Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 112
Filtrar
1.
J Youth Adolesc ; 53(6): 1370-1382, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38553580

RESUMO

Non-Suicidal Self-Injury (NSSI) is associated with a heightened overall risk of future psychopathological problems. However, elucidating specific characteristics that determine an increased risk for certain individuals remains an area requiring further exploration. This study aimed to identify latent subgroups in a sample of college students with NSSI. Additionally, it sought to explore the differential associations of these subgroups with their psychopathological status (e.g., borderline symptoms and suicidal tendencies) both at baseline and after two years. The sample comprised 259 participants (89% females, Mage = 20.39, SD = 1.90) who reported engaging in NSSI in the last year. Three latent groups were found. The group exhibiting severe NSSI-features, high emotion dysregulation, and low perceived social support was the profile with high-risk of psychopathology both at baseline and follow-up. The findings enhance our understanding of the complex association between NSSI and future mental health issues, aiding in the early identification of at-risk individuals.


Assuntos
Comportamento Autodestrutivo , Estudantes , Humanos , Feminino , Comportamento Autodestrutivo/psicologia , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Masculino , Adulto Jovem , Seguimentos , Universidades , Ideação Suicida , Apoio Social , Fatores de Risco , Adolescente , Regulação Emocional , Adulto , Transtorno da Personalidade Borderline/psicologia
2.
Psychosom Med ; 84(1): 64-73, 2022 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-34611112

RESUMO

OBJECTIVE: Previous imaging studies in patients with borderline personality disorder (BPD) have detected functional brain dysfunctions. Mindfulness training may improve the symptoms of BPD, although the neural mechanisms involved remain poorly understood. This study had several key aims: a) to investigate the role of right anterior insula (rAI) functional connectivity in modulating baseline emotional status in BPD, b) to compare differences in connectivity changes after mindfulness training versus interpersonal effectiveness intervention, and c) to explore the correlation between longitudinal changes in imaging data and clinical indicators. METHODS: Thirty-eight patients with BPD underwent resting-state functional magnetic resonance imaging. Participants completed self-report clinical scales and participated in a dialectical-behavioral therapy (mindfulness versus interpersonal effectiveness modules). Changes in clinical and imaging variables were evaluated longitudinally after completion of the first 10-week sessions of psychotherapeutic intervention. RESULTS: At baseline, the rAI was strongly connected with the other salience network nodes and anticorrelated with most core nodes of the default mode network (p < .05, corrected). The functional connectivity of the rAI correlated with emotional dysregulation and deficits in mindfulness capacities (p < .05, corrected). After completion of psychotherapeutic intervention, both groups (mindfulness and interpersonal effectiveness) showed divergent posttherapy functional connectivity changes, which were in turn associated with the clinical response. CONCLUSIONS: The functional connectivity of the rAI seems to play an important role in emotion dysregulation and deficits in mindfulness capacities in individuals with BPD. Psychotherapy seems to modulate this functional connectivity, leading to beneficial changes in clinical variables.


Assuntos
Transtorno da Personalidade Borderline , Atenção Plena , Terapia Comportamental , Transtorno da Personalidade Borderline/diagnóstico por imagem , Transtorno da Personalidade Borderline/terapia , Emoções/fisiologia , Humanos , Imageamento por Ressonância Magnética/métodos , Atenção Plena/métodos
3.
Acta Psychiatr Scand ; 145(4): 332-342, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35088405

RESUMO

OBJECTIVE: Polypharmacy and overprescription of off-label medications are common in patients with borderline personality disorder (BPD). The aim of the present naturalistic study was to explore whether the skills training module of dialectical-behavioural therapy (DBT) can reduce polypharmacy in these patients in routine clinical practice. METHODS: Retrospective, observational study of 377 patients with a primary diagnosis of BPD consecutively admitted to the BPD outpatient unit from 2010 through 2020. All patients were invited to participate in the DBT skills training module (DBT-ST). DBT-ST participants (n = 182) were compared with a control group who did not participate in DBT-ST (n = 195). Pre-post intervention changes in medication load and use of antidepressants, benzodiazepines, mood stabilizers, and antipsychotics were evaluated. RESULTS: At baseline, most patients (84.4%) were taking at least one medication and 46.9% were on polypharmacy. Compared to controls, patients in the DBT-ST group presented a significant reduction in the number of medications (2.67-1.95 vs. 2.16-2.19; p < 0.001), medication load (4.25-3.05 vs. 3.45-3.48; p < 0.001), use of benzodiazepines (54.4%-27.5% vs. 40%-40.5%; p < 0.001), mood stabilizers (43.4%-33% vs. 36.4%-39.5%; p < 0.001), and antipsychotics (36.3%-29.1% vs. 34.4%-36.9%; p < 0.001). CONCLUSIONS: These findings suggest that patients with BPD can benefit from the DBT-ST module, which may reduce the medication load, particularly of sedatives. The results suggest that DBT-ST may be useful to treat overmedication in patients with BPD and could help to promote "deprescription" in clinical practice.


Assuntos
Antipsicóticos , Transtorno da Personalidade Borderline , Antipsicóticos/uso terapêutico , Terapia Comportamental/métodos , Benzodiazepinas/uso terapêutico , Transtorno da Personalidade Borderline/tratamento farmacológico , Humanos , Polimedicação , Estudos Retrospectivos , Resultado do Tratamento
4.
Acta Neurol Scand ; 146(5): 448-464, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36121184

RESUMO

The aim of this systematic review was to assess the effectiveness of Internet-based psychological interventions in the treatment of physical, socio-affective and cognitive symptoms and quality of life (QoL) in people with multiple sclerosis (pwMS) to provide currently available evidence. Systematic searches for eligible studies were carried out in four databases (August 2021) using key words. Studies were screened, data extracted, quality appraised and analysed by three independent reviewers, using predefined criteria and following the PRISMA rules. Study quality was assessed using Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields QUALSYST tool. Physical, socio-affective and cognitive symptoms and QoL were the primary outcomes. Thirteen studies were included. Two principal approaches were reported: Cognitive behavioural therapy (CBT) and mindfulness-based interventions (MBI). Interventions varied from tailored versions to videoconference by a clinician, duration mean 8 weeks, delivered via individually and groups, all online. The review found that iCBT interventions were effective for improve depression, anxiety, fatigue and QoL, and slightly in cognitive functioning in pwMS, whereas MBI interventions reported benefits in depression, anxiety, stress and QoL, and less evidence in fatigue. Generally, study quality was acceptable in most studies; eleven of the studies scored a low risk of bias on all items in the Qualsyst Tool, whereas only two studies were considered unacceptable. Psychological online interventions may improve physical, socio-affective and cognitive symptoms as well as QoL in pwMS, overcoming the face-to-face barriers (i.e. disability). Contact with the therapist and groups sessions have been identified as enablers of the online interventions. Nevertheless, the limited number of studies and the heterogeneity of health outcomes reported made difficult to afford robust conclusions on psychological intervention effects in pwMS.


Assuntos
Intervenção Baseada em Internet , Esclerose Múltipla , Depressão/etiologia , Depressão/terapia , Fadiga/terapia , Humanos , Esclerose Múltipla/complicações , Esclerose Múltipla/psicologia , Esclerose Múltipla/terapia , Intervenção Psicossocial , Qualidade de Vida/psicologia
5.
Hum Psychopharmacol ; 37(1): e2807, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34411343

RESUMO

OBJECTIVE: Ayahuasca is a psychedelic brew that originated in the Amazon basin. The psychological effects of this drug are becoming better understood due to the growing research interest in identifying new potential therapeutic agents for the treatment of emotion dysregulation and other disorders. Previous studies suggest that ayahuasca enhances mindfulness-related capacities (decentering, non-judging, non-reacting and acceptance) and emotion regulation. The aim of the present exploratory study was to determine the effects of ayahuasca on self-compassion in a community sample. METHODS: We administered validated questionnaires (the Self-Compassion Scale-Short Form and Forms of Self-Criticism and Self-Reassurance) to evaluate pre-post changes in self-compassion and self-criticism/self-reassurance in 45 volunteers (27 women; 60%) before and after (≤24 h) an ayahuasca ceremony. Most participants (n = 29; 67.4%) had previously used ayahuasca. RESULTS: Ayahuasca resulted in significant improvements, with medium to large effect sizes (η2  = 0.184-0.276), in measures of self-compassion (p < 0.05), self-criticism (p < 0.01) and self-reassurance (p < 0.01). CONCLUSIONS: The findings of this study suggest that ayahuasca promotes well-being and self-compassion, which could have a therapeutic effect on individuals with negative affect and other psychopathological conditions. Large, controlled studies are needed to confirm these findings.


Assuntos
Banisteriopsis , Alucinógenos , Atenção Plena , Feminino , Alucinógenos/farmacologia , Alucinógenos/uso terapêutico , Humanos , Autoavaliação (Psicologia) , Autocompaixão
6.
J Hum Evol ; 154: 102967, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33751963

RESUMO

The Final Gravettian in Europe overlapped with the cold and dry climatic event of Heinrich 2 (ca. 27-23.5 kyr cal BP), which caused the contraction of human distribution over refuge regions in the southern peninsulas of Europe. Here, we consider the human subsistence in the northeast Iberian Peninsula, where an extensive range of small to large prey was available. Four human remains from the Serinyà caves were investigated using the stable isotope ratios of carbon, nitrogen, and sulfur of bulk collagen (δ13Ccoll, δ15Ncoll, δ34Scoll) and of phenylalanine and glutamine amino acids (δ15NPhe, δ15NGlu). Direct AMS dating of the human and animal remains from the Final Gravettian levels of Mollet III, Reclau Viver, and Arbreda at Serinyà confirmed their chronological position from 27.5 to 22.6 kyr cal BP and the occurrence of four different human individuals. The δ13Ccoll and δ15Ncoll values showed a large contribution of terrestrial prey to the dietary protein of the individuals. The δ34Scoll values were consistent with a subsistence based on the local continental resources, without detectable contribution of marine resource. The δ15NPhe and δ15NGlu values confirm that freshwater resources were not a substantial component of the diet of the considered individuals. Contrast in the isotopic amounts in bulk collagen could be interpreted as the result of different proportions of terrestrial prey in human diet at Serinyà. Altogether, the isotopic investigation reveals the importance of terrestrial over aquatic resources in the subsistence of the studied Final Gravettian individuals from the Serinyà caves in northeastern Iberia during the Last Glacial Maximum. It would be consistent with a scenario of a productive enough terrestrial ecosystem to sustain hunter-gatherer subsistence in this refuge region.


Assuntos
Dieta/história , Isótopos/análise , Animais , Osso e Ossos/química , Cavernas , Colágeno/química , Ecossistema , História Antiga , Humanos , Região do Mediterrâneo , Espanha
7.
Psychiatr Q ; 92(3): 1035-1054, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33475912

RESUMO

Non-suicidal self-injury (NSSI) is an increasingly prevalent phenomenon associated with many detrimental outcomes, ranging from poor academic performance to suicide attempts. Research on self-harming behaviors has identified emotion dysregulation, negative affect, and borderline pathology as strong risk factors of NSSI, whereas the potential protective effects of metacognitive skills such as decentering have not yet been explored. The current study combined ecological momentary assessment (EMA) and self-report measures to explore potential risk and protective factors of NSSI in a clinical group of Borderline Personality Disorder (BPD) patients with NSSI (N = 22), a subclinical group of college students with NSSI (N = 19), and a non-clinical healthy control group (N = 23). Participants completed self-report measures of borderline pathology, emotion dysregulation, decentering ability, and negative emotional symptoms, and they used the Sinjur App (EMA instrument) at least three times a day for 15 days to capture negative affect and NSSI in daily life. A multilevel mixed-effect regression analysis with both self-report and EMA measures was conducted to identify predictors of NSSI. The multilevel analysis showed that only momentary frustration directly predicted NSSI. Momentary guilt and anger only predicted NSSI when interacting with more stable traits of borderline pathology and negative emotional symptoms. Most importantly, greater decentering capacity protected against self-injury and attenuated the association between momentary sadness and NSSI. Findings contribute novel knowledge about NSSI, documenting the protective effects of decentering and highlighting the benefit of interventions that target metacognitive emotion regulation skills.


Assuntos
Transtorno da Personalidade Borderline , Comportamento Autodestrutivo , Avaliação Momentânea Ecológica , Humanos , Autorrelato , Comportamento Autodestrutivo/epidemiologia , Tentativa de Suicídio , Adulto Jovem
8.
Psychol Med ; 50(10): 1746-1754, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-31456534

RESUMO

BACKGROUND: Although executive and other cognitive deficits have been found in patients with borderline personality disorder (BPD), whether these have brain functional correlates has been little studied. This study aimed to examine patterns of task-related activation and de-activation during the performance of a working memory task in patients with the disorder. METHODS: Sixty-seven DSM-IV BPD patients and 67 healthy controls underwent fMRI during the performance of the n-back task. Linear models were used to obtain maps of within-group activations and areas of differential activation between the groups. RESULTS: On corrected whole-brain analysis, there were no activation differences between the BPD patients and the healthy controls during the main 2-back v. baseline contrast, but reduced activation was seen in the precentral cortex bilaterally and the left inferior parietal cortex in the 2-back v. 1-back contrast. The patients showed failure of de-activation affecting the medial frontal cortex and the precuneus, plus in other areas. The changes did not appear to be attributable to previous history of depression, which was present in nearly half the sample. CONCLUSIONS: In this study, there was some, though limited, evidence for lateral frontal hypoactivation in BPD during the performance of an executive task. BPD also appears to be associated with failure of de-activation in key regions of the default mode network.


Assuntos
Transtorno da Personalidade Borderline/fisiopatologia , Rede de Modo Padrão/fisiopatologia , Lobo Parietal/fisiopatologia , Adulto , Mapeamento Encefálico , Estudos de Casos e Controles , Feminino , Humanos , Imageamento por Ressonância Magnética/instrumentação , Imageamento por Ressonância Magnética/métodos , Masculino , Memória de Curto Prazo , Espanha , Adulto Jovem
9.
Nature ; 512(7514): 306-9, 2014 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-25143113

RESUMO

The timing of Neanderthal disappearance and the extent to which they overlapped with the earliest incoming anatomically modern humans (AMHs) in Eurasia are key questions in palaeoanthropology. Determining the spatiotemporal relationship between the two populations is crucial if we are to understand the processes, timing and reasons leading to the disappearance of Neanderthals and the likelihood of cultural and genetic exchange. Serious technical challenges, however, have hindered reliable dating of the period, as the radiocarbon method reaches its limit at ∼50,000 years ago. Here we apply improved accelerator mass spectrometry (14)C techniques to construct robust chronologies from 40 key Mousterian and Neanderthal archaeological sites, ranging from Russia to Spain. Bayesian age modelling was used to generate probability distribution functions to determine the latest appearance date. We show that the Mousterian ended by 41,030-39,260 calibrated years bp (at 95.4% probability) across Europe. We also demonstrate that succeeding 'transitional' archaeological industries, one of which has been linked with Neanderthals (Châtelperronian), end at a similar time. Our data indicate that the disappearance of Neanderthals occurred at different times in different regions. Comparing the data with results obtained from the earliest dated AMH sites in Europe, associated with the Uluzzian technocomplex, allows us to quantify the temporal overlap between the two human groups. The results reveal a significant overlap of 2,600-5,400 years (at 95.4% probability). This has important implications for models seeking to explain the cultural, technological and biological elements involved in the replacement of Neanderthals by AMHs. A mosaic of populations in Europe during the Middle to Upper Palaeolithic transition suggests that there was ample time for the transmission of cultural and symbolic behaviours, as well as possible genetic exchanges, between the two groups.


Assuntos
Aculturação/história , Extinção Biológica , Geografia , Homem de Neandertal , Análise Espaço-Temporal , Animais , Teorema de Bayes , História Antiga , Humanos , Espectrometria de Massas , Homem de Neandertal/genética , Homem de Neandertal/fisiologia , Datação Radiométrica , Fatores de Tempo , Comportamento de Utilização de Ferramentas , Incerteza
10.
Clin Psychol Psychother ; 26(5): 562-571, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31132302

RESUMO

Patients with borderline personality disorder (BPD) present dysfunctions of the default mode network (DMN). Mindfulness training has proven effective to improve the symptoms of BPD. The present study examines the effect of mindfulness training on BPD symptomatology and DMN activity during the performance of a working memory task in patients with BPD. Sixty-five individuals with BPD were randomized to receive psychotherapy with either the mindfulness module of dialectical behavioural therapy (DBT-M) or with interpersonal effectiveness module (DBT-IE). The impact of treatments was evaluated with clinical and mindfulness variables as well as with functional magnetic resonance imaging during performance of the task. Both groups showed improvement in BPD symptoms and other clinical variables after treatment. Unexpectedly, there were no between-group differences in DMN activation or deactivation. However, activation of the left anterior insula increased in both groups after the intervention. Compared with the control group, participants in the DBT-M group presented higher deactivation in a cluster extending bilaterally from the calcarine to the cuneus and superior occipital gyri.


Assuntos
Transtorno da Personalidade Borderline/terapia , Atenção Plena/métodos , Adulto , Feminino , Humanos , Masculino , Psicoterapia/métodos , Resultado do Tratamento
11.
BMC Psychiatry ; 18(1): 284, 2018 09 04.
Artigo em Inglês | MEDLINE | ID: mdl-30180825

RESUMO

In the original publication of this article [1] the funding acknowledgement for grant "PI13/00134, ERDF Funds" was missing.

12.
Actas Esp Psiquiatr ; 46(6): 226-33, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30552812

RESUMO

BACKGROUND: Dialectical behaviour therapy skills training (DBT-ST) has proven effective to treat individuals with borderline personality disorder (BPD). However, therapy still faces the problem of early dropout. The aim of the present study is to examine which factors are associated with early dropout from DBT-ST in a sample of subjects with BPD. METHOD: 118 subjects with BPD diagnosis were included in the study. Apart from socio-demographic and clinical variables, childhood trauma history, personality dimensions, and comorbidities with other psychiatric disorders were collected. Differences in regards to the aforementioned variables were compared between individuals who dropped out prematurely from therapy and those who finalized it. RESULTS: Significant differences between groups regarding socio-demographic and clinical variables, including childhood trauma history and comorbid personality disorders, were not found. Both groups differed significantly in regards to trait impulsiveness and in comorbidity with Eating Disorders (ED) and Cocaine Use Disorder (CUD). The regression analyses showed that ED and CUD significantly predicted drop-out (p=0.011 and p=0.031 respectively), while scores in trait impulsivity showed a tendency towards signification (p=0.063). CONCLUSIONS: Comorbidities between BPD and axis I disorders (i.e., ED and CUD) should be taken into account when referring patients to DBT-ST.


Assuntos
Transtorno da Personalidade Borderline/terapia , Terapia do Comportamento Dialético , Pacientes Desistentes do Tratamento/estatística & dados numéricos , Adulto , Feminino , Previsões , Humanos , Masculino , Fatores de Risco , Fatores Socioeconômicos , Fatores de Tempo
13.
Actas Esp Psiquiatr ; 46(4): 146-55, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30079928

RESUMO

Non-suicidal self-injury (NSSI) is defined as the direct and deliberate destruction of one’s own body tissue in the absence of lethal intent. Following decades of progressive increase in the incidence of NSSI among adolescents and young adults, as well as growing scientific interest, the disorder was listed as a condition for further study in the Diagnostic and Statistical Manual of Mental Disorders (fifth edition). In this review we provide updated information on this phenomenon, focusing on: prevalence, course and prognosis; associated factors; its relationship with psychopathology; and the role of the mass media, social networks, and the internet. Finally, we discuss some conclusions and future proposals, emphasizing the need for collaborative work to better understand NSSI in Spain, and to improve prevention and treatment strategies.


Assuntos
Comportamento Autodestrutivo , Adolescente , Adulto , Humanos , Prevalência , Prognóstico , Comportamento Autodestrutivo/diagnóstico , Comportamento Autodestrutivo/epidemiologia , Comportamento Autodestrutivo/etiologia
14.
Int J Neuropsychopharmacol ; 20(9): 698-711, 2017 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-28525587

RESUMO

Background: Ayahuasca is a plant tea containing the psychedelic 5-HT2A agonist N,N-dimethyltryptamine and harmala monoamine-oxidase inhibitors. Acute administration leads to neurophysiological modifications in brain regions of the default mode network, purportedly through a glutamatergic mechanism. Post-acutely, ayahuasca potentiates mindfulness capacities in volunteers and induces rapid and sustained antidepressant effects in treatment-resistant patients. However, the mechanisms underlying these fast and maintained effects are poorly understood. Here, we investigated in an open-label uncontrolled study in 16 healthy volunteers ayahuasca-induced post-acute neurometabolic and connectivity modifications and their association with mindfulness measures. Methods: Using 1H-magnetic resonance spectroscopy and functional connectivity, we compared baseline and post-acute neurometabolites and seed-to-voxel connectivity in the posterior and anterior cingulate cortex after a single ayahuasca dose. Results: Magnetic resonance spectroscopy showed post-acute reductions in glutamate+glutamine, creatine, and N-acetylaspartate+N-acetylaspartylglutamate in the posterior cingulate cortex. Connectivity was increased between the posterior cingulate cortex and the anterior cingulate cortex, and between the anterior cingulate cortex and limbic structures in the right medial temporal lobe. Glutamate+glutamine reductions correlated with increases in the "nonjudging" subscale of the Five Facets Mindfulness Questionnaire. Increased anterior cingulate cortex-medial temporal lobe connectivity correlated with increased scores on the self-compassion questionnaire. Post-acute neural changes predicted sustained elevations in nonjudging 2 months later. Conclusions: These results support the involvement of glutamate neurotransmission in the effects of psychedelics in humans. They further suggest that neurometabolic changes in the posterior cingulate cortex, a key region within the default mode network, and increased connectivity between the anterior cingulate cortex and medial temporal lobe structures involved in emotion and memory potentially underlie the post-acute psychological effects of ayahuasca.


Assuntos
Banisteriopsis/química , Córtex Cerebral/efeitos dos fármacos , Córtex Cerebral/metabolismo , Alucinógenos/farmacologia , Atenção Plena , Adulto , Ácido Aspártico/análogos & derivados , Ácido Aspártico/metabolismo , Mapeamento Encefálico , Feminino , Seguimentos , Ácido Glutâmico/metabolismo , Voluntários Saudáveis , Humanos , Imageamento Tridimensional , Imageamento por Ressonância Magnética , Espectroscopia de Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Fatores de Tempo
15.
Conscious Cogn ; 49: 172-180, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-28214767

RESUMO

Several meditation practices are associated with mindfulness-based interventions but little is known about their specific effects on the development of different mindfulness facets. This study aimed to assess the relations among different practice variables, types of meditation, and mindfulness facets. The final sample was composed of 185 participants who completed an on-line survey, including information on the frequency and duration of each meditation practice, lifetime practice, and the Five Facet Mindfulness Questionnaire. A Multiple Indicators Multiple Causes structural model was specified, estimated, and tested. Results showed that the Model's overall fit was adequate: χ2 (1045)=1542.800 (p<0.001), CFI=0.902, RMSEA=0.042. Results revealed that mindfulness facets were uniquely related to the different variables and types of meditation. Our findings showed the importance of specific practices in promoting mindfulness, compared to compassion and informal practices, and they pointed out which one fits each mindfulness facet better.


Assuntos
Atenção/fisiologia , Conscientização/fisiologia , Emoções/fisiologia , Meditação/psicologia , Atenção Plena , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
16.
Clin Psychol Psychother ; 24(1): 278-286, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26818533

RESUMO

The aim of this randomized pilot study is to investigate the effects of a short training programme in loving-kindness and compassion meditation (LKM/CM) in patients with borderline personality disorder. Patients were allocated to LKM/CM or mindfulness continuation training (control group). Patients in the LKM/CM group showed greater changes in Acceptance compared with the control group. Remarkable changes in borderline symptomatology, self-criticism and self-kindness were also observed in the LKM/CM group. Mechanistic explanations and therapeutic implications of the findings are discussed. HIGHLIGHTS: Three weeks of loving-kindness and compassion meditations increased acceptance of the present-moment experience in patients with borderline personality disorder. Significant improvements in the severity of borderline symptoms, self-criticism, mindfulness, acceptance and self-kindness were observed after the LKM/CM intervention. LKM/CM is a promising complementary strategy for inclusion in mindfulness-based interventions and Dialectical Behavioural Therapy for treating core symptoms in borderline personality disorder. Copyright © 2016 John Wiley & Sons, Ltd.


Assuntos
Transtorno da Personalidade Borderline/psicologia , Transtorno da Personalidade Borderline/terapia , Empatia , Meditação , Psicoterapia/métodos , Autocuidado/psicologia , Adulto , Terapia Combinada , Transtorno Depressivo Maior/psicologia , Transtorno Depressivo Maior/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Atenção Plena , Projetos Piloto , Recidiva , Autoimagem
17.
Eur Arch Psychiatry Clin Neurosci ; 266(4): 307-16, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26182893

RESUMO

Current knowledge suggests that borderline personality disorder (BPD) results from the interaction between genetic and environmental factors. Research has mainly focused on monoaminergic genetic variants and their modulation by traumatic events, especially those occurring during childhood. However, to the best of our knowledge, there are no studies on the genetics of hypothalamus-pituitary-adrenal (HPA) axis, despite its vulnerability to early stress and its involvement in BPD pathogenesis. The aim of this study was to investigate the contribution of genetic variants in the HPA axis and to explore the modulating effect of childhood trauma in a large sample of BPD patients and controls. DNA was obtained from a sample of 481 subjects with BPD and 442 controls. Case-control differences in allelic frequencies of 47 polymorphisms in 10 HPA axis genes were analysed. Modulation of genetic associations by the presence of childhood trauma was also investigated by dividing the sample into three groups: BPD with trauma, BPD without trauma and controls. Two FKBP5 polymorphisms (rs4713902-C and rs9470079-A) showed significant associations with BPD. There were also associations between BPD and haplotype combinations of the genes FKBP5 and CRHR1. Two FKBP5 alleles (rs3798347-T and rs10947563-A) were more frequent in BPD subjects with history of physical abuse and emotional neglect and two CRHR2 variants (rs4722999-C and rs12701020-C) in BPD subjects with sexual and physical abuse. Our findings suggest a contribution of HPA axis genetic variants to BPD pathogenesis and reinforce the hypothesis of the modulating effect of childhood trauma in the development of this disorder.


Assuntos
Transtorno da Personalidade Borderline , Maus-Tratos Infantis/psicologia , Sistema Hipotálamo-Hipofisário/metabolismo , Sistema Hipófise-Suprarrenal/metabolismo , Adulto , Transtorno da Personalidade Borderline/etiologia , Transtorno da Personalidade Borderline/genética , Transtorno da Personalidade Borderline/patologia , Estudos de Casos e Controles , Criança , Feminino , Frequência do Gene , Estudos de Associação Genética , Genótipo , Humanos , Masculino , Escalas de Graduação Psiquiátrica , Receptores de Hormônio Liberador da Corticotropina/genética , Proteínas de Ligação a Tacrolimo/genética , Adulto Jovem
18.
BMC Psychiatry ; 15: 180, 2015 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-26220555

RESUMO

BACKGROUND: Deficits in mindfulness-related capacities have been described in borderline personality disorder (BPD). However, little research has been conducted to explore which factors could explain these deficits. This study assesses the relationship between temperamental traits and childhood maltreatment with mindfulness in BPD. METHODS: A total of 100 individuals diagnosed with BPD participated in the study. Childhood maltreatment was assessed using the Childhood Trauma Questionnaire (CTQ-SF), temperamental traits were assessed using the Zuckerman-Khulman Personality Questionnaire (ZKPQ), and mindfulness capabilities were evaluated with the Five Facet Mindfulness Questionnaire (FFMQ). RESULTS: Hierarchical regression analyses were performed including only those CTQ-SF and ZKPQ subscales that showed simultaneous significant correlations with mindfulness facets. Results indicated that neuroticism and sexual abuse were predictors of acting with awareness; and neuroticism, impulsiveness and sexual abuse were significant predictors of non-judging. Temperamental traits did not have a moderator effect on the relationship between childhood sexual abuse and mindfulness facets. CONCLUSIONS: These results provide preliminary evidence for the effects of temperamental traits and childhood trauma on mindfulness capabilities in BPD individuals. Further studies are needed to better clarify the impact of childhood traumatic experiences on mindfulness capabilities and to determine the causal relations between these variables.


Assuntos
Transtorno da Personalidade Borderline/diagnóstico , Transtorno da Personalidade Borderline/psicologia , Maus-Tratos Infantis/psicologia , Atenção Plena , Temperamento , Adolescente , Adulto , Maus-Tratos Infantis/tendências , Estudos Transversais , Feminino , Humanos , Masculino , Atenção Plena/tendências , Inventário de Personalidade , Inquéritos e Questionários , Adulto Jovem
19.
BMC Psychiatry ; 15: 255, 2015 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-26487284

RESUMO

BACKGROUND: Follow-up studies revealed that subjects with borderline personality disorder (BPD) present high rates of clinical remission, although psychosocial functioning often remains impaired. The aim of this study is to evaluate the efficacy of a cognitive rehabilitation intervention versus a psychoeducational program on psychosocial functioning in subjects with BPD. METHODS: A multicenter, randomized, and positive-controlled clinical trial was conducted. Seventy outpatients with BPD were randomized to cognitive rehabilitation or psychoeducational group interventions. Participants were evaluated after completion of the intervention period (16 weeks) and after the follow-up period (6 months). Psychosocial functioning, clinical and neuropsychological outcomes were evaluated. RESULTS: No main effects of group or group x time were observed on functionality but a significant effect of time was found. Post-hoc analyses showed that only cognitive rehabilitation increased psychosocial functioning significantly at endpoint. Psychoeducation showed a significant enhancement of depressive symptoms. CONCLUSIONS: Cognitive rehabilitation and psychoeducational interventions appeared to show good efficacy in improving disabilities in daily life in subjects with BPD. These interventions are easily implemented in mental health settings and have the advantage of improving general functioning and clinical symptoms. TRIAL REGISTRATION: Clinicaltrials.gov: NCT02033044. Registered 9 January 2014.


Assuntos
Transtorno da Personalidade Borderline/reabilitação , Terapia Cognitivo-Comportamental/métodos , Adulto , Assistência Ambulatorial , Transtorno da Personalidade Borderline/psicologia , Depressão/reabilitação , Função Executiva/fisiologia , Feminino , Seguimentos , Humanos , Relações Interpessoais , Masculino , Memória/fisiologia , Educação de Pacientes como Assunto/métodos , Resultado do Tratamento
20.
BMC Complement Altern Med ; 15: 303, 2015 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-26329810

RESUMO

BACKGROUND: Primary health care professionals (PHPs) usually report high levels of distress and burnout symptoms related to job strain. Mindfulness, defined as non-judgmental-present-moment awareness, seems to be a moderator in the causal association between life stressors and well-being. This study aimed to verify correlations among self-reported mindfulness, perceived stress (PS), and subjective well-being (SW) in Brazilian PHPs. METHODS: We performed a correlational cross-sectional study in a purposive sample of Brazilian PHPs (physicians, nurses, nursing assistants, and community health workers), working in community-oriented primary care programs (known locally as "Family Health Programs"). We used validated self-reporting instruments: the Mindful Attention Awareness Scale (MAAS), the Perceived Stress Scale (PSS), and the Subjective Well-being Scale (SWS). We performed a multivariate analysis of variance (MANOVA), through regression coefficients (beta) in relation to the professional category (nursing assistant), in addition to the length of time in the same job (under than 6 months) that had indicated the lowest level of PS. RESULTS: Participants (n=450) comprised community health workers (65.8%), nursing assistants (18%), registered nurses (10.0%), and doctors (family physicians) (6.0%); 94% were female and 83.1% had worked in the same position for more than one year. MANOVA regression analysis showed differences across professional categories and length of time in the same job position in relation to mindfulness, PS, and SW. Nurses demonstrated lower levels of mindfulness, higher PS, and SW negative affect, as well as lower SW positive affect. Being at work for 1 year or longer showed a clear association with higher PS and lower SW positive affect, and no significance with mindfulness levels. Pearson's coefficient values indicated strong negative correlations between mindfulness and PS, and medium correlations between mindfulness and SW. CONCLUSION: In this study, there were clear correlations between mindfulness, PS, and SW across different primary care professional categories and time in the same job position, suggesting specific vulnerabilities that should be addressed through the development of staff awareness, stress prevention, and well-being interventions.


Assuntos
Esgotamento Profissional/epidemiologia , Pessoal de Saúde/estatística & dados numéricos , Atenção Plena , Estresse Psicológico/epidemiologia , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Atenção Primária à Saúde
SELEÇÃO DE REFERÊNCIAS
Detalhe da pesquisa