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1.
BMJ Open ; 13(1): e065075, 2023 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-36669845

RESUMO

INTRODUCTION: Fear of cancer recurrence (FCR) is a prevalent and frequently debilitating response to a cancer diagnosis, affecting a substantial proportion of cancer survivors. Approximately 30% of local Hong Kong Chinese cancer survivors in a recent survey reportedly experienced persistent high FCR over the first-year post-surgery. This was associated with lower levels of psychological well-being and quality of life. A manualised intervention (ConquerFear) developed primarily based on the Self-Regulatory Executive Function Model and the Rational Frame Theory, has been found to reduce FCR effectively among Caucasian cancer survivors. The intervention now has been adapted to a Chinese context; ConquerFear-HK. The primary aim of this study is to evaluate its efficacy vs a standard-survivorship-care control (BasicCancerCare) in FCR improvement in a randomised control trial (RCT). METHODS AND ANALYSIS: In this RCT, using the sealed envelope method, 174 eligible Chinese cancer survivors will be randomised to either the ConquerFear-HK or BasicCancerCare intervention. Both interventions include six sessions over 10 weeks, which will be delivered via face to face or online by trained therapists. The ConquerFear-HK intervention incorporates value classification, metacognitive therapy, attentional training, detached mindfulness and psychoeducation; BasicCancerCare includes relaxation training, dietary and physical activity consultations. Participants will be assessed at prior randomisation (baseline; T0), immediately postintervention (T1), 3 months (T2) and 6 months postintervention (T3) on the measures of FCR (Fear of Cancer Recurrence Inventory) as a primary outcome; metacognition (30-item Metacognitions Quesionnaire) and cognitive attentional syndrome (Cognitive-attentional Syndrome Questionnaire) as process outcomes; psychological distress (Hospital Anxiety and Depression Scale), cancer-related distress (Chinese Impact of Events Scale), quality of life (European Organisation for Research and Treatment of Cancer Quality of Life Core Questionnaire) and treatment satisfaction are secondary outcomes. ETHICS AND DISSEMINATION: Ethics approval has been obtained from HKU/HA HKW Institutional Review Board (ref: UW19-183). The patients/participants provide their written informed consent to participate in this study. The study results will be disseminated through international peer-review publications and conference presentations. TRIAL REGISTRATION NUMBER: NCT04568226.


Assuntos
Sobreviventes de Câncer , Metacognição , Humanos , Sobreviventes de Câncer/psicologia , Recidiva Local de Neoplasia/psicologia , Medo/psicologia , Sobreviventes/psicologia , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto
2.
Artigo em Inglês | MEDLINE | ID: mdl-36673662

RESUMO

The burgeoning eHealth campaigns and the emerging daughter-to-mother health communication necessitate a close examination of the intricate mechanism behind recommending preventive behaviors in online settings. The present study addresses existing gaps by investigating how message characteristics and platform-generated virality cues jointly influence younger females' intention to recommend breast cancer screening to their mothers. Drawing on the extended parallel process model (EPPM) as the theoretical basis, a 2 (threat: low vs. high) × 2 (efficacy: low vs. high) × 2 (virality: low vs. high) randomized between-subjects experiment (n = 269) was performed. Results revealed a three-way interaction effect between threat, efficacy, and virality on message involvement. Message involvement was positively associated with recommendation intention and mediated the three-way interaction effect on recommendation intention. This study demonstrates that a high threat can initiate message involvement but fail to trigger recommendation intention. In contrast, a low-threat, high-efficacy, high-virality combination would yield a salutary outcome. Besides, the indispensable role of message involvement in the underlying psychological mechanism behind recommending preventive behaviors was reaffirmed. Theoretical and practical implications are further discussed.


Assuntos
Neoplasias da Mama , Intenção , Feminino , Humanos , Neoplasias da Mama/prevenção & controle , Sinais (Psicologia) , Detecção Precoce de Câncer , Medo/psicologia
3.
Psicothema ; 35(1): 30-40, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36695848

RESUMO

BACKGROUND: Using a foreign language can influence emotion modulation, but whether different psychotherapy processes would be affected by a foreign language is still unclear. The current study explored the foreign language effect on the extinction of fear. METHOD: During the conditioning phase, part of the neutral stimuli presented to the participants were associated with a threat, while they performed a countdown task in their native language. In the extinction phase, participants performed the same task either in their native/foreign language and were informed that the threat would no longer appear. We collected self-reports of fear, and pupil dilation and electrodermal activity as physiological measures of arousal. RESULTS: Extinction was successful, indicated by greater self-reported fear and pupil dilation during the threat condition compared to neutral in the conditioning phase, but no significant differences during extinction. Although the foreign language group presented higher arousal, fear extinction occurred regardless of the linguistic context. CONCLUSIONS: Fear extinction via verbal instructions is equally effective in a foreign and a native language context. These results indicate that evidence should be continue to be gathered on the role of foreign languages using basic paradigms with clinical applications.


Assuntos
Extinção Psicológica , Medo , Humanos , Medo/fisiologia , Medo/psicologia , Extinção Psicológica/fisiologia , Emoções , Idioma , Psicoterapia , Resposta Galvânica da Pele
4.
PLoS One ; 18(1): e0280740, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36706069

RESUMO

OBJECTIVE: The fear-avoidance model of pain posits that a painful stimulus is interpreted through pain catastrophizing, which leads to negative downstream cognitions, emotions, and behaviors that shape the experience of pain. As dispositional mindfulness is associated with less catastrophizing and pain, some researchers have suggested incorporating mindfulness into the fear-avoidance model. Across two studies, we empirically tested dispositional mindfulness as a stand-alone component within the fear-avoidance model of pain. METHODS: Two independent, online cross-sectional surveys (Ns = 362 and 580 U.S. adults) were conducted. Participants completed validated assessments of mindfulness, pain catastrophizing, fear of pain, pain vigilance, depression, pain intensity, and pain sensitivity. Using structural equation modeling, we tested the inclusion of dispositional mindfulness in the fear-avoidance model of pain. We proposed that greater mindfulness would be associated with less pain catastrophizing, which in turn would be associated with less fear of pain, leading to less depression, and then ultimately less pain intensity and pain sensitivity. RESULTS: Across both studies, the fear-avoidance model of pain did not fit the data well, with or without mindfulness included. We found that a simplified model fit the data best (Study 1: χ2/df = 1.83; CFI = .981; RMSEA = .049, 90% CI [0.019, 0.076]; SRMR = 0.031; Study 2: χ2/df = 2.23; CFI = .976; RMSEA = .046, 90% CI [0.026, 0.067]; SRMR = .031), such that greater mindfulness was significantly associated with less pain catastrophizing and, in turn, lower levels of pain intensity and pain sensitivity. CONCLUSION: Our findings suggest that a simplified model, compared to the traditional fear-avoidance model, may partly explain the experience of pain among individuals without chronic pain. Future work should examine the temporal associations among these variables to inform the employment of future empirically supported interventions for pain management.


Assuntos
Dor Crônica , Atenção Plena , Adulto , Humanos , Estudos Transversais , Medo/psicologia , Dor Crônica/psicologia , Catastrofização/psicologia , Inquéritos e Questionários
5.
Curr Oncol ; 29(12): 9501-9510, 2022 12 03.
Artigo em Inglês | MEDLINE | ID: mdl-36547160

RESUMO

BACKGROUND: Fear of cancer recurrence (FCR) has been demonstrated to be one of the most frequently reported unmet psychological needs among cancer survivors. The aim of this study was to explore and describe the potential triggers and coping strategies for FCR in Chinese cancer survivors. METHODS: The study process was conducted using an interpretive phenomenological research method, and Chinese cancer survivors were interviewed face-to-face in a semi-structured interview, using purposive sampling combined with a maximum variance sampling strategy, and the interviews were transcribed, organized, and analyzed by applying Giorgi analysis with the help of NVivo11 software. RESULTS: A total of 10 participants, 4 males and 6 females, were interviewed. Three themes emerged in terms of potential triggers for FCR: (1) intrusive thoughts; (2) disease symptoms; and (3) awaiting medical examination. Two themes regarding positive coping and avoidance coping emerged with regard to coping strategies adopted by cancer survivors when experiencing FCR. Under these 2 themes were 5 sub-themes: (1) seeking medical support; (2) self-health management; (3) spiritual coping; (4) unaccompanied toleration; and (5) attention shifting. CONCLUSION: FCR as the most common psychological problem for cancer survivors, and it should be given more attention. Early identification and precise intervention for potential triggers of FCR may prevent the emergence and development of FCR. The guidance toward and cultivation of positive coping strategies when cancer survivors experience FCR could be an important direction in future nursing education.


Assuntos
Sobreviventes de Câncer , Masculino , Feminino , Humanos , Sobreviventes de Câncer/psicologia , Recidiva Local de Neoplasia/psicologia , Medo/psicologia , Adaptação Psicológica , Pesquisa Qualitativa
6.
Cult. cuid ; 26(64): 1-13, 3º Cuatrimestre 2022.
Artigo em Espanhol | IBECS | ID: ibc-213740

RESUMO

The aim of this phenomenological article is to analyse the relationship of care in the context of contemporaneity and the pandemic. Methodology: The experience of care in the frameworkof Covid19 has allowed us to understand some physical and spatial barriers imposed in the syndemic framework. In order to reflect on this phenomenon, some philosophical postulates of Hanand Lévinas, related to the splitting of intersubjective relationships in the 20th century, as well asthe ontological construction of care proposed by Siles, have been taken as theoretical references.Conclusion: talking, being listened to and accompanied is therapeutic; while repression of the symbolic act increases painful tension. In the midst of this reality, it is worth remembering that, withoutcare, man ceases to be human. Without care, from birth to death, the human being disarticulates,weakens, loses meaning and dies. If, in the course of life, everything he undertakes is not undertaken with care, he will end up harming himself and destroying everything around him. (AU)


El objetivo de este artículo de carácter fenomenológico, es analizar la relación de cuidadoen el marco de la contemporaneidad y la pandemia. Metodología: La experiencia de cuidado en elmarco del Covid19 ha permitido comprender algunas barreras físicas y espaciales impuestas en elmarco sindemico, para la reflexión sobre este fenómeno, se han tomando como referentes teóricosalgunos postulados filosóficos de Han y Lévinas, relacionados con la escisión de las relaciones intersubjetivas en el siglo XX, así como también, la construcción ontológica del cuidado propuesta porSiles. Conclusión: hablar, ser escuchado y acompañado es terapéutico; mientras que la represión delacto simbólico incrementa la tensión dolorosa. En medio de esta realidad cabe recordar que, sin elcuidado, el hombre deja de ser humano. Si no se recibe cuidado, desde el nacimiento hasta la muerte,el ser humano se desarticula, se debilita, pierde sentido y muere. Si, en el transcurso de la vida, todolo que emprende no lo hace con cuidado, acabará por perjudicarse a sí mismo y por destruir todo loque se halla a su alrededor. (AU)


O objectivo deste artigo fenomenológico é analisar a relação dos cuidados no contexto dacontemporaneidade e da pandemia. Metodologia: A experiência dos cuidados no quadro da Covid19permitiu-nos compreender algumas barreiras físicas e espaciais impostas no quadro sindémico. Parareflectir sobre este fenómeno, alguns postulados filosóficos de Han e Lévinas, relacionados com adivisão das relações intersubjectivas no século XX, bem como a construção ontológica dos cuidadosproposta por Siles, foram tomados como referências teóricas. Conclusão: falar, ser ouvido e acompanhado é terapêutico; enquanto a repressão do acto simbólico aumenta a tensão dolorosa. No meiodesta realidade, vale a pena recordar que, sem cuidado, o homem deixa de ser humano. Sem cuidados, do nascimento à morte, o ser humano desarticula-se, enfraquece, perde o sentido e morre. Se,no decurso da vida, tudo o que ele empreende não for empreendido com cuidado, acabará por seprejudicar a si próprio e destruir tudo à sua volta. (AU)


Assuntos
Humanos , Medo/psicologia , Infecções por Coronavirus/epidemiologia , Cuidados de Enfermagem/psicologia , Pandemias
7.
Artigo em Inglês | MEDLINE | ID: mdl-36497911

RESUMO

Sex differences in emotion regulation strategies may impact sex differences in affective disorders. Using cognitive reappraisal strategy in the discriminative task of conditioned fear was studied to understand how sex differences in emotion regulation impact on conditioned fear in men and women. College students with low cognitive reappraisal scores completed the task of conditioned fear during two days: acquisition and extinction at the first day, and re-extinction at the second day. The reappraisal training was carried out before conditioned fear task. The self-reported fear rating of the conditioned stimulus (CS) and US-expectancy in the conditioned fear (unconditioned stimulus, US) were analyzed. Results showed all subjects acquired conditional fear and successfully distinguished CS+ from CS-. Cognitive reappraisal significantly reduces the fear rating and improves the extinction of US-expectancy in both sexes, but the fear rating in female reappraisal group decreases more slowly than that in male reappraisal group, as well as the extinction of US-expectancy in woman requiring a longer time and more trials of extinction than that in men. For individuals with low cognitive reappraisal scores, cognitive reappraisal promotes the extinction of conditioned fear in both males and females. Because of the original gender difference of conditioned fear extinction and emotion regulation, the effect of cognitive reappraisal on conditioned fear is complex, which shows differently in influence speed and practice effect.


Assuntos
Extinção Psicológica , Medo , Feminino , Masculino , Humanos , Medo/psicologia , Extinção Psicológica/fisiologia , Caracteres Sexuais , Condicionamento Clássico/fisiologia , Cognição/fisiologia
8.
BMC Geriatr ; 22(1): 901, 2022 11 24.
Artigo em Inglês | MEDLINE | ID: mdl-36434527

RESUMO

BACKGROUND: Fear of falling (FOF) is a common and major health concern in older adults. The consequences of FOF include reduced physical performance, social activity, and health-related quality of life. Ramsay Hunt syndrome (RHS) is a herpes zoster-related facial nerve dysfunction accompanied by an erythematous vesicular rash on the ear or mouth that may complicate ipsilateral facial paralysis and otalgia, vertigo, tinnitus, hearing loss, and meningoencephalitis. However, repeated falls and subsequent FOF due to RHS have not been reported in older adults. CASE PRESENTATION: A 65-year-old woman diagnosed with RHS experienced repeated falls during hospital admission and after discharge. Despite recovery of balance and no subsequent falls, the patient presented with persistent FOF at the geriatric outpatient follow-up visit 1 year after the RHS episode. The fear sensation impaired the patient's instrumental daily activities and was confirmed by documentation of serial comprehensive geriatric assessments, especially the Timed Up and Go test scores. CONCLUSIONS: RHS may cause repeated falls and FOF, leading to impairment in daily activities and psychosocial function in older adults. Therefore, clinicians should be mindful of falls and FOF when caring for older patients with RHS and should develop multidimensional strategies for fall prevention and FOF.


Assuntos
Acidentes por Quedas , Herpes Zoster da Orelha Externa , Feminino , Humanos , Idoso , Acidentes por Quedas/prevenção & controle , Herpes Zoster da Orelha Externa/complicações , Herpes Zoster da Orelha Externa/diagnóstico , Medo/psicologia , Equilíbrio Postural , Qualidade de Vida , Estudos de Tempo e Movimento
9.
Sci Rep ; 12(1): 19620, 2022 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-36380072

RESUMO

There is now scientific evidence that, in dogs, distinctive facial actions are produced in response to different emotionally-arousing stimuli suggesting a relationship between lateralized facial expressions and emotional states. Although in humans, relationships between facial asymmetry and both emotional and physiological distress have been reported, there are currently no data on the laterality of dogs' facial expressions in response to social stimuli with respect to canine behavioral disorders. The aim of the present work was to investigate the facial asymmetries of dogs with fear and aggressive behavior towards humans during two different emotional situations: (1) while the dogs were alone in the presence of their owners and (2) during the approach of an unfamiliar human being. Overall, our results demonstrated high levels of asymmetries in facial expressions of dogs displaying fear and aggressive behaviors towards humans indicating that measuring facial asymmetries in dogs could prove to be a useful non-invasive tool for investigating physiology-based behavioral disorders.


Assuntos
Assimetria Facial , Expressão Facial , Cães , Humanos , Animais , Medo/psicologia , Emoções/fisiologia , Face/fisiologia
10.
PLoS One ; 17(11): e0277793, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36399451

RESUMO

Vicarious learning, i.e. learning through observing others rather than through one's own experiences, is an integral skill of social species. The aim of this study was to assess the causal role of affect sharing, an important aspect of empathy, in vicarious fear learning. N = 39 participants completed a vicarious Pavlovian fear conditioning paradigm. In the learning stage, they watched another person-the demonstrator-responding with distress when receiving electric shocks to a color cue (conditioned stimulus; CS+; a different color served as CS-). In the subsequent test stage, an increased skin conductance response (SCR) to the CS+ presented in the absence of the demonstrator indexed vicarious fear learning. Each participant completed this paradigm under two different hypnotic suggestions, which were administered to induce high or low affect sharing with the demonstrator in the learning stage, following a counterbalanced within-subject design. In the learning stage, high affect sharing resulted in stronger unconditioned SCR, increased eye gaze toward the demonstrator's face, and higher self-reported unpleasantness while witnessing the demonstrator's distress. In the test stage, participants showed a stronger conditioned fear response (SCR) when they had learned under high, compared to low, affect sharing. In contrast, participants' declarative memory of how many shocks the demonstrator had received with each cue was not influenced by the affect sharing manipulation. These findings demonstrate that affect sharing is involved in enhancing vicarious fear learning, and thus advance our understanding of the role of empathy, and more generally emotion, in social observational learning.


Assuntos
Condicionamento Clássico , Medo , Humanos , Medo/psicologia , Condicionamento Clássico/fisiologia , Aprendizagem/fisiologia , Empatia , Fixação Ocular
11.
PLoS One ; 17(11): e0276967, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36395173

RESUMO

INTRODUCTION: Fear of falling has serious implications for health and is an important threat to autonomy. The purpose of this cross-sectional study was to investigate risk factors for fear of falling among Palestinian older adults in Hebron district. METHODS: A cross-sectional study was conducted among Palestinians > 60 years living in Hebron, West Bank. The Falls Efficacy Scale-International was used to predict falls among Palestinian older adults. Moreover, socio-demographic data, medical history, lifestyle habits, body composition, nutritional status, cognitive status (using the Montreal cognitive assessment tool), and functional status (using activities of daily living and instrumental activities of daily living scale), the presence of depressive symptoms (using geriatric depression scale), and physical fitness performance (using senior fitness test) were collected through an interview-based questionnaire. Data were analyzed using univariate and multivariate approach. RESULTS: A total of 200 participants were included in the study; 137 (68.5%) females and 63 (31.5%) males. Mean age was 70.5 ± 5.7 years, ranged from 65 to 98 years old. Fear of falling was significantly higher among older adults with advanced aged, living in villages or camps, low educational level, and being married (p < 0.05). Functional status (ADL and IADL), physical fitness status (timed up and go), and depression symptoms were significantly related to fear of falling (p < 0.05). CONCLUSION: High concern of falling is significantly associated with advanced age, low education level, being married, and living in villages or camps. ADLs were among the factors that had a significant relationship with increased fear of falling. Predictors of fear of falling among Palestinian older adults were IADL scores, body fat percentage, rapid gait speed, timed up and go test. Future studies could investigate further correlates of fear of falling among older adults.


Assuntos
Medo , Vida Independente , Masculino , Feminino , Humanos , Idoso , Idoso de 80 Anos ou mais , Medo/psicologia , Acidentes por Quedas/prevenção & controle , Estudos Transversais , Atividades Cotidianas/psicologia , Árabes , Equilíbrio Postural , Estudos de Tempo e Movimento
12.
Ned Tijdschr Tandheelkd ; 129(11): 513-518, 2022 Nov.
Artigo em Holandês | MEDLINE | ID: mdl-36345676

RESUMO

For dental anxiety, cognitive behavioral therapy is the treatment of choice and exposure therapy is a major part of this treatment program. This article describes the underlying working mechanism of exposure therapy. Exposure should be directed toward the patient's harm expectancies. Moreover, the patient needs to be ensured that their harm expectation will not be violated, despite being challenged to the maximum. In addition, it is important that patients perform exposure exercises in as many different contexts as possible and to ensure a lot of repetition. Combining different fear-inducing stimuli during exposure sessions is also recommended. Currently, the inhibition model is the best explanatory working mechanism model and this article contrasts the new inhibition model with the older habituation model, that is still often used in clinical practice. The most important clinical implications of the inhibition model are described and illustrated with practical examples.


Assuntos
Ansiedade , Terapia Cognitivo-Comportamental , Humanos , Medo/psicologia
13.
Complement Ther Clin Pract ; 49: 101686, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36347151

RESUMO

OBJECTIVE: Mindfulness-based interventions (MBIs) targeting cancer-related emotions and quality of life have attracted extensive attention in recent years. The purpose of the current study was to assess the feasibility and acceptability of an online mindfulness-based intervention and examine its effects on Chinese breast cancer survivors. METHODS: Sixty-five breast cancer survivors were randomized to either an online MBI or to wait for the next available program. The control group received usual care, while the intervention group also received six weeks of online MBI training. Participants completed the Short Form of the Fear of Cancer Recurrence Inventory (FCRI-SF), Five Facet Mindfulness Questionnaire (FFMQ) and European Organization for Research and Treatment of Cancer questionnaire (EORTC-QLQ-C30) at baseline (T1), immediately after the intervention (postintervention: T2) and 1 month later (1-month postintervention: T3). In addition, answers provided to questions about the experience of participating in the course were analyzed. RESULTS: Compared with the control group, the mindfulness, emotional and cognitive function of the MBI group was significantly improved after the intervention, and the FCR of breast cancer survivors was significantly alleviated. These effects were still significant 1 month after the end of the intervention. Additionally, participants were satisfied with the online MBI through the qualitative survey. CONCLUSION: This online MBI showed promise for Chinese breast cancer survivors, facilitating a reduction in FCR and improving their quality of life. The results of our study indicated that online MBI treatment could offer a scalable approach to manage FCR and maintain mental health for breast cancer survivors.


Assuntos
Neoplasias da Mama , Sobreviventes de Câncer , Atenção Plena , Humanos , Feminino , Sobreviventes de Câncer/psicologia , Atenção Plena/métodos , Qualidade de Vida , Neoplasias da Mama/terapia , Neoplasias da Mama/psicologia , Medo/psicologia , China
14.
Eur J Psychotraumatol ; 13(2): 2127185, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36353527

RESUMO

Background: The COVID-19 outbreak in early 2020 was associated with an immediate increase in mental health problems in a significant percentage of the general population. Therefore, it is crucial to investigate how the COVID-19 pandemic - as a psychosocial stressor - affected the aetiological processes of mental disorders. Previous research has shown that stress potentiates associative (fear) learning and analogue symptoms of posttraumatic stress disorder (PTSD) and that analogue PTSD symptoms can emerge in response to associative learning. Objective: We investigated whether distress in response to the COVID-19 outbreak support the development of intrusions and rumination after exposure to a non-COVID-19-related analogue trauma. Moreover, we examined if these effects are mediated by the strength of associative learning during analogue trauma. Method: 122 undergraduate university students participated in an online experiment between March and July 2020. They completed questionnaires measuring distress and rumination related to the COVID-19 outbreak. On a subsequent day, they went through an associative learning task, in which neutral stimuli were paired with the appearance of a highly aversive film clip. Subjective ratings were assessed as indicators of associative learning. On the next day, participants documented film-related intrusions and rumination. Results: COVID-19-related distress but not rumination was associated with post-film intrusion and rumination load. These effects were mediated by associative learning. Conclusions: The current findings are in line with the assumptions that stress enhanced both associative learning and PTSD symptoms. Specifically, they indicate that prolonged psychosocial stress - like during the COVID-19 outbreak - is linked to individual differences in memory processing of aversive events. Further confirmatory research is needed to replicate these results.


Antecedentes: El brote de COVID-19 a principios de 2020 se asoció con un aumento inmediato de problemas de salud mental en un porcentaje significativo de la población general. Por lo tanto, es crucial investigar cómo la pandemia de COVID-19, como estresor psicosocial, afectó los procesos etiológicos de los trastornos mentales. Investigaciones anteriores han demostrado que el estrés potencia el aprendizaje asociativo (miedo) y los síntomas análogos del trastorno de estrés postraumático (TEPT) y que los síntomas análogos del TEPT pueden surgir en respuesta al aprendizaje asociativo.Objetivo: Investigamos si el malestar psicológico en respuesta al brote de COVID-19 contribuye al desarrollo de intrusiones y rumiación después de la exposición a un trauma análogo no relacionado con COVID-19. Además, examinamos si estos efectos están mediados por la fuerza del aprendizaje asociativo durante el trauma analógico.Método: 122 estudiantes universitarios de pregrado participaron en un experimento en línea entre marzo y julio de 2020. Completaron cuestionarios que midieron el malestar psicológico y la rumiación relacionados con el brote de COVID-19. Al día siguiente, realizaron una tarea de aprendizaje asociativo, en la que se emparejaron estímulos neutrales con la exposición a un clip de película altamente aversivo. Las calificaciones subjetivas se evaluaron como indicadores de aprendizaje asociativo. Al día siguiente, los participantes documentaron intrusiones y rumiaciones relacionadas con la película.Resultados: El malestar psicológico relacionado con COVID-19, pero no la rumiación, se asoció con la intrusión posterior a la película y la carga de rumiación. Estos efectos fueron mediados por el aprendizaje asociativo.Conclusiones: Los hallazgos actuales están en línea con las suposiciones de que el estrés potenció tanto el aprendizaje asociativo como los síntomas del TEPT. Específicamente, indican que el estrés psicosocial prolongado, como el ocurrido durante el brote de COVID-19, está relacionado con diferencias individuales en el procesamiento de la memoria de eventos aversivos. Se necesita más investigación confirmatoria para replicar estos resultados.


Assuntos
COVID-19 , Transtornos de Estresse Pós-Traumáticos , Humanos , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Pandemias , Memória/fisiologia , Medo/psicologia
15.
PLoS One ; 17(11): e0277004, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36327253

RESUMO

BACKGROUND: Fear of childbirth (FoB) and depressive symptoms (DS) are experienced by many women and can negatively affect women during and after pregnancy. This study assessed patterns of FoB and DS over time and associations of postpartum FoB and DS with sociodemographic and obstetric characteristics. METHODS: We conducted a longitudinal study at six health facilities in Tanzania in 2018-2019. Pregnant women were consecutively assessed for FoB and DS before and after childbirth using the Wijma Delivery Expectancy/Experience Questionnaire versions A & B and the Edinburgh antenatal and postnatal depressive scale. This paper is based on 625 women who completed participation. RESULTS: The prevalence rates of FoB and DS during pregnancy were 16% and 18.2%, respectively, and after childbirth, 13.9% and 8.5%. Some had FoB (6.4%) and DS (4.3%) at both timepoints. FoB was strongly associated with DS at both timepoints (p < 0.001). Both FoB (p = 0.246) and DS (p < 0.001) decreased after childbirth. Never having experienced obstetric complications decreased the odds of postpartum and persisting FoB (adjusted odds ratio (aOR) 0.44, 95% confidence interval (CI) 0.23-0.83). Giving birth by caesarean section (aOR 2.01, 95% CI 1.11-3.65) and having more than 12 hours pass between admission and childbirth increased the odds of postpartum FoB (aOR 2.07, 95% CI 1.03-4.16). Postpartum DS was more common in women with an ill child/stillbirth/early neonatal death (aOR 4.78, 95% CI 2.29-9.95). Persisting DS was more common in single (aOR 2.59, 95% CI 1.02-6.59) and women without social support from parents (aOR 0.28, 95% 0.11-0.69). CONCLUSIONS: FoB and DS coexist and decrease over time. Identifying predictors of both conditions will aid in recognising women at risk and planning for prevention and treatment. Screening for FoB and DS before and after childbirth and offering psychological support should be considered part of routine antenatal and postnatal care. Furthermore, supporting women with previous obstetric complications is crucial. Using interviews instead of a self-administered approach might have contributed to social desirability. Also, excluding women with previous caesarean sections could underestimate FoB and DS prevalence rates.


Assuntos
Cesárea , Depressão , Feminino , Humanos , Recém-Nascido , Gravidez , Cesárea/psicologia , Parto Obstétrico/psicologia , Depressão/epidemiologia , Medo/psicologia , Estudos Longitudinais , Parto/psicologia , Inquéritos e Questionários , Tanzânia/epidemiologia
16.
BMC Psychiatry ; 22(1): 732, 2022 11 24.
Artigo em Inglês | MEDLINE | ID: mdl-36424567

RESUMO

BACKGROUND: The COVID-19 pandemic has induced high levels of stress. The aim of the study was to assess the relationship between emotional stress (COVID-19 related fear, anger, frustration, and loneliness) and the use of coping strategies among adults in Nigeria during the COVID-19 pandemic. METHODS: Data from adults aged 18 years and above were collected through an online survey from July to December 2020. The dependent variables were COVID-19 related fear (fear of infection and infecting others with COVID-19), anger, frustration, and loneliness. The independent variables were coping strategies (use of phones to communicate with family and others, video conferencing, indoor exercises, outdoor exercises, meditation/mindfulness practices, engaging in creative activities, learning a new skill, following media coverage related to COVID-19) and alcohol consumption. Five logistic regression models were developed to identify the factors associated with each dependent variables. All models were adjusted for sociodemographic variables (age, sex at birth, and the highest level of education). RESULTS: Respondents who consumed alcohol, followed media coverage for COVID-19 related information, and who spoke with friends or family on the phone had higher odds of having fear of contracting COVID-19 or transmitting infection to others, and of feeling angry, frustrated, or lonely (p < 0.05). Respondents who exercised outdoors (AOR: 0.69) or learned a new skill (AOR: 0.79) had significantly lower odds of having fear of contracting COVID-19. Respondents who practiced meditation or mindfulness (AOR: 1.47) had significantly higher odds of feeling angry. Those who spoke with friends and family on the phone (AOR: 1.32) and exercised indoors (AOR: 1.23) had significantly higher odds of feeling frustrated. Those who did video conferencing (AOR: 1.41), exercised outdoors (AOR: 1.32) and engaged with creative activities (AOR: 1.25) had higher odds of feeling lonely. CONCLUSION: Despite the significant association between emotional stress and use of coping strategies among adults in Nigeria during the COVID-19 pandemic, it appears that coping strategies were used to ameliorate rather than prevent emotional stress. Learning new skills and exercising outdoors were used to ameliorate the fear of contracting COVID-19 in older respondents.


Assuntos
COVID-19 , Angústia Psicológica , Adulto , Recém-Nascido , Humanos , Idoso , Nigéria/epidemiologia , Pandemias , Estudos Transversais , Adaptação Psicológica , Medo/psicologia
17.
BMJ Open ; 12(11): e066435, 2022 11 25.
Artigo em Inglês | MEDLINE | ID: mdl-36428018

RESUMO

OBJECTIVES: To identify factors associated with kinesiophobia (fear of movement) after cardiac hospitalisation and to assess the impact of kinesiophobia on cardiac rehabilitation (CR) initiation. DESIGN: Prospective cohort study. SETTING: Academic Medical Centre, Department of Cardiology. PARTICIPANTS: We performed a prospective cohort study in cardiac patients recruited at hospital discharge. In total, 149 patients (78.5% male) with a median age of 65 years were included, of which 82 (59%) were referred for CR. PRIMARY AND SECONDARY OUTCOME MEASURES: We assessed kinesiophobia with the Tampa Scale for Kinesiophobia (TSK). For this study, the total score was used (range 13-52). We assessed baseline factors (demographics, cardiac disease history, questionnaire data on anxiety, biopsychosocial complexity and self-efficacy) associated with kinesiophobia using linear regression with backward elimination. For linear regression, the standardised beta (ß) was reported. Prospectively, the impact of kinesiophobia on probability of CR initiation, in the first 3 months after hospital discharge (subsample referred for CR), was assessed with logistic regression. For logistic regression, the OR was reported. RESULTS: Moderate and severe levels of kinesiophobia were found in 22.8%. In the total sample, kinesiophobia was associated with cardiac anxiety (ß=0.33, 95% CI: 0.19 to 0.48), social complexity (ß=0.23, 95% CI: 0.06 to 0.39) and higher education (ß=-0.18, 95% CI: -0.34 to -0.02). In those referred for CR, kinesiophobia was negatively associated with self-efficacy (ß=-0.29, 95% CI: -0.47 to -0.12) and positively with cardiac anxiety (ß=0.43, 95% CI: 0.24 to 0.62). Kinesiophobia decreased the probability of CR initiation (OR Range13-52 points =0.92, 95% CI: 0.85 to 0.99). CONCLUSION: In patients hospitalised for cardiovascular disease, kinesiophobia is associated with cardiac anxiety, social complexity, educational level and self-efficacy. Kinesiophobia decreased the likelihood of CR initiation with 8% per point on the TSK.


Assuntos
Reabilitação Cardíaca , Transtornos Fóbicos , Humanos , Masculino , Idoso , Feminino , Estudos Prospectivos , Medo/psicologia , Inquéritos e Questionários
18.
Arch Psychiatr Nurs ; 41: 306-311, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36428065

RESUMO

This study investigated the mediating effect of fear of COVID-19 on the relationship between the impact of an event and indirect trauma during the pandemic. The study was conducted online from February 8 to 18, 2021, with 215 participants who had never been diagnosed with COVID-19. The collected data were analyzed using SPSS and PROCESS macro software. It was confirmed that fear of COVID-19 partially mediates the relationship between the impact of an event and indirect trauma. This means that the greater the degree of impact of COVID-19, the higher the level of indirect trauma. Additionally, the greater the fear of COVID-19, the higher the level of indirect trauma. These results indicate that the prolonged spread of COVID-19 may vary depending on the country's quarantine systems. Overall, the findings of this study can assist in understanding the psychological problems of people who have experienced COVID-19 and in preparing relevant countermeasures for emotional problems.


Assuntos
COVID-19 , Humanos , Medo/psicologia , Quarentena
19.
Neurosci Biobehav Rev ; 143: 104923, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36280184

RESUMO

The neurobiology of extinction learning has been translated to inform the delivery of exposure therapy, the gold-standard treatment for fear and anxiety disorders. The inhibitory retrieval model suggests that extinction leads to the formation of a new inhibitory memory which competes with the original fear memory that remains intact, resulting in potential return of fear over time and across different contexts. Implications for exposure therapy include behavioral and pharmacological strategies to 1) maximize prediction error through expectancy violation, and 2) enhance consolidation, generalization, and retrievability of extinction learning. Yet, not all individuals respond to treatment. In order to enhance the effectiveness and durability of exposure-based treatments, future research on reward processing, stimulus valuation, and decision-making is needed. Understanding the complex relationships among threat, reward, and cognitive processes holds promise for developing personalized treatments to meet the needs of individuals with fear and anxiety disorders.


Assuntos
Medo , Terapia Implosiva , Humanos , Medo/psicologia , Extinção Psicológica , Aprendizagem , Transtornos de Ansiedade/terapia
20.
Lab Anim (NY) ; 51(11): 293-300, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36266512

RESUMO

Post-traumatic stress disorder (PTSD) is a debilitating mental health condition for which current treatments have long-term efficacy in 50% of patients. There is a clear need for better understanding of the mechanisms underlying PTSD and the development of new treatment approaches. Analog trauma procedures in animals, such as the stress-enhanced fear learning (SEFL) procedure, can be used to produce behavioral and neurobiological changes that have validity in modeling PTSD. However, by necessity, the modeling of PTSD in animals requires them to potentially experience pain and suffering. Consistent with the '3Rs' (reduction, refinement and replacement) of animal research, this study aimed to determine whether the SEFL procedure can be refined to reduce potential animal pain and suffering while retaining the same behavioral and neurobiological changes. Here we showed that PTSD-relevant changes could be produced in both behavior and the brain of rats that were group- rather than single-housed and that received lower-magnitude electric shocks in the 'trauma analog' session. We also varied the number of shock exposures in the trauma analog session, finding SEFL-susceptible and SEFL-resilient populations at all levels of shock exposure, but with greater levels of shock increasing the proportion of rats showing the SEFL-susceptible phenotype. These data demonstrate that the SEFL procedure can be used as an animal analog of PTSD with reduced potential pain and suffering to the animals and that variations in the procedure could be used to generate specific proportions of SEFL-susceptible and SEFL-resilient animals in future studies.


Assuntos
Transtornos de Estresse Pós-Traumáticos , Ratos , Animais , Transtornos de Estresse Pós-Traumáticos/genética , Transtornos de Estresse Pós-Traumáticos/psicologia , Modelos Animais de Doenças , Medo/psicologia , Aprendizagem , Estresse Psicológico/psicologia , Dor
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