RESUMO
Being diagnosed with cancer is commonly associated with psychological distress. Especially patients with advanced disease report a range of distinct symptoms that are referred to as existential distress. The conceptualization of existential distress is mainly characterized by the loss of a sense of meaning and purpose in life resulting from the confrontation with a life-threatening disease. Existential distress has a significant impact on health care outcomes and quality of life. It has been found to be associated with suicidal ideation, even in the absence of mental disorders such as depression. Meaning-centered psychotherapy offers effective interventions with regard to reducing existential distress in cancer patients.
Assuntos
Transtornos Mentais , Neoplasias , Humanos , Qualidade de Vida/psicologia , Psicoterapia/métodos , Neoplasias/complicações , Neoplasias/terapia , Neoplasias/psicologia , Existencialismo/psicologia , Transtornos Mentais/terapia , Transtornos Mentais/complicações , Cuidados Paliativos/psicologiaRESUMO
Panic disorder (PD) patients show aberrant neural responses to threatening stimuli in an extended fear network, but results are only partially comparable, and studies implementing disorder-related visual scenes are lacking as stimuli. The neural responses and functional connectivity to a newly developed set of disorder-related, ecologically valid scenes as compared with matched neutral visual scenes, using event-related functional magnetic resonance imaging (fMRI) in 26 PD patients and 26 healthy controls (HC) were investigated. PD patients versus HC showed hyperactivation in an extended fear network comprising brainstem, insula, thalamus, anterior, and mid-cingulate cortex and (dorso-)medial prefrontal cortex for disorder-related versus neutral scenes. Amygdala differences between groups failed significance. Subjective levels of anxiety significantly correlated with brainstem activation in PD patients. Analysis of functional connectivity by means of beta series correlation revealed no emotion-specific alterations in connectivity in PD patients versus HC. The results suggest that subjective anxiety evoked by external stimuli is directly related to altered activation in the homeostatic alarm system in PD. With novel disorder-related stimuli, the study sheds new light on the neural underpinnings of pathological threat processing in PD. Hum Brain Mapp 37:4439-4453, 2016. © 2016 Wiley Periodicals, Inc.