-Frontal/fisiopatologia , Núcleos Septais/fisiopatologia
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