Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 31.009
Filtrar
1.
Adv Exp Med Biol ; 1191: 35-59, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32002921

RESUMO

Electrocortical network dynamics are integral to brain function. Linear and nonlinear connectivity applications enrich neurophysiological investigations into anxiety disorders. Discrete EEG-based connectivity networks are unfolding with some homogeneity for anxiety disorder subtypes. Attenuated delta/theta/beta connectivity networks, pertaining to anterior-posterior nodes, characterize panic disorder. Nonlinear measures suggest reduced connectivity of ACC as an executive neuro-regulator in germane "fear circuitry networks" might be more central than considered. Enhanced network complexity and theta network efficiency at rest define generalized anxiety disorder, with similar tonic hyperexcitability apparent in social anxiety disorder further extending to task-related/state functioning. Dysregulated alpha connectivity and integration of mPFC-ACC/mPFC-PCC relays implicated with attentional flexibility and choice execution/congruence neurocircuitry are observed in trait anxiety. Conversely, state anxiety appears to recruit converging delta and beta connectivity networks as panic, suggesting trait and state anxiety are modulated by discrete neurobiological mechanisms. Furthermore, EEG connectivity dynamics distinguish anxiety from depression, despite prevalent clinical comorbidity. Rethinking mechanisms implicated in the etiology, maintenance, and treatment of anxiety from the perspective of EEG network science across micro- and macroscales serves to shed light and move the field forward.


Assuntos
Transtornos de Ansiedade/fisiopatologia , Encéfalo/fisiopatologia , Eletroencefalografia , Rede Nervosa , Transtornos de Ansiedade/diagnóstico , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/fisiopatologia , Medo , Humanos
2.
Adv Exp Med Biol ; 1191: 103-120, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32002925

RESUMO

Oxytocin, a neuropeptide synthesized by the hypothalamus, plays a central role in human social behavior, social cognition, anxiety, mood, stress modulation, and fear learning and extinction. The relationships between oxytocin and psychiatric disorders including depression, anxiety, schizophrenia, and autism spectrum disorder have been extensively studied. In this chapter, we focus on the current knowledge about oxytocin and anxiety disorder. We discuss the anxiolytic effects of oxytocin in preclinical and clinical findings, possible related neurobehavioral mechanisms (social cognition, fear learning, and extinction), related neurotransmitter and neuroendocrine systems (hypothalamus-pituitary-adrenal axis, serotoninergic, and GABAergic systems), and studies regarding plasma levels of oxytocin, genetic and epigenetic findings, and effects of intranasal oxytocin in DSM-5 anxiety disorder (primarily social anxiety disorder and separation anxiety disorder) patients.


Assuntos
Transtornos de Ansiedade/metabolismo , Ocitocina/metabolismo , Ansiedade/metabolismo , Medo , Humanos , Comportamento Social
3.
Adv Exp Med Biol ; 1191: 523-541, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32002944

RESUMO

Exposure therapy, a key treatment for anxiety disorders, can be modelled in the laboratory using Pavlovian fear extinction. Understanding the hormonal and neurobiological mechanisms underlying fear extinction in females, who are twice more likely than males to present with anxiety disorders, may aid in optimising exposure therapy outcomes in this population. This chapter will begin by discussing the role of the sex hormones, estradiol and progesterone, in fear extinction in females. We will also propose potential mechanisms by which these hormones may modulate fear extinction. The second half of this chapter will discuss the long-term hormonal, neurological and behavioural changes that arise from pregnancy and motherhood and how these changes may alter the features of fear extinction in females. Finally, we will discuss implications of this research for the treatment of anxiety disorders in women with and without prior reproductive experience.


Assuntos
Transtornos de Ansiedade/metabolismo , Transtornos de Ansiedade/terapia , Ansiedade/metabolismo , Ansiedade/terapia , Estradiol/metabolismo , Progesterona/metabolismo , Reprodução , Ansiedade/psicologia , Transtornos de Ansiedade/psicologia , Extinção Psicológica , Medo , Feminino , Humanos , Gravidez
4.
Bone Joint J ; 102-B(1): 17-25, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31888370

RESUMO

AIMS: The aim of this study was to develop a psychometrically sound measure of recovery for use in patients who have suffered an open tibial fracture. METHODS: An initial pool of 109 items was generated from previous qualitative data relating to recovery following an open tibial fracture. These items were field tested in a cohort of patients recovering from an open tibial fracture. They were asked to comment on the content of the items and structure of the scale. Reduction in the number of items led to a refined scale tested in a larger cohort of patients. Principal components analysis permitted further reduction and the development of a definitive scale. Internal consistency, test-retest reliability, and responsiveness were assessed for the retained items. RESULTS: The initial scale was completed by 35 patients who were recovering from an open tibial fracture. Subjective and objective analysis permitted removal of poorly performing items and the addition of items suggested by patients. The refined scale consisted of 50 Likert scaled items and eight additional items. It was completed on 228 occasions by a different cohort of 204 patients with an open tibial fracture recruited from several UK orthoplastic tertiary referral centres. There were eight underlying components with tangible real-life meaning, which were retained as sub-scales represented by ten Likert scaled and eight non-Likert items. Internal consistency and test-retest reliability were good to excellent. CONCLUSION: The Wales Lower Limb Trauma Recovery (WaLLTR) Scale is the first tool to be developed from patient data with the potential to assess recovery following an open tibial fracture. Cite this article: Bone Joint J 2020;102-B(1):17-25.


Assuntos
Fraturas Expostas/cirurgia , Fraturas da Tíbia/cirurgia , Atividades Cotidianas , Adaptação Psicológica , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Medo/psicologia , Fraturas Expostas/psicologia , Fraturas Expostas/reabilitação , Humanos , Pessoa de Meia-Idade , Medidas de Resultados Relatados pelo Paciente , Estudos Prospectivos , Recuperação de Função Fisiológica , Autoeficácia , Índice de Gravidade de Doença , Fraturas da Tíbia/psicologia , Fraturas da Tíbia/reabilitação , Adulto Jovem
5.
Harefuah ; 159(1): 54, 2020 01.
Artigo em Hebraico | MEDLINE | ID: mdl-31930810

Assuntos
Imperícia , Medo , Humanos
6.
Zhongguo Zhen Jiu ; 40(1): 37-40, 2020 Jan 12.
Artigo em Chinês | MEDLINE | ID: mdl-31930897

RESUMO

OBJECTIVE: To observe the effect of hypnosis on pain and fear in the healthy acupuncture subjects. METHODS: A total of 52 healthy subjects were randomized into an observation group and a control group, 26 cases in each one. In the observation group, the subjects received the first-time acupuncture under hypnosis. After wakened up and 30 min later, the subjects received the second-time acupuncture under clear consciousness condition. In the control group, the subjects received the first-time acupuncture under clear consciousness condition, 30 min later, received the second-time acupuncture under hypnosis. Likert scale was adopted to investigate the relaxation, pain sensation and the willingness in the subjects at the normal condition before acupuncture, after the first-time and the second-time acupuncture of the two groups separately. Using Boeran electronic blood pressure monitor, the pulse and blood pressure were measured in the subjects at the normal condition and after the first-time acupuncture of the two groups. RESULTS: Compared with the normal condition, the relaxation degree was increased, the pain sensation decreased and the willingness enhanced after acupuncture either after hypnosis or after wakened-up in the observation group (P<0.001). The difference was not significant in each index between acupuncture after hypnosis and acupuncture after wakened-up in the observation group (P>0.05). In the control group, compared with the normal condition, after the first-time acupuncture (acupuncture in clear consciousness), the relaxation degree was decreased, pain was alleviated and the willingness was increased when acupuncture was exerted once again (P<0.001, P<0.05); compared with the normal condition, after the second-time acupuncture (acupuncture after hypnosis), pain was alleviated and the willingness increased (P<0.001), but the difference in relaxation was not significant (P>0.05); compared with the first-time acupuncture, the relaxation degree was increased, pain alleviated and willingness enhanced after the second-time acupuncture (acupuncture after hypnosis) (P<0.05, P<0.001). Compared with the control group after the first-time acupuncture (acupuncture in clear consciousness), the relaxation degree and willingness were increased and the pain sensation was reduced in the observation group during acupuncture either after hypnosis or after wakened-up (P<0.001). Compared with the control group the second-time acupuncture (during acupuncture after hypnosis), the relaxation degree was increased and pain sensation reduced in the observation group during acupuncture either after hypnosis or after wakened-up (P<0.01, P<0.001), but the difference was not significant in willingness (P>0.05). In the control group, compared with the normal condition, the pulse was faster, both the diastolic pressure and systolic pressure were increased after the first-time acupuncture (P<0.05, P<0.01). In the observation group, compared with the normal condition, the pulse was getting slow and blood pressure was reduced after the first-time (acupuncture under hypnosis, P<0.01). Compared with the first-time acupuncture in the control group, pulse was getting slow and blood pressure was reduced in the observation group after acupuncture under hypnosis (P<0.001). CONCLUSION: During acupuncture, with hypnosis combined, the fear alleviates, pain reduces and the willingness of acupuncture increases in the subjects.


Assuntos
Terapia por Acupuntura , Medo , Hipnose , Manejo da Dor , Humanos , Dor
11.
Acta Odontol Scand ; 78(1): 13-19, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31287346

RESUMO

Objective: To estimate the prevalence of dental anxiety, and to explore factors that may increase the risk of reporting dental anxiety among 18-year-old Norwegians in 2016. A further objective was to report changes in dental anxiety since 1996.Material and methods: An anonymous survey from a strategic sample of upper secondary students (n = 351) in 2016 with high response rate (93%) was compared with the results of an investigation of a similar population conducted in 1996.Results: The prevalence of dental anxiety and dental distrust was reduced from 1996 to 2016. Dental Fear Survey (DFS) from 19 to 8% (p < .001), and Dental Belief Survey (DBS) from 15 to 6% (p < .001). Geer Fear Scale (GFS) which measure phobic anxiety did not show a similar reduction (17 versus 15%, p = .37). Phobic anxiety, avoidance behaviour, self-reported poor oral health and previous experiences of pain were all associated with dental anxiety.Conclusion: The prevalence of dental anxiety was reduced from 1996 to 2016, but 8% still report dental anxiety. Proper pain management and use of behavioural management techniques still needs to be highlighted to prevent development of dental anxiety, avoidance behaviour and poor oral health.


Assuntos
Ansiedade ao Tratamento Odontológico/epidemiologia , Medo , Adolescente , Ansiedade ao Tratamento Odontológico/etiologia , Ansiedade ao Tratamento Odontológico/psicologia , Assistência Odontológica/psicologia , Humanos , Noruega/epidemiologia , Saúde Bucal , Dor/epidemiologia , Dor/psicologia , Prevalência , Odontologia em Saúde Pública , Fatores de Risco , Inquéritos e Questionários
12.
Am J Clin Hypn ; 62(1-2): 138-158, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31265373

RESUMO

It is unquestioned that reaching the hypnotic state is helped along by relational factors and that, conversely, relational experiences can be deepened through hypnosis. It is also true that deepening the experience of being in a relationship with another person is neither comfortable nor indicated for every patient or therapist. Most humans feel ambivalent about closeness. People vary in their desire for and their skill in sustaining mature intimacy. When we move along the continuum from rudimentary notions about relational factors in psychotherapy, such as rapport, to complex concepts, such as enactments, we move along a corresponding continuum of increasing need for specialized training, supervised experience, and personal therapy. The field of psychotherapy has been plagued from its inception by not knowing what to do with the tensions that emerge when two people listen to and look at each other. Avoiding relational factors may be a very human response to a very daunting matter.


Assuntos
Medo , Relações Profissional-Paciente , Psicoterapia , Emoções , Medo/psicologia , Humanos , Hipnose , Relações Interpessoais , Psicanálise , Aliança Terapêutica
13.
F1000Res ; 82019.
Artigo em Inglês | MEDLINE | ID: mdl-31824654

RESUMO

Fear is a highly adaptive emotion that has evolved to promote survival and reproductive fitness. However, maladaptive expression of fear can lead to debilitating stressor-related and anxiety disorders such as post-traumatic stress disorder. Although the neural basis of fear has been extensively researched for several decades, recent technological advances in pharmacogenetics and optogenetics have allowed greater resolution in understanding the neural circuits that underlie fear. Alongside conceptual advances in the understanding of fear memory, this increased knowledge has clarified mechanisms for some currently available therapies for post-traumatic stress disorder and has identified new potential treatment targets.


Assuntos
Medo , Transtornos de Estresse Pós-Traumáticos , Humanos , Memória
14.
Niger J Clin Pract ; 22(12): 1635-1643, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31793468

RESUMO

Background: Prenatal distress and fear of childbirth negatively affect the health of the mother and the fetus. Sociodemographic and pregnancy related characteristics may influence prenatal distress and fear of childbirth. Aim: This study aimed to explore the relationship between fear of childbirth and prenatal distress levels with accompanying factors. Subjects and Methods: The study was designed as a cross-sectional survey study and conducted in the outpatient clinic of Obstetrics and Gynecology Department of Pamukkale University Hospital, Denizli, Turkey, between April 2017 and January 2018. Survey data were collected from 103 third-trimester pregnant women who had admitted to the hospital for routine prenatal examination. Sociodemographic Information Form, the Revised Prenatal Distress Questionnaire (NUPDQ), and the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQ) were used to collect data. Sociodemographics, obstetrics, and other variables were summarized by descriptive statistics. Mann-Whitney U-test, Chi-squared test, and Fisher's exact test were used for comparison of data between groups. Results: The mean score of NUPDQ was 7.58 (SD 4.09) in the nulliparous group and 8.17 (SD 5.16) in the multiparous group (P = 0.68). The mean W-DEQ score was 40.46 (SD 21.80) in nulliparous women and 45.55 (SD 26.72) in multiparous women (P = 0.38). The W-DEQ and NUPDQ scores were moderately correlated with a Spearman correlation co-efficient of 0.58 (P < 0.001). Conclusions: The results of this study revealed that fear of childbirth and prenatal distress were moderately and positively correlated. NUPDQ and W-DEQ can be used during pregnancy to understand if pregnant women have fear or distress. This could help to give a better support to pregnant women.


Assuntos
Ansiedade/psicologia , Parto Obstétrico/psicologia , Medo/psicologia , Parto/psicologia , Gestantes/psicologia , Adulto , Estudos Transversais , Feminino , Humanos , Paridade , Gravidez , Cuidado Pré-Natal , Estresse Psicológico , Inquéritos e Questionários , Turquia , Adulto Jovem
15.
Zh Nevrol Psikhiatr Im S S Korsakova ; 119(10): 111-120, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31793552

RESUMO

The high prevalence of anxiety disorders around the world leads to a high interest in the study of anxiety. At the moment, a lot of knowledge about the pathogenesis and therapy of anxiety disorders has been accumulated, which is well covered in modern domestic and world medical literature. It is known that many areas of the brain are involved in the modulation of anxiety, among which the amygdala is considered the key in the modulation of anxiety and fear. A large body of evidence supports the involvement of different neurotransmitter systems in the processes of anxiogenesis-anxiolysis (GABA, monoamines, glutamate, neuropeptides, neurosteroids). This article provides an analysis of methods of pharmacological impact on each of these systems, which serve to optimize the already known strategies of anxiolytic therapy.


Assuntos
Ansiolíticos , Transtornos de Ansiedade , Tonsila do Cerebelo/efeitos dos fármacos , Tonsila do Cerebelo/fisiopatologia , Ansiolíticos/uso terapêutico , Ansiedade , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/tratamento farmacológico , Medo , Humanos
16.
Rev Fac Cien Med Univ Nac Cordoba ; 76(4): 227-232, 2019 11 28.
Artigo em Espanhol | MEDLINE | ID: mdl-31833746

RESUMO

Introduction: In the present study were determined the psychological, social and cultural factors that are related to organ donation in a Peruvian sample from the districts of San Isidro, Lince and San Juan de Lurigancho (Lima-Peru). Methods: Observational, retrospective, cross-sectional study controls that included adults between 18-60 years. Districts of Lima of different socioeconomic levels (A, B and C), A - San Isidro, B - Lince, and C - San Juan de Lurigancho were included. The questionnaire was administered to people who indicated they were donors and those who were not according to their district of domicile, with an equitable distribution of the surveyed population and the sectors of each district: San Isidro, Lince and San Juan de Lurigancho (5 sectors), 32 inhabitants for each sector of the district. Results: psychological factor was significantly associated with organ donation (OR = 6.407; p <0.001), altruism and fear of disfiguring the body being the ones with the greatest strength of association to organ donation. Social factors (OR = 0.879; p> 0.05) and cultural factors (OR = 0.659; p> 0.05) were not significantly associated. Major conclusion: The statistically significant associated factor to organ donation in the three districts of Lima was the psychological factor; the social and cultural factor did not show association in the districts evaluated.


Assuntos
Altruísmo , Características Culturais , Medo/psicologia , Psicologia , Obtenção de Tecidos e Órgãos/estatística & dados numéricos , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Peru , Estudos Retrospectivos , Inquéritos e Questionários , Adulto Jovem
17.
Sheng Li Xue Bao ; 71(6): 905-916, 2019 Dec 25.
Artigo em Chinês | MEDLINE | ID: mdl-31879746

RESUMO

One of the core symptoms in anxiety disorders is dysregulated fear response. It is crucial for psychologists and neuroscientists to understand how fear responses are enhanced and inhibited. Although oxytocin (OXT) was initially conceived as a prosocial molecule and mammalian neuropeptide that enhances cooperation and trust, later studies showed that it produces modulatory influence on fear responses. Therefore, OXT is now regarded as a promising pharmacological agent to boost treatment response in anxiety disorders. However, the effect of OXT on fear responses have been somewhat complex, and there are some contradictions among animal experiments and human studies. In this article, we summarize recent studies that employed animal models, brain region-specific manipulations and preclinical studies to explore the role of OXT in the acquisition and processing of fear response. We also discuss the methodological differences among these studies and review the potential factors that may contribute to the complicated effect of OXT on fear response. This review will help to promote the potential clinical application of OXT.


Assuntos
Medo , Ocitocina , Animais , Encéfalo/efeitos dos fármacos , Medo/efeitos dos fármacos , Humanos , Ocitócicos/farmacologia , Ocitocina/farmacologia
19.
Nat Neurosci ; 22(12): 2000-2012, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31712775

RESUMO

Acquisition and extinction of learned fear responses utilize conserved but flexible neural circuits. Here we show that acquisition of conditioned freezing behavior is associated with dynamic remodeling of relative excitatory drive from the basolateral amygdala (BLA) away from corticotropin releasing factor-expressing (CRF+) centrolateral amygdala neurons, and toward non-CRF+ (CRF-) and somatostatin-expressing (SOM+) neurons, while fear extinction training remodels this circuit back toward favoring CRF+ neurons. Importantly, BLA activity is required for this experience-dependent remodeling, while directed inhibition of the BLA-centrolateral amygdala circuit impairs both fear memory acquisition and extinction memory retrieval. Additionally, ectopic excitation of CRF+ neurons impairs fear memory acquisition and facilities extinction, whereas CRF+ neuron inhibition impairs extinction memory retrieval, supporting the notion that CRF+ neurons serve to inhibit learned freezing behavior. These data suggest that afferent-specific dynamic remodeling of relative excitatory drive to functionally distinct subcortical neuronal output populations represents an important mechanism underlying experience-dependent modification of behavioral selection.


Assuntos
Complexo Nuclear Basolateral da Amígdala/fisiologia , Núcleo Central da Amígdala/fisiologia , Medo/fisiologia , Ácido Glutâmico/fisiologia , Animais , Condicionamento Clássico/fisiologia , Hormônio Liberador da Corticotropina/genética , Hormônio Liberador da Corticotropina/metabolismo , Potenciais Pós-Sinápticos Excitadores/fisiologia , Extinção Psicológica/fisiologia , Reação de Congelamento Cataléptica/fisiologia , Camundongos Transgênicos , Vias Neurais/fisiologia , Somatostatina/genética , Somatostatina/metabolismo
20.
J Indian Soc Pedod Prev Dent ; 37(4): 345-349, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31710008

RESUMO

Aim: The aim of the study was to assess the prevalence of dental fear and anxiety among children aged 4-13 years using three fear scales, i.e., facial image scale (FIS), Nepalese version of Children's Fear Survey Schedule-Dental Subscale (CFSS-DS), and Modified Child Dental Anxiety Scale (MCDAS). Materials and Methods: The study was conducted on 300 children (4-13 years) who visited the Department of Pedodontics and Preventive Dentistry. The fear and anxiety levels were measured using three fear measurement scales, i.e., FIS, Nepalese version of CFSS-DS, and MCDAS. The dental behavior observed was rated according to the Frankl's Behavior Rating Scale (FBRS). Results: The prevalence of dental fear according to FIS was 11.9% as evident from children having FIS 4 and 5 scores. Dental fear with CFSS-DS ≥38 was identified in 49 children (21 [12.5%] male and 28 [21.21%] female). In assessment of the behavior of children in the clinics through FBRS, it was observed that the maximum number of respondents (70.6%) showed Frankl's rating 3, i.e., positive. Conclusion: The Nepalese versions of the CFSS-DS and the MCDAS are both reliable and valid scales for evaluating dental anxiety and fear in young children. Assessing dental anxiety and fear is useful, as behavior management can be designed accordingly for child patients.


Assuntos
Comportamento Infantil , Ansiedade ao Tratamento Odontológico , Adolescente , Criança , Pré-Escolar , Medo , Feminino , Humanos , Masculino , Odontopediatria , Prevalência
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA