RESUMO
INTRODUCTION: A relationship between different types of childhood trauma, parental care, and defensive styles and development of psychiatric symptoms in adulthood is proposed in this study. Understanding the nature of this association is essential to assist psychotherapists who treat patients with a history of past trauma. This study aims to examine the associations between childhood trauma, parental bonding, and defensive styles and current symptoms in adult patients who sought care at an analytical psychotherapy clinic. METHODS: The sample comprised 197 patients from an analytically oriented psychotherapy clinic. Participants responded to four self-report instruments that assessed, respectively, presence and frequency of several types of early trauma, type of parental attachment, styles of defenses, and current symptoms encompassing a wide variety of psychopathological syndromes. RESULTS: Only 5% of patients reported not having experienced any traumatic experience in childhood. Several traumas such as emotional and physical abuse, emotional neglect, and physical neglect showed positive and significant associations with several dimensions of current symptoms, and also with parental bonding and defensive styles. When analyzed together with the other variables, defensive styles explained the level of psychological suffering caused by the symptoms. CONCLUSIONS: This study offers additional support for understanding the associations between childhood trauma, parental bonding styles, and defense styles and the psychiatric symptoms of patients in analytically oriented psychotherapy.
Assuntos
Experiências Adversas da Infância , Maus-Tratos Infantis , Transtornos Mentais , Adulto , Ansiedade , Criança , Humanos , Apego ao Objeto , PaisRESUMO
INTRODUCTION: Suicide is one of the leading causes of death in the world. For every person who commits suicide, twenty or more have attempted to take their own lives. The emotional state of anger is often associated with suicidal behavior. However, this association needs to be further clarified. OBJECTIVES: This study sought to investigate the profiles of traits and expressions of anger in inpatients admitted to a general emergency hospital after surviving a suicide attempt. METHODS: In this case-control study, a sample of 28 suicide survivors was matched for sex, age, and educational level with 56 controls. The State-Trait Anger Expression Inventory-2 was used to measure anger traits and expression. RESULTS: Suicide survivors scored higher for anger traits and expression and lower for anger control than the control group. They also had lower levels of state anger and willingness to express anger verbally than the control group. CONCLUSIONS: Patients who attempted suicide and had high scores for anger expression (in and out) are inclined to have extreme difficulty in interpersonal relationships and rigidity towards change and are at higher risk of developing psychopathologies.
Assuntos
Ira , Tentativa de Suicídio , Brasil , Estudos de Casos e Controles , Hospitais , HumanosRESUMO
OBJECTIVE: To analyze associations between attempted suicide and childhood trauma. METHODS: A seven month comparative case-control study (28 subjects - patients with suicide attempt; 56 controls - patients without suicide attempt). The following instruments were used: Childhood Trauma Questionnaire (CTQ), Mini International Neuropsychiatric Interview (MINI), and Medical Outcomes Study (MOS). RESULTS: The group with suicide attempt had significantly higher scores for some variables: emotional abuse (p < 0.001), physical abuse (p < 0.001), emotional neglect (p < 0.001), and physical neglect (p < 0.001). CONCLUSIONS: The results suggest that variables related to previous trauma may influence future suicide attempts. The adoption of preventive and therapeutic actions related to mistreatments during child development is a crucial factor in reduction of suicide risk.
Assuntos
Sobreviventes Adultos de Maus-Tratos Infantis/estatística & dados numéricos , Experiências Adversas da Infância/estatística & dados numéricos , Trauma Psicológico/epidemiologia , Tentativa de Suicídio/estatística & dados numéricos , Adulto , Idoso , Brasil/epidemiologia , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
INTRODUCTION: The Personality Inventory for the DSM-5 - Brief Form (PID-5-BF) - is an instrument for assessment of the five pathological personality traits from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) alternative model of personality disorders. OBJECTIVES: To determine the psychometric properties of the version of the PID-5-BF translated and adapted to Brazilian Portuguese. METHODS: The process of translating and cross-culturally adapting the text was carried out by independent translators and the resulting version was administered to 176 patients in two hospitals in Rio Grande do Sul. The internal structure was tested by means of confirmatory factor analysis. Evidence of reliability was tested by examining the internal consistency of the scales and their convergent and concurrent validity with other methods of psychopathology. RESULTS: The five factors were replicated in the present sample with adequate indicators of fit of the data to the model. Appropriate reliability coefficients for the scales and evidence of validity were observed, indicating the clinical usefulness of the PID-5-BF in the Brazilian context. CONCLUSION: The psychometric properties of PID-5-BF proved satisfactory in an initial sample of Brazilians.
Assuntos
Manual Diagnóstico e Estatístico de Transtornos Mentais , Transtornos da Personalidade/diagnóstico , Inventário de Personalidade/normas , Escalas de Graduação Psiquiátrica/normas , Psicometria/normas , Adulto , Brasil , Características Culturais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria/instrumentação , Psicometria/métodos , Tradução , Adulto JovemRESUMO
OBJECTIVE: To explore and describe a profile of patients admitted to a psychiatric emergency facility, comparing patients with and without a recent suicide attempt in terms of their clinical characteristics and aggression. METHODS: This was an exploratory comparative study where patients were assessed using the Brief Psychiatric Rating Scale (BPRS) and the Overt Aggression Scale (OAS). Participants with a suicide attempt in the last 24 hours (SA) were compared to participants with a prior history of suicide attempt but no recent attempt (PHSA). RESULTS: 63 individuals (SA: 26; PHSA: 37) were selected. Both groups had similar demographic and clinical characteristics. The most prevalent diagnoses were mood (57.1%) and personality (50.8%) disorders. The majority of patients in both groups had a history of aggression episodes. Physical aggression in the week prior to admission was more prevalent in the PHSA group (51.4 vs. 19.2%, p = 0.017). The PHSA group also presented higher activation scores (p = 0.025), while the SA group presented higher affect scores on BPRS dimensions (p = 0.002). CONCLUSION: The majority of individuals with a history of suicide attempt also presented a history of aggression. Inpatients with recent suicide attempt were hospitalized mainly due to the risk of suicide, while those with no recent suicide attempt were hospitalized mainly due to the risk of hetero-aggression. These findings support the hypothesis of an aggressive profile in suicidal patients and may open up a path for future research.
Assuntos
Agressão/fisiologia , Serviços de Emergência Psiquiátrica , Hospitalização , Transtornos Mentais/fisiopatologia , Tentativa de Suicídio , Adolescente , Adulto , Idoso , Serviços de Emergência Psiquiátrica/estatística & dados numéricos , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Transtornos Mentais/terapia , Pessoa de Meia-Idade , Transtornos do Humor/fisiopatologia , Transtornos do Humor/terapia , Transtornos da Personalidade/fisiopatologia , Transtornos da Personalidade/terapia , Tentativa de Suicídio/estatística & dados numéricos , Adulto JovemRESUMO
OBJECTIVE: To evaluate the relationship among personality (according to Cloninger's psychobiological model), posttraumatic stress disorder (PTSD) symptoms, trait resilience and quality of life (QoL) in people who were exposed to the Kiss nightclub fire. METHODS: 188 participants were assessed with the Posttraumatic Checklist-civilian version (PCL-C), the Resilience Scale (RS), the Temperament and Character Inventory (TCI), the World Health Organization Quality of Life-Bref (WHOQOL-Bref), and the WHOQOL-100 Spirituality, religiousness, and personal beliefs (WHOQOL-100-SRPB). Data were analyzed in a dimensional approach, with correlation analysis, multiple linear regression and Structural Equation Modeling (SEM), with PCL-C, RS, and WHOQOL-Bref dimensions as dependent variables. RESULTS: Multiple linear regression showed that PTSD symptoms were predicted by harm avoidance (ß = .34, p < .001), self-directedness (ß = -.28, p < .01), and self-transcendence (ß = .24, p < .01). Trait resilience was predicted by harm avoidance (ß = -.38, p < .01), self-directedness (ß = .20, p < .05), and self-transcendence (ß = .18, p < .05). Also, PTSD symptoms had considerable negative effect on all dimensions of QoL. Self-transcendence was a positive predictor of subjective and spiritual QoL. SEM showed that QoL was predicted by PTSD symptoms (ß = -.52, p < .001), trait resilience (ß = .30, p < .001), cooperativeness (ß = .135, p = 0.40), and self-directedness (ß = .27, p < .01). The effect of self-directedness on QoL was mediated by PTSD symptoms and trait resilience. PTSD symptoms also mediated the relationship between trait resilience and QoL, and RS mediated the relationship of personality and PTSD symptoms. CONCLUSION: The study gives insights on prediction of PTSD severity, trait resilience and QoL from temperament and character traits, in a sample of people exposed to the Kiss nightclub fire. Harm avoidance was the most influent trait on PTSD symptoms and trait resilience. Self-directedness was the most import trait related to QoL, still that it was more related to PTSD severity than personality traits. Self-transcendence had positive effects on both PTSD symptoms and trait resilience, indicating a coping style that may coexist with psychopathology.
Assuntos
Adaptação Psicológica , Incêndios , Redução do Dano , Personalidade , Qualidade de Vida , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Adulto , Brasil/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos de Estresse Pós-Traumáticos/psicologia , Adulto JovemRESUMO
OBJECTIVE: To assess the association between brain-derived neurotrophic factor (BDNF) levels and acute stress disorder (ASD) in patients who have suffered physical trauma. METHODS: Data were collected at an emergency hospital in Porto Alegre, state of Rio Grande do Sul, southern Brazil. Participants were over 18 years of age, victims of physical trauma, and had been hospitalized for a minimum of 48 hours. A total of 117 hospitalized patients who agreed to participate in the research were grouped according to the shift in which blood was collected (38 subjects from the morning shift and 79 from the afternoon shift), had their BDNF levels measured and responded to other questionnaires. Respondents were further grouped by age into three ranges: 18-30, 31-50 and 51-70 years. RESULTS: We found a significant difference in the distribution of BDNF between the two shifts in which blood samples were collected, with the afternoon group having higher BDNF levels (U = 1906.5, p = 0.018). A difference was observed only between the 18-30 group and the 51-70 group in the afternoon shift (Umorning = 1107, pmorning = 0.575; Uafternoon = 7175, pafternoon = 0.028). CONCLUSIONS: The population whose blood samples were collected in the afternoon showed significantly higher values of BDNF compared to those of the morning shift. This same population presented lower BDNF levels when associated with ASD subtypes A1, A2, and A. We hypothesize that the lower values of BDNF measured in the morning shift were due to a response to the circadian cycle of cortisol, whose action inhibits the expression of serum neurotrophins.
Assuntos
Fator Neurotrófico Derivado do Encéfalo/metabolismo , Transtornos de Estresse Traumático Agudo/sangue , Ferimentos e Lesões/psicologia , Adolescente , Adulto , Idoso , Biomarcadores/metabolismo , Brasil , Ritmo Circadiano , Serviço Hospitalar de Emergência , Tratamento de Emergência/métodos , Feminino , Hospitalização , Humanos , Hidrocortisona/metabolismo , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto JovemRESUMO
Childhood trauma (CT) is a modifiable risk factor for lifetime suicide attempts (SA). However, the extent to which each type of CT increases SA risk is unclear. This study aimed to conduct a meta-analysis of longitudinal studies published in the last 10 years about the relationship between CT and lifetime SA risk. The PUBMED, PsycINFO, ISI, and EMBASE databases were searched for cohort studies that reported AS during follow-up and included an assessment of CT. A meta-analysis was conducted to identify potential effects of each type of CT on SA. Seven unique studies were included for review. Sexual (n=6, OR=3.73, 95%CI 2.94-4.75, p<0.001), physical (n=6, OR=4.11, 95%CI 2.30-7.33, p<0.001), and emotional abuse (n=3, OR=3.98, 95%CI 2.89-5.64, p<0.001), as well as physical neglect (n=2, OR=3.42, 95%CI 2.09-5.59, p<0.001), were associated with SA. Emotional neglect and a broken home were not significantly associated with further SA. The modes of CT that most contribute to SA in later life are physical, emotional, and sexual abuse and physical neglect, in descending order.
Assuntos
Adultos Sobreviventes de Eventos Adversos na Infância/psicologia , Maus-Tratos Infantis/psicologia , Tentativa de Suicídio/psicologia , Adolescente , Adulto , Feminino , Humanos , Estudos Longitudinais , Masculino , Fatores de Risco , Adulto JovemRESUMO
INTRODUCTION: Acute stress disorder (ASD) encompasses a set of symptoms that can arise in individuals after exposure to a traumatic event. This study assessed the defense mechanisms used by victims of physical trauma who developed ASD. METHOD: This was a controlled cross-sectional study of 146 patients who suffered physical trauma and required hospitalization. A structured questionnaire was used to evaluate ASD symptoms based on DSM-5 diagnostic criteria, in addition to the Defense Style Questionnaire (DSQ). RESULTS: Ten participants (6.85%) received a positive diagnosis of ASD, and 136, (93.15%) a negative diagnosis. The majority of the sample consisted of men with median age ranging from 33.50 to 35.50. The most prevalent defense mechanisms among the 10 patients with ASD were cancellation and devaluation, which belong to the neurotic and immature factors, respectively. Positive associations between the presence of symptoms from criterion B of the DSM-5 and defense mechanisms from the DSQ were found. These included the mechanisms of undoing, projection, passive aggression, acting out, autistic fantasy, displacement, and somatization. CONCLUSION: Patients with ASD employed different defense mechanisms such as undoing and devaluation when compared to patients not diagnosed with ASD. These results mark the importance of early detection of ASD symptoms at a preventative level, thereby creating new possibilities for avoiding exacerbations related to the trauma, which represents an important advance in terms of public health.
Assuntos
Mecanismos de Defesa , Transtornos de Estresse Traumático Agudo/psicologia , Adulto , Estudos Transversais , Serviços Médicos de Emergência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos de Estresse Traumático Agudo/diagnóstico , Transtornos de Estresse Traumático Agudo/epidemiologia , Transtornos de Estresse Traumático Agudo/terapia , Inquéritos e Questionários , Adulto JovemRESUMO
OBJETIVO: avaliar o funcionamento psicodinâmico de pacientes pós-tentativa de suicídio através do Diagnóstico Psicodinâmico Operacionalizado (OPD-2) e de outros instrumentos complementares. MÉTODOS: estudo de caso utilizando métodos mistos de análise (quali-quantitativa). Os pacientes foram avaliados em follow up 3 anos após a primeira entrevista (que ocorreu logo após a tentativa de suicídio), e dois deles concordaram em participar do follow up. RESULTADOS: observou-se nível moderado de funcionamento global nos pacientes. Os conflitos psíquicos com maior prevalência foram o de 'autoestima' e 'necessidade de ser cuidado' versus 'autossuficiência'. Em suas relações, mostraram-se dependentes, impulsivos e exigentes, o que ocasiona sensação constante de abandono. Nessa perspectiva, o medo de ser abandonado faz com que se distanciem e se isolem. Os fatores protetivos de tendências suicidas foram a qualidade da rede de apoio (MOS), a maior interação social, a maior estabilidade do self, o nível de defesas maduras e o tratamento em saúde mental posterior à alta hospitalar. CONCLUSÃO: o OPD-2 demonstrou-se um instrumento apropriado para uma ampla compreensão psicológica de pessoas que tiveram tentativas de suicídio.(AU)
OBJECTIVE: to evaluate the psychodynamic functioning of patients after suicide attempts through the Operationalization Psychodynamic Diagnosis (OPD-2) and other complementary instruments. METHODS: case study using mixed methods of analysis (quali-quantitative). Patients were evaluated in follow up 3 years after the first interview (which occurred shortly after the suicide attempt), and two of them has agreed in participating of the follow up. RESULTS: a moderate level of overall functioning was observed in the patients. The most prevalent psychic conflicts were 'self-esteem' and 'need to be cared for' versus 'self-sufficiency'. In their relationships, they have shown up to be dependent, impulsive and demanding, which causes a constant feeling of abandonment. In this perspective, the fear of being abandoned causes them to distance themselves and be isolated. The protective factors of suicidal tendencies were the quality of the support network (MOS), the greater social interaction, the greater stability of the self, the level of mature defenses and the mental health treatment after hospital discharge. CONCLUSION: OPD-2 proved to be an appropriate instrument for a broad psychological comprehension of people who had suicide attempts.(AU)
OBJETIVO: evaluar el funcionamiento psicodinámico de pacientes tras intentos de suicidio a través del Diagnóstico Psicodinámico Operacionalizado (OPD-2) y otros instrumentos complementarios. MÉTODOS: estudio de caso utilizando métodos mixtos de análisis (cuali-cuantitativo). Los pacientes fueron evaluados en el seguimiento 3 años después de la primera entrevista (que ocurrió poco después del intento de suicidio), y dos de ellos han aceptado participar del seguimiento. RESULTADOS: se observó un nivel moderado de funcionamiento general en los pacientes. Los conflictos psíquicos más prevalentes fueron la "autoestima" y la "necesidad de ser atendido" versus la "autosuficiencia". En sus relaciones se han mostrado dependientes, impulsivos y exigentes, lo que provoca un constante sentimiento de abandono. En esta perspectiva, el miedo al abandono hace que se distancien y se aíslen. Los factores protectores de las tendencias suicidas fueron la calidad de la red de apoyo (MOS), la mayor interacción social, la mayor estabilidad del yo, el nivel de defensas maduras y el tratamiento de salud mental tras el alta hospitalaria. CONCLUSIÓN: OPD-2 resultó ser un instrumento apropiado para una amplia comprensión psicológica de las personas que tuvieron intentos de suicidio.(AU)
Assuntos
Apoio Social , Tentativa de Suicídio , Saúde Mental , Fatores de Proteção , DiagnósticoRESUMO
As reações corporais e emocionais sentidas pelos pacientes com manifestações histéricas podem atingir tamanha intensidade, a ponto de prejudicar sua vida social, familiar e laboral. O trabalho parte dos seguintes questionamentos: como são as manifestações histéricas na atualidade? Qual a compreensão sobre a histeria na literatura da área ao longo do tempo? O objetivo é descrever aspectos teóricos sobre a histeria e o trauma infantil, articulando-os com a clínica atual. Foi desenvolvida uma revisão da literatura por meio do método narrativo. Os resultados encontrados foram 106 estudos nos últimos 6 anos (Bireme e Dialnet), sendo que, de 2017 em diante, houve um decréscimo nas publicações científicas sobre o tema. Apesar de a categoria psicopatológica da histeria ter desaparecido dos manuais de transtornos mentais, na clínica atual as manifestações histéricas são facilmente confundidas com outros transtornos (depressivos, dissociativos e distúrbio borderline). As manifestações somáticas aparecem no corpo para comunicar eventos traumáticos não contidos pelo aparelho psíquico. Conclui-se que as manifestações histéricas seguem presentes nos dias de hoje, e o corpo tende a ser uma via de expressão somática. No contexto da relação entre sintomas histéricos e traumas vivenciados na infância, a psicoterapia ocupa lugar de destaque, promovendo ressignificações para tais eventos traumáticos.(AU)
The bodily and emotional reactions felt by patients with hysterical manifestations can reach such intensity as to harm their social, family and work life, causing several losses for the individual. The study starts from the following questions: how are the hysterical manifestations today? What about understanding hysteria in the literature of the area over time? The objective is to describe theoretical aspects of hysteria and childhood trauma, in conjunction with the current clinic. A literature review using the narrative method was developed. The results found were 106 studies in the last 6 years (Bireme and Dialnet), and as of 2017 there is a decrease in scientific publications on the topic. Although the psychopathological category of hysteria has disappeared from the manuals of mental disorders, nowadays in the clinic the hysterical manifestations are easily confused with other disorders (depressive, dissociative and borderline). Somatic manifestations appear in the body to communicate traumatic events not contained by the psychic apparatus. It is concluded that the hysterical manifestations are still present today, and the body tends to be an important way of expressing symptoms through the somatic path. In the context of the relationship between hysterical symptoms and childhood trauma, psychotherapy occupies a prominent place, promoting reframing for such traumatic events.(AU)
Las reacciones corporales y emocionales que sienten los pacientes con manifestaciones histéricas pueden alcanzar tal intensidad como para dañar su vida social, familiar y laboral, causando varias pérdidas para el individuo. El estudio parte de las siguientes preguntas: ¿Cómo son hoy las manifestaciones histéricas? ¿Cuál es la comprensión de la histeria en la literatura de la zona a lo largo del tiempo? El objetivo es describir aspectos teóricos de la histeria y el trauma infantil, en conjunto con la clínica actual. Se ha elaborado una revisión de la literatura utilizando el método narrativo. Los resultados encontrados fueron 106 estudios en los últimos 6 años (Bireme y Dialnet), y a partir de 2017 hubo una disminución en las publicaciones científicas sobre el tema. Aunque la categoría psicopatológica de histeria ha desaparecido de los manuales de trastornos mentales, hoy en día en la clínica las manifestaciones histéricas se confunden fácilmente con otros trastornos (depresivo, disociativo y borderline). Las manifestaciones somáticas aparecen en el cuerpo para comunicar eventos traumáticos no contenidos por el aparato psíquico. Se concluye que las manifestaciones histéricas todavía están presentes hoy en día, y el cuerpo tiende a ser una forma importante de expresar los síntomas a través de las vías somáticas. En el contexto de la relación entre los síntomas histéricos y el trauma vivido en la infancia, la psicoterapia ocupa un lugar destacado, promoviendo replanteamiento para tales eventos traumáticos.(AU)
Assuntos
Psicoterapia , Trauma Psicológico , Histeria , Criança , Transtornos MentaisRESUMO
Abstract Introduction A relationship between different types of childhood trauma, parental care, and defensive styles and development of psychiatric symptoms in adulthood is proposed in this study. Understanding the nature of this association is essential to assist psychotherapists who treat patients with a history of past trauma. This study aims to examine the associations between childhood trauma, parental bonding, and defensive styles and current symptoms in adult patients who sought care at an analytical psychotherapy clinic. Methods The sample comprised 197 patients from an analytically oriented psychotherapy clinic. Participants responded to four self-report instruments that assessed, respectively, presence and frequency of several types of early trauma, type of parental attachment, styles of defenses, and current symptoms encompassing a wide variety of psychopathological syndromes. Results Only 5% of patients reported not having experienced any traumatic experience in childhood. Several traumas such as emotional and physical abuse, emotional neglect, and physical neglect showed positive and significant associations with several dimensions of current symptoms, and also with parental bonding and defensive styles. When analyzed together with the other variables, defensive styles explained the level of psychological suffering caused by the symptoms. Conclusions This study offers additional support for understanding the associations between childhood trauma, parental bonding styles, and defense styles and the psychiatric symptoms of patients in analytically oriented psychotherapy.
RESUMO
INTRODUCTION: The pandemic caused by the novel coronavirus (SARS-CoV-2) has changed the lifestyle of the general population, mainly due to the distancing and isolation measures adopted to contain the spread of the disease. These measures generated a series of stressors, including an increase in domestic violence. OBJECTIVE: To identify the occurrence of domestic violence during isolation resulting from the COVID-19 pandemic in Brazil, its association with issues related to mental health and poorly adaptive personality traits. METHOD: Non-probabilistic study, composed of a sample of 3625 participants who were assessed using the PCL-5, DASS-21, PID-5-BF and AUDIT-C. Instruments were administered on-line from April 22, 2020 to May 8, 2020. RESULTS: 379 (13%) of respondents experienced some type of adverse situation during social distancing. Participants who experienced violence had higher alcohol consumption (p=0.004), greater severity of symptoms related to a diagnosis of PTSD (p <0.001), and greater prevalence of anxiety (p<0.001) and depression (p<0.001) symptoms in relation to those who had no such experiences. They also demonstrated higher PID-5 scores of maladaptive personality traits, such as negative affectivity (p<0.001), distance (p<0.001), antagonism (p<0.001), disinhibition (p<0.001) and psychoticism (p<0.001). CONCLUSION: Isolation due to the pandemic is having a great impact on people's mental health, specifically on those who have experienced violence. Together with public agencies and the private sector, strategies should be created aimed at scaling up interventions to mitigate this impact of the pandemic, especially by providing expanded listening spaces in the health and social care sectors.(AU)
INTRODUÇÃO: A pandemia causada pelo novo coronavírus (SARS-CoV-2) alterou o estilo de vida da população em geral, principalmente através das medidas de distanciamento e isolamento adotadas para contenção do avanço da doença. Estas medidas geraram uma série de estressores, dentre eles o aumento da violência doméstica. OBJETIVO: Identificar a ocorrência de violência doméstica durante o isolamento decorrente da pandemia de COVID-19 no Brasil, a sua associação com questões relacionadas à saúde mental e traços mal adaptativos de personalidade. MÉTODO: Estudo não probabilístico, composto por uma amostra de 3625 participantes que foram avaliados através do PCL-5, DASS-21, PID-5-BF e AUDIT-C. Instrumentos aplicados on-line no período entre 22 de abril de 2020 a 08 de maio de 2020. RESULTADOS: 379 (13%) dos respondedores sofreu algum tipo de situação adversa durante o distanciamento social. Os participantes que vivenciaram violência possuem maior consumo de álcool (p=0,004), maior gravidade dos sintomas relacionada ao diagnóstico de TEPT (p<0,01), maior presença de sintomas de ansiedade (p<0,001), depressão (p<0,001), em relação àquelas que não sofreram. Demonstraram ainda possuir, de acordo com o PID-5, escores mais elevados de traços mal adaptativos de personalidade, como afetividade negativa (p<0.001), distanciamento (p<0.001), antagonismo (p<0.001), desinibição (p < 0.001) e psicoticismo (p<0.001). CONCLUSÃO: O isolamento devido a pandemia está causando grande impacto na saúde mental das pessoas, especificamente naquelas que sofreram violência. É necessário, junto ao órgão públicos e privados, criar estratégias visando uma escalada de intervenções relacionadas ao impacto da pandemia, sobretudo ampliando espaços de escuta no setor de saúde e na assistência social.(AU)
INTRODUCCIÓN: La pandemia provocada por el nuevo coronavirus (SARS-CoV-2) ha cambiado el estilo de vida de la población en general, principalmente a través de las medidas de distancia y aislamiento adoptadas para contener el avance de la enfermedad. Estas medidas generaron una serie de factores estresantes, entre ellos el aumento de la violencia intrafamiliar. OBJETIVO: Identificar la ocurrencia de violencia doméstica durante el aislamiento resultante de la pandemia COVID-19 en Brasil, su asociación con problemas relacionados con la salud mental y rasgos de personalidad poco adaptables. MÉTODO: Estudio no probabilístico, compuesto por una muestra de 3625 participantes que fueron evaluados mediante la PCL-5, DASS-21, PID-5-BF y AUDIT-C. Instrumentos aplicados on-line en el período comprendido entre el 22 de abril de 2020 y el 8 de mayo de 2020. RESULTADOS: 379 (13%) de los encuestados sufrieron algún tipo de situación adversa durante la distancia social. Los participantes que experimentaron violencia tienen mayor consumo de alcohol (p=0,004), mayor gravedad de los síntomas relacionados con el diagnóstico de TEPT (p<0,01), mayor presencia de síntomas de ansiedad (p<0,001), depresión (p<0,001), en relación con los que no sufrieron. También demostraron tener, según PID-5, puntuaciones más altas de rasgos de personalidad poco adaptativos, como afectividad negativa (p<0.001), distancia (p<0.001), antagonismo (p<0.001), desinhibición (p<0.001) y psicoticismo (p<0.001). CONCLUSIÓN: El aislamiento debido a la pandemia está teniendo un gran impacto en la salud mental de las personas, específicamente en quienes han sufrido violencia. Es necesario, junto con los organismos públicos y privados, crear estrategias orientadas a ampliar las intervenciones relacionadas con el impacto de la pandemia, especialmente ampliando los espacios de escucha en el sector salud y la asistencia social.(AU)
Assuntos
Ansiedade , Violência Doméstica , Coronavirus , Depressão , Comportamento Social , ViolênciaRESUMO
INTRODUÇÃO: Enfrentar o tema da morte como uma consequência natural da vida não é fácil para muitas pessoas, e as circunstâncias se tornam mais complexas quando o assunto é suicídio. OBJETIVO: essa comunicação breve visa apresentara construção de um questionário sobre intenção suicida chamado "biópsia psicológica". MÉTODOS: Na literatura mundial não há uma definição consistente do termo "biópsia psicológica" conforme busca em diversas bases de dados (PubMed, SciELO, Bireme, PsycInfo, Web of Science, Google Acadêmico, Embase, SCOPUS, LILACS ou BVS Psicologia). RESULTADOS: o questionário construído propõe investigar a intenção suicida, ou seja, realizar uma biópsia psicológica. CONCLUSÃO: A biópsia psicológica foi projetada para produzir um diagnóstico de tentativa de suicídio, a fim de complementar as informações necessárias para qualificar os distúrbios emocionais da pessoa.(AU)
INTRODUCTION: To face the topic of death as a natural consequence of life is not easy for many persons, and circumstances become more complex when suicide is brought into the picture. OBJETIVE: this brief communication presents abuild of a questionnaire about suicidal attempt called "psychological biopsy". METHODS: In the worldwide literature there are no consistent definition of the term "psychological biopsy" according to the search carried out in several databases (PubMed, SciELO, Bireme, PsycInfo, Web of Science, Google Scholar, Embase, SCOPUS, LILACS or BVS Psicologia). RESULTS: questionnaire constructed proposes to investigate suicidal intention, that is, to carry out a psychological biopsy. CONCLUSION: The psychological biopsy was desinged to produce a diagnosis of attempted suicide in order to complement information needed to qualify the emotional disturbances of the person.(AU)
INTRODUCCIÓN: Para muchas personas, enfrentar el tema de la muerte como una consecuencia natural de la vida no es fácil, y las circunstancias se vuelven más complejas cuando se pone en evidencia el suicidio. OBJETIVO: Esta breve comunicación presenta un cuestionario sobre un intento de suicidio llamado "biopsia psicológica". MÉTODOS: en la literatura mundial no existe una definición coherente del término "biopsia psicológica" según la búsqueda realizada en varias bases de datos (PubMed, SciELO, Bireme, PsycInfo, Web of Science, Google Scholar, Embase, SCOPUS, LILACS o BVS Psicología). RESULTADOS: el cuestionario construido propone investigar la intención suicida, es decir, realizar una biopsia psicológica. CONCLUSIÓN: La biopsia psicológica fue diseñada para producir un diagnóstico de intento de suicidio con el fin de complementar la información necesaria para calificar los trastornos emocionales de la persona.(AU)
Assuntos
Inquéritos e Questionários , Ideação Suicida , PsicanáliseRESUMO
Abstract Objective To analyze associations between attempted suicide and childhood trauma. Methods A seven month comparative case-control study (28 subjects - patients with suicide attempt; 56 controls - patients without suicide attempt). The following instruments were used: Childhood Trauma Questionnaire (CTQ), Mini International Neuropsychiatric Interview (MINI), and Medical Outcomes Study (MOS). Results The group with suicide attempt had significantly higher scores for some variables: emotional abuse (p < 0.001), physical abuse (p < 0.001), emotional neglect (p < 0.001), and physical neglect (p < 0.001). Conclusions The results suggest that variables related to previous trauma may influence future suicide attempts. The adoption of preventive and therapeutic actions related to mistreatments during child development is a crucial factor in reduction of suicide risk.
Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Tentativa de Suicídio/estatística & dados numéricos , Sobreviventes Adultos de Maus-Tratos Infantis/estatística & dados numéricos , Trauma Psicológico/epidemiologia , Experiências Adversas da Infância/estatística & dados numéricos , Brasil/epidemiologia , Estudos de Casos e ControlesRESUMO
Experiências traumáticas na infância podem gerar sofrimento psicológico e aumento das vulnerabilidades e predisposições para posterior desenvolvimento de psicopatologias na vida adulta. Sintomas de comportamentos autodestrutivos e tentativas de suicídio estão entre algumas das fortes possibilidades de manifestações. O presente estudo foi realizado em um hospital de emergência, em Porto Alegre/RS, e teve como objetivo principal estudar a correlação entre traumas na infância perpetrados por figuras parentais e a TS na adultez, em uma amostra de pessoas que internaram como sobreviventes de TS. Os resultados apontaram associação entre eventos traumáticos na infância e posterior tentativa de suicídio na vida adulta. Essa correlação realça o papel do trauma psíquico precoce no desejo de interromper a própria vida posteriormente. Fica visível a necessidade de compreensão das consequências dos traumas infantis, bem como a necessidade de serem pensadas intervenções precoces na infância e nos adultos vítimas de trauma. Novos estudos são sugeridos.(AU)
Traumatic childhood experiences can generate psychological distress and the increase vulnerabilities and predispositions for later development of psychopathologies in adulthood. Symptoms of self-defeating behaviors as well as suicide attempts are among some of the strong possibilities for manifestations. The present study was conducted in an emergency hospital in Porto Alegre/RS and its main objective was to study the correlation between childhood trauma perpetrated by parental figures and TS in adulthood, in a sample of people who were hospitalized as TS survivors. The results of the investigation pointed to the association between the presence of trauma in childhood and suicide attempts in adulthood. The results showed an association between traumatic events in childhood and subsequent suicide attempt in adulthood. This correlation highlights the role of early psychic trauma in the desire to interrupt their own lives later. The need to understand the consequences of childhood trauma and the need to think about early interventions in childhood and in trauma victims adults is visible. New studies are suggested.
Las experiencias traumáticas de la infancia pueden generar angustia psicológica y el aumento de las vulnerabilidades y predisposiciones para el desarrollo posterior de psicopatologías en la edad adulta. Los síntomas del comportamiento autodestructivo y los intentos de suicidio se encuentran entre las mayores posibilidades de manifestaciones. El presente estudio se llevó a cabo en un hospital de emergencia, en Porto Alegre/RS, y su objetivo principal fue estudiar la correlación entre el trauma infantil perpetrado por figuras parentales y TS en la edad adulta, en una muestra de personas que fueron hospitalizadas como sobrevivientes de TS. Los resultados mostraron una asociación entre eventos traumáticos en la infancia y el posterior intento de suicidio en la edad adulta. Esta correlación destaca el papel del trauma psíquico temprano en el deseo de interrumpir su propia vida más tarde. La necesidad de comprender las consecuencias del trauma infantil, así como la necesidad de pensar en las intervenciones tempranas en la infancia y en los adultos víctimas de trauma es visible. Se sugieren nuevos estudios.(AU)
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Apoio Social , Tentativa de Suicídio , Psicologia da Criança , Trauma Psicológico , Angústia Psicológica , PsicanáliseRESUMO
Abstract Introduction The Personality Inventory for the DSM-5 - Brief Form (PID-5-BF) - is an instrument for assessment of the five pathological personality traits from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) alternative model of personality disorders. Objectives To determine the psychometric properties of the version of the PID-5-BF translated and adapted to Brazilian Portuguese. Methods The process of translating and cross-culturally adapting the text was carried out by independent translators and the resulting version was administered to 176 patients in two hospitals in Rio Grande do Sul. The internal structure was tested by means of confirmatory factor analysis. Evidence of reliability was tested by examining the internal consistency of the scales and their convergent and concurrent validity with other methods of psychopathology. Results The five factors were replicated in the present sample with adequate indicators of fit of the data to the model. Appropriate reliability coefficients for the scales and evidence of validity were observed, indicating the clinical usefulness of the PID-5-BF in the Brazilian context. Conclusion The psychometric properties of PID-5-BF proved satisfactory in an initial sample of Brazilians.
Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Transtornos da Personalidade/diagnóstico , Inventário de Personalidade/normas , Escalas de Graduação Psiquiátrica/normas , Psicometria/normas , Manual Diagnóstico e Estatístico de Transtornos Mentais , Psicometria/instrumentação , Psicometria/métodos , Tradução , Brasil , Características CulturaisRESUMO
A psicoterapia psicanalítica com pessoas surdas é um recurso de cuidado psicológico que está se construindo e ainda é desconhecida, como possibilidade de exercício, por muitos profissionais. Apesar de estar, lentamente, se tornando alvo de interesse de alguns psicoterapeutas, ainda carece de pesquisas e mais publicações que a descrevam e convidem a reflexões sobre a prática. Assim como com ouvintes, a escuta do sofrimento de pacientes surdos é viável e efetiva. Contudo, é importante que aquele que trata esteja ciente das diferenças e alterações necessárias, advindas da condição da surdez, para que as sessões ocorram sem romper com os fundamentos psicanalíticos. Este artigo tem por objetivo conduzir o leitor a pensar sobre as particularidades desse atendimento. A partir de entrevistas feitas com psicólogos clínicos que realizam essa atividade, os fundamentos da psicoterapia psicanalítica e uma pesquisa teórica sobre a surdez,foi possível considerar algumas adaptações importantes ao setting e ao sujeito que se dispõe a fazer essa escuta aparentemente diferenciada.(AU)
The psychoanalytic psychotherapy with deaf people is a psychological care facility that is being built and still unknown, as a possibility of exercise by many professionals. Moreover, although it is slowly becoming the subject of interest of some psychotherapists, still needs more research and publications that describe and invite for reflections about the practice. As with listeners, listening to the suffering of deaf patients is feasible and effective. However, it is important that the one who do that, be aware of the differences and necessary changes arising from the condition of deafness, so that the sessions take place without breaking with the psychoanalytic fundamentals. Thus, this monograph aims to discuss the profile and performance of the professional who worksin this niche, leading the reader to think about the particulars of this service. From an analysis, interweaving interviews with clinicians who perform this activity, the fundamentals of psychoanalytic psychotherapy and the research bibliography diverse made about deafness, hypotheses were raised. Such considerations indicate some important adaptations to the setting and the guy who is willing to do this listening, apparently, differentiated.(AU)
La psicoterapia psicoanalítica con personas sordas es un recurso de cuidado psicológico que se está construyendo y aún es desconocida, como posibilidad de ejercicio, por muchos profesionales. Aunque esté, lentamente, convirtiéndose en blanco de interés de algunos psicoterapeutas, todavía carece de investigaciones y más publicaciones que la describen e inviten a reflexiones sobre la práctica. Así como con oyentes, la escucha del sufrimiento de pacientessordos es viable y efectiva. Sin embargo, esimportante que el que trata sea consciente de las diferencias y alteraciones necesarias, derivadas de la condición de la sordera, para que las sesiones ocurra sin romper con los fundamentos psicoanalíticos. Este artículo tiene por objetivo conducir al lector a pensar sobre las particularidades de esa atención. A partir de entrevistas realizadas con psicólogos clínicos que realizan esa actividad, los fundamentos de la psicoterapia psicoanalítica y una investigación teórica sobre la sordera, fue posible considerar algunas adaptaciones importantes al setting y al sujeto que se dispone a hacer esa escucha aparentemente diferenciada.(AU)
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Relações Médico-Paciente , Psicanálise , Psicoterapia , Pessoas com Deficiência AuditivaRESUMO
Abstract Objective To explore and describe a profile of patients admitted to a psychiatric emergency facility, comparing patients with and without a recent suicide attempt in terms of their clinical characteristics and aggression. Methods This was an exploratory comparative study where patients were assessed using the Brief Psychiatric Rating Scale (BPRS) and the Overt Aggression Scale (OAS). Participants with a suicide attempt in the last 24 hours (SA) were compared to participants with a prior history of suicide attempt but no recent attempt (PHSA). Results 63 individuals (SA: 26; PHSA: 37) were selected. Both groups had similar demographic and clinical characteristics. The most prevalent diagnoses were mood (57.1%) and personality (50.8%) disorders. The majority of patients in both groups had a history of aggression episodes. Physical aggression in the week prior to admission was more prevalent in the PHSA group (51.4 vs. 19.2%, p = 0.017). The PHSA group also presented higher activation scores (p = 0.025), while the SA group presented higher affect scores on BPRS dimensions (p = 0.002). Conclusion The majority of individuals with a history of suicide attempt also presented a history of aggression. Inpatients with recent suicide attempt were hospitalized mainly due to the risk of suicide, while those with no recent suicide attempt were hospitalized mainly due to the risk of hetero-aggression. These findings support the hypothesis of an aggressive profile in suicidal patients and may open up a path for future research.
Resumo Objetivo Explorar e descrever o perfil de pacientes internados em uma unidade de emergência psiquiátrica, comparando os pacientes com e sem tentativa recente de suicídio em termos de suas características clínicas e agressividade. Métodos Trata-se de um estudo exploratório comparativo, onde os pacientes foram avaliados por meio da Escala Breve de Avaliação Psiquiátrica (BPRS) e da Escala de Agressividade Declarada (OAS). Os participantes com tentativa de suicídio (TS) nas últimas 24 horas foram comparados com participantes com história prévia de tentativa de suicídio, mas sem tentativa recente (HPTS). Resultados Foram selecionados 63 indivíduos (TS: 26; HPTS: 37). Ambos os grupos tinham características demográficas e clínicas semelhantes. Os diagnósticos mais prevalentes foram transtornos de humor (57,1%) e de personalidade (50,8%). A maioria dos pacientes em ambos os grupos apresentava história de agressão. A agressão física na semana anterior à internação foi mais prevalente no grupo HPTS (51,4 vs. 19,2%, p = 0,017). O grupo HPTS também apresentou maior ativação (p = 0,025), enquanto o grupo TS apresentou maior afetividade nas dimensões da BPRS (p = 0,002). Conclusão A maioria dos indivíduos com história de tentativa de suicídio também apresentou história de agressão. Os pacientes internados com tentativa recente de suicídio foram hospitalizados principalmente devido ao risco de suicídio, enquanto aqueles sem tentativa recente de suicídio foram hospitalizados principalmente devido ao risco de heteroagressão. Esses achados apoiam a hipótese de um perfil agressivo em pacientes suicidas e podem abrir caminho para pesquisas futuras.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Idoso , Adulto Jovem , Agressão/fisiologia , Transtornos Mentais/fisiopatologia , Transtornos da Personalidade/fisiopatologia , Transtornos da Personalidade/terapia , Tentativa de Suicídio/estatística & dados numéricos , Transtornos do Humor/fisiopatologia , Transtornos do Humor/terapia , Serviços de Emergência Psiquiátrica/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Transtornos Mentais/terapia , Pessoa de Meia-IdadeRESUMO
Abstract Objective To assess the association between brain-derived neurotrophic factor (BDNF) levels and acute stress disorder (ASD) in patients who have suffered physical trauma. Methods Data were collected at an emergency hospital in Porto Alegre, state of Rio Grande do Sul, southern Brazil. Participants were over 18 years of age, victims of physical trauma, and had been hospitalized for a minimum of 48 hours. A total of 117 hospitalized patients who agreed to participate in the research were grouped according to the shift in which blood was collected (38 subjects from the morning shift and 79 from the afternoon shift), had their BDNF levels measured and responded to other questionnaires. Respondents were further grouped by age into three ranges: 18-30, 31-50 and 51-70 years. Results We found a significant difference in the distribution of BDNF between the two shifts in which blood samples were collected, with the afternoon group having higher BDNF levels (U = 1906.5, p = 0.018). A difference was observed only between the 18-30 group and the 51-70 group in the afternoon shift (Umorning = 1107, pmorning = 0.575; Uafternoon = 7175, pafternoon = 0.028). Conclusions The population whose blood samples were collected in the afternoon showed significantly higher values of BDNF compared to those of the morning shift. This same population presented lower BDNF levels when associated with ASD subtypes A1, A2, and A. We hypothesize that the lower values of BDNF measured in the morning shift were due to a response to the circadian cycle of cortisol, whose action inhibits the expression of serum neurotrophins.
Resumo Objetivo Verificar a associação entre os níveis de fator neurotrófico derivado do cérebro (brain-derived neurotrophic factor [BDNF]) e transtorno de estresse agudo (TEA) em pacientes que sofreram trauma físico. Métodos Os dados foram coletados em um hospital de emergência de Porto Alegre, Rio Grande do Sul, Brasil. Os participantes eram maiores de 18 anos, vítimas de trauma físico e estavam hospitalizados por um período mínimo de 48 horas. Um total de 117 pacientes hospitalizados que concordaram em participar da pesquisa foram agrupados de acordo com o turno de realização da coleta de sangue (38 sujeitos no turno da manhã e 79 sujeitos no turno da tarde), tiveram seus níveis de BDNF medidos e responderam a outros questionários. Os entrevistados também foram agrupados por idade em três faixas etárias: 18-30, 31-50 e 51-70 anos. Resultados Encontramos uma diferença significativa na distribuição de BDNF entre os turnos, sendo que o grupo da tarde apresentou níveis maiores de BDNF (U = 1906,5, p = 0,018). Houve diferença entre o grupo de 18-30 anos e o de 51-70 anos no turno da tarde (Umanhã = 1107, pmanhã = 0,575; Utarde = 7175, ptarde = 0,028). Conclusões A população cuja coleta ocorreu à tarde apresentou valores significativamente maiores de BDNF em relação à coleta do turno da manhã. Esta mesma população apresentou menores níveis dessa neurotrofina quando associada com os subtipos A1, A2 e A de TEA. É possível hipotetizar que os menores valores de BDNF aferidos na coleta do turno da manhã se devam a uma resposta ao ciclo circadiano do cortisol, cuja ação inibe a expressão de neurotrofinas séricas.