Evaluación de un protocolo de intervención en Terapia Sistémica Breve para personas expuestas a un evento estresante reciente / Evaluation of a Brief Systemic Therapy intervention protocol for people who have experienced a recent stressful event

Resumen Los eventos altamente estresantes son sucesos que potencialmente generan consecuencias negativas en las personas afectadas, como síntomas postraumáticos y depresivos. El presente estudio evalúa un protocolo de intervención preventiva, orientado a personas que han vivido un evento altamente estresante reciente, basado en la Terapia Sistémica Breve. Cuatro terapeutas aplicaron el protocolo a cuatro usuarias. Se entrevistó a estas ocho personas acerca de su experiencia en la aplicación y recepción del protocolo. Mediante escalas de fiabilidad y validez contrastada se evaluaron los cambios pre-post en sintomatología postraumática, sintomatología depresiva, crecimiento postraumático y satisfacción con la vida; también se midió la relación terapéutica. Los resultados muestran apreciaciones positivas en terapeutas y usuarias, el desarrollo de una relación terapéutica adecuada y avances en tres de los cuatro indicadores cuantitativos de cambio. Se concluye que el protocolo está en condiciones de utilizarse en estudios controlados.

Abstract Highly stressful events are occurrences that potentially create negative consequences for the affected people, such as post-traumatic and depressive symptoms. This study assesses a preventive intervention protocol, aimed to people who have lived a recent highly stressful event, based on the Brief Systemic Therapy. Four therapists applied the protocol to four female users. These eight persons were interviewed about the experience in relation to the application and reception of the protocol. Through contrasted reliability and validity scales, pre and post changes in posttraumatic symptomatology, depressive symptomatology, posttraumatic growth and satisfaction with life were assessed; the therapeutic relation was also measured. The results show positive appraisals in therapists and female users, the development of a proper therapeutic relation and progress in three out of four quantitative change indicators. It is concluded that the protocol is suitable to be used in controlled studies.

Classes of childhood adversities and their associations to the mental health of college undergraduates: a nationwide cross-sectional study

BACKGROUND@#Childhood adversities pose deleterious consequences on health and well-being, but limited studies explore whether unique patterns of adverse childhood experiences (ACEs) impact the mental health of emerging adults and the mediating role of current stressful events (CSEs). This study examined classes of ACEs and how they relate to CSEs, psychological distress, and subjective well-being among Eritrean College undergraduates.@*METHODS@#Cross-sectional data on ACEs, CSEs, symptoms of psychological distress, and subjective well-being were collected from a national sample of college students (N = 507). We identified ACE patterns using latent class analysis and further examined whether CSEs mediated the effects of ACE classes on psychological distress and subjective well-being.@*RESULTS@#86.4% of the sample experienced at least one ACE. Collective violence, domestic violence, and physical abuse were the most common ACEs. Three subgroups, low ACEs (66.3%), household violence (19.1%), and multiple ACEs (14.6%) were identified. We found that relative to low ACEs, household violence (β = 0.142, 95% CI 0.046, 0.248) and multiple ACEs (β = 0.501, 95% CI 0.357, 0.666) indirectly influenced psychological distress through CSEs, and CSEs mediated the relationships between household violence (β = -0.096, 95% CI -0.176, -0.033), multiple ACEs (β = -0.338, 95% CI -0.498, -0.210), and subjective well-being. However, there were nonsignificant relative direct effects of ACE patterns on both psychological distress and subjective well-being.@*CONCLUSIONS@#Experiencing multiple ACEs and household violence in conjunction with CSEs significantly predict psychological distress and subjective well-being. Contextual interventions for the early identification of ACEs and the management of CSEs may play a crucial role in the prevention of mental health problems.

Evidence of validity, reliability and psychometric parameters of the items of the Cognitive Emotion Regulation Questionnaire-Short (CERQ-Short) / Evidência de validade, fidedignidade e parâmetros psicométricos dos itens do Questionário Cognitivo de Regulação Emocional-Short (CERQ-Short) / Evidencia de validez, fidedignidad y parámetros psicométricos de los ítems del Cuestionario Cognitivo de Regulación Emocional-Short (CERQ-Short)

The aim of the present study was to evaluate the construct validity, internal consistency and psychometric indicators of the reduced version of the Cognitive Emotion Regulation Questionnaire (CERQ-short). The CERQ-short was adapted and translated to Portuguese prior to its administration to 254 adults, mainly from the state of Paraíba, Brazil. The Difficulties in Emotion Regulation Scale (DERS), the Compulsive Buying Scale (CBS) and a sociodemographic questionnaire were also applied. The original CERQ-short nine-factor structure was preserved. The convergent and discriminant validity, the reliability and the psychometric adequacy concerning item difficulty and item discrimination were also confirmed. The results support the use of this scale for rapid screening and research. (AU)

O presente estudo teve como objetivo buscar evidências de validade de construto, de consistência interna e indicadores psicométricos dos itens da versão adaptada para o português do Questionário Cognitivo de Regulação Emocional versão reduzida (CERQ-short). Após tradução e adaptação, foi aplicado o CERQ-Short, as escalas de dificuldade em regulação emocional (DERS) e de Compras Compulsivas (CBS), além de um questionário demográfico em uma amostra de 254 adultos, maioria de paraibanos. Verificou-se que a estrutura original de nove fatores do CERQ-Short foi mantida, também foram confirmadas as validades convergente e discriminante, a fidedignidade e a adequação psicométrica dos itens no que se refere à dificuldade e à discriminação dos itens. A escala apresentou evidência para a utilização em rastreio rápido e pesquisas. (AU)

El presente artículo tuvo como objetivo la búsqueda de evidencias de la validez del construto e indicadores psicométricos de los ítems, de una versión adaptada para el portugués, del Cuestionario Cognitivo de Regulación Emocional, versión reducida (CERQ-short). Inicialmente, fue realizada la traducción y adaptación semántica; posteriormente, fue aplicado el cuestionario CERQ-Short a las escalas de dificultad en regulación emocional (DERS) y de las Compras Compulsivas (CBS), además de un cuestionario demográfico en una muestra de 254 adultos, la mayoría de los paraibanos. Se verificó que la estructura original de nueve factores del CERQ-Short fue mantenida, así como las evidencias de validez del construto, fiabilidad y adecuación psicométrica de los ítems. La escala presentó evidencias para la utilización en rastreo rápido y pesquisas. (AU)

Dificuldades percebidas na transição para a universidade / Dificultades percibidas en la transición para la universidad / xxx

Este estudo investigou as principais dificuldades enfrentadas por estudantes universitários durante o ingresso no ensino superior e se a percepção das mesmas poderia variar em função do gênero, do semestre no curso, do fato do estudante estar frequentando o curso inicialmente desejado e tipo de instituição. Participaram dessa pesquisa 423 estudantes. Através de duas questões abertas, investigou-se as principais dificuldades acadêmicas e não acadêmicas vivenciadas pelos estudantes. As respostas foram submetidas a análise de conteúdo temática. A principal dificuldade acadêmica observada foi relacionada a diferenças entre o ensino médio e o superior. Já entre as dificuldades não acadêmicas, "gestão do tempo" foi a mais frequentemente citada. Alunos da Universidade tenderam a apresentar um pouco mais de dificuldades do que os do Instituto Federal. Implicações metodológicas e práticas dos resultados são discutidas.

This study investigated the main difficulties faced by undergraduate students when entering higher education, and whether their perception could vary according to gender, semester, if the student is attending the course initially desired and type of institution. 423 students participated in this study. Through two open questions, the main academic and non-academic difficulties experienced by the students were investigated. The answers were submitted to thematic content analysis. The main academic difficulty observed was related to differences between high school and higher education. Among the non-academic difficulties, "time management" was the most frequently cited. Students from the University tended to present a little more difficulties than those of the Federal Institute. Methodological and practical implications of the results were discussed.

Este estudio investigó las principales dificultades enfrentadas por estudiantes universitarios al ingresar a la educación superior y si la percepción de las mismas podría variar con relación al género, semestre, hecho del estudiante estar frecuentando la carrera inicialmente deseada y tipo de institución. Participaron en la investigación 423 estudiantes. A través de dos cuestiones abiertas, se estudiaron las principales dificultades académicas y no académicas vivenciadas por los estudiantes. Las respuestas fueron sometidas a análisis de contenido temático. La principal dificultad académica observada está relacionada con las diferencias entre la enseñanza media y superior. Entre las dificultades no académicas, "la gestión del tiempo" fue citada con mayor frecuencia. Los estudiantes de la Universidad tienden a presentar un poco más de dificultades que los de la Institución Federal. Se discuten las implicaciones metodológicas y prácticas de los resultados.

Condiciones psicométricas de la Escala de Acontecimientos Vitales Estresantes usada en población colombiana / Psychometric Conditions of the Stressful Life Events Scale Used on Colombian Population

Resumen Objetivo. Determinar las condiciones psicométricas desde el modelo TRI y evaluar la permanencia a través del tiempo de su calidad métrica determinada desde la Teoría Clásica de los Test de la Escala de Acontecimientos Vitales Estresantes. Muestra. Fue de 1225 colombianos entre 17 y 64 años (M = 33.14; DT = 12.47) de edad y ambos sexos, estratificada por sexos y procedencia. Metodología. Se analizaron las condiciones psicométricas de la escala desde la Teoría de Respuesta al Ítem (TRI), se mejoró el formato de presentación, se definieron límites de interpretación de los puntajes, y se analizó la diferencia en el impacto psicológico provocado por cada evento de acuerdo al sexo. Resultados. Los resultados muestran que la escala cuenta con un nivel adecuado de validez y confiabilidad, que el cambio de formato facilita su diligenciamiento y que es necesario ratificar si existen diferencias de sexo que deben ser estudiadas.

Abstract Objective. This paper seeks to find the psychometric qualities of validity and reliability of the Scale of Stressful Life Events for Colombian people. Sample. 1225 participants aged between 17 and 64, (M = 33.14 years old; SD = 12.47) stratified by gender and origin. Method. We analyzed the psychometric conditions of the scale from the Item Response Theory (IRT) improved the format of presentation, defined limits of interpretation of the scores, and analyzed the difference in psychological impact caused by each event according to sex. Results. The results show that the scale has an adequate level of validity and reliability, that the change of format facilitates its correct fulfillment, and that the need to study differences between the sexes must be assessed further.

Acute stress disorder and defense mechanisms: a study of physical trauma patients admitted to an emergency hospital / Transtorno de estresse agudo e mecanismos de defesa: pesquisa com pacientes que sofreram trauma físico atendidos em um hospital de emergência

Abstract 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.

Resumo Introdução: O transtorno de estresse agudo (TEA) reúne um conjunto de sintomas que pode surgir nos indivíduos após exposição a um evento traumático. Este estudo verificou a relação entre o estilo defensivo e o desenvolvimento de TEA e seus sintomas em uma amostra de pacientes que sofreram trauma físico. Métodos: Este estudo transversal controlado envolveu 146 pacientes que sofreram trauma físico e necessitaram hospitalização. Um questionário estruturado foi utilizado para avaliar sintomas de TEA, baseado nos critérios diagnósticos do DSM-5, além do Questionário de Estilo Defensivo (Defense Style Questionnaire - DSQ). Resultados: Dez (6,85%) pacientes tiveram diagnóstico positivo para TEA, e 136 (93,15%), diagnóstico negativo. A maioria da amostra foi composta por homens com idade mediana variando de 33,50 a 35,50. Nos 10 pacientes positivos para TEA, destacou-se a maior utilização de mecanismos de defesa de anulação e desvalorização, pertencentes ao fator neurótico e ao fator imaturo, respectivamente. Foram observadas associações positivas entre presença de sintomas de TEA do critério B do DSM-5 e os mecanismos de defesa do DSQ, sobretudo nos mecanismos de anulação, projeção, agressão passiva, acting out, fantasia autística, deslocamento e somatização. Conclusão: Pacientes com TEA utilizaram mais mecanismos de defesa do tipo anulação e desvalorização quando comparados aos pacientes sem diagnóstico de TEA. Ressalta-se a importância da detecção precoce de sintomas de TEA a fim de evitar outros agravos relacionados ao trauma, o que representa uma importante evolução em termos de saúde pública.

Transtornos relacionados a traumas e a estressores / Trauma and stressor-related disorders

Os Transtornos relacionados a traumas e a estressores são quadros psiquiátricos relacionados a exposi- ção a um evento traumático ou estressante, resultando em sofrimento psicológico relevante, prejuízo social, profissional e em outras áreas importantes da vida do indivíduo. A apresentação clínica de tais transtornos é caracterizada por sintomas de ansiedade e de medo, anedonia, disforia, externalizações da raiva, agressividade e sintomas dissociativos. De acordo com a 5ª edição do Manual Diagnóstico e Estatístico de Transtornos Mentais (DSM-5), as categorias diagnósticas inclusas nesse espectro são Transtorno de Apego Reativo, Transtorno de Interação Social Desinibida, Transtorno de Estresse PósTraumático, Transtorno de Estresse Agudo e os Transtornos de Adaptação. O objetivo desta revisão é introduzir o debate sobre a conceituação clínica e as diretrizes terapêuticas dos Transtornos Relacionados a Traumas e a Estressores, direcionando a escolha do profissional pelas práticas terapêuticas adequadas relacionadas a tais categorias diagnósticas. Além disso, os autores discutem as consequências do Estresse Precoce (situações traumáticas ocorridas na infância e adolescência) na vida adulta. (AU)

Trauma and Stressor-Related Disorders are psychiatric conditions related to exposure to a traumatic or stressful event, resulting in significant psychological distress social, professional and other relevant areas of the individual's life. The clinical presentation of these disorders is characterized by symptoms of anxiety and fear, anhedonia, dysphoria, externalizations of anger, aggressiveness and dissociative symptoms. According to the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the diagnostic categories included in this spectrum are Reactive Attachment Disorder, Disinhibited Social Engagement Disorder, Posttraumatic Stress Disorder, Acute Stress Disorder and Adjustment Disorders. The objective of this review is to introduce the debate on clinical conceptualization and therapeutic guidelines of Trauma and Stressor-Related Disorders, directing professional's choice for proper therapeutic practices related to such diagnostic categories. Also, the authors discuss the consequences of early life stress (traumatic situations that occur in childhood and adolescence) in adulthood. (AU)

Fatores associados ao bem-estar subjetivo de crianças e adolescentes em situação de rua / Factors associated with the subjective well-being of children and adolescents in street situation / Factores asociados con el bienestar subjetivo de los niños y adolescentes en situación de la calle

Buscou-se caracterizar o bem-estar subjetivo de crianças e adolescentes em situação de rua de três capitais brasileiras: Fortaleza, Porto Alegre e Salvador, verificando os fatores a ele associados (idade, sexo, eventos estressores e rede de apoio). Participaram 111 jovens (M=14,18 anos; DP=2,4), sendo a maioria (n=90; 81,1%) meninos. Utilizou-se o Inventário de Eventos Estressores, Mother dos Cinco Campos, Escala de Satisfação de Vida e Escalas de Afeto Positivo e Negativo. Os participantes avaliaram positivamente a satisfação de vida e relataram mais afetos positivos que negativos, embora tenham vivenciado eventos estressores. Satisfação de vida associou-se negativamente com idade e afetos negativos associaram-se positivamente ao impacto dos eventos estressores e negativamente ao fator de proximidade da rede de apoio. Discute-se que as adversidades não afetaram a expressão de afetos positivos e satisfação de vida, bem como a importância da rede de apoio para promoção de bem-estar.

This study aimed to characterize the subjective well-being of children and adolescents in street situation from: Fortaleza, Porto Alegre and Salvador, verifying the factors associated with it (age, gender, stressful events and support network). Participants were 111 young people (M=14.18 years, SD=2.4), the majority (n=90; 81.1%) were male. Stressful Events Inventory, the Five Field Map, Life Satisfaction Scale and Positive and Negative Affect Scale were used. Participants positively evaluated the life satisfaction and reported more positive emotions than negative, although they have often experienced the stressful events. There was a negative correlation between age and life satisfaction and negative affect was positively associated to the impact of stressful events and negatively to the proximity factor of the support network. We discuss that adversities do not affect the expression of positive affect and life satisfaction, and the importance of the support network for well-being promotion.

Este estudio tuvo como objetivo caracterizar el bienestar subjetivo de los niños y adolescentes que viven en la calle de tres ciudades de Brasil: Fortaleza, Porto Alegre y Salvador, la verificación de los factores asociados a el bienestar subjetivo (edad, sexo, eventos estresantes; red de apoyo) . Participaron 111 jóvenes (M=14,18 años, SD=2.4), la mayoría (n=90; 81,1%) eran de sexo masculino. Se utilizó el Inventario de Eventos Estresantes, Mother de Cinco Campos, Escala de Satisfacción con la Vida y Escala de Afecto Positivo y Negativo. Los participantes evaluaron positivamente la satisfacción con la vida y reportaron más emociones positivas que negativas, aunque a menudo han experimentado los eventos estresantes. Se observaron una correlación negativa entre la edad y la satisfacción con la vida y afecto negativo se asoció positivamente con el impacto de los eventos estresantes y negativamente con el factor de la proximidad de la red de apoyo. Se discute que las adversidades no afectan a la expresión de afecto positivo y satisfacción con la vida y la importancia de la red de apoyo para la promoción de bienestar.

Relationship between chronic psychosocial stress and BMI among adolescents / 中华流行病学杂志

Objective To evaluate the influence of chronic psychosocial stress on BMI in adolescents.Methods Physical examination and questionnaire survey were conducted among the students of junior grade 1 and senior grade 1 in 10 middle schools in Xuzhou in September 2011.Their body height and weight were measured at baseline survey and the self-report information about socio-demographic data,emotional symptoms (depressive symptoms,anxiety symptoms),and life style/behavior were collected from them.Chronic psychosocial stress was assessed with Multidimensional Life Events Rating Questionnaire (MLERQ),which consists of five items,stress of family life,school life,peer relation,gender relation and health growth.Results A total of 5 473 valid questionnaires were collected for analysis (2 841 from boys and 2 632 from girls).The follow-up measurement of body height and weight were conducted in September 20 13.A total of 4 316 students (2 171 boys,2 145 girls) were surveyed,and 1 157 students missed the follow up.The psychosocial stress score in the overweight and obese girls at baseline survey was positively associated with BMI-Z increase at follow up survey (P＜0.01).No such effect was observed among the boys at follow-up survey.Conclusion High level of chronic psychosocial stress could lead to BMI increase in overweight and obese girls,suggesting that female adolescents are susceptible population of psychosocial stress induced obesity.

TPH2 Variant rs7305115 and its Interaction with Acute Stressful Life Events in Etiology of Suicide Attempt in Serbian Psychiatric Patients.

Introduction: Suicide attempt (SA) is in the middle of continuum of complex suicidal behavior phenotype. Psychiatric disorders and acute stressful life events (SLEs) are triggers for suicidal behavior. Serotonin system genes are often implicated in suicidal behavior. Tryptophan hydroxylase 2 (TPH2), exclusively expressed in the brain, is the rate-limiting enzyme for serotonin biosynthesis. TPH2 may be enrolled in stress-response mechanisms via hypothalamic–pituitary–adrenal axis, while TPH2 variant rs7305115 has been reported to affect gene expression in postmortem human pons. To date, only poor examination of this variant in etiology of suicidal behavior has reported conflicting results. The aim of the present study was to assess rs7305115 main effect and its interaction with acute SLEs in SA pathology among Serbian psychiatric patients. Methods: 165 suicide attempters and 188 suicide non-attempters, suffering from major psychiatric disorders, participated in the study. Acute SLEs score was assessed using the List of Threatening Experiences Questionnaire. Variant rs7305115 was genotyped using TaqMan-based allelic discrimination assay. Statistical analyses were done in SNPstats by applying logistic regression adjusted by psychiatric diagnoses. Results: Variant rs7305115 was not associated with SA in Serbian psychiatric patients, neither alone, nor in combination with acute SLEs, for all five models of inheritance tested (P>0.05). Discussion: Our finding does not support the main and moderating implication of TPH2 variant rs7305115 in SA liability among Serbian psychiatric patients. Further examination in larger samples of this variant in SA patology is necessary due to its functional relevance.

Stress events and their relation with alcohol consumption in college students / Eventos estresantes y su relación con el consumo de alcohol en estudiantes universitarios / Eventos estressantes e sua relação com o consumo de álcool em estudantes universitários

En la investigación se tuvo como objetivo conocer la relación entre los eventos estresantesy el consumo de alcohol en estudiantes universitarios. Se desarrolló medianteun estudio descriptivo y correlacional. La población fueron estudiantes universitariosde una institución pública ubicada en el estado de Nuevo León, México. El muestreofue aleatorio estratificado con asignación proporcional al tamaño del estrato. Lamuestra fue de 220 estudiantes. Entre las técnicas utilizadas para la recolección deinformación se incluyó la aplicación de dos instrumentos que median las variableseventos estresantes y consumo de alcohol. Los resultados mostraron que la prevalenciadel consumo de alcohol fue mayor alguna vez en la vida (92,3 %) y en el últimoaño (83,6 %). La mayoría de los estudiantes presentan un consumo sensato de alcohol(48,9 %) seguido por el riesgoso (27,2 %). En esta población solo existen diferenciassignificativas respecto a la prevalencia del consumo de alcohol en la última semana poredad (U = 4391,50; p < 0,05). Así mismo, se observa que existen diferencias significativasentre hombres (39,3 %) y mujeres (24,1 %) en el consumo de alcohol en la últimasemana (χ2 = 5,86; p < 0,05). En general, los eventos estresantes y el consumo de alcoholse relacionan positiva y significativamente entre los estudiantes universitarios (rs =0,185; p < 0,05). Se puede concluir que existe relación significativa entre la presenciade eventos estresantes, en general, y el consumo de alcohol...

The objective of the research was to determine the relationship between the stressfulevents and alcohol consumption among university students. It was conducted usinga descriptive and correlational study. The analysis was performed among students ofa public university located in the state of Nuevo Leon, Mexico. It was a random sampling,stratified, and proportional to the size of the strata. The sample consisted of 220students. Among the techniques used for data collection we included the applicationof two instruments that measured the variables of: stressful events and alcohol consumption.The results showed that the prevalence of alcohol consumption was higheronce in life (92.3%) and in the last year (83.6%). Most of the students have a reasonablealcohol consumption (48.9%) followed by a much riskier one (27.2%). In this populationonly significant differences exist regarding the prevalence of alcohol consumptionin the last week, by age (U = 4391.50, p <0.05). It also reveals that significant differencesexist between men (39.3%) and women (24.1%) in the alcohol consumption in thelast week (χ2 = 5.86, p <0.05). In general, the stressful events and alcohol consumptionare related positively and significantly among university students (rs = 0.185, P <0.05).It can be concluded that there is a significant relationship between the stressful lifeevents, in general, and alcohol consumption...

A pesquisa teve como objetivo conhecer a relação entre os eventos estressantes e oconsumo de álcool em estudantes universitários. Foi desenvolvida mediante um estudodescritivo correlacional. A população foram estudantes universitários de umainstituição pública localizada no estado de Nuevo León, México. A mostra foi aleatóriaestratificada e proporcional ao tamanho do estrato. A mostra foi de 220 estudantes.Entre as técnicas utilizadas para a coleta de informação foram incluídas a aplicação dedois instrumentos que mediam as variáveis eventos estressantes e consumo de álcool.Os resultados mostraram que a prevalência do consumo de álcool foi maior algumavez na vida (92,3 %) e no último ano (83,6 %). A maioria dos estudantes apresenta umconsumo sensato de álcool (48,9 %) seguido pelo arriscado (27,2 %). Nesta populaçãosó existem diferenças significativas com respeito à prevalência do consumo de álcoolna última semana por idade (U = 4391,50; p < 0,05). Da mesma forma, observa-se queexistem diferenças significativas entre homens (39,3 %) e mulheres (24,1 %) no consumode álcool na última semana (χ2 = 5,86; p < 0,05). Em geral, os eventos estressantese o consumo de álcool se relacionam positiva e significativamente entre os estudantesuniversitários (rs = 0,185; p < 0,05). Pode-se concluir que existe uma relação significativaentre a presença de eventos estressantes, em geral, e o consumo de álcool...

Nível de stress em corredores de maratona amadores em período de pré-competição / Stress level in amateur marathon runners in pre-competition period

O stress é uma reação psicofisiológica que leva a um desequilíbrio no funcionamento global e comprometer a qualidade de vida e gerar danos à saúde. A atividade física é um dos pilares no combate ao stress, mas que em nível elevado e se competitivo, pode tornar-se um agente estressor. O objetivo foi avaliar o nível de stress em corredores de maratona amadores em período pré-competição e correlacionar com as variáveis sexo e faixa etária. Participaram 65 corredores amadores, 84% do sexo masculino, com idades entre 27 e 67 anos, que corriam há mais de um ano, com treinador físico e treinavam ao menos quatro vezes por semana. Utilizou-se o Inventário de Sintomas de Stress para adultos de Lipp (ISSL) e um Protocolo de Caracterização Sócio-Demográfica na avaliação. Os dados foram analisados por estatística descritiva e o teste de Qui-quadrado, com nível de significância de p≤0,05. Os resultados mostraram que apenas 9% apresentavam algum nível de stress, sendo todos do sexo masculino. Destes, 67% estavam na fase de resistência, com maior sintomatologia psicológica (83,3%). Não houve correlação significativa entre stress, sexo e faixa etária, p = 0,278 e p = 0,221, respectivamente. Ao se comparar com dados populacionais, o nível de stress observado neste estudo foi menor, isto sugere que não houve stress em período pré-competitivo em nível significativo, nem diferenças entre sexo ou faixa etária. Percebe-se que a corrida de rua, mesmo extenuante como a maratona, não demonstrou ser um fator que compromete a saúde psicológica do praticante. Considera-se que novos estudos envolvendo grupos populacionais maiores são necessários para a generalização dos resultados, bem como para proporcionar maior conhecimento sobre as possíveis variáveis que interferem no resultado da prova, como por exemplo, aspectos cognitivos e emocionais dos esportistas.

Stress is a psychophysiological reaction that leads to an imbalance in overall functioning and impair quality of life and create health hazards. Physical activity is one of the pillars in the fight against stress1, but at a high level and be competitive, can become an agent estressor2. The objective was to assess the level of stress in amateur marathon runners in pre-competition and correlate with the sex and age. 65 amateur runners participated, 84% male, aged between 27 and 67, who ran for over a year, with physical trainer and trained at least four times a week. We used the Inventory of Stress Symptoms for adults Lipp (ISSL) and a Memorandum of Socio-Demographic evaluation. Data were analyzed by descriptive statistics and chi-square, with a significance level of p ≤ 0.05. The results showed that only 9% had some level of stress, being all male. Of these, 67% were in the resistance phase, with greater psychological symptoms (83.3%). There was no significant correlation between stress, sex and age group, p = 0.278 and p = 0.221, respectively. When compared to population data, the level of stress observed in this study was lower, this suggests that there was no stress in pre-competitive level significant differences between sex or even age. It is noticed that the street race, even strenuous as the marathon, not shown to be a factor that affects the psychological health of the practitioner. It is considered that further studies involving larger populations are needed to generalize the results, as well as to provide greater insight into the possible variables that affect the test results, such as cognitive and emotional aspects of sports.

Predictors of relapse in the second follow-up year post cognitive-behavior therapy for panic disorder / Preditores de recaída no segundo ano após terapia cognitivo-comportamental para pacientes com transtorno de pânico

OBJECTIVE: To investigate predictors of relapse two years after a brief cognitive-behavior group therapy in patients with panic disorder who had failed to respond to pharmacologic treatment. METHOD: A total of 56 patients with panic disorder were followed who had met remission criteria at 1 year evaluation after 12 sessions of cognitive-behavior group therapy. Demographic and clinical features and life stressors were investigated as predictors of relapse. RESULTS: At the 2 year assessment, 39 (70 percent) patients maintained remission status and use of medication was reduced significantly, such that 36 (64 percent) patients were not undergoing any psychiatric treatment. Among all independent variables investigated, only "conflict" as a stressful life event, RR = 3.20 (CI95 percent 1.60; 7.20 - p = 0.001), and the severity or residual anxiety symptoms, RR = 3.60 for each scale point (CI95 percent 1.02; 1.08 - p < 0.001), emerged as nonredundant predictors. CONCLUSION: In spite of the high treatment gains across two years of follow-up, clinicians should pay attention to stress management and to the role of residual symptoms during this period. Results were discussed in the context of treatment cost-efficacy and potential strategies to prolong treatment gains from cognitive-behavior group therapy.

OBJETIVO: Investigar os preditores de recaída após dois anos de terapia cognitivo-comportamental em grupo breve para pacientes com transtorno do pânico que não responderam ao tratamento farmacológico. MÉTODO: Um total de 56 pacientes com transtorno do pânico que preencheram os critérios de remissão em um ano de avaliação após as 12 sessões da terapia cognitivo-comportamental em grupo foram acompanhados. As características demográficas, clínicas e os estressores de vida foram investigados como preditores de recaída. RESULTADOS: No segundo ano de avaliação, 39 (70 por cento) pacientes mantiveram-se em remissão e o uso de medicação reduziu significativamente, de tal forma que 36 (64 por cento) pacientes não estavam em tratamento psiquiátrico. Entre todas as variáveis independentes investigadas, somente o "conflito" como evento estressor de vida, RR = 3,20 (CI95 por cento 1,60; 7,20 - p = 0,001) e a gravidade ou os sintomas residuais de ansiedade, RR = 3,60 para cada ponto a mais da escala (CI95 por cento 1,02; 1,08 - p < 0,001), foram preditores de recaída. CONCLUSÃO: A despeito dos ganhos do tratamento através dos dois anos, os terapeutas devem manter-se atentos em relação ao manejo do estresse e no papel dos sintomas residuais de ansiedade durante este período. Os resultados são discutidos no contexto de custo-eficácia do tratamento e nas potenciais estratégias para prolongar os ganhos da terapia cognitivo-comportamental em grupo.

Problemas de saúde mental na adolescência: características familiares, eventos traumáticos e violência / Mental health problems in adolescence: family characteristics, traumatic events and violence

A ocorrência de situações traumáticas, exposição à violência e características das relações parentais são fatores de risco para saúde mental. Este estudo procurou identificar as situações individuais, familiares e contextuais associadas às manifestações de problemas de saúde mental em adolescentes estudantes da região metropolitana de Porto Alegre, RS. Os instrumentos utilizados foram o Inventário de Eventos Estressores na Adolescência, Triagem da Exposição de Crianças à Violência na Comunidade, Inventário de Estilos Parentais e o Child Behavior Checklist- versão YRF. Participaram 245 adolescentes, sendo 114 (46,5 por cento) do sexo masculino com idade média de 16,02 anos (DP=1,83). A análise dos dados realizou-se através de estatística descritiva e inferencial para estimar os determinantes do diagnóstico clínico. Situações de violência, práticas parentais negativas e eventos traumáticos associaram-se ao diagnóstico clínico. Aponta-se a necessidade de implantação de ações preventivas e de atenção em saúde mental na infância e adolescência.

The occurrence of traumatic events, exposure to violence and characteristics of parental relationship are risk factors associated to mental health. This study aimed to identify individual, family and contextual factors associated to the manifestation of mental health problems in a sample of adolescent students from the metropolitan region of the city of Porto Alegr e, RS. The instruments used were the Stressful Adolescence Events Inventory, Screening of Exposure to Community Violence, Parental Style Inventory and the Child Behavior Checklist- YRF version. Two hundred and forty five adolescents, of which 114 (46,5 percent) male, mean age 16,02 (DP=1,83) participated in the study. Data analysis was done through descriptive and inferential statistics to estimate the determinants of clinical diagnostics. Violence situations, negative parenting practices and traumatic events were associated to clinical diagnosis. It is appointed the need to implement preventive actions and intervention geared to child and adolescent mental health.

Apoio social, eventos estressantes e depressão em casos de tentativa de suicídio: um estudo de caso-controle realizado em um hospital de emergência do Rio de Janeiro. / Social support, stressful life events and depression in suicide attempts: a case-control study developed in an emergency hospital inRio de Janeiro, Brazil.

O objetivo deste estudo foi estimar a prevalência de eventos estressantes, suporte social e depressão e verificar a associação entre essas variáveis e as tentativas de suicídio atendidas em um hospital de emergência na cidade do Rio de Janeiro, durante o período de 2006 a 2007. Trata-se de um estudo de caso-controle (caso: n=59) (controle: n=118). Os instrumentos utilizados foram: questionário sociodemográfico, International Development Interview (CIDI), versão 2.1, para avaliação de depressão, Escala de Avaliação de Reajustamento Social e a Escala de Apoio Social (Medical Outcomes Study). Foi observada diferença estatisticamente significante entre casos e controles na prevalência de eventos estressantes, escassez de apoio social e depressão. Os casos e controles foram nível baixo de escolaridade (50,8 e 61,9%, respectivamente) e não - participação no mercado formal de trabalho (52,6 e 55,0%, respectivamente). Nossos achados sugerem que a prevenção das tentativas de suicídio precisa ser multissetorial, incluindo políticas e ações dirigidas a educação e emprego, além das medidas de intervenção e tratamento direcionadas aos transtornos mentais, como também suporte social.

The goal of this study was to estimate the prevalence of stressful life events, social support and depression, and to evaluate the association among these variables and suicide attempts seen in an emergency hospital in Rio de Janeiro, Brazil, between 2006 and 2007. This was a case-control study (case: n=59) (control: n=118) using the following instruments: a socio-demographic questionnaire, the International Development Interview (CIDI), version 2.1, for assessing depression; the Scale for Assessment of Social Readjustment, and the Social Support Scale (Medical Outcomes Study). There was a significant difference between cases and controls in the prevalence of stressful life events, absence of social support and depression. Cases and controls were low literacy proportions (50.8 and 61.9%, respectively) and informal workers (52.6 and 55.0%, respectively). Our findings suggest that suicide attempts prevention must be multidisciplinary. This includes educational and employment policies and actions, along with interventions on mental health care, as well as social support.

Eventos estressores e conduta social na adolescência / Stressful events and social conduct during adolescence

Este estudo tem como objetivo verificar a existência de relação entre a ocorrência de eventos estressores e a conduta social de adolescentes. Utilizando a Escala de Conduta Social e o Inventário de Eventos Estressores na Adolescência, buscou-se identificar, em uma amostra de 144 adolescentes, o comportamento predominante (antissocial, pró-social, desafio-oposição) e os tipos de eventos estressores mais frequentes e a intensidade percebida acerca dos eventos. A relação entre eventos estressores e conduta social foi verificada por meio do Teste-t e do Teste de Correlação de Pearson e as análises mostraram que determinadas vivências têm correlação significativa com a conduta social dos adolescentes. Os resultados indicaram média significativamente mais alta para o comportamento antissocial entre meninos. Dentre os eventos investigados, o "abuso psicológico" foi o mais frequente e o "abuso sexual" o de maior impacto. A ocorrência de "abuso psicológico" pode ser fator de risco para o desenvolvimento de "conduta antissocial".

This study aimed to verify the existence of the relationship between the occurrence of stressful life events and the social behavior of adolescents. Using the Social Behavior Scale and the Adolescent Stressful Life Events Inventory, this study sought to identify, in a sample of 144 adolescents, the predominant behavior (antisocial, prosocial, oppositional-defiant), the most frequent types of stressful events and their perceived intensity. The relation between stressful events and social conduct was verified by means of the t-Test and the Pearson Correlation Test, and the analyses showed that some experiences have a significant relation with the adolescents' social conduct. The results showed an average significantly higher for the antisocial behavior among boys. Among the investigated events, "psychological abuse" was the most frequent and "sexual abuse" was the one causing the biggest impact. The occurrence of "psychological abuse" may be a risk factor for the development of "antisocial behavior".

Psychometric Properties of the Life Events Checklist-Korean Version

OBJECTIVE: The Life Events Checklist is a brief screening instrument that is used for potentially traumatic events such as accidents, disasters, sexual or physical assaults, or combat-related exposures. The original English version was recently tested for reliability and validity and it showed good psychometric properties, and so its use is recommended for the assessment of trauma. METHODS: This study investigated the reliability and validity of a Life Events Checklist-Korean version in 157 consecutive psychiatric outpatients at a university-affiliated teaching hospital. The questionnaire also included the Impact of Events Scale-Revised (IES-R), the Beck Depression Inventory (BDI), and the State and Trait Anxiety Inventory (STAI). Correlation and principal component analyses were conducted. RESULTS: The four week test-retest reliability was good and the internal consistency was acceptable. In addition, the number of traumatic events was significantly correlated with the posttraumatic depressive and anxiety symptoms, which demonstrated the convergent validity of the scale. Additionally, exploratory factor analysis identified a six-factor structure that explained 57.2% of the total variance. CONCLUSION: These findings support the reliability and validity of the Life Events Checklist-Korean version.

Sintomas depressivos e eventos estressores em crianças e adolescentes no contexto de institucionalização / Depressive symptoms and stressful events in children and adolescents in the institutionalized context

INTRODUÇÃO: O presente estudo verificou a manifestação de sintomas depressivos e a freqüência e o impacto de eventos estressores em crianças e adolescentes institucionalizados e não-institucionalizados. MÉTODO: Participaram 257 jovens de 7 a 16 anos de ambos os sexos, sendo que 130 residiam em abrigos de proteção e 127 moravam com suas famílias na região metropolitana de Porto Alegre. Todos os participantes freqüentavam da 1ª à 8ª série do ensino fundamental de escolas públicas localizadas em bairros de baixas condições socioeconômicas. Foram aplicados os instrumentos Children's Depression Inventory e o Inventário de Eventos Estressores na Infância e Adolescência. RESULTADOS: Foram encontradas médias mais altas no Children's Depression Inventory e no Inventário de Eventos Estressores na Infância e Adolescência no grupo institucionalizado, com diferença significativa. Os eventos mais freqüentes foram "ter que obedecer às ordens de seus pais" para o grupo da família e "ser levado para um abrigo" no outro grupo. Os eventos que apresentaram maior impacto foram "morte de um dos pais", "ser estuprado", "ser rejeitado pelos familiares" e "ser tocado sexualmente contra a vontade". Foram encontradas diferenças entre os sexos e entre os contextos no impacto atribuído aos eventos. Os adolescentes, independentemente dos contextos, apresentaram freqüência de eventos significativamente maior do que as crianças, o que não ocorreu quanto ao impacto. CONCLUSÃO: Os jovens abrigados apresentaram maior exposição a situações potenciais de risco, o que pode estar relacionado à maior manifestação de sintomas depressivos. A avaliação do impacto de um evento estressante, no entanto, não esteve correlacionada com o Children's Depression Inventory em nenhum dos contextos.

INTRODUCTION: The present study examined the manifestation of depressive symptoms, as well as frequency and impact of stressful events in institutionalized and non-institutionalized children and adolescents. METHOD: A total of 257 youths, of both genders, aged 7-16 years were included in this study. Of these, 130 lived in protection youth shelters and 127 lived with their families in the metropolitan area of Porto Alegre. All participants were attending 1st to 8th grades of public elementary schools located in low-income neighborhoods. Children's Depression Inventory and Stressful Events in Childhood and Adolescence Inventory were used. RESULTS: Data pointed out a significant difference, with higher means in the Children's Depression Inventory and Stressful Events in Childhood and Adolescence Inventory for the institutionalized group. The most frequent events for the family group was "to have to obey your parent's rules," and "to be taken to a protection shelter" was most frequent for the other group. The events of greater impact were "death of one parent," "to be raped," "to be rejected by members of the family," and "to be sexually touched against one's will". Considering the participant's gender and context, differences were found in attributed impact. Adolescents, regardless of context, had a higher frequency of significant events than children, which did not occur concerning impact. CONCLUSION: Results indicated that institutionalized youths were more exposed to potential risk situations, which could be related to the manifestation of more depressive symptoms. However, assessment of the impact of a stressful event was not correlated with the Children's Depression Inventory in any context.

Moderating Role of Sense of Humor to the Relationship Between Stressful Events and Mental Health / 中国临床心理学杂志

Objective: To investigate moderating role of sense of humor to the relationship between stressful events and mental health. Methods: 836 middle-school students were investigated by MSHS, ASLEC and GHQ-20. Results: Sense of humor had a positive effect on students’ mental health, and strong humor could deduce the level of anxiety and depressed emotion. Sense of humor could buffer the relationship of stressful events and depression, but it could not adjust the relationship of stressful events with self-affirmation and anxiety. Conclusion: Sense of humor has a moderating effect on the stressful events and some aspects of mental health.

Analysis for Circumstantial Factors in Onset of Subarachnoid Hemorrhage

Seasonal and climatic variations have been linked to the occurrence of some types of cerebrovascular disease. However, the conditions that lead to intracranial aneurysm rupture are not known. The purpose of the present study was to determine whether predisposing factors are more related to intracranial aneurysm rupture and to determine relation of the stressful condition to intracranial aneurysm rupture. In order to determine the predisposing factors, the authors have examined the relationship between seasonal variation and predisposing factors of cerebral aneurysm. The author investigated activities of the patients and events as well as diurnal and seasonal variations in the onset of subarachnoid hemorrhage(SAH) in 336 consecutive patients. The results showed that the onset of SAH was associated with working in 11.0%, defecation and/or urination in 8.3%, sleeping in 6.9% and 4.2% walking. Hypertensive patients in aneurysmal rupture was 36.0%. Subarachnoid hemorrhage occurred during stressful events in 36.3% of the patients, during nonstreneous events in 34.8% and during rest or sleep in 9.8%. The activities or events preceding subarachnoid hemorrhage were not known in the remaining 18.8%. Men were more likely to have suffered their hemorrhages during stressful events than women(47% vs 30%). Peak times of intracranial aneurysm rupture usually occurred from 6 to 11 A.M.(36.0%) and from 4 to 6 P.M.(20.5%). The seasonal variation of the onset of SAH showed the incidence to be slightly higher in winter than in any other seasons. We concluded that the occurrence of subarachnoid hemorrhage display seasonal and diurnal variation. And the precipitation of aneurysmal rupture have two important factors; increased arterial blood pressure and decreased cerebrospinal fluid pressure around the aneurysm. Also, the onset of the subarachnoid hemorrhage is related to the physiological circadian periodicity of blood pressure, climatic change and stressful events.