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1.
Medicine (Baltimore) ; 99(37): e22018, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32925735

RESUMO

BACKGROUND: Autism spectrum disorder (ASD) is a common neurodevelopmental disorder, which lacks specific medical treatment. Intervention is the key point of rehabilitation training for ASD. Social stories (SS) are a commonly used intervention practice in individuals with ASD. However, there is mixed evidence on the effectiveness of SS. Thus, the objective of this systematic review and meta-analysis is to assess studies of the effects of SS for children and adolescents with ASD. METHODS: To identify relevant studies, we will search PubMed, EMBASE, Cochrane Library, Web of Science, Google Scholar and trials registers (the World Health Organization International Clinical Trial Registration Platform, ClinicalTrials.gov, and Chinese Clinical Trial Register) from inception to May 2020. In addition, we will also perform handsearching of grey literature, such as conference proceedings and academic degree dissertations. Only the randomized control trials will be accepted, no matter what the languages they were reported. We will first focus on the effectiveness of the intervention on the behavior of the targets. Then we will do further analysis of the study design, including the length and intensity of intervention, the characteristics of participants and interveners, the methods of assessment, the place, the medium, and the economic feasibility. Two independent reviewers will carry out literature identification, data collection, and study quality assessment. Discrepancies will be resolved by a third reviewer. The Cochrane Risk of Bias Tool will be used to evaluate the risk of bias of the randomized controlled trials. Data analysis will be calculated using the STATA 13.0 software. RESULT: This study will offer new evidence whether the SS is an appropriate intervention of benefiting the children and adolescents with ASD, and to determine which factors affect the effectiveness of SS. CONCLUSION: The conclusion drawn from this systematic review will benefit the children and adolescents with ASD.


Assuntos
Transtorno do Espectro Autista/terapia , Metanálise como Assunto , Terapia Narrativa/métodos , Habilidades Sociais , Revisões Sistemáticas como Assunto , Adolescente , Transtorno do Espectro Autista/psicologia , Criança , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
2.
Pediatr. aten. prim ; 22(87): 273-281, jul.-sept. 2020. ilus, tab, graf
Artigo em Espanhol | IBECS | ID: ibc-194299

RESUMO

INTRODUCCIÓN: los niños muestran sentimientos y vivencias que no saben o no se atreven a expresar y que se pueden conocer a través de sus dibujos e imaginación. La Asociación Española de Pediatría de Atención Primaria (AEPap) se ha propuesto conocer cómo han vivido los niños el confinamiento. MATERIAL Y MÉTODOS: se ha organizado un concurso en la página web Familia y Salud. Sujetos: niños o niñas de todo el territorio nacional con edades comprendidas entre los 3 y 16 años. Trabajos: dibujos, cuentos y vídeos breves. RESULTADOS: hemos recibido 53 trabajos procedentes de diferentes comunidades autónomas y entregado cinco premios. Los elementos que más se repiten son: el coronavirus, figuras de niños dentro de las casas, el arco iris entre las nubes y los sanitarios. El aburrimiento, la tristeza de no poder ver a abuelos y amigos, la confianza en los sanitarios, la valoración positiva del cambio de vida en la familia, la mejora en la contaminación ambiental y el mensaje positivo de que todo va a salir bien son algunos de los temas expresados. CONCLUSIONES: los resultados obtenidos en el presente estudio denotan optimismo en general, y permiten concluir que los dibujos, los relatos y los vídeos son herramientas útiles para analizar la percepción de esta población ante situaciones de riesgo. Además, destaca el interés de los pediatras de Atención Primaria por conocer cómo han vivido los niños el confinamiento a causa de la infección por coronavirus y crear la inquietud de que el dibujo infantil debe ser estudiado de manera rigurosa


INTRODUCTION: children have feelings and experiences that they cannot or will not express and that may manifest through their drawings and imagination. The Asociación Española de Pediatría de Atención Primaria (Spanish Association of Primary Care Pediatrics, AEPap) wanted to explore how children have experienced the confinement. MATERIAL AND METHODS: we organized a contest through the Family and Health website. The study population consisted of children residing anywhere in Spain aged 3 to 16 years. The works submitted were drawings, micro stories or micro videos. RESULTS: we received 53 works from children in different autonomous communities and gave 5 awards. The elements featured most frequently were the coronavirus, figures of children indoors, a rainbow in the clouds and health care professionals. Some of the subjects expressed in the works were boredom, missing grandparents and friends, trust in health care professionals, a positive perception of the change in life in the family, the improvement in environmental pollution and a positive view that everything will turn out well. CONCLUSIONS: the results obtained in this study suggest a generalized optimism and allow us to conclude that drawings, stories and videos are a useful tool to analyze the perception of this population in risk situations. We also ought to highlight the interest of primary care paediatricians in how children have experienced the confinement imposed due to the coronavirus pandemic and raise awareness that children's drawings should be carefully studied


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Quarentena/psicologia , Infecções por Coronavirus/psicologia , Terapia Narrativa/métodos , Transtornos do Comportamento Infantil/psicologia , Pinturas/psicologia , Experiências Adversas da Infância , Fatores de Risco , Atenção Primária à Saúde/organização & administração
3.
Rev Bras Enferm ; 73(1): e20180228, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32049243

RESUMO

OBJECTIVE: To know the repercussions of the experience of family violence from the oral history of adolescents. METHOD: Qualitative study based on the Oral History method, conducted from interviews with adolescents enrolled in a public school in Salvador, State of Bahia, Brazil. The data were systematized according to the thematic analysis and supported by theoretical references on family violence and adolescence. RESULTS: Family violence implies physical illness associated with the damage caused by physical aggression and somatization of violent events, as well as compromising mental health, provoking feelings of deep sadness, self-injury behavior and suicidal ideation. All of these factors impair interpersonal relationships, school performance, as well as making them more vulnerable to alcohol intake. FINAL CONSIDERATIONS: The study indicates signs suggestive of grievance, from which the professionals should proceed the investigation in order to refute or confirm the experience of the phenomenon, as well as intervene in the cases.


Assuntos
Comportamento do Adolescente/psicologia , Violência Doméstica/psicologia , Terapia Narrativa/métodos , Adolescente , Brasil , Feminino , Humanos , Relações Interpessoais , Entrevistas como Assunto/métodos , Masculino , Pesquisa Qualitativa
4.
J Child Adolesc Ment Health ; 31(3): 189-200, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31805840

RESUMO

This study aimed to determine the efficacy of narrative group therapy in reducing depression and anxiety among children with imprisoned parents. The study design was a randomised clinical trial with an experimental group, and waiting list group as the control group. Eighty-five children with imprisoned parents were selected by convenience sampling method. They were randomly assigned to the experimental and control groups. The experimental group received the narrative group therapy while the control group did not. The research measurement instrument comprised the Children's Depression Inventory (CDI) and the Revised Children's Manifest Anxiety Scale (RCMAS). Analysis of univariate covariance (ANCOVA) and independent t-test was employed to test the study hypothesis. The findings showed that depression and anxiety reduced among children with imprisoned parents with a high effect size (anxiety = 0.90 and depression = 3.05). Thus, the principle and techniques of narrative therapy and the benefits of group therapy reduced depression and anxiety among children with imprisoned parents. Therefore, this study showed that this intervention can be useful for children with imprisoned parents.


Assuntos
Ansiedade/terapia , Filho de Pais Incapacitados/psicologia , Depressão/terapia , Terapia Narrativa/métodos , Prisioneiros , Ansiedade/etiologia , Criança , Depressão/etiologia , Feminino , Humanos , Masculino , Projetos Piloto , Prisioneiros/psicologia , Escalas de Graduação Psiquiátrica , Resultado do Tratamento
5.
Eur. j. psychol. appl. legal context (Internet) ; 11(2): 71-79, jul.-dic. 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-183601

RESUMO

Priority given to investigating the onset and maintenance of criminal behavior in the past is currently giving way to a new focus on the process of criminal desistance. Early narratives of future desistance are the first step in this process and, although they do not assure withdrawal from crime, they are the beginning of the personal change that precedes a progressive desistance from criminal activity. This study analyzes early desistance narratives of offenders still in prison and whether these narratives differed depending on their personal, criminal, and social characteristics. Participants were 44 imprisoned male offenders, aged between 20 and 50 years old at different stages of their sentence and in three different prison regimes. They were interviewed using Cid and Martí's protocol and their accounts were accordingly coded in three categories: early narratives towards a non-criminal identity, perceived self-efficacy to desist from crime, and will to desist. The results show that participants' early desistance narratives vary depending on their personal, criminal, and social variables. Results on the periods of sentence completion and prison regimes are discussed in terms of how prisons could contribute to enhancing the narratives of desistance from crime


La prioridad otorgada en el pasado a la investigación sobre el inicio y mantenimiento de la conducta delictiva está dando paso actualmente al análisis del proceso de desistimiento delictivo. Las narrativas tempranas del desistimiento futuro son el primer paso en este proceso y, aunque no aseguran dicho desistimiento, son el comienzo del cambio personal que precede al abandono progresivo de la actividad delictiva. Este estudio analiza las narrativas tempranas de desistimiento de delincuentes aún en prisión y si estas narrativas difieren según sus características personales, delictivas y sociales. Los participantes fueron 44 varones encarcelados, con edades comprendidas entre los 20 y los 50 años, en diferentes fases de su sentencia y en tres grados penitenciarios distintos. Fueron entrevistados utilizando el protocolo de Cid y Martí y sus relatos fueron codificados en tres categorías: narrativas tempranas sobre una identidad no delictiva, autoeficacia percibida para desistir del delito y voluntad para desistir. Los resultados muestran que las narrativas tempranas de desistimiento de los participantes difieren según sus características personales, delictivas y sociales. Los resultados relativos a la fase de la sentencia y a los grados penitenciarios se discuten en términos de cómo las prisiones pueden contribuir a potenciar las narrativas de desistimiento delictivo


Assuntos
Humanos , Masculino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Comportamento Criminoso , Criminosos/psicologia , Autoeficácia , Terapia Narrativa/métodos , Avaliação de Eficácia-Efetividade de Intervenções , Psicologia Criminal/métodos
6.
Artigo em Inglês | MEDLINE | ID: mdl-31569711

RESUMO

This study assessed the efficacy of an educational program focused on the promotion of school engagement in children with Cerebral Palsy. A 9 weeks, narrative-based intervention program, with a pre-post neuropsychological and self-report evaluation, was developed with a dual focus: a self-regulation theoretical model and executive function stimulation. Fifteen children with Cerebral Palsy participated in the study. Results showed a significant main effect of time (F(2.82) = 6.04, p = 0.0066, partial η2 = 0.30; F(2.82) = 9.91, p = 0.0006, partial η2 = 0.41; F(2.82) = 26.90, p < 0.0001, partial η2 = 0.66) in the three dimensions of school engagement. Findings indicate that the program to train self-regulated competences and executive function skills was efficacious in promoting school engagement in children with Cerebral Palsy. Educational implications were discussed.


Assuntos
Paralisia Cerebral/terapia , Função Executiva , Terapia Narrativa/métodos , Autocontrole , Paralisia Cerebral/psicologia , Criança , Feminino , Humanos , Masculino , Testes Neuropsicológicos , Instituições Acadêmicas , Autorrelato , Resultado do Tratamento
7.
Palliat Med ; 33(10): 1255-1271, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31368845

RESUMO

BACKGROUND: People living with life-threatening illness experience unmet existential needs despite the growing research and clinical field of palliative care. Narrative interventions show promise in managing these problems, but more knowledge is needed on the characteristics of narrative interventions and the feasibility of using personal narratives in a hospital. AIM: To review the literature on personal narratives in hospital-based palliative care interventions and to strengthen palliative care practices. DESIGN: We conducted a systematic integrative review with qualitative analysis and narrative synthesis in accordance with PRISMA where applicable (PROSPERO#:CRD42018089202). DATA SOURCES: We conducted a systematic search in PubMed, Embase, Scopus, Cinahl, SocINDEX and PsychInfo for primary research articles published until June 2018. We assessed full-text articles against the eligibility criteria followed by a discussion of quality using the Critical Appraisal Skills Programme. RESULTS: Of 480 articles, we found 24 eligible for this review: 8 qualitative, 14 quantitative and 2 mixed methods. The articles reported on dignity therapy, legacy building, outlook, short-term life review and life review. Data analysis resulted in five themes: core principles, theoretical framework, content of narrative, outcome and, finally, acceptability and feasibility. CONCLUSION: Various types of systematic palliative care interventions use personal narratives. Common to these is a shared psychotherapeutic theoretical understanding and aim. Clinical application in a hospital setting is both feasible and acceptable but requires flexibility regarding the practices of the setting and the needs of the patient.


Assuntos
Terapia Narrativa/métodos , Cuidados Paliativos/normas , Assistência Terminal/métodos , Humanos , Cuidados Paliativos/métodos , Pesquisa Qualitativa
8.
Clin Psychol Psychother ; 26(5): 626-635, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31111531

RESUMO

Previous studies have found an association between therapeutic alliance and treatment outcome, but only recently have researchers begun to analyse time-lagged relationships between session-to-session measures of alliance and outcomes with hierarchical linear modelling (HLM). HLM assumes simple correlation structures between any two measurements from the same client. In this paper, we suggest that this assumption might be problematic. Session-to-session measurements of outcomes (Outcome Questionnaire-10.2) and alliance (Working Alliance Inventory) in a sample (N = 63) were used to perform HLM analyses to test time-lagged (lag +1) relations between outcomes and alliance in both directions. A first set of analyses replicated the models consistently used in the literature, whereas a second set of models considered a correlation structure as a function of time. A correlation independent of time distance resulted in a bidirectional influence between alliance and outcomes (the model commonly used in the literature), but when considering a correlation structure as a function of time, only the outcomes were predictive of alliance. Considering a more complex correlation structure as a function of time seems to be an important analytical strategy for addressing the issue of variability in within-client measurements over time. This study highlights how the misspecification of a statistical model, namely, not considering a time-dependent correlation structure of the response variable, may lead to misleading findings in HLM studies. This is particularly relevant in process-outcome research, such as studies analysing the impact of therapeutic alliance on clinical outcomes.


Assuntos
Terapia Cognitivo-Comportamental/métodos , Transtorno Depressivo Maior/terapia , Modelos Estatísticos , Terapia Narrativa/métodos , Aliança Terapêutica , Transtorno Depressivo Maior/psicologia , Humanos , Índice de Gravidade de Doença , Inquéritos e Questionários , Resultado do Tratamento
9.
Br J Psychiatry ; 214(6): 369-377, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30957736

RESUMO

BACKGROUND: Evidence-based treatment and age-specific services are required to address the needs of trauma-affected older populations. Narrative exposure therapy (NET) may present an appropriate treatment approach for this population since it provides prolonged exposure in a lifespan perspective. As yet, however, no trial on this intervention has been conducted with older adults from Western Europe.AimsExamining the efficacy of NET in a sample of older adults. METHOD: Out-patients with post-traumatic stress disorder (PTSD), aged 55 years and over, were randomly assigned to either 11 sessions of NET (n = 18) or 11 sessions of present-centred therapy (PCT) (n = 15) and assessed on the Clinician-Administered PTSD Scale (CAPS) pre-treatment, post-treatment and at follow-up. Total scores as well as symptom scores (re-experience, avoidance and hyperarousal) were evaluated. RESULTS: Using a piecewise mixed-effects growth model, at post-treatment a medium between-treatment effect size for CAPS total score (Cohen's d = 0.44) was found, favouring PCT. At follow-up, however, the between-treatment differences were non-significant. Drop-out rates were low (NET 6.7%, PCT 14.3%) and no participant dropped out of the study because of increased distress. CONCLUSIONS: Both NET and PCT appear to be safe and efficacious treatments with older adults: PCT is non-intrusive and NET allows for imaginal exposure in a lifespan perspective. By selectively providing these approaches in clinical practice, patient matching can be optimised.Declaration of interestNone.


Assuntos
Terapia Implosiva/métodos , Terapia Narrativa/métodos , Transtornos de Estresse Pós-Traumáticos/terapia , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos de Estresse Pós-Traumáticos/psicologia , Resultado do Tratamento
10.
Soc Psychiatry Psychiatr Epidemiol ; 54(11): 1363-1378, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30937510

RESUMO

PURPOSE: A substantial body of research indicates that self-stigma is associated with poorer outcomes related to recovery among people with severe mental illnesses. Narrative Enhancement and Cognitive Therapy (NECT) is a structured, group-based approach which targets the effects of self-stigma. A randomized-controlled trial was conducted to examine the efficacy of NECT. METHODS: One hundred and seventy persons, recruited from both outpatient and comprehensive treatment settings, meeting criteria for schizophrenia-spectrum disorders and moderate-to-elevated self-stigma, were randomly assigned to NECT or supportive group therapy and assessed at four time points over the course of nearly a year. Participants completed measures of self-stigma, hope, self-esteem, functioning, psychiatric symptoms, coping with symptoms, and narrative insight. RESULTS: Analyses indicated that NECT participants in outpatient sites improved significantly more over time in self-stigma compared to supportive group therapy participants in outpatient sites, while NECT participants in comprehensive (including day treatment and psychiatric rehabilitation program) sites improved significantly more in hopelessness and narrative insight than other participants. NECT participants as a group showed decreases in the social withdrawal component of self-stigma, decreased in their use of avoidant coping strategies, and were more engaged in treatment than supportive group therapy participants. There was no evidence for effects of NECT on social functioning or psychiatric symptoms. CONCLUSIONS: Findings suggest that NECT primarily impacts self-stigma and related outcomes, and that the degree of its effects is partially dependent on the treatment context in which it is offered.


Assuntos
Terapia Cognitivo-Comportamental/métodos , Terapia Narrativa/métodos , Esquizofrenia/terapia , Psicologia do Esquizofrênico , Estigma Social , Adaptação Psicológica , Adulto , Feminino , Esperança , Humanos , Masculino , Pessoa de Meia-Idade , Pacientes Ambulatoriais , Autoimagem , Ajustamento Social , Resultado do Tratamento , Adulto Jovem
11.
Health Promot Pract ; 20(4): 502-512, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30736703

RESUMO

We currently see an interdisciplinary shift toward a "participatory turn" in health research and promotion under which community engagement, shared decision making and planning, and the use of visual and digital methods have become paramount. Digital storytelling (DST) is one such innovative and engaging method increasingly used in applied health interventions, with a growing body of research identifying its value. Despite its increasing use, a standard approach to empirically assess the impacts on individuals participating in DST interventions does not currently exist. In this article, we define DST as a distinct narrative intervention, illustrate key elements that inform the methodology, and present a conceptual model to examine how DST may contribute to increased socioemotional well-being and bolster positive health outcomes. Our proposed model is informed by elements of narrative theory, Freirian conscientization, multimodality, and social cognitive theory and can serve as a guide for public health practitioners and researchers interested in assessing the potential benefits of DST as an applied health intervention. Recommendations for practice call for a rigorous methodological approach to apply and test this model across a range of health contexts and populations.


Assuntos
Promoção da Saúde/métodos , Terapia Narrativa/métodos , Teoria Psicológica , Comunicação , Processos Grupais , Humanos , Saúde Pública
12.
J Clin Psychol ; 75(2): 271-281, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30597546

RESUMO

This paper explores the triumphs and challenges of providing free, integrative treatment to veterans and military families through secure video connections into their homes. Two case studies of telemental health treatment conducted through the Greater NYC Military Family Consortium in conjunction with the Steven A. Cohen Military Family Center at NYU Langone Health in New York City illustrate the complexities and opportunities that emerge in the course of treatment, most of which was conducted remotely. The access to people's lives through a portal adds new wrinkles to evidence-based practice in military settings while underscoring the overall need to broaden a network of care in partnership with Veterans Affairs hospital (VAs), Vet Centers, and community providers to reach those who might otherwise not seek help.


Assuntos
Prestação Integrada de Cuidados de Saúde/métodos , Transtornos Mentais/terapia , Serviços de Saúde Mental , Família Militar , Psicoterapia/métodos , Telemedicina/métodos , Veteranos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Família Militar/psicologia , Terapia Narrativa/métodos , Cidade de Nova Iorque , Estados Unidos , United States Department of Veterans Affairs , Veteranos/psicologia
13.
Int J Artif Organs ; 42(4): 167-174, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30681018

RESUMO

Medical progress in dialysis therapy made it possible to treat patients with the end-stage renal disease for many years. But at the other side it may lead to profound changes in everyday life and may induce depression and anxiety. The research presented in this article explores the influence of psychological interventions on anxiety and depression levels in patients undergoing dialysis therapy. The experimental design included two experimental groups: cognitive intervention and cognitive/narrative intervention and one control group (standard treatment). In total, 139 participants aged 22-75, including 67 women and 72 men diagnosed with end-stage renal disease and treated with dialysis, were divided into a control group and two experimental groups. Two well-known tools were used in the study: Beck Depression Inventory and State-Trait Anxiety Inventory. It was indicated that cognitive intervention may decrease the level of anxiety as a state, whereas cognitive/narrative intervention may decrease the level of anxiety as a state and the level of depression in dialysis patients. The stronger effect in the case of using narrative therapy may be the consequence of the fact that narrative therapy stimulates deeper analysis of the discussed issues (involving emotional level).


Assuntos
Ansiedade , Terapia Cognitivo-Comportamental/métodos , Depressão , Falência Renal Crônica , Terapia Narrativa/métodos , Técnicas Psicológicas , Diálise Renal , Adulto , Idoso , Ansiedade/diagnóstico , Ansiedade/etiologia , Ansiedade/terapia , Depressão/diagnóstico , Depressão/etiologia , Depressão/terapia , Feminino , Humanos , Falência Renal Crônica/psicologia , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Escalas de Graduação Psiquiátrica , Diálise Renal/métodos , Diálise Renal/psicologia , Resultado do Tratamento , Adulto Jovem
14.
Brain Behav Immun ; 77: 101-109, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30579939

RESUMO

BACKGROUND: Chronic caregiving stress may accelerate biological aging; however, the ability to integrate the meaning of caregiving through self-awareness, adaptation, and growth can buffer the negative effects of stress. Narrative researchers have shown that people who coherently integrate difficult experiences into their life story tend to have better mental health, but no prior study has examined the prospective association between narrative identity and biological indicators, such as telomere length. We tested whether narrative identity might be prospectively associated with resilience to long-term parenting stress, depressive symptoms, and protection from telomere shortening, especially among caregivers. METHODS: We conducted a semi-structured interview about parenting and quantified narrative themes by applying well-validated, standardized coding systems with high inter-rater reliability among 88 mothers: 32 "caregivers" (mothers with a child diagnosed with an autism spectrum disorder), and 56 "controls" (mothers with a neurotypical child). To assess longitudinal changes, we measured mental health (parenting stress [PS], depressive symptoms [DS]) and leukocyte telomere length [LTL], a biomarker of aging, at baseline and again 18 months later. We examined whether narrative identity themes were related to these outcomes and whether associations differed across caregivers versus controls. RESULTS: Caregivers exhibited significantly higher basal levels of PS and DS relative to controls (all p's < .05), but no significant difference in LTL (p > .05). Caregivers rated higher in the narrative theme of integration showed healthier future 18-month trajectories in PS (B = -0.832, 99% CI: [-1.315, -0.155], p < .01) and LTL (B = 1.193, 99% CI: [0.526, 2.130], p < .01), but no differences in depressive symptoms (p > .05), adjusting for age and antidepressant use. Analyses examining affective themes in caregiver narratives did not demonstrate significant associations. Narrative themes did not predict outcomes in controls. CONCLUSIONS: The data suggest that narratives reflecting coherent integration, but not necessarily affect, prospectively relate to psychological and biological stress resilience. Maternal caregivers' ability to tell an integrated story of their parenting experiences forecasts lower parenting stress and telomere shortening over time. This study suggests the possibility that helping individuals better integrate the meaning of stressful experiences, but not necessarily to affectively redeem them, may constitute a potential novel target for intervention among chronically stressed populations such as caregivers.


Assuntos
Cuidadores/psicologia , Estresse Fisiológico/fisiologia , Telômero/fisiologia , Adulto , Senescência Celular/fisiologia , Depressão/psicologia , Feminino , Humanos , Leucócitos , Saúde Mental , Mães , Narração , Terapia Narrativa/métodos , Poder Familiar/psicologia , Estudos Prospectivos , Reprodutibilidade dos Testes , Resiliência Psicológica , Estresse Psicológico/genética , Estresse Psicológico/psicologia , Inquéritos e Questionários , Encurtamento do Telômero/fisiologia
15.
Clin Gerontol ; 42(3): 334-343, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29220628

RESUMO

OBJECTIVES: Conceiving narration as a resource to promote older people's wellbeing, the present work aimed to implement a narrative-based intervention to empower the subjective and psychological wellbeing of older adults living in nursing homes. METHODS: Twenty-one nursing-home residents took part in a narrative training experience consisting of three weekly interview sessions. During each interview, a psychologist helped the participants to construct an autobiographical narrative about their present life in the nursing home based on a Deconstruction-Reconstruction technique. Subjective and psychological wellbeing variables were assessed before and after the intervention. RESULTS: Subjective but not psychological wellbeing increased over the course of the intervention. The participants reported to appreciate the intervention. CONCLUSIONS: Although preliminary, the results suggest that brief narrative training based on narrative therapy can positively affect nursing-home residents' subjective wellbeing. CLINICAL IMPLICATIONS: Brief narrative interventions implementing deconstruction-reconstruction techniques are feasible for long-term care residents.


Assuntos
Narração , Terapia Narrativa/métodos , Casas de Saúde/organização & administração , Qualidade de Vida/psicologia , Idoso , Idoso de 80 Anos ou mais , Autobiografias como Assunto , Educação/métodos , Empoderamento , Feminino , Humanos , Entrevistas como Assunto , Assistência de Longa Duração/organização & administração , Masculino , Casas de Saúde/estatística & dados numéricos , Psicologia/métodos
16.
Transl Psychiatry ; 8(1): 251, 2018 11 22.
Artigo em Inglês | MEDLINE | ID: mdl-30467376

RESUMO

The probability to develop posttraumatic stress disorder (PTSD), characterized by vivid, intrusive emotional memories of the encountered traumatic events, depends - among other factors - on the number of previous traumatic experiences (traumatic load) and individual genetic vulnerability. So far, our knowledge regarding the biological underpinnings of PTSD is relatively sparse. Genome-wide association studies (GWAS) followed by independent replication might help to discover novel, so far unknown biological mechanisms associated with the development of traumatic memories. Here, a GWAS was conducted in N = 924 Northern Ugandan rebel war survivors and identified seven suggestively significant single nucleotide polymorphisms (SNPs; p ≤ 1 × 10-5) for lifetime PTSD risk. Of these seven SNPs, the association of rs3852144 on chromosome 5 was replicated in an independent sample of Rwandan genocide survivors (N = 370, p < .01). While PTSD risk increased with accumulating traumatic experiences, the vulnerability was reduced in carriers of the minor G-allele in an additive manner. Correspondingly, memory for aversive pictures decreased with higher number of the minor G-allele in a sample of N = 2698 healthy Swiss individuals. Finally, investigations on N = 90 PTSD patients treated with Narrative Exposure Therapy indicated an additive effect of genotype on PTSD symptom change from pre-treatment to four months after treatment, but not between pre-treatment and the 10-months follow-up. In conclusion, emotional memory formation seems to decline with increasing number of rs3852144 G-alleles, rendering individuals more resilient to PTSD development. However, the impact on therapy outcome remains preliminary and further research is needed to determine how this intronic marker may affect memory processes in detail.


Assuntos
Emoções/fisiologia , Genocídio , Estudo de Associação Genômica Ampla , Terapia Implosiva/métodos , Memória/fisiologia , Avaliação de Resultados em Cuidados de Saúde , Transtornos de Estresse Pós-Traumáticos , Sobreviventes , Exposição à Guerra , Adulto , Feminino , Seguimentos , Humanos , Masculino , Terapia Narrativa/métodos , Polimorfismo de Nucleotídeo Único , Resiliência Psicológica , Risco , Ruanda , Transtornos de Estresse Pós-Traumáticos/genética , Transtornos de Estresse Pós-Traumáticos/fisiopatologia , Transtornos de Estresse Pós-Traumáticos/terapia , Suíça , Uganda , Adulto Jovem
17.
J Behav Med ; 41(5): 614-626, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30291538

RESUMO

Pregnancy, birth and adjusting to a new baby is a potentially stressful time that can negatively affect the health of women. There is some evidence that expressive writing can have positive effects on psychological and physical health, particularly during stressful periods. The current study aimed to evaluate whether expressive writing would improve women's postpartum health. A randomized controlled trial was conducted with three conditions: expressive writing (n = 188), a control writing task (n = 213), or normal care (n = 163). Measures of psychological health, physical health and quality of life were measured at baseline (6-12 weeks postpartum), 1 and 6 months later. Ratings of stress were taken before and after the expressive writing task. Intent-to-treat analyses showed no significant differences between women in the expressive writing, control writing and normal care groups on measures of physical health, anxiety, depression, mood or quality of life at 1 and 6 months. Uptake and adherence to the writing tasks was low. However, women in the expressive writing group rated their stress as significantly reduced after completing the task. Cost analysis suggest women who did expressive writing had the lowest costs in terms of healthcare service use and lowest cost per unit of improvement in quality of life. Results suggest expressive writing is not effective as a universal intervention for all women 6-12 weeks postpartum. Future research should examine expressive writing as a targeted intervention for women in high-risk groups, such as those with mild or moderate depression, and further examine cost-effectiveness.Clinical trial registration number ISRCTN58399513 www.isrctn.com.


Assuntos
Depressão/prevenção & controle , Terapia Narrativa/métodos , Período Pós-Parto/psicologia , Qualidade de Vida/psicologia , Estresse Psicológico/prevenção & controle , Redação , Adaptação Psicológica , Adulto , Teorema de Bayes , Depressão/psicologia , Feminino , Humanos , Saúde Mental , Gravidez , Reprodutibilidade dos Testes , Inquéritos e Questionários
18.
J Child Adolesc Psychiatr Nurs ; 31(2-3): 87-96, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30317688

RESUMO

TOPIC: The Brief Services psychotherapy paradigm has evolved to produce cost-effective and clinically significant outcomes in children's mental health. Though its clinical evaluation is still in its infancy, it has been utilized to a much lesser degree with autism spectrum disorders, which typically require a longer-term approach to psychotherapy treatment. PURPOSE: The current paper introduces a novel, four-session intervention that aims to decrease anxiety experienced by clients presenting with high-functioning autism. Externalizing Metaphors Therapy is based upon the externalization of problems, transformation of metaphoric imagery, shifting of maladaptive emotional schemas, and the generalization of problems. A case study is utilized to visually aid in the understanding of this new treatment intervention. SOURCE: A composite literature review was conducted with regards to significant works in Narrative Therapy, treatment interventions for anxiety and high functioning autism, evidence-based treatments for anxiety, and practice based approaches in psychotherapy. Works were selected based on their relevance to the research filed of anxiety and autism. CONCLUSIONS: This clinical research challenges the children's mental health field in addressing anxiety and high-functioning autism from a brief framework. Further clinical research is needed to clinically evaluate the current model.


Assuntos
Transtornos de Ansiedade/terapia , Transtorno do Espectro Autista/terapia , Metáfora , Terapia Narrativa/métodos , Psicoterapia Breve/métodos , Adolescente , Feminino , Humanos
19.
Trials ; 19(1): 480, 2018 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-30201053

RESUMO

BACKGROUND: Traumatic events like critical illness and intensive care are threats to life and bodily integrity and pose a risk factor for posttraumatic stress disorder (PTSD). PTSD affects the quality of life and morbidity and may increase health-care costs. Limited access to specialist care results in PTSD patients being treated in primary care settings. Narrative exposure therapy (NET) is based on the principles of cognitive behavioral therapy and has shown positive effects when delivered by health-care professionals other than psychologists. The primary aims of the PICTURE trial (from "PTSD after ICU survival") are to investigate the effectiveness and applicability of NET adapted for primary care with case management in adults diagnosed with PTSD after intensive care. METHODS/DESIGN: This is an investigator-initiated, multi-center, primary care-based, randomized controlled two-arm parallel group, observer-blinded superiority trial conducted throughout Germany. In total, 340 adult patients with a total score of at least 20 points on the posttraumatic diagnostic scale (PDS-5) 3 months after receiving intensive care treatment will be equally randomized to two groups: NET combined with case management and improved treatment as usual (iTAU). All primary care physicians (PCPs) involved will be instructed in the diagnosis and treatment of PTSD according to current German guidelines. PCPs in the iTAU group will deliver usual care during three consultations. In the experimental group, PCPs will additionally be trained to deliver an adapted version of NET (three sessions) supported by phone-based case management by a medical assistant. At 6 and 12 months after randomization, structured blinded telephone interviews will assess patient-reported outcomes. The primary composite endpoint is the absolute change from baseline at month 6 in PTSD symptom severity measured by the PDS-5 total score, which also incorporates the death of any study patients. Secondary outcomes cover the domains depression, anxiety, disability, health-related quality-of-life, and cost-effectiveness. The principal analysis is by intention to treat. DISCUSSION: If the superiority of the experimental intervention over usual care can be demonstrated, the combination of brief NET and case management could be a treatment option to relieve PTSD-related symptoms and to improve primary care after intensive care. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03315390 . Registered on 10 October 2017. German Clinical Trials Register, DRKS00012589 . Registered on 17 October 2017.


Assuntos
Administração de Caso , Cuidados Críticos/métodos , Terapia Narrativa/métodos , Atenção Primária à Saúde/métodos , Transtornos de Estresse Pós-Traumáticos/terapia , Cuidados Críticos/psicologia , Alemanha , Humanos , Estudos Multicêntricos como Assunto , Ensaios Clínicos Controlados Aleatórios como Assunto , Índice de Gravidade de Doença , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/psicologia , Fatores de Tempo , Resultado do Tratamento
20.
Clin Psychol Psychother ; 25(6): 827-841, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30079583

RESUMO

OBJECTIVE: The mental health needs of women affected by intimate partner violence (IPV) and living under continuous domestic violence are currently not well understood. The present study investigates the feasibility and efficacy of narrative exposure therapy (NET), compared with commonly used counselling (treatment-as-usual, TAU), in a group of currently IPV-affected women in Tehran, Iran. METHOD: Forty-five IPV-affected women with a diagnosis of post-traumatic stress disorder (PTSD) were randomized to 10 to 12 sessions of either NET (n = 24) or TAU (n = 21). Primary outcome measures, including PTSD, depression, and perceived stress symptoms, were examined at pretreatment and 3- and 6-month follow-ups. IPV experiences, general lifetime traumatic events, childhood adversities, borderline symptoms, and daily functioning impairment were also inspected. RESULTS: NET participants showed a significantly greater symptom reduction in comparison with the TAU group in PTSD, depression, and perceived stress at both follow-ups. Improvement in daily functioning and reduction of IPV experiences and borderline symptoms at 3- and 6-month follow-ups were pronounced but not significantly different between the two treatment groups. CONCLUSION: IPV-affected women living under continuous threat and violence would benefit from trauma-focused interventions such as NET.


Assuntos
Terapia Implosiva/métodos , Violência por Parceiro Íntimo/psicologia , Terapia Narrativa/métodos , Transtornos de Estresse Pós-Traumáticos/psicologia , Transtornos de Estresse Pós-Traumáticos/terapia , Adulto , Estudos de Viabilidade , Feminino , Humanos , Irã (Geográfico) , Resultado do Tratamento
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