Dental Fear/Anxiety in Children and Child Emotional and Behavioural Problems

ABSTRACT Objective: To investigate the association between emotional and behavioural problems and dental fear/anxiety (DFA) in children aged four to 12 years treated at a clinic in southern Brazil. Material and Methods: In this cross-sectional study where mother-child dyads were interviewed, emotional and behavioural problems were investigated using the Strengths and Difficulties Questionnaire (SDQ) (considering five subscales). Children's DFA was evaluated through the Venham Picture Test. For each SDQ subscale, Poisson regression model was explored. Prevalence ratios (PR) were estimated, considering a significant level of p ≤ 0.05. Results: Overall, 128 children participated in this study. Most children were female (54.7%) and aged between 7 and 9 years (39.8%). The prevalence of emotional problems was 47.7% and behavioural problems were 46.1%. The prevalence of DFA was 18.8%. Children with emotional problems had a 2.3 higher prevalence of DFA (95%CI 1.06-5.04). In general, behavioural problems were not associated with DFA (95%CI 0.84-3.34) only when conduct problems were considered (2.20; 95%CI 1.02-4.70). Conclusion: Children aged between 4 and 12 years who present emotional and conduct problems tend to show higher DFA.

Affective response of postmenopausal women to resistance training on stable and unstable surfaces: a randomized cross-over study / Respostas afetivas de mulheres pós-menopausadas submetidas ao treinamento com pesos em superfície estável e instável: um estudo cross-over randomizado

Objective: To compare the affective response of postmenopausal women who undergo 6 weeks of resistance training on stable and unstable surfaces. Methods: This randomized counterbalanced cross-over study carried included 14 postmenopausal women (55 [SD, 3] years; height 1.55 [SD, 0.03] m; body mass 78.70 [SD, 12.00] kg; and body mass index 32.80 [SD, 4.90] kg/m²), who underwent 6 weeks of resistance training on stable and unstable surfaces. The participants were initially allocated to 1 experimental condition (stable or unstable) in a randomized counterbalanced manner. The intervention consisted of 8 exercises in 3 series of 8-10 repetitions, with intervals of 60-90 seconds, for 3 weeks. After the first 3-week protocol, they were switched to the other experimental condition for another 3 weeks. To evaluate affective response, the Hardy and Rejeski Sensation Scale was applied weekly at the end of each exercise and again at the end of the 6 weeks. Results: Affective response was similar to the general affect observed at the end of the sessions (stable surface: 5.00 [3.00]; unstable surface: 5.00 [1.00]; p = 0.114), except for the bridge exercise (stable surface: 3.00 [2.00]; unstable surface: 4.00 [2.00]; p = 0.048]). Conclusions: The affective response of these women was not affected by training on unstable surfaces, except for the bridge exercise, in which the unstable surface increased affective response

Objetivo: Comparar as respostas afetivas de mulheres pós-menopausadas submetidas a seis semanas de treinamento com pesos realizado em superfície estável e instável. Metodologia: Trata-se de um estudo cross-over, randomizado e contrabalanceado realizado com 14 mulheres pós-menopausadas (55 ± 3 anos; estatura de 1,55 ± 0,03 m; massa corporal 78,70 ± 12,00 kg; e índice de massa corporal de 32,80 ± 4,90 kg/m²) submetidas a seis semanas de treinamento com pesos em superfície estável e instável. As participantes foram alocadas, inicialmente, numa das condições experimentais de forma randomizada e contrabalanceada. A intervenção foi composta por oito exercícios em três séries de oito a dez repetições, com intervalos entre 60 e 90 segundos, durante três semanas. Para avaliação das respostas afetivas, foi aplicada a Escala de Sensação de Hardy e Rejeski ao fim da última série de cada exercício e ao final das sessões, durante as seis semanas. Resultados: As respostas afetivas foram similares para o afeto geral observado ao final das sessões [Superfície estável: 5,00 (3,00); Superfície instável: 5,00 (1,00); p = 0,114], mas não para o exercício de ponte [Superfície estável: 3,00 (2,00); Superfície instável: 4,00 (2,00); p = 0,048)]. Conclusões: Conclui-se que as respostas afetivas de mulheres pós-menopausadas, observadas ao final da sessão, não foram afetas pela instabilidade. Contudo, as sensações de prazer, no exercício de ponte, foram maiores com a inserção da instabilidade

Research on burnout level of juvenile trampolinists and relevant affecting factors / Pesquisa sobre o nível de burnout de trampolinistas juvenis e fatores afetivos relevantes / Investigación sobre el nivel de burnout de los trampolinistas juveniles y los factores afectivos relevantes

ABSTRACT Introduction The paper investigates burnout causes and relevant affecting factors of juvenile trampolinists. Objective With 93 participants aged U10-16 of 2019 National Juvenile Trampoline Championship as investigation objects, to improve the current situation of juvenile burnout, exploring the methodology to alleviate and eliminate it, enhancing the sense of achievement in training and competition and providing a theoretical basis for coaches to train and cultivate athletes. Methods Questionnaire survey, semi-structured interview, mathematical statistics. Results The burnout level of the trampolinists is below the moderate level, and the overall burnout level of athletes is not high; the sense of achievement decrease> negative evaluation of sports>emotional/physical exhaustion; the correlation between the overall level of burnout of athletes and different genders, training age, education stage and athlete level is not significant; in terms of burnout, there are very significant positive correlations(P<0.01) between overload factor, personal factor, and situational factor, and emotional/physical exhaustion, sense of achievement decrease and negative evaluation of sports respectively. Conclusions Strengthen the communication with trampolinists, improve their self-regulation ability in various ways, master the methods to alleviate burnout, and increase social support for them. Level of evidence II; Therapeutic studies - investigation of treatment results.

RESUMO Introdução O artigo investiga as causas do burnout e os fatores que afetam os jovens trampolinistas. Objetivo Ter como objeto de pesquisa 93 participantes de U10-16 do Campeonato Nacional Juvenil de Trampolim 2019, para melhorar a situação atual do burnout juvenil, explorando a metodologia para amenizá-lo e eliminá-lo, potencializando a sensação de realização em treinamentos e competições e proporcionando uma base para os treinadores trabalharem com os atletas. Métodos Questionário de levantamento, entrevista semiestruturada, estatística matemática. Resultados O nível de burnout dos trampolinistas está abaixo do nível moderado e o nível geral de burnout dos atletas não é alto; diminuição da sensação de realização> avaliação negativa de esportes> burnout emocional/físico; a correlação entre o nível geral de burnout dos atletas e os diferentes gêneros, a idade de treinamento, o estágio educacional e o nível do atleta não é significativa; Em termos de burnout, existem correlações positivas altamente significativas (P <0,01) entre o fator de sobrecarga, o fator pessoal e o fator situacional, e burnout emocional/físico, a diminuição do senso de realização e a avaliação negativa dos esportes, respectivamente. Conclusões Fortalecer a comunicação com os trampolinistas, melhorar sua capacidade de autorregulação de várias maneiras, dominar os métodos para aliviar o burnout e aumentar o apoio social para eles. Nível de evidência II; Estudos terapêuticos: investigação dos resultados do tratamento.

RESUMEN Introducción El artículo investiga las causas del burnout y los factores que afectan a los trampolinistas juveniles. Objetivo Con 93 participantes de edades U10-16 del Campeonato Nacional Juvenil de Trampolín 2019 como objetos de investigación, mejorar la situación actual del burnout juvenil, explorando la metodología para aliviarlo y eliminarlo, potenciando el sentido de logro en entrenamientos y competencias y brindando un base para que los entrenadores trabajen con los atletas. Métodos Encuesta por cuestionario, entrevista semiestructurada, estadística matemática. Resultados El nivel de burnout de los trampolinistas está por debajo del nivel moderado y el nivel de burnout general de los atletas no es alto; disminución del sentido de logro> evaluación negativa de los deportes> burnout emocional / físico; la correlación entre el nivel general de burnout de los atletas y los diferentes géneros, la edad de entrenamiento, la etapa educativa y el nivel del atleta no es significativa; en términos de burnout, existen correlaciones positivas muy significativas (P <0,01) entre el factor de sobrecarga, el factor personal y el factor situacional, y el burnout emocional / físico, la disminución del sentido de logro y la evaluación negativa de los deportes, respectivamente. Conclusiones Fortalecer la comunicación con los trampolinistas, mejorar su capacidad de autorregulación de diversas formas, dominar los métodos para aliviar el burnout y aumentar el apoyo social a ellos. Nivel de evidencia II; Estudios terapéuticos: investigación de los resultados del tratamiento.

Estrategias de afrontamiento y alteraciones emocionales en pacientes con dolor crónico de la espalda: Cienfuegos 2020 (Cuba) / Coping strategies and emotional alterations in patients with chronic back pain. Cienfuegos 2020. (Cuba)

Introducción: El dolor crónico de la espalda forma parte de los síntomas que afectan la salud musculoesquelética. Las estrategias de afrontamiento van a determinar la experiencia del dolor actuando como mediador de las emociones. Objetivo General: Caracterizar las estrategias de afrontamiento y las alteraciones emocionales en pacientes con dolor crónico de la espalda, Cienfuegos 2020. Material y Método: Se realizó un estudio descriptivo, de serie de casos, en el Hospital Provincial Dr. Gustavo Aldereguía Lima de la provincia de Cienfuegos, Cuba, en los meses de septiembre de 2019 a enero de 2020. Se realizó un muestreo no probabilístico casual o a conveniencia de participantes voluntarios, con los pacientes que fueron atendidos en consulta de Ortopedia durante el periodo de investigación declarado. El análisis estadístico de la información se realizó en el paquete estadístico SPSS. Resultados: Se obtuvo un predominio de estrategias de afrontamiento pasivas, así como alteraciones emocionales donde predomina la ansiedad y la depresión en niveles moderado-alto, mientras que en la ira se obtuvieron valores inferiores. Conclusión: Las estrategias de afrontamiento utilizadas por los pacientes de estudio se caracterizan por ir dirigidas fundamentalmente a la modificación de las reacciones emocionales que genera el dolor, pero no a lograr una adaptación a las nuevas circunstancias impuestas por la enfermedad, ni a un control instrumental del mismo.

Introduction: Chronic back pain is one of the symptoms that affect musculoskeletal health. Coping strategies will determine the experience of pain acting as a mediator of emotions. General aim: To characterize coping strategies and the emotional alterations in patients with chronic back pain, Cienfuegos 2020. Material and method: It was carried out a descriptive study, series of cases, in the University Hospital "Dr. GustavoAldereguía Lima", Cienfuegos municipality, Cuba, from September, 2019 to January, of 2020. It was done a non-probabilistic sampling to convenience. The patients who were treated at the outpatient orthopedics consulting office and voluntarily accepted to participate in the study during the declared period of investigation were chosen. The statistical analysis of the information was carried out in the statistical package SPSS. Results: A prevalence of passive coping strategies was obtained, so much in the interview semiestructurada as in the Coping Reduced Questionnaire to the pain. Regarding the negatives emotional states prevailed the anxiety and depression in moderate-high levels, while in anger lower values were obtained. Conclusions: The most frequent coping strategies in the studied patients were the passive ones, aimed to regulate emotional states, but not to control pain.

El uso excesivo de pantallas está asociado con labilidad emocional en niños preescolares / Excessive screen time is associated with emotional lability in preschool children

Introducción. En estudios anteriores, el uso excesivo o la exposición temprana a pantallas se asoció con atención deficiente, falta de control de la conducta, retraso del lenguaje y déficit en la función ejecutiva. El objetivo de este estudio fue investigar la relación entre el tiempo de uso de pantallas y la regulación emocional, que afecta las relaciones sociales de los niños de 2 a 5 años.Población y métodos. Estudio descriptivo transversal en un hospital universitario del 1.º de enero al 1.º de marzo de 2018. Se incluyó a madres de niños sanos de 2 a 5 años con un uso de pantallas inferior a 1 hora o superior a 4 horas. A quienes aceptaron participar se les administró una encuesta estructurada y la Emotion Regulation Checklist para padres.Resultados. De los 240 niños participantes, 98 (el 40,8 %) tenían un uso de pantallas ≥ 4 horas. Ser cuidado por la madre, tener 12 meses o más durante la primera exposición y no estar acompañado por los padres al usarlas se asociaron con ≥ 4 horas de uso de pantallas (p = 0,002; p = 0,002; p = 0,012, respectivamente). La proporción de participantes con una puntuación alta de labilidad/negatividad (L/N) fue significativamente mayor entre los niños con ≥ 4 horas de uso de pantallas y que no estaban acompañados por sus padres al usarlas (p = 0,004; p = 0,033, respectivamente).Conclusiones. Este estudio determinó que un uso excesivo de pantallas se asocia con labilidad emocional durante esta etapa temprana de la infancia.

Introduction. Previous studies have found that excessive screen time or early screen exposure is associated with poor attention, lack of behavioral control, delayed language and deficit in executive functions. The aim of this study was to investigate the relationship between screen time and emotion regulation skills, which is one of the important life components affecting the social relations of children aged 2 to 5 years.Population and methods.This cross-sectional descriptive study was carried out in a university hospital between January 1, 2018 and March 1, 2018. Mothers of healthy children aged 2-5 years with a daily screen time of less than 1 hour or over 4 hours were included in the study. A structured survey and the Emotion Regulation Checklist for parents were applied to the mothers who agreed to participate.Results. Of 240 children participating in the study, 98 (40.8 %) had ≥4 hours of screen time. Caring by mother, age at first screen exposure 12 months and older, not co-viewing with parents were found to be associated with ≥ 4 hours of screen time (p = 0.002, p = 0.002, p = 0.012, respectively). The ratio of participants with high-lability/negativity (L/N) score was significantly higher in children with screen time of ≥ 4 hours and not co-viewing with parents (p = 0.004, p = 0.033, respectively).Conclusions. This study investigating the relationship between the emotion regulation skill and screen time revealed that excessive screen time is associated with emotional lability in this early childhood period.

Psychotic and affective symptoms of early-onset bipolar disorder: an observational study of patients in first manic episode

Objective: Presence of psychotic symptoms seems to be a commonplace in early-onset bipolar disorder (BD). However, few studies have examined their occurrence in adolescent-onset BD. We sought to investigate the frequency of affective and psychotic symptoms observed during the first manic episode in adolescents. Methods: Forty-nine adolescents with bipolar I disorder (DSM-IV criteria) were admitted to a psychiatric hospital during their first acute manic episode. Assessment for current psychiatric diagnosis was performed by direct clinical interview and the DSM-IV version of the Diagnostic Interview for Children and Adolescents (DICA). Results: Teenage inpatients with BD consistently exhibited typical manic features, such as euphoria, grandiosity, and psychomotor agitation. In addition, disorganization and psychotic symptoms were present in 82 and 55% of the total sample, respectively. There was no significant difference in symptoms between early- and late-adolescent subgroups. Remarkably, most patients (76%) reported previous depressive episode(s); of these, 47% had prominent psychotic features in the prior depressive period. Conclusion: These findings suggest that disorganization and psychotic symptoms during the first manic episode are salient features in adolescent-onset BD, and that psychotic depression frequently may precede psychotic mania. Nevertheless, differential diagnosis with schizophrenia should be routinely ruled out in cases of early-onset first psychotic episode.

Desarrollo afectivo-sexual en las personas con trastornos del espectro autista / Affective-sexual development in people with autistic spectrum disorders

Los trastornos del espectro autista (TEA) son trastornos del neurodesarrollo que afectan la comunicación social y que presentan patrones de conducta repetitiva, estereotipada o/y inflexible. Un tercio de los casos diagnosticados de TEA tienen discapacidad intelectual y 2/3 una capacidad intelectual dentro de la norma. Los síntomas nucleares de autismo y otros asociados pueden afectar el desarrollo afectivo-sexual. En este artículo se expone qué dificultades en el desarrollo afectivo-sexual pueden presentar las personas con TEA y cuáles son las más frecuentemente descritas. Se propone de una manera breve, guías dirigidas a la evaluación y a la ayuda para un desarrollo afectivo-sexual satisfactorio en las personas con autismo-TEA.

Autistic spectrum disorders (ASD) are neurodevelopmental disorders that affect social communication and present repetitive, stereotyped and inflexible behaviour. A third of the people with a diagnosis of ASD also have intellectual disability associated and two thirds present an intellectual capacity within the average range. The nuclear autistic and others associated symptoms can affect the affective and sexual development. This article exposes which are the problems people with ASD present in the affective and sexual development, the most frequently described and brief guides for evaluation and support for an adequate affective-sexual development in people with ASD.

Emotional repercussions and quality of life in children and adolescents undergoing hemodialysis or after kidney transplantation / Repercussões emocionais e qualidade de vida das crianças e adolescentes em hemodiálise ou após transplante renal

ABSTRACT Objective: To investigate the emotional repercussions and quality of life (QOL) associated with end-stage kidney disease (ESKD) in children and adolescents undergoing hemodialysis or a kidney transplant (TX). Methods: We conducted a quantitative-qualitative study. 48 children and adolescents with ESKD were interviewed; half of them underwent hemodialysis treatment, and the other half had a kidney transplantation. Their respective 48 caregivers also participated in the study. The questionnaire involved both the Pediatric Quality of Life Inventory and a thematic story-drawing tool. An analysis of the QOL questionnaire's results was done by comparing the sum of points between groups and the theme-based story-drawing consisted of interpreting the data contained in the material using Freudian and Lacanian theories. Results: In the QOL questionnaires, the total score was higher in the transplanted patients and in their caregivers, suggesting a perception of better QOL after kidney transplantation. In the specific aspects of the questionnaire, physical capacity was considered superior by children who underwent transplants and their caregivers. There were no differences between the groups in the emotional, social and school aspects. However, the caregivers of the patients who had a transplant perceived a significant difference in QOL in the school aspect. In the thematic story-drawings, emotional suffering in the two analyzed groups was evidenced regardless of the treatment. Conclusions: Despite the questionnaire results suggesting that transplantation does improve some aspects of QOL, there were no differences observed between kidney replacement therapies regarding the emotional repercussion of chronic kidney disease.

RESUMO Objetivo: Investigar as repercussões emocionais e a qualidade de vida (QV) associadas à doença renal crônica em crianças e adolescentes submetidos à hemodiálise ou ao transplante renal. Métodos: Foram entrevistadas 48 crianças e adolescentes com doença renal crônica, metade dos quais submetidos ao tratamento hemodialítico, e a outra metade, ao transplante renal. Os 48 respectivos cuidadores também participaram da pesquisa. Utilizou-se o questionário de QV Pediatric Quality of Life Inventory e o instrumento de desenho-estória com tema. A análise dos resultados do questionário de QV foi feita pela somatória dos pontos e a dos desenhos-estórias com tema consistiu na interpretação dos dados do material, utilizando as teorias freudiana e lacaniana. Resultados: Nos questionários de QV, a pontuação total foi superior na opinião dos pacientes transplantados e seus cuidadores, indicando percepção de melhor QV após o transplante renal. Nos aspectos específicos, a capacidade física também foi considerada superior por esse grupo. Não houve diferenças entre os grupos de pacientes nos aspectos emocional, social e escolar, porém os cuidadores dos pacientes transplantados notaram diferença na QV no aspecto escolar. Nos desenhos-estórias com tema, observou-se que o sofrimento emocional foi evidenciado nos dois grupos estudados. Conclusões: Não foram percebidas diferenças entre as terapêuticas renais substitutivas quanto às repercussões emocionais da doença renal crônica. Por outro lado, verificou-se que o transplante melhora a QV no aspecto geral.

Evaluation of affective temperament and anxiety-depression levels in fibromyalgia patients: a pilot study

Objective: Fibromyalgia (FM) patients have higher rates of depression and anxiety disorders than healthy controls. Affective temperament features are subclinical manifestations of mood disorders. Our aim was to evaluate the affective temperaments of FM patients and investigate their association with depression and anxiety levels and clinical findings. Methods: This cross-sectional study included FM patients and healthy controls. The Hospital Anxiety and Depression Scale (HADS) was used to determine patient anxiety and depression levels, and the Temperament Scale of Memphis, Pisa and San Diego, self-administered version was applied to assess affective temperaments in all subjects. Disease severity was assessed in FM patients with the Fibromyalgia Criteria and Severity Scales and the Fibromyalgia Impact Questionnaire (FIQ). Differences between groups were evaluated using Student's t-tests. Correlations among parameters were performed. Results: This study involved 38 patients with FM (30 female) and 30 healthy controls (25 female). Depressive, anxious and cyclothymic temperaments were significantly higher in FM patients than healthy controls. Statistically significant positive correlations were found between HADS depression score and all temperaments except hyperthymic, as well as between HADS anxiety score and cyclothymic and anxious temperaments. HADS depression and anxiety scores were correlated with symptom severity. We found a higher risk of depression and anxiety among FM patients with higher FIQ scores. Conclusion: This study is the first to evaluate affective temperament features of FM patients. Evaluating temperamental traits in FM patients may help clinicians determine which patients are at risk for depression and anxiety disorders.

Emotional and behavioral problems: a school-based study in southern Brazil / Problemas emocionais e comportamentais: um estudo de base escolar no sul do Brasil

Abstract Introduction Mental health assessment in childhood needs to be carried out within a broader context that includes different factors. Objective To assess the prevalence of emotional and behavioral problems in schoolchildren and associated factors. Method A cross-sectional study was conducted with a school-based sample at 20 schools selected by systematic random sampling. Participants consisted of children aged 7-8 year old and their parents or primary caregivers. The Strengths and Difficulties Questionnaire (SDQ) was used to screen for the presence of emotional and behavioral problems in children. Results A total of 596 dyads were evaluated. The prevalence of emotional and behavioral problems was 30.0% among boys and 28.2% among girls. Hyperactivity/inattention were more prevalent among boys (p=0.015). Belonging to economically disadvantaged strata increased the likelihood of emotional and behavioral problems among schoolchildren by 71% (p=0.001), while having parents or caregivers with mental disorder increased by 2.2 times that probability (p<0.001). Conclusion: Our findings showed a high prevalence of emotional and behavioral problems among schoolchildren, as well as the influence of economic conditions and of the mental health of parents and caregivers on child mental health.

Resumo Introdução A avaliação da saúde mental na infância necessita ser realizada dentro de um contexto amplo que considere os diferentes fatores envolvidos. Objetivo Verificar a prevalência de problemas emocionais e comportamentais em escolares, bem como fatores associados. Método Estudo transversal, com amostra de base escolar em que foram selecionadas 20 escolas por amostragem aleatória sistemática. Participaram crianças com 7-8 anos e seus pais ou principais cuidadores. A presença de problemas emocionais e comportamentais nas crianças foi rastreada pelo Strengths and Difficulties Questionnaire (SDQ). Resultados Foram avaliadas 596 díades. A prevalência de problemas emocionais e comportamentais foi de 30,0% entre os meninos e 28,2% entre as meninas. Sintomas de hiperatividade/desatenção foram mais prevalentes entre meninos (p=0,015). Pertencer a camadas menos favorecidas economicamente aumentou em 71% a probabilidade de problemas emocionais e comportamentais entre os escolares (p=0,001), enquanto ter pais ou cuidadores com transtorno mental aumentou 2,2 vezes tal probabilidade (p<0,001). Conclusões: Nossos achados demonstram a elevada prevalência de problemas emocionais e comportamentais entre escolares, bem como a influência das condições econômicas e da saúde mental de pais e cuidadores sobre a saúde mental infantil.

Emotion regulation as the mediator of reductions in anxiety and depression in the Unified Protocol (UP) for transdiagnostic treatment of emotional disorders: double-blind randomized clinical trial / Regulação emocional como mediadora de reduções em ansiedade e depressão no Protocolo Unificado para o tratamento transdiagnóstico de transtornos psicológicos: ensaio clínico randomizado duplo-cego

Abstract Objective: An important subject in evaluation of the efficacy of treatments is to examine how the intervention is effective and to identify the consequences of that treatment. In this regard, the current study investigates the role of emotion regulation as the mediator of the treatment outcomes of therapy using the Unified Protocol (UP) for transdiagnostic treatment of emotional disorders. Method: This article describes a double-blind randomized clinical trial. A sample of 26 individuals was selected based on cut-off scores for the Beck Depression Inventory and Beck Anxiety Inventory and their final diagnoses were confirmed with the Anxiety Disorders Interview Schedule for DSM-IV (ADIS-IV). The sample was randomly divided into two groups: control and treatment (13 patients each). The treatment group received 20 one-hour UP sessions. The Beck Depression Inventory, the Beck Anxiety Inventory, and the Difficulties in Emotion Regulation Scale were administered at two stages, pre-treatment and post-treatment. Results: The UP reduced anxiety and depression in patients through improvement in emotion regulation. Furthermore, the results showed that the difficulty engaging in goal-directed behavior and non-acceptance of emotional response subscales were capable of predicting 62% of variance in anxiety scores. In turn, two subscales, difficulty engaging in goal-directed behavior and lack of emotional clarity, predicted 72% of variance in depression scores. Conclusion: Emotion regulation can be considered as a potential mediating factor and as predictive of outcomes of transdiagnostic treatment based on the UP. Clinical trial registration: Iranian Registry of Clinical Trials, IRCT2017072335245N1.

Resumo Objetivo: É importante, na avaliação da eficácia de tratamentos, examinar como a intervenção tem efeito e identificar suas consequências. O presente estudo investiga o papel da regulação emocional enquanto mediadora de desfechos do tratamento que emprega o Protocolo Unificado (PU) para o tratamento transdiagnóstico de transtornos psicológicos. Método: Este artigo descreve um ensaio clínico randomizado duplo-cego. Uma amostra de 26 indivíduos foi selecionada com base em escores pré-estabelecidos para o Inventário de Depressão de Beck e o Inventário de Ansiedade de Beck, e seus diagnósticos finais foram confirmados utilizando o instrumento Anxiety Disorders Interview Schedule for DSM-IV (ADIS-IV). A amostra foi dividida aleatoriamente em dois grupos: controle e tratamento (13 pacientes em cada). O grupo tratamento recebeu 20 sessões de PU de 1 hora cada. O Inventário de Depressão de Beck, Inventário de Ansiedade de Beck Beck e Escala de Dificuldades de Regulação Emocional foram administrados em duas etapas, antes e depois do tratamento. Resultados: O PU reduziu a ansiedade e a depressão em pacientes, ao melhorar a regulação emocional. Além disso, os resultados mostraram que as subescalas dificuldade de se engajar em comportamentos orientados por objetivos e não aceitação de resposta emocional responderam por 62% da variância nos escores de ansiedade. Nos escores de depressão, duas subescalas, dificuldade de se engajar em comportamentos orientados por objetivos e falta de claridade emocional, explicaram 72% da variância. Conclusão: A regulação emocional pode ser considerada o principal fator mediador e também preditora de desfechos do tratamento transdiagnóstico baseado no PU. Registro do ensaio clínico: Iranian Registry of Clinical Trials, IRCT2017072335245N1.

Bloqueio no desenvolvimento emocional: diálogo entre as concepções de couraça e falso self / Bloqueo en el desarrollo emocional: el diálogo entre las concepciones del coraza y falso self / Blockage on emotional development: dialogue between the concepts of armor and false self

Ao longo da literatura psicanalítica, observamos casos em que o analista encontra dificuldade ao lidar com certos tipos de pacientes, estes que apresentam pouca melhora sem um manejo especial. Baseando-se nisso, consideramos que Donald Winnicott e Wilhelm Reich trazem importantes contribuições para o tema, principalmente quando introduzem os conceitos de falso self e couraça. Nosso objetivo, portanto, delineia-se em estabelecer um breve diálogo entre estes conceitos, destacando algumas aproximações e distanciamentos. A metodologia de pesquisa se faz por meio do levantamento bibliográfico, sendo de natureza qualitativa e histórica. Ao final do trabalho, concluímos que os conceitos de couraça e falso self mais se aproximam do que se distanciam, na medida em que dizem respeito ao bloqueio emocional, da motilidade, da agressividade e da espontaneidade (AU).

Throughout the psychoanalytic literature, we observe cases where the analyst finds difficulty to deal with some kind of patients, those who do not present a significant improvement without a special handling. Based on this, we consider that Donald Winnicott and Wilhelm Reich bring important contributions to the theme, especially when they introduce the concepts of false self and armor. Our objective, therefore, is to establish a short dialogue between these concepts, emphasizing some approximations and distinctions. The research methodology is done through a bibliographic survey, being of qualitative and historical nature. At the end of the work, we concluded that the concepts of armor and false self are more similar than they are different in relation to emotional, motility, aggressiveness and spontaneity blockage (AU).

A lo largo de la literatura psicoanalítica, hemos observado casos en los que al analista le resulta difícil trabajar con ciertos tipos de pacientes, estos que tienen poca mejora sin tratamiento especial. En base a esto, creemos que Donald Winnicott y Wilhelm Reich traen importantes contribuciones al tema, principalmente cuando introducen los conceptos de falso self y coraza. Nuestro objetivo, por tanto, se delinea en establecer un breve diálogo entre estos conceptos, destacando algunas aproximaciones y distanciamientos. La metodología de investigación se produce por medio del levantamiento bibliográfico, siendo de naturaleza cualitativa e histórica. Al final del trabajo, nosotros concluimos que los conceptos de coraza y falso self están más cerca que distantes en lo que se refiere al bloqueo emocional, la motilidad, la agresividad y la espontaneidad (AU).

Contexto familiar de niños con autismo: Implicaciones en el desarrollo social y emocional / Family context of children with autism. Implications for emotional and social development

Las familias de niños con trastorno del espectro del autismo (TEA) pueden diferenciarse en función de indicadores sociodemográficos y del clima familiar caracterizado por el nivel de estrés parental, el uso de estrategias de afrontamiento y la búsqueda de apoyo social. El objetivo de este estudio fue analizar las diferencias conductuales, emocionales y sociales de niños con TEA en relación con distintas tipologías de familias caracterizadas en función de los factores de riesgo como de riesgo alto, moderado y bajo. Los participantes fueron 52 madres y sus hijos de entre 7 y 11 años, con TEA sin discapacidad intelectual, que aportaron información del desarrollo socioemocional de los hijos mediante el Cuestionario de Cualidades y Dificultades, que valora síntomas emocionales, problemas de conducta, hiperactividad/ problemas de atención, problemas de relación con los compañeros y conducta prosocial. Los análisis de comparación entre grupos que se llevaron a cabo, indicaron que los niños con familias de riesgo alto mostraron puntuaciones significativamente más bajas en conductas prosociales y experimentaron un nivel significativamente superior de problemas emocionales que los niños de las familias del grupo de bajo riesgo. Por consiguiente, los resultados mostraron la relación que tiene el contexto familiar con el desarrollo socioemocional de niños con TEA. Subrayan asimismo la importancia del asesoramiento a las familias para potenciar las habilidades de regulación emocional y las conductas prosociales, debido a su impacto en la adaptación social a largo plazo.

Families of children with autism spectrum disorder (ASD) can be differentiated according to socio-demographics and environmental risk factors characterized by stress parental, the use of coping strategies and social support. The aim of this study was to analyze the behavioral, emotional and social manifestations of children with ASD, related to different types of families characterized according risk factors as families with "high risk", with "moderated risk" and with "low risk". Participants were 52 mothers and their children between 7 and 11 years old with ASD without intellectual disability. All mothers provided information about children's behavior through the Strengths and Difficulties Questionnaire, which includes the following scales: emotional symptoms, behavioral problems, hyperactivity/inattention, peer problems and prosocial behavior. Comparisons analysis showed that children belonging to the high family risk group exhibited less prosocial behaviors and a higher level of emotional problems compared to the low risk group. The findings from the present study illustrate the importance of considering the characteristics of entire family system in the emotional and social development of children with ASD. The role of family counseling to enhance emotional regulation skills and prosocial behaviors is underlined due to their impact on long-term social adjustment.

Solidão como variável preditora na depressão em adultos / Loneliness as a predictive variable in adult depression / Soledad como variable predictora en la depressión en adultos

Depressão é um transtorno multifatorial, de alta prevalência, considerada um problema de saúde pública mundial. Diversas são as variáveis implicadas no desenvolvimento e manutenção deste transtorno, como as psicológicas, sociais e biológicas. O objetivo desta pesquisa foi avaliar a solidão como fator preditivo na depressão em adultos, após controle de outros preditores tais como ansiedade, estresse, neuroticismo e variáveis clínicas. A amostra foi composta de 297 universitários de Minas Gerais, São Paulo e Rio de Janeiro. As escalas utilizadas foram a EBADEP-A, DASS-21, UCLA, MHI-5 e IGFP-5. Após regressão múltipla hierárquica, os resultados demonstraram que a saúde mental, neuroticismo, ansiedade e solidão foram os principais preditores, sendo que a solidão, após controle de todas as variáveis, acresceu 1% de variância isolada no modelo e demonstrou ser uma das variáveis mais importantes relacionadas à depressão. A avaliação clínica e intervenções devem levar em consideração esta variável na prática clínica.

Depression is a multifactorial and high prevalence disorder considered a global public health problem. There are several variables involved in the development and maintenance of this disorder, including psychological, social and biological ones. The objective of this research was to evaluate loneliness as a predictive factor in adult depression, after controlling other predictors such as anxiety, stress, neuroticism and clinical variables. The sample consisted of 297 university students from Minas Gerais, São Paulo and Rio de Janeiro. The scales used were EBADEP-A, DASS-21, UCLA, MHI-5 and IGFP-5. After multiple hierarchical regression, the results showed that mental health, neuroticism, anxiety and loneliness were the main predictors. Loneliness, after controlling for all variables, increased 1% of exclusive variance in the model and was one of the most relevant predictors of depression. Clinical evaluation and interventions should consider loneliness in clinical practice.

La depresión es un trastorno multifactorial, de alta prevalencia, considerado un problema de salud pública mundial. Diversas son las variables implicadas en el desarrollo y mantenimiento de este trastorno, entre ellos psicológicos, sociales y biológicos. El objetivo de esta investigación fue evaluar la soledad como factor predictivo en la depresión en adultos, tras el control de otros predictores tales como ansiedad, estrés, neuroticismo y variables clínicas. La muestra fue compuesta de 297 universitarios de Minas Gerais, São Paulo y Río de Janeiro. Las escalas utilizadas fueron la EBADEP-A, DASS-21, UCLA, MHI-5 e IGFP-5. Después de la regresión múltiple jerárquica, los resultados demostraron que la salud mental, el neuroticismo, la preocupación y la soledad eran los preditores principales, y la soledad, después del control de todas las variables, aumentó un 1% de varianza aislada en el modelo y demostró ser una de las variables más importantes relacionadas con la depresión. La evaluación clínica e intervenciones deben tener en cuenta esta variable en la práctica clínica.

Psychopathology and alexithymia in patients with psoriasis

Abstract: Background: Psoriasis is a chronic, inflammatory, relapsing skin disease that has a psychosocial impact on the patients' life. Objective: This study aimed to investigate psychopathology in patients with psoriasis based on a valid psychometric instrument, as well as on the relationship between psychopathology and alexithymia. Methods: 108 patients with psoriasis were included in the study. Psychopathology was evaluated with the Symptom Checklist-90-Revised (SCL-90-R) and alexithymia with the Toronto Alexithymia Scale (TAS-20). Disease severity was clinically assessed using the Psoriasis Area and Severity Index. Results: As regards the psychopathological dimensions, female patients presented with statistically significant higher somatization, depression, anxiety, phobic anxiety, and psychoticism than males. Patients with alexithymia presented with statistically significant higher somatization, interpersonal sensitivity, anxiety, and phobic anxiety than non-alexithymic patients. Alexithymia positively correlated with somatization (r = 0.26, p < 0.01), interpersonal sensitivity (r = 0.24, p < 0.05), depression (r = 0.27, p < 0.01), anxiety (r = 0.26, p < 0.01), and phobic anxiety (r = 0.26, p < 0.01). In addition, alexithymia also contributed to the prediction of these conditions. Study Limitations: A larger study sample could yield safer generalized results. Nevertheless, to the best of our knowledge, this was the first study to investigate various psychopathological dimensions in patients with psoriasis. Conclusions: Our study results indicate that alexithymia and female sex were associated with several psychopathological dimensions in patients with psoriasis. It may be suggested that alexithymia constitutes an important factor in the development of mental disorders among patients with psoriasis.

Relación entre estados emocionales y variables clínicas en pacientes con dolor crónico lumbar / Connection between emotional states and clinical variables in patient with chronic lumbar pain

Introducción: el dolor lumbar crónico es una de las causas de sufrimiento en el mundo, y las emociones influyen en la respuesta del individuo ante la enfermedad. Objetivo: relacionar los estados emocionales de ansiedad, depresión e ira en pacientes con dolor crónico lumbar con algunas variables clínicas (tiempo de evolución, intensidad y persistencia). Métodos: estudio observacional, descriptivo-correlacional, policlínico de Cartagena, entre septiembre de 2012 y abril de 2013. Universo: 30 pacientes, muestra: 25 pacientes escogidos por muestreo intencional. Técnicas empleadas: entrevista estructurada, escala analógica visual, Idare, Staxi-2, Inventario de Beck. Resultados: distinguen como variables identificativas el sexo masculino y la configuración del vínculo de pareja (84 por ciento), ocupación: trabajadores (76 por ciento), la edad: adultos jóvenes (52 por ciento), con niveles medios de escolaridad (40 por ciento). En las variables clínicas predominó tiempo de evolución de 13 a 24 meses (56 por ciento), con una intensidad leve del dolor (48 por ciento) y persistencia intermitente (84 por ciento). Los estados emocionales mostraron porcentajes medios de ansiedad estado (60 por ciento), altos de ansiedad rasgo (56 por ciento), niveles de depresión moderados (40 por ciento), nulos de ira estado, moderados como rasgo (48 por ciento), y expresiones elevadas de esta (52 por ciento). Conclusiones: la presencia de porcentajes altos de sintomatología ansiosa, depresión e ira manifiestas en la muestra estudiada se asemejó a lo descrito en la literatura. La ansiedad e ira como rasgo de la personalidad no guardó relación con las variables clínicas estudiadas, se hallaron asociaciones entre intensidad y persistencia del dolor con la depresión y ansiedad e ira como estado y entre tiempo de evolución de la enfermedad y la ira estado(AU)

Introduction: Chronic lumbar pain is one of the suffering causes worldwide, and emotions influence the individual's response to the disease. Objective: To relate the emotional states of anxiety, depression and anger in patients with chronic lumbar pain with some clinical variables (time of evolution, intensity and persistence). Methods: Observational, descriptive-correlational study at Cartagena Polyclinic between September 2012 and April 2013. Universe: 30 patients, sample: 25 patients, selected by intentional sampling. Techniques employed: structured interview, visual analogue scale, Idare, Staxi-2, Beck Inventory. Results: Male sex and engagement configuration (84 percent) appear as identification variables, occupation: workers (76 percent), age: young adults (52 percent), mean schooling (40 percent) were identified as identification. The clinical variables predominated in the evolution period from 13 to 24 months (56 percent), with mild pain intensity (48 percent) and intermittent persistence (84 percent). Emotional states showed average percentages of state anxiety (60 percent), high trait anxiety (56 percent), moderate depression (40 percent), and mild anger status, moderate as trait (48 percent), (52 percent). Conclusions: The presence of high percentages of anxious symptoms, depression and anger manifested in the sample studied was similar to that described in the literature. Anxiety and anger as a personality trait was not related to the clinical variables studied, associations were found between intensity and persistence of pain with depression and anxiety and anger as a state and between time evolution of disease and anger state(AU)

Mediator role of experiential avoidance in relationship of perceived stress and alexithymia with mental health

This cross-sectional study investigated the mediatory role of experiential avoidance in the relationship between perceived stress and alexithymia with mental health. We enrolled 440 students [age 18-30 years] at Kermanshah University of Medical Sciences through stratified random sampling method. The study tools were demographic checklist, GHQ-28, Toronto Alexithymia Scale-20 and Perceived Stress Scale. Data were analysed by SPSS-18 and AMOS-18 using Pearson correlation, hierarchical regression analysis and structural equation modelling [SEM]. There was a significant positive correlation between perceived stress and experiential avoidance, and alexithymia and mental health problems [P < 0.001]. SEM showed that the relationship between perceived stress and mental health problems by experiential avoidance was 0.19 [[beta = 0.19; standard error [SE] = 0.09; P = 0.001], and the relationship between alexithymia and mental health problems through experiential avoidance was 0.09 [beta = 0.09; SE = 0.43; P = 0.01]. The mediatory role of experiential avoidance was confirmed in such a way that the effects of alexithymia and perceived stress decreased

Enfoque psicológico del estilo de vida de los adultos medios diabéticos tipo II / Psychologic approach of the lifestyle of average adults with type 2 diabetes

Introducción: la Diabetes Mellitus es considerada por la Organización Mundial de la Salud la pandemia de las enfermedades conductuales, por su estrecha y directa relación con los estilos de vida desarrollados durante la vida. Objetivo: determinar el vínculo entre el estilo de vida, algunos recursos personológicos relevantes y los estados emocionales en los enfermos de Diabetes Mellitus tipo II. Métodos: estudio de serie de casos en el consultorio 15 perteneciente al Área de salud III, Cienfuegos, 2013. Población: 20 pacientes en el rango de edad de 40-59. Instrumentos: entrevista, Guía para estilo de vida, Inventario de Ansiedad (IDARE) y Test de Zung. Procesamiento: SSPS. Presentación de los resultados: frecuencias absolutas y relativas. Resultados: más de la mitad eran mujeres, edad media 52 años, nivel medio de escolarización, trabajadores y con vínculo de pareja. Comorbilidad: Hipertensión arterial. Se halló convergencia entre la adherencia terapéutica y el autocuidado; ninguno tiene estilos de vida saludables, áreas más afectadas: condición física, hábitos alimentarios y relaciones sexuales. Los diabéticos con estilos de vida no saludables utilizan con menor frecuencia los recursos de: satisfacción consigo mismo, firmeza, perseverancia en la toma de decisiones y autocontrol de las emociones. Predominó la ansiedad alta y media como estado y como rasgo y moderada distimia depresiva. Conclusiones: se evidencia el intervínculo entre el estilo de vida no saludable con los estados emocionales negativos como estado y como rasgo con los recursos personológicos no dirigidos al manejo adecuado ante la enfermedad(AU)

Introduction: Diabetes Mellitus is considered by WHO as the pandemic of behavioral diseases due to its close and direct relationship with lifestyles. Objective: to determine the link between lifestyle, some relevant personological resources and emotional states in adult patients with Type II Diabetes Mellitus. Methods: study of case series from Consulting Office 15, belonging to the Area of ​​Health III, Cienfuegos, 2013. Population: 20 persons: all the patients in the age range of 40-59. Instruments: Interview, Guide for Lifestyle, Anxiety Inventory (STAI) and Zung Test. Processing: SSPS. Presentation of results: absolute numbers and frequencies. Results: Sex: more than half are women; average age 52; average level of schooling, workers and couples. Comorbidity: Arterial hypertension. The longer the history of the illness, the higher the comorbidity. Convergence between therapy adherence and self-care was found; Lifestyle: none have healthy lifestyles. Most affected areas: physical fitness, eating habits and sex. Personological resources; Patients with unhealthy life styles used less frequently resources as satisfaction with themselves. With poor firmness and perseverance in decision making and in self-control of emotions. Emotions: predominance of middle and high anxiety as a condition and as a trait and moderate depressive dysthymia in patients with unhealthy life styles. Conclusions: There is evidence of a bond between unhealthy lifestyles and negative emotional states as a condition and as a trait; with personological resources which are not directed to the proper management of the disease(AU)

Niveles de recuperación de personas con trastornos mentales severos

En el nuevo decenio de 1990 se asientan no sólo las bases para una nueva visión de las prestaciones de servicios para las personas que sufren de enfermedades mentales sino el surgimiento de un nuevo concepto en el ámbito de la salud mental, la Recuperación. A pesar de no existir un consenso explícito respecto al significado del término recuperación, este concepto es cada vez más apreciado en las políticas y prácticas asistenciales en los sistemas del campo de salud mental pública. La recuperación requiere un cambio de paradigma en nuestro pensamiento como investigadores, administradores, director de programas, proveedores de servicios, y como consumidores de servicios en salud mental. El estudio de la recuperación en la salud mental y el desarrollo de instrumentos de medición son temáticas actuales. En el campo de las investigaciones es interesante señalar el gran interés que ha generado la posibilidad de medir la Recuperación, lo que contribuye a la ampliación de su conocimiento. Las medidas de recuperación abarcan instrumentos que miden algún aspecto de la misma, por ejemplo, las actitudes, la visión, entre otros. The Recovery Assessment Scale (R.A.S) de Daniel Giffort y colegas, es una escala que permite valorar los aspectos de recuperación de las personas con trastornos mentales severos

Abstract: The new 1990s not only the basis for a new vision of the services for people suffering from mental illness but the emergence of a new concept in the field of mental health, Recovery settle. Despite the absence of an explicit consensus on the meaning of recovery, this concept is increasingly appreciated in policies and practices in health care systems of public mental health field. Recovery requires a paradigm shift in our thinking as researchers, managers, program director, service providers, and consumers of mental health services. The study of mental health recovery and development of measuring instruments are current issues. In the field of research it is interesting to note the great interest generated by the possibility of measuring the recovery, contributing to the expansion of knowledge. Recovery measures include instruments that measure some aspect of it, for example, attitudes, vision among others