Navegando por Palavras-chave "posttraumatic stress disorder"
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- ItemSomente MetadadadosCorpus callosum in maltreated children with posttraumatic stress disorder: A diffusion tensor imaging study(Elsevier B.V., 2008-04-15) Jackowski, Andrea P. [UNIFESP]; Douglas-Palumberi, Heather; Jackowski, Marcel; Win, Lawrence; Schultz, Robert T.; Staib, Lawrence W.; Krystal, John H.; Kaufman, Joan; Yale Univ; Universidade Federal de São Paulo (UNIFESP); Universidade de São Paulo (USP)Contrary to expectations derived from preclinical studies of the effects of stress, and imaging studies of adults with posttraumatic stress disorder (PTSD), there is no evidence of hippocampus atrophy in children with PTSD. Multiple pediatric studies have reported reductions in the corpus callosum - the primary white matter tract in the brain. Consequently, in the present study, diffusion tensor imaging was used to assess white matter integrity in the corpus callosum in 17 maltreated children with PTSD and 15 demographically matched normal controls. Children with PTSD had reduced fractional anisotropy in the medial and posterior corpus, a region which contains interhemispheric projections from brain structures involved in circuits that mediate the processing of emotional stimuli and various memory functions - core disturbances associated with a history of trauma. Further exploration of the effects of stress on the corpus callosum and white matter development appears a promising strategy to better understand the pathophysiology of PTSD in children. (C) 2007 Elsevier Ireland Ltd. All rights reserved.
- ItemSomente MetadadadosA experiência dissociativa no trauma: uma abordagem qualitativa(Universidade Federal de São Paulo (UNIFESP), 2015-06-26) Mattos, Patricia Ferreira [UNIFESP]; Mello, Marcelo Feijo de Mello [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Peritraumatic dissociation has been considered an important feature to development of post-traumatic stress disorders, but this concept still remains unclear. Studies on the concept of dissociation are rare and prospective studies during or immediately after a trauma event are scarce. Most of them are retrospective, based on standardized questionnaires and carried out long after the trauma event. In order to adequately explore the peritraumatic dissociative phenomenon, we considered the nature of conscious human experience and the subjectivity of our object of study. We interviewed eight patients, victims of urban violence up to 1 month after the traumatic event. The interviews? content were compared, analyzed and encoded according to the Grounded Theory. The reported alterations by these individuals were coded on (A) their perceptions about the inner world, (B) the outer world, (C) as well as the impressions of third-party including the examiner?s observations. Patients manifested entire intermeshed experiences of feelings, expressions, beliefs and actions, all permeated with biographical details, but not integrated enough to allow their perceptual experience to be congruent, consistent and meaningful as the experience of being/existing. Peritraumatic dissociative experience presented itself as a failure in the capacity to synthesize the emerging signs of the inner (their mind/body unit) and outer world (other people and objects, including the space-time flow structure) in a consistent and meaningful way, departing from intact cognitive-perceptual tools. Adequate and faithful distinctions of a concept are the fundamental basis for classification, research and treatment. This finding implies on critical positioning to manage peritraumatic dissociation.
- ItemAcesso aberto (Open Access)Os pacientes invisíveis: transtorno de estresse pós-traumático em pais de pacientes com fibrose cística(Faculdade de Medicina da Universidade de São Paulo, 2010-01-01) Cabizuca, Mariana; Mendlowicz, Mauro; Marques-Portella, Carla; Ragoni, Celina; Coutinho, Evandro Silva Freire; Souza, Wanderson de; Mari, Jair de Jesus [UNIFESP]; Figueira, Ivan; Universidade Federal do Rio de Janeiro Instituto de Psiquiatria; Universidade Federal Fluminense Departamento de Psiquiatria e Saúde Mental; Fundação Oswaldo Cruz Escola Nacional de Saúde Pública; Universidade Federal de São Paulo (UNIFESP)BACKGROUND: Besides the growing acknowledgment of the relevance of posttraumatic stress disorder (PTSD) related to medical illness, there is no study in cystic fibrosis yet. OBJECTIVE: To assess the prevalence of PTSD and the three clusters of posttraumatic stress symptoms (PTSS) in parents of patients with cystic fibrosis. METHODS: Parents of patients with cystic fibrosis (age range: 2 to 33 years) were drawn from the Cystic Fibrosis Association of the city of Rio de Janeiro. In this cross-sectional study, parents were asked to fulfill a questionnaire for social and demographic characteristics and were interviewed by means of the PTSD module of the Structured Clinical Interview for DSM-IV. RESULTS: The sample comprised 62 subjects (46 mothers and 16 fathers). Current prevalence for full PTSD was 6.5% and that for partial PTSD was 19.4%. Parents with and without PTSS differed significantly in two psychosocial aspects: the former reported more emotional problems (p = 0.001); and acknowledged more often the need for psychological or psychiatric interventions (p = 0.002) than the latter. However, only 6.3% of the parents with PTSS were in psychological/psychiatric treatment. DISCUSSION: This preliminary study showed that the frequency of PTSD symptoms is fairly high among parents of patients with cystic fibrosis, and although these parents recognize they have emotional problems and need psychological/psychiatric treatment, their suffering remains invisible to the medical system, leading to underdiagnosis and undertreatment.
- ItemAcesso aberto (Open Access)Psychometric properties of the Brazilian version of the Pittsburgh Sleep Quality Index Addendum for PTSD (PSQI-A)(Associação Brasileira de Psiquiatria - ABP, 2014-12-01) Barbosa Neto, Jair B.; Germain, Anne; Mattos, Patrícia F.; Serafim, Paula M.; Santos, Roberta C.m.; Martini, Larissa Campagna [UNIFESP]; Suchecki, Deborah [UNIFESP]; Mello, Marcelo Feijó de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); University of Pittsburgh School of Medicine Department of PsychiatryObjective: Sleep disturbances play a fundamental role in the pathophysiology posttraumatic stress disorder (PTSD), and are not only a secondary feature. The aim of this study was to validate and assess the psychometric properties of the Brazilian version of the Pittsburgh Sleep Quality Index Addendum for PTSD (PSQI-A-BR), a self-report instrument designed to assess the frequency of seven disruptive nocturnal behaviors, in a sample of participants with and without PTSD. Methods: PSQI-A was translated into Brazilian Portuguese and applied to a convenience sample of 190 volunteers, with and without PTSD, who had sought treatment for the consequences of a traumatic event. Results: The PSQI-A-BR displayed satisfactory internal consistency (Cronbach's coefficient of 0.83 between all items) and convergent validity with the Clinician Administered PTSD Scale (CAPS), even when excluding sleep-related items (r = 0.52). Test-retest yielded high agreement in the global PSQI-A-BR, with good stability over time (r = 0.88). A global PSQI-A-BR cutoff score of 7 yielded a sensitivity of 79%, specificity of 64%, and a global score of 7 yielded a positive predictive value of 93% for discriminating participants with PTSD from those without PTSD. Conclusion: The PSQI-A-BR is a valid instrument for PTSD assessment, applicable to both clinical and research settings.
- ItemSomente MetadadadosA SYSTEMATIC REVIEW ON the EFFECTIVENESS of COGNITIVE BEHAVIORAL THERAPY for POSTTRAUMATIC STRESS DISORDER(Baywood Publ Co Inc, 2008-01-01) Mendes, Deise Daniela [UNIFESP]; Mello, Marcelo Feijo [UNIFESP]; Ventura, Paula; Passarela, Cristiane de Medeiros; Mari, Jair de Jesus [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Federal do Rio de Janeiro (UFRJ)Objective: Cognitive behavioral therapy (CBT) is the most common psychotherapy approach for the treatment of PTSD. Nevertheless, previous reviews on the efficacy of several types of psychotherapy were unable to detect differences between CBT and other psychotherapies. the purpose of this study was to conduct systematic review on the efficacy of CBT in comparison with studies that used other psychotherapy techniques. Method: Databases were searched using the following terms: posttraumatic stress disorder/stress disorder, treatment/psychotherapy/behavior cognitive therapy, randomized trials, and adults. Randomized clinical trials published between 1980 and 2005 and that compared CBT with other treatments for PTSD was included. the main outcomes were remission, clinical improvement, dropout rates and changes in symptoms. Results: the 23 clinical trials included in the review comprised 1,923 patients: 898 in the treatment group and 1,025 in the control group. CBT had better remission rates than EMDR (RR = 0.35; 95%CI: 0.16; 0.79; p = 0.01) or supportive therapies (RR = 0.43; 95%CI: 0.25; 0.74; p = 0.002, completer analysis). CBT was comparable to Exposure Therapy (ET) (RR = 0.90; 95%CI: 0.58; 1.40; p = 0.64), and cognitive therapy (CT) (RR = 1.01; 95%CI: 0.67; 1.51; p = 0.98) in terms of efficacy and compliance. Conclusions: These findings suggest that specific therapies, such as CBT, exposure therapy and cognitive therapy are equally effective, and more effective than supportive techniques in the treatment of PTSD.
- ItemSomente MetadadadosTopiramate in treatment-resistant depression and binge-eating disorder(Blackwell Munksgaard, 2002-08-01) Prado-Lima, Pedro Antonio Schmidt do; Bacaltchuk, Josué [UNIFESP]; Biomed Res Inst; Universidade Federal de São Paulo (UNIFESP)