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1.
Enferm. intensiva (Ed. impr.) ; 30(4): 163-169, oct.-dic. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-184480

RESUMO

La muerte de un niño en la Unidad de Cuidado Intensivo Pediátrico (UCIP) es difícil, la pérdida genera sentimientos de tristeza y dolor; en este estudio se destacan las diferentes estrategias de afrontamiento utilizadas por las enfermeras para manejar esta situación y poder fortalecerse para brindar cuidado al final de la vida. Objetivo Explorar las estrategias de afrontamiento utilizadas por las enfermeras en la UCIP frente a la muerte. Métodos: Estudio realizado en la ciudad de Manizales, Colombia, durante los meses de octubre, noviembre y diciembre. Se utilizó un enfoque cualitativo, fenomenológico hermenéutico. El método de muestreo fue intencional para la selección de las enfermeras participantes (n = 10) que trabajan en la UCIP; se realizaron entrevistas en profundidad para la construcción de la información y los datos se analizaron según los procedimientos propuestos por Cohen, Kahn y Steeves. Resultados: Las enfermeras utilizan estrategias de afrontamiento centradas en las emociones: inhiben los sentimientos frente al paciente y la familia, usan la comunicación y oración con el paciente, así como el acompañamiento para aliviar el sufrimiento de la familia. Conclusión: Las enfermeras de la UCIP desarrollan estrategias de afrontamiento frente a los cuidados al final de la vida utilizando recursos espirituales y de comunicación con la familia que necesita apoyo permanente, reflexionando ante la muerte y el acompañamiento del niño en su trascendencia


The death of a child in the Paediatric Intensive Care Unit (PICU) is difficult, the loss generates feelings of sadness and pain; this study highlights the different coping strategies used by nurses to manage this situation and find the strength to provide care at the end of life. Objective: Explore the strategies used by nurses in the PICU in coping with death. Methods: Study conducted in the city of Manizales, Colombia, during the months of October, November and December. A qualitative, hermeneutical phenomenological approach was used. The method of intentional sampling for the selection of participating nurses (n = 10) working in PICU, in-depth interviews were conducted for the construction of the information and the data were analyzed according to the procedures proposed by Cohen, Kahn and Steeves. Results: Nurses use coping strategies focused on emotions: they inhibit their feelings towards the patient and their family; they use communication and prayer with the patient, as well as accompaniment to alleviate the suffering of the family. Conclusion: UCIP nurses develop coping strategies for end-of-life care using spiritual resources and communication with the family who require ongoing support, reflecting on death and accompanying the child in its transcendence


Assuntos
Humanos , Criança , Unidades de Terapia Intensiva Pediátrica , Adaptação Psicológica/fisiologia , Cuidados Críticos/psicologia , Enfermagem de Cuidados Paliativos na Terminalidade da Vida/métodos , Cuidados Paliativos na Terminalidade da Vida/psicologia , Comunicação
2.
Health Psychol ; 38(12): 1159-1167, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31580130

RESUMO

OBJECTIVE: Using baseline data from a community-based weight-gain prevention intervention study, the authors examined whether coping self-efficacy moderated the associations between chaotic home environment and psychosocial health (perceived psychosocial stress, depressive symptoms, and positive and negative affect) in low-income women who are overweight or obese. METHOD: Participants (N = 740; Mage = 28.06 ± 5.12) completed validated self-report measures of coping self-efficacy, chaotic home environment, perceived psychosocial stress, depressive symptoms, and positive and negative affect. Composite indicator structural equation modeling was used to test the moderation effects. Effect size was calculated using proportion of maximum possible (POMP) scores in the endogenous variables per unit change in the exogenous variable. RESULTS: Coping self-efficacy significantly moderated the associations between chaotic home environment and depressive symptoms (p < .001, POMP = -0.62%) and between chaotic home environment and negative affect (p < .01, POMP = -0.36%). However, coping self-efficacy did not moderate the association between chaotic home environment and perceived psychosocial stress or positive affect. CONCLUSIONS: This study suggests that coping self-efficacy could explain some individual differences in responses to home chaos or to interventions aimed at alleviating depressive symptoms and negative affect in low-income women who are overweight or obese and who experience chaos at home. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Adaptação Psicológica/fisiologia , Obesidade/psicologia , Sobrepeso/psicologia , Pobreza/psicologia , Adulto , Feminino , Humanos , Masculino
3.
Dev Neuropsychol ; 44(7): 495-512, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31608666

RESUMO

We examined the visuomotor adaptation of children and adults with and without explicit aiming strategies. Younger children were slower and less smooth in visuomotor adaption than adults. Specifically, in the course of adaptation and re-adaptation, older children had better movement accuracy than adults, while their movement speed and smoothness were similar to those of the adults. Explicit aiming improved movement accuracy for all participants, but also facilitated movement smoothness for younger children. The contribution of explicit adjustment was greater for older children than for younger children. These results show the ongoing development of cognitive functions and movement experiences in children.


Assuntos
Adaptação Fisiológica/fisiologia , Atividade Motora/fisiologia , Desempenho Psicomotor/fisiologia , Percepção Visual/fisiologia , Adaptação Psicológica/fisiologia , Adulto , Criança , Cognição , Feminino , Humanos , Masculino , Movimento
5.
Health Psychol ; 38(10): 936-947, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31403812

RESUMO

OBJECTIVE: Little is known about the cardiovascular effects of mutual emotional spousal support given for health concerns. We examined the hypotheses that: (a) mutual support (both spouses giving and receiving support) compared to one-sided or no support, would decrease blood pressure and heart rate in both spouses during a recovery period; and (b) wives would benefit more from mutual support than would husbands. A second aim was to examine gender differences in cardiovascular reactivity, distress, and closeness in response to receiving support regardless of mutuality. METHOD: In 98 married couples (Age 50+), spouses discussed health concerns and were assigned randomly to one of four conditions: neither spouse received support (n = 26), only the wife received support from the husband (n = 22), only the husband received support from the wife (n = 23), or both received support (n = 27). Systolic and diastolic blood pressure and heart rate were measured during baseline, the discussions, and recovery. Distress, closeness, and support were self-reported. Support quality was observationally coded. RESULTS: Mutual support did not affect cardiovascular reactivity. When husbands received support from wives, husbands' blood pressure and distress decreased, and both partners' closeness increased. When wives received support, husbands and wives felt closer, but both partners' heart rate remained elevated and wives felt more distressed. CONCLUSIONS: Receiving support individually may be more important than receiving support mutually for older adult spouses coping with their health concerns. Also, support interventions for couples coping with health conditions should take into account that husbands receive greater benefits from spousal support than wives. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Adaptação Psicológica/fisiologia , Doenças Cardiovasculares/etiologia , Emoções/fisiologia , Casamento/psicologia , Idoso , Doenças Cardiovasculares/patologia , Feminino , Identidade de Gênero , Humanos , Masculino , Pessoa de Meia-Idade
6.
BMC Ophthalmol ; 19(1): 181, 2019 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-31409325

RESUMO

BACKGROUND: Retinitis pigmentosa (RP) are a group of incurable and inherited eye conditions, and the leading cause of inherited blindness in people under the age of 60. The aim of this systematic review and meta-synthesis was to present a comprehensive overview of qualitative papers on experiences and coping strategies of adults living with RP, and how these influence quality of life. METHODS: A pre-registered search strategy was applied in nine databases and 12 articles met eligibility criteria. Studies included were from Australia, Brazil, Ireland, Netherlands, Republic of Korea, United Kingdom, and USA. The overall sample was based on 126 people with RP (ages ranging from 18 to 85; at least 65 female). Principles of meta-ethnography were used to synthesise the articles revealing five higher-level meta-themes. RESULTS: The five higher-level meta-themes were, 1) managing identity: making sense of RP, managing autonomy and independence; 2) living with RP: practical and emotional issues; 3) experiences with healthcare professionals and other social support; 4) adaptive and maladaptive coping strategies; and 5) impact of RP on work and career. A conceptual model was developed by grouping higher-level meta-themes as intra- and inter-individual factors and how they may be implicated with coping strategies and quality of life. CONCLUSIONS: This review established factors that can be explored as potential psychosocial influences in the relationship between coping strategies and quality of life in people with RP. Further understanding of these factors and mechanisms can help inform intervention development to support adaptive coping in living with RP and positively impact quality of life.


Assuntos
Adaptação Psicológica/fisiologia , Qualidade de Vida/psicologia , Retinite Pigmentosa/psicologia , Acuidade Visual , Humanos
7.
Nat Neurosci ; 22(9): 1413-1423, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31427770

RESUMO

Understanding the transcriptional changes that are engaged in stress resilience may reveal novel antidepressant targets. Here we use gene co-expression analysis of RNA-sequencing data from brains of resilient mice to identify a gene network that is unique to resilience. Zfp189, which encodes a previously unstudied zinc finger protein, is the highest-ranked key driver gene in the network, and overexpression of Zfp189 in prefrontal cortical neurons preferentially activates this network and promotes behavioral resilience. The transcription factor CREB is a predicted upstream regulator of this network and binds to the Zfp189 promoter. To probe CREB-Zfp189 interactions, we employ CRISPR-mediated locus-specific transcriptional reprogramming to direct CREB or G9a (a repressive histone methyltransferase) to the Zfp189 promoter in prefrontal cortex neurons. Induction of Zfp189 with site-specific CREB is pro-resilient, whereas suppressing Zfp189 expression with G9a increases susceptibility. These findings reveal an essential role for Zfp189 and CREB-Zfp189 interactions in mediating a central transcriptional network of resilience.


Assuntos
Adaptação Psicológica/fisiologia , Estresse Psicológico/genética , Dedos de Zinco/genética , Animais , Redes Reguladoras de Genes/genética , Camundongos , Camundongos Endogâmicos C57BL , Córtex Pré-Frontal/metabolismo , Transcrição Genética
8.
J Autism Dev Disord ; 49(11): 4646-4657, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31463630

RESUMO

In a context described as a challenge in parenting (having an autistic child), we sought to highlight the emotional skills that mothers gain as a result of interacting with their child, and how they then use these skills. Mothers of autistic children (n = 136) and mothers of non-autistic children (n = 139) responded to emotional intelligence, resilience, and coping scales. Comparisons revealed smaller differences between groups than expected. Nevertheless, mothers of autistic children showed greater resilience abilities than mothers of non-autistic children. Moreover, we noted differences between both groups regarding their use of emotional skills. Emotional intelligence is a resource that deserves to be explored in terms of its clinical implications, especially among the parents of autistic children.


Assuntos
Adaptação Psicológica/fisiologia , Transtorno Autístico/psicologia , Inteligência Emocional/fisiologia , Mães/psicologia , Poder Familiar/psicologia , Resiliência Psicológica , Adolescente , Adulto , Transtorno Autístico/diagnóstico , Transtorno Autístico/terapia , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pais/psicologia , Estresse Psicológico/diagnóstico , Estresse Psicológico/psicologia , Estresse Psicológico/terapia , Adulto Jovem
9.
Nat Commun ; 10(1): 3500, 2019 08 02.
Artigo em Inglês | MEDLINE | ID: mdl-31375665

RESUMO

Attention can both enhance and suppress cortical sensory representations. However, changing sensory representations can also be detrimental to behavior. Behavioral consequences can be avoided by flexibly changing sensory readout, while leaving the representations unchanged. Here, we asked human observers to attend to and report about either one of two features which control the visibility of motion while making concurrent measurements of cortical activity with BOLD imaging (fMRI). We extend a well-established linking model to account for the relationship between these measurements and find that changes in sensory representation during directed attention are insufficient to explain perceptual reports. Adding a flexible downstream readout is necessary to best explain our data. Such a model implies that observers should be able to recover information about ignored features, a prediction which we confirm behaviorally. Thus, flexible readout is a critical component of the cortical implementation of human adaptive behavior.


Assuntos
Adaptação Psicológica/fisiologia , Atenção/fisiologia , Córtex Cerebral/fisiologia , Percepção Visual/fisiologia , Adolescente , Adulto , Córtex Cerebral/diagnóstico por imagem , Medições dos Movimentos Oculares , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Movimento (Física) , Estimulação Luminosa , Adulto Jovem
10.
Integr Cancer Ther ; 18: 1534735419866923, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31364416

RESUMO

Background: This small qualitative study reports on the experiences of patients and family caregivers who participated in a dyadic yoga pilot trial while undergoing cancer treatment in the midst of Hurricane Harvey. Our primary purpose was to determine if participants implemented components of the program to cope with the stressors associated with Hurricane Harvey and if they perceived benefits from the yoga practices. Methods: We administered brief semistructured interviews to the dyads participating in a dyadic yoga pilot trial. Participants (n = 5 dyads) were asked to discuss their experience with Hurricane Harvey, including factors that helped them cope with the event while receiving treatment. Result: Patients had a mean age of 55.6 years, were mostly non-Hispanic White, male, and had advance stage head and neck cancer. Caregivers had a mean age of 58 years and were mainly non-Hispanic White and female. Analyses of the interviews revealed 2 overarching themes: (1) the storm's negative impact and (2) the use of yoga to cope with the hurricane-related stressors. Conclusions: Patient-caregiver dyads experienced psychological distress during the storm and/or its aftermath. Dyads used yoga techniques to cope with these psychological stressors. Yoga served as a means of social support as dyads either participated in these activities together or with other family members.


Assuntos
Cuidadores/psicologia , Neoplasias de Cabeça e Pescoço/psicologia , Estresse Psicológico/psicologia , Ioga/psicologia , Adaptação Psicológica/fisiologia , Adulto , Idoso , Tempestades Ciclônicas , Gerenciamento Clínico , Feminino , Humanos , Masculino , Meditação/psicologia , Pessoa de Meia-Idade , Desastres Naturais , Qualidade de Vida/psicologia , Apoio Social , Adulto Jovem
11.
J Shoulder Elbow Surg ; 28(8): 1431-1440, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31327393

RESUMO

BACKGROUND: The purpose of this study was to identify factors associated with limitations in function measured by patient-reported outcome measures (PROMs) 6-9 months after elbow fractures in adults from a range of demographic, injury, psychological, and social variables measured within a week and 2-4 weeks after injury. METHODS: We enrolled 191 adult patients sustaining an isolated elbow fracture and invited them to complete PROMs at their initial visit to the orthopedic outpatient clinic (within a maximum of 1 week after fracture), between 2 and 4 weeks, and between 6 and 9 months after injury; 183 patients completed the final assessment. Bivariate analysis was performed, followed by multivariable regression analysis accounting for multicollinearity. This was evaluated using partial R2, correlation matrices, and variable inflation factor assessment. RESULTS: There was a correlation between multiple variables within a week of injury and 2-4 weeks after injury with PROMs 6-9 months after injury in bivariate analysis. Kinesiophobia measured within a week of injury and self-efficacy measured at 2-4 weeks were the strongest predictors of limitations 6-9 months after injury in multivariable regression. Regression models accounted for substantial variance in all PROMs at both time points. CONCLUSIONS: Developing effective coping strategies to overcome fears related to movement and reinjury and finding ways of persevering with activity despite pain within a month of injury may enhance recovery after elbow fractures. Heightened fears around movement and suboptimal coping ability are modifiable using evidence-based behavioral treatments.


Assuntos
Adaptação Psicológica/fisiologia , Artralgia/psicologia , Articulação do Cotovelo/lesões , Fraturas Ósseas/psicologia , Medidas de Resultados Relatados pelo Paciente , Amplitude de Movimento Articular , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Artralgia/diagnóstico , Artralgia/etiologia , Articulação do Cotovelo/fisiopatologia , Feminino , Fraturas Ósseas/complicações , Fraturas Ósseas/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Adulto Jovem
12.
Psychol Aging ; 34(5): 640-654, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31328931

RESUMO

Accommodative coping has often been measured as a one-dimensional disposition with the Flexible Goal Adjustment Questionnaire (FGA; Brandtstädter & Renner, 1990). Because several ways of accommodative coping have been proposed, we constructed the Accommodative Coping Facets Questionnaire (ACCO-5), a multidimensional questionnaire encompassing five dimensions: positive reappraisal/personal growth, lowering of aspirations/acceptance, downward comparison, reorientation, and detachment from goal. The present study examined (a) the multidimensional structure of accommodative coping, (b) the correlations between the ACCO-5 dimensions, age, and indicators of positive adaptation, and (c) differences in age correlations that result from a dispositional and goal-specific approach to accommodation. Study 1 (N = 702) investigated the dimensional structure of ACCO-5 dimensions (disposition) and showed significant correlations with age and positive adaptation. Study 2 (N = 150) investigated the correlations with the FGA Scale. In Study 3 (N = 321) ACCO-5 was applied to concrete blocked goals reported by the individuals. This study showed no age differences but significant correlations between the ACCO-5 dimensions and indicators of positive adaptation. Study 4 (N = 240) investigated the correlations between goal-specific ACCO-5, subjective goal control, and age. In summary, the present paper provides evidence that the components of ACCO-5 do measure similar, but not identical facets of a complex construct in developmental regulation. Differentiating between these facets contributes to a better understanding of the structure and function of accommodative processes in adulthood. We emphasize that the differentiated assessment of these facets is important for intervention studies or longitudinal research examining the complexity and dynamics of accommodative coping. (PsycINFO Database Record (c) 2019 APA, all rights reserved).


Assuntos
Adaptação Psicológica/fisiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Metas , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
13.
Pediatr Emerg Care ; 35(8): 585-588, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31335785

RESUMO

Physicians suffer from most medical conditions at the same rate as their lay peers. However, physicians' self-care is often sacrificed for patient care. This third article in our series examines physician and trainee illness and impairment. Presenteeism, physician impairment, and substance use disorder (SUD) are defined. We call attention to the potential for harm of dated cultural norms, which often fuel physicians' neglect of their own health and development of ill-advised coping skills.Although any medical condition may become a functional impairment, the primary cause of physician impairment is SUD. Alcohol and prescription opioids top the list of substances used in excess by physicians. Although SUD is less prevalent in residency, we focus on the rise of marijuana and alcohol use in emergency medicine trainees. A nonpunitive model for the prevention and treatment of SUD in residency is described.Physicians are ethically and legally mandated to report any concern for impairment to either a state physician health program or a state medical board. However, recognizing physician SUD is challenging. We describe its clinical presentation, voluntary and mandated treatment tracks, provisions for protecting reporters from civil liability, prognosis for return to practice, and prevention efforts. We underscore the need to model healthy coping strategies and assist trainees in adopting them.In closing, we offer our colleagues and trainees today's to-do list for beginning the journey of reclaiming your health. We also provide resources focused on the practical support of ill and/or impaired physicians.


Assuntos
Inabilitação do Médico/psicologia , Médicos/psicologia , Autocuidado/métodos , Estresse Psicológico/psicologia , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle , Adaptação Psicológica/fisiologia , Alcoolismo/complicações , Alcoolismo/psicologia , Analgésicos Opioides/efeitos adversos , Medicina de Emergência/estatística & dados numéricos , Humanos , Internato e Residência/estatística & dados numéricos , Inabilitação do Médico/estatística & dados numéricos , Presenteísmo/estatística & dados numéricos , Estresse Psicológico/complicações , Transtornos Relacionados ao Uso de Substâncias/complicações , Transtornos Relacionados ao Uso de Substâncias/psicologia , Reino Unido/epidemiologia
14.
Lancet Psychiatry ; 6(9): 766-777, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31350208

RESUMO

BACKGROUND: Little is known about the compensatory profile in autism; that is, people with autism spectrum disorder who show few symptoms in their behavioural presentation, despite continuing to report autism-related cognitive difficulties or differences. Even less is known about the specific compensatory strategies that these individuals use to disguise autism at the behavioural surface, both in the clinic and everyday life. It is also currently unclear whether individuals without a formal autism diagnosis, but experiencing autistic-like difficulties, use similar compensatory strategies, potentially enabling them to sit below the diagnostic threshold. This study aimed to investigate social compensatory strategies, and their effect on diagnosis and clinical outcome, in adults with and without autism. METHODS: In this study, individuals aged 18 years or older who responded to a study advert that was distributed worldwide via social media and the UK National Autistic Society formed a convenience sample. Participants self-reported their use and experiences of compensatory strategies using an online platform. Novel analyses, including a qualitative thematic approach, were used to interpret their responses and gain insight into compensatory strategies in autism. FINDINGS: Between Oct 19, 2017, and Jan 2, 2018, 136 adults (58 had a clinical diagnosis of autism, 19 self-identified but were not formally diagnosed as autistic, and 59 were not diagnosed or self-identified, but nevertheless reported social difficulties) completed the online study questions. The findings suggested that there are multiple compensatory strategies with distinct characteristics, individual and environmental factors that modulate compensatory strategy use and success, positive (social relationships, independence, employment) and negative (poor mental health, late diagnosis) outcomes associated with compensatory strategy use, and that individuals without a diagnosis use compensatory strategies that are qualitatively similar to individuals with a diagnosis. INTERPRETATION: Increased awareness and measurement of compensatory strategy use in autism should guide future diagnostic guidelines, towards improved diagnostic accuracy and support for people with autism spectrum disorder whose cognitive difficulties are not immediately evident in observable behaviour. FUNDING: UK Medical Research Council and UK National Institute for Health Research.


Assuntos
Adaptação Psicológica/fisiologia , Transtorno do Espectro Autista/psicologia , Transtorno Autístico/psicologia , Disfunção Cognitiva/psicologia , Autorrelato/estatística & dados numéricos , Adolescente , Adulto , Idoso , Transtorno do Espectro Autista/diagnóstico , Transtorno Autístico/diagnóstico , Conscientização , Disfunção Cognitiva/etiologia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Comportamento Social , Meio Social , Adulto Jovem
15.
Am J Occup Ther ; 73(4): 7304205100p1-7304205100p10, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31318674

RESUMO

OBJECTIVE: A reliable, valid, and readily usable method of measuring coping is essential for occupational therapy practitioners and researchers working with children with developmental disabilities. The aim of this study was to examine evidence for the construct validity and internal and test-retest reliability of the Coping Inventory (CI), a 48-item survey designed for use with children. METHOD: School staff (N = 39) completed CIs for 79 students with developmental disabilities age 5-13 yr (mean = 8.0, standard deviation = 2.0) who were primarily boys (n = 52; 68%) with autism spectrum disorder (n = 40 of 47 diagnoses provided). We used Rasch analysis to examine construct validity, internal reliability, and possible redundancy of items and intraclass correlations, Pearson correlations, Bland-Altman plots, and t tests were used to examine test-retest reliability. RESULTS: Rasch analysis provided evidence of construct validity: All items correlated positively with the overall measure; data from 94% of items conformed with Rasch expectations, and the items form a logical hierarchy. Intraclass correlations revealed an average coefficient of .96, providing evidence of test-retest reliability. CONCLUSION: The CI demonstrated good evidence for construct validity and internal and test-retest reliability. Redundancy of items suggests that some items could be eliminated after further research.


Assuntos
Transtorno do Espectro Autista , Deficiências do Desenvolvimento , Adaptação Psicológica/fisiologia , Criança , Humanos , Masculino , Reprodutibilidade dos Testes , Inquéritos e Questionários
16.
NeuroRehabilitation ; 44(4): 523-530, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31256091

RESUMO

BACKGROUND: Headache is among the most common persistent symptoms after mild traumatic brain injury (mTBI). Currently available treatments have limited efficacy. OBJECTIVE: To present a rationale for a novel behavioral treatment approach and a supporting case series with a multiple baseline design. METHOD: Pervasive avoidance of common headache triggers may be maladaptive, promoting sensitization and restricting life participation. Graded exposure to triggers that are prone to sensitization (e.g., stress, light flicker, loud noise) may represent an alternative behavioral approach to treating chronic headaches after mTBI. The present study reports on a series of physician-referred patients (N = 4, aged 28-48, enrolled at 9-19 months post-injury) with persistent headache attributed to mTBI. They participated in an 8-session manualized treatment with a registered psychologist. Patients completed a daily headache diary before, during, and after treatment, as well as pre- and post-treatment assessments with a battery of questionnaires. RESULTS: All patients finished treatment and no adverse events were reported. Improvement was variable across measures of headache frequency/intensity, headache trigger avoidance, post-concussion symptoms, disability, and patient global impression of change. CONCLUSION: Future directions for behavioral management of headache triggers as a potential treatment for chronic post-traumatic headaches after mTBI are discussed.


Assuntos
Adaptação Psicológica , Concussão Encefálica/terapia , Terapia Cognitivo-Comportamental/métodos , Síndrome Pós-Concussão/terapia , Cefaleia Pós-Traumática/terapia , Adaptação Psicológica/fisiologia , Adulto , Concussão Encefálica/epidemiologia , Concussão Encefálica/psicologia , Feminino , Humanos , Pessoa de Meia-Idade , Síndrome Pós-Concussão/epidemiologia , Síndrome Pós-Concussão/psicologia , Cefaleia Pós-Traumática/epidemiologia , Cefaleia Pós-Traumática/psicologia , Inquéritos e Questionários
17.
Dev Cogn Neurosci ; 38: 100665, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31176282

RESUMO

Detecting errors and adjusting behaviour appropriately are fundamental cognitive abilities that are known to improve through adolescence. The cognitive and neural processes underlying this development, however, are still poorly understood. To address this knowledge gap, we performed a thorough investigation of error processing in a Flanker task in a cross-sectional sample of participants 8 to 19 years of age (n = 98). We examined age-related differences in event-related potentials known to be associated with error processing, namely the error-related negativity (ERN) and the error positivity (Pe), as well as their relationships with task performance, post-error adjustments and regional cingulate cortex thickness and surface area. We found that ERN amplitude increased with age, while Pe amplitude remained constant. A more negative ERN was associated with higher task accuracy and faster reaction times, while a more positive Pe was associated with higher accuracy, independently of age. When estimating post-error adjustments from trials following both incongruent and congruent trials, post-error slowing and post-error improvement in accuracy both increased with age, but this was only found for post-error slowing when analysing trials following incongruent trials. There were no age-independent associations between either ERN or Pe amplitude and cingulate cortex thickness or area measures.


Assuntos
Adaptação Psicológica/fisiologia , Comportamento do Adolescente/fisiologia , Comportamento do Adolescente/psicologia , Encéfalo/diagnóstico por imagem , Encéfalo/crescimento & desenvolvimento , Eletroencefalografia/métodos , Adolescente , Fatores Etários , Criança , Estudos Transversais , Potenciais Evocados/fisiologia , Feminino , Giro do Cíngulo/fisiologia , Humanos , Masculino , Estimulação Luminosa/métodos , Desempenho Psicomotor/fisiologia , Tempo de Reação/fisiologia , Adulto Jovem
18.
Nat Neurosci ; 22(7): 1110-1121, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31160741

RESUMO

Learning to predict rewards based on environmental cues is essential for survival. The orbitofrontal cortex (OFC) contributes to such learning by conveying reward-related information to brain areas such as the ventral tegmental area (VTA). Despite this, how cue-reward memory representations form in individual OFC neurons and are modified based on new information is unknown. To address this, using in vivo two-photon calcium imaging in mice, we tracked the response evolution of thousands of OFC output neurons, including those projecting to VTA, through multiple days and stages of cue-reward learning. Collectively, we show that OFC contains several functional clusters of neurons distinctly encoding cue-reward memory representations, with only select responses routed downstream to VTA. Unexpectedly, these representations were stably maintained by the same neurons even after extinction of the cue-reward pairing, and supported behavioral learning and memory. Thus, OFC neuronal activity represents a long-term cue-reward associative memory to support behavioral adaptation.


Assuntos
Adaptação Psicológica/fisiologia , Aprendizagem por Associação/fisiologia , Sinalização do Cálcio , Condicionamento Clássico/fisiologia , Memória de Longo Prazo/fisiologia , Neurônios/fisiologia , Córtex Pré-Frontal/fisiologia , Recompensa , Estimulação Acústica , Animais , Proteína Quinase Tipo 2 Dependente de Cálcio-Calmodulina/fisiologia , Sinais (Psicologia) , Comportamento de Ingestão de Líquido/fisiologia , Extinção Psicológica , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Proteínas do Tecido Nervoso/fisiologia , Neurônios/enzimologia , Optogenética , Técnicas de Patch-Clamp , Córtex Pré-Frontal/citologia , Análise de Célula Única , Área Tegmentar Ventral/fisiologia
19.
PLoS One ; 14(5): e0217320, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31150432

RESUMO

The occurrence of a stressful event is considered to increase the risk of developing depression. In the present study we explore whether the breakup of a romantic relationship can be used as an experimental model to study a depression-like state during a period of stress in individuals without a psychiatric disorder. The primary aim of our study was to investigate: 1) whether individuals with a recent romantic relationship breakup (''heartbreak") demonstrate symptoms of depression, 2) how to describe heartbreak characteristics based on data from a comprehensive questionnaire battery, and 3) whether this description can capture severity of depression symptoms. Secondary, we were interested in gender differences with regard to the above study objectives. Subjects who have experienced a relationship breakup in the preceding six months (N = 71) or are in a romantic relationship (N = 46) participated in our study. A questionnaire battery was administered to acquire information related to depression, mood, the breakup and (former) relationship. Principal Component Analysis with Procrustes bootstrapping was performed to extract components from the questionnaire data. Even though our sample of individuals who recently have experienced a relationship breakup can be on average considered non-depressed, group-level depression scores were elevated compared to individuals in a relationship (p = .001) and 26.8% reported symptoms corresponding to mild, moderate or severe depression. We described heartbreak by two principal components interpreted as ''sudden loss" and ''lack of positive affect", respectively. Highly significant correlations between the component scores and depression scores were found (p < .001 and p < .001, respectively), although these correlations differed between the genders. Based on these findings, we propose that the experience of a romantic relationship breakup is a viable experimental model to examine symptoms of depression in individuals without a psychiatric disorder. This way, stress-related coping and depression vulnerability can be studied in further research.


Assuntos
Afeto/fisiologia , Depressão/psicologia , Transtorno Depressivo/psicologia , Adaptação Psicológica/fisiologia , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Relações Interpessoais , Amor , Masculino , Modelos Teóricos , Adulto Jovem
20.
J Pak Med Assoc ; 69(6): 794-798, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31189284

RESUMO

OBJECTIVE: To explore the role of metaworry in mediating the relationship between emotion-oriented coping and negative beliefs about rumination. METHODS: The cross-sectional transversal study was conducted at private, government and semi-government organization from February to October 2016. The sample comprised of educated adults from various professions working in the twin cities Rawalpindi and Islamabad, Pakistan. The subjects were administered self-reporting Coping Inventory for Stressful Situation, Negative Beliefs about Rumination Scale and the Anxious Thought Inventory instruments to assess metacognitive self-regulation. RESULTS: Of the 514 subjects, 130(26%) were males and 384(74%) were females. The overall mean age was 32.56}6.69 years. The mean professional experience was approximately 9}6.30 years, with a mean 8.5}8.12 working hours. Academic cut-off was set at graduation, but approximately 355 (69%) subjects were postgraduates. The highest mean value for stressors was in the personal category 1.19}0.8, followed by work stressors 1.18}0.95, family stressors 1.08}-0.92 and environmental stressors 1.04}0.81.The mediating effects of metaworry had an effect size of 12.44% which depicted a small size. CONCLUSIONS: Metaworry may not be specific to Generalised Anxiety Disorder, but is a susceptibility factor of psychological dysfunction in nonclinical population.


Assuntos
Adaptação Psicológica/fisiologia , Ansiedade , Emoções/fisiologia , Estresse Psicológico , Adulto , Ansiedade/epidemiologia , Ansiedade/psicologia , Estudos Transversais , Feminino , Humanos , Masculino , Paquistão/epidemiologia , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia
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