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1.
Article in Spanish | LILACS | ID: biblio-1452057

ABSTRACT

El maltrato infantil (MI) es un problema multidimensional. El estrés crónico producido por dicho fenómeno afecta el desarrollo cerebral de niños, niñas y adolescentes (NNA), incidiendo negativamente en la evolución de diversos aspectos del desarrollo, condicionando su vida futura. El objetivo de este estudio es analizar el desempeño sociocognitivo de NNA que han vivenciado MI, mediante el análisis de las funciones del neurodesarrollo, evaluado con subpruebas de la NEPSY II. Se analizan funciones ejecutivas y percepción social, bases del razonamiento y adaptación social. Se estudia el desempeño de 14 de NNA pertenecientes a un Programa de la Fundación Súmate, cuya Misión es la recuperación de la escolaridad NNA que han visto alterado el curso de su desarrollo por MI. Los resultados dan cuenta de alteraciones cerebrales asociadas al MI, las que se evidencian en un deficitario desarrollo funcional de las variables estudiadas. Existe grave descenso en los procesos y subprocesos del funcionamiento ejecutivo. En relación con la percepción social, la muestra estudiada presenta un mejor desarrollo, el que desciende a medida que aumenta la edad. Las funciones estudiadas tienen directa relación con el razonamiento cognitivo y desarrollo socio adaptativo, bases sobre las que se estructura el desarrollo académico. Los hallazgos, refuerzan la urgencia de abordar esta sensible realidad desde la práctica médica en la atención primaria y especializada. Los resultados también son de utilidad para orientar el desarrollo de políticas públicas que efectivamente contribuyan al progreso de nuestro país.


Abstract. Child maltreatment (MI) is a multidimensional problem. The chronic stress produced by this phenomenon affects the brain development of children and adolescents (NNA), negatively affecting the evolution of various aspects of development, conditioning their future life. The objective of this study is to analyze the sociocognitive performance of children and adolescents who have experienced IM, through the analysis of the performance of neurodevelopmental functions, evaluated through subtests of the NEPSY II. Executive functions and social perception, reasoning bases and social adaptation are studied. The performance of 14 NNA belonging to a Fundación Súmate Program is studied, whose mission is the recovery of NNA schooling that has seen the course of their development altered by IM. The results show brain alterations associated with MI, evidenced in a deficient functional development of the variables studied. There is a serious decline in the processes and threads of executive functioning. In relation to social perception, the studied sample presents a better development, which decreases as age increases. The functions studied are directly related to cognitive reasoning and socio-adaptive development, based on which academic development is structured. The findings reinforce the urgency of addressing this sensitive reality from medical practice in primary and specialized care. The results are also useful to guide the development of public policies that effectively contribute to the progress of our country.


Subject(s)
Humans , Male , Female , Child , Adolescent , Child Abuse/psychology , Executive Function , Stress Disorders, Post-Traumatic , Chile/epidemiology , Epidemiology, Descriptive
2.
Distúrb. comun ; 35(2): 54491, 02/08/2023.
Article in English, Portuguese | LILACS | ID: biblio-1444691

ABSTRACT

Introdução: este artigo apresenta a constituição psíquica e linguística de um jovem autista, proveniente de uma família de imigrantes em situação de pós-guerra, em que entram em questão temas como o luto, a constituição psíquica transgeracional, e a presença de angústias no processo de desenvolvimento da criança em uma situação singular que é a presença do autismo. Objetivo: analisar os efeitos singulares da imigração e multiculturalismo em um caso de autismo e sua evolução terapêutica. Método: estudo de caso longitudinal, que utilizou diário clínico e filmagens de sessões com observações do desenvolvimento de Rafael, desde os dezoito meses até a idade adulta. Como abordagem terapêutica e análise dos resultados, foram utilizados aportes da constituição psíquica da teoria psicanalítica, e sobre o desenvolvimento linguístico em uma perspectiva enunciativa. Resultados: O multiculturalismo acarretava um desafio maior ao processo de aquisição da linguagem por parte da criança com autismo, enquanto o silêncio consequente da dor do luto, presente nos adultos, dificultava a troca verbal e atrasava sua constituição psíquica. O autismo, por sua vez, apresentou-se como transtornos qualitativos na comunicação, necessitando maior investimento por parte de seus cuidadores para que a aquisição da linguagem se desse, pois o paciente precisou ser fisgado para a nossa cultura. Conclusão: Diante de todo esse quadro, o caso clínico demonstra a importância do suporte terapêutico à família e do investimento contínuo na subjetivação, considerando e valorizando os diferentes códigos culturais que compõem o núcleo familiar. (AU)


Introduction: this article presents the psychic and linguistic constitution of an autistic young man, from a post-war immigrant family, in which themes such as mourning, the transgenerational psychic constitution, and the presence of anxieties in the process come into question of the child development in a unique situation that is the presence of autism. Objective: to analyze the unique effects of immigration and multiculturalism in a case of autism and its therapeutic evolution. Method: longitudinal case study, which used a clinical diary and footage of sessions with observations of the development of R. from eighteen months to adulthood. As a therapeutic approach and analysis of results, contributions from the psychic constitution of psychoanalytic theory, and on linguistic development in an enunciative perspective, were used. Results: Multiculturalism posed a greater challenge to the process of language acquisition by the child with autism, while the consequent silence of the pain of grief, present in adults, hindered verbal exchange and delayed their psychic constitution. Autism, in turn, presented itself as qualitative disorders in communication, requiring greater investment on the part of its caregivers for the acquisition of language to take place, as it needed to be hooked for our culture. Conclusion: Given this situation, this clinical case demonstrates the importance of therapeutic support to the family and the continuous investment in subjectivity, considering and valuing the different cultural codes that make up the family nucleus. (AU)


Introducción: este artículo presenta la constitución psíquica y lingüística de un joven autista, proveniente de una familia inmigrante de posguerra, en la que se cuestionan temas como el luto, la constitución psíquica transgeneracional y la presencia de ansiedades en el proceso del desarrollo del niño en una situación única que es la presencia del autismo. Objetivo: analizar los efectos singulares de la inmigración y la multiculturalidad en un caso de autismo y su evolución terapéutica. Método: estudio de caso longitudinal, que utilizó un diario clínico y metraje de sesiones con observaciones del desarrollo de R. desde los dieciocho meses hasta la edad adulta. Como abordaje terapéutico y análisis de resultados se utilizaron aportes desde la constitución psíquica de la teoría psicoanalítica y sobre el desarrollo lingüístico en perspectiva enunciativa. Resultados: El multiculturalismo supuso un mayor desafío al proceso de adquisición del lenguaje por parte del niño con autismo, mientras que el consiguiente silencio del dolor del duelo, presente en los adultos, dificultó el intercambio verbal y retrasó su constitución psíquica. El autismo, a su vez, se presentó como un trastorno cualitativo en la comunicación, requiriendo una mayor inversión por parte de sus cuidadores para que se produjera la adquisición del lenguaje, pues necesitaba engancharse a nuestra cultura. Conclusión: Ante esta situación, este caso clínico demuestra la importancia del apoyo terapéutico a la familia y la continua inversión en la subjetividad, considerando y valorando los diferentes códigos culturales que conforman el núcleo familiar. (AU)


Subject(s)
Humans , Male , Infant , Child, Preschool , Child , Adolescent , Young Adult , Cultural Diversity , Emigration and Immigration , Autism Spectrum Disorder/psychology , Personality Development , Stress Disorders, Post-Traumatic , Child Development , Combat Disorders , Family Relations/psychology , Language Development
4.
Prensa méd. argent ; 109(1): 19-24, 20230000. tab
Article in Spanish | LILACS, BINACIS | ID: biblio-1427448

ABSTRACT

Objetivo: Determinar la prevalencia del trastorno de estrés postraumático (TEPT) en una muestra de médicos residentes del Hospital de Clínicas, José de San Martín, Buenos Aires, Argentina, un año después del cierre total durante la cuarentena por COVID-19. Materiales y métodos: Se administraron los siguientes cuestionarios autoadministrados: una encuesta demográfica, el cuestionario de la Escala de Trauma de Davidson y la Escala de Experiencias Disociativas (EED). Se excluyeron a los residentes de primer año de especialidades básicas, a aquellos que por su especialidad no tienen contacto con pacientes y a los médicos con licencia fueron excluidos. Resultados: La prevalencia de TEPT fue de 24.3% (n=25). Las medianas de las puntuaciones de DES fueron mayores en los participantes con puntaje positivo para TEPT en comparación con los que no lo presentaban (Mann-Whitney U:13.30, p = 0.001). Se encontraron asociaciones entre el género (X2:6.074, p = 0.013), el TEPT y el tipo de especialidad (prueba exacta de Fisher, p = 0.017). No se encontraron otras asociaciones entre las demás variables analizadas y el TEPT. Conclusion: La prevalencia del TEPT fue similar a los informes previos. Se hallaron asociaciones entre este desorden, el género y el tipo de especialidad. Estos resultados deberían llamar la atención de los sistemas de salud para establecer medidas preventivas y terapéuticas para manejar esta situación.


Objective: Determine the prevalence of posttraumatic stress disorder (PTSD) in a sample of resident doctors of the Hospital de Clínicas, José de San Martín, Buenos Aires, Argentina, one year after the total closure during the quarantine by COVID-19. Materials and Methods: The following self-administered questionnaires were dispensed: a demographic survey, the Davidson Trauma Scale questionnaire, and the Scale of Dissociative Experiences (EED). First year residents of basic specialties were excluded, those who for their specialty do not have contact with patients and licensed doctors were excluded. Results: PTSD prevalence was 24.3% (n = 25). The medium-sized ones were greater in the participants with positive score for PTSD compared to those who did not present it (Mann-Whitney U: 13.30, p = 0.001). Associations between the genre were found (X2: 6,074, p = 0.013), the PTSD and the type of specialty (Fisher's exact test, p = 0.017). No other associations were found between the other variables analyzed and the PTSD. Conclusion: The prevalence of the PTSD was similar to the previous reports. Associations between this disorder, gender and type of specialty were found. These results should draw the attention of health systems to establish preventive and therapeutic measures to handle this situation


Subject(s)
Humans , Male , Female , Stress Disorders, Post-Traumatic , Dissociative Disorders/therapy , Mental Health Assistance , COVID-19 , Medical Staff, Hospital
6.
Alerta (San Salvador) ; 6(1): 70-77, ene. 30, 2023.
Article in Spanish | BISSAL, LILACS | ID: biblio-1413706

ABSTRACT

El término violencia obstétrica tiene sus orígenes en Latinoamérica, se considera una expresión de violencia de género y de violencia institucional contra la mujer. Puede ser ejercida de dos maneras, física y psicológica, por lo que se pretende definir la violencia obstétrica, su origen, divisiones, relación con los derechos sexuales y reproductivos de la mujer, así como identificar sus consecuencias físicas y psicológicas. Se realizó una búsqueda bibliográfica en Medigraphic, SciELO y Google Académico, fueron incluidas únicamente las publicaciones que se encontraron a texto completo, en español, inglés y portugués durante los años 2014 al 2022. La violencia obstétrica provoca que los derechos sexuales y reproductivos de las mujeres sean quebrantados, lo que hace imprescindible que todos los involucrados en la atención en salud conozcan las repercusiones físicas y psicológicas relacionadas que contribuyen a la morbimortalidad de la madre y el recién nacido, tales como: desgarros vaginales, problemas en la lactancia materna, síndrome de estrés postraumático y depresión posparto


The term obstetric violence has its origins in Latin America, it is considered an expression of gender violence and institutional violence against women. It can be exercised in two ways, physical and psychological, therefore, the aim is to define obstetric violence, its origin, divisions, and relation with women's sexual and reproductive rights, as well as to identify its physical and psychological consequences. A bibliographic search was conducted in Medigraphic, SciELO, and Google Scholar, including only publications that were found in full text, in Spanish, English, and Portuguese during the years 2014 to 2022. Obstetric violence causes the violation of women's sexual and reproductive rights, which makes it essential for all those involved in health care to be aware of the related physical and psychological repercussions that contribute to maternal and newborn morbidity and mortality, such as vaginal tears, breastfeeding problems, post-traumatic stress syndrome, and postpartum depression


Subject(s)
Physics , Women , Reproductive Rights , Obstetric Violence , Stress Disorders, Post-Traumatic , Breast Feeding , Morbidity , Violence Against Women
7.
Chinese Journal of Preventive Medicine ; (12): 1032-1039, 2023.
Article in Chinese | WPRIM | ID: wpr-985505

ABSTRACT

Objective: To explore the risk intensity and related influencing factors of post-traumatic stress disorder (PTSD) among high-stress rescue workers, and to provide effective tools for the risk assessment of PTSD in military rescue workers. Method: From June to August 2022, cluster sampling was used to select the high-stress rescue personnel of an Army department as the survey subjects. The acute Stress reaction (ASD) scale and PTSD checklist were used to evaluate the risk of PTSD in military rescue personnel. Multivariate logistic regression were used to analyze the influencing factors of PTSD. Results: The age of 4 460 subjects was (24.38±4.072) years old, including 4 396 males (98.6%). The positive rate of initial screening for ASD was 2.85% (127/4 460). The positive rate of PTSD was 0.67% (30/4 460). Multivariate logistic regression model analysis showed that female, older age, recent trauma exposure history, passive smoking and alcohol consumption were at higher risk of ASD, the values of OR (95%CI) were 4.183 (1.819-9.618), 6.278 (1.363-28.912), 3.094 (1.500-6.379), 2.059 (1.298-3.267) and 2.607 (1.614-4.211), respectively; Lower education level was associated with lower risk of ASD, OR (95%CI) was 0.593 (0.359-0.978); People who are older, thinner, have a history of mental illness, and drink alcohol were at higher risk for PTSD, the values of OR (95%CI) were 20.144 (2.459-165.043), 10.287 (2.218-47.700), 91.104 (8.592-965.980) and 2.866 (1.144-7.180), respectively. Conclusion: Gender, age, education level, passive smoking, alcohol consumption, past history of mental illness and body mass index may be related to the potential risk of PTSD in rescue workers,passive smoking, alcohol consumption, and weight controlling should be focused on to reduce potential risks of PTSD.


Subject(s)
Male , Humans , Female , Young Adult , Adult , Stress Disorders, Post-Traumatic/prevention & control , Tobacco Smoke Pollution , Risk Assessment , Military Personnel , Alcohol Drinking
8.
Journal of Integrative Medicine ; (12): 385-396, 2023.
Article in English | WPRIM | ID: wpr-982693

ABSTRACT

OBJECTIVE@#This study investigated trends in the study of phytochemical treatment of post-traumatic stress disorder (PTSD).@*METHODS@#The Web of Science database (2007-2022) was searched using the search terms "phytochemicals" and "PTSD," and relevant literature was compiled. Network clustering co-occurrence analysis and qualitative narrative review were conducted.@*RESULTS@#Three hundred and one articles were included in the analysis of published research, which has surged since 2015 with nearly half of all relevant articles coming from North America. The category is dominated by neuroscience and neurology, with two journals, Addictive Behaviors and Drug and Alcohol Dependence, publishing the greatest number of papers on these topics. Most studies focused on psychedelic intervention for PTSD. Three timelines show an "ebb and flow" phenomenon between "substance use/marijuana abuse" and "psychedelic medicine/medicinal cannabis." Other phytochemicals account for a small proportion of the research and focus on topics like neurosteroid turnover, serotonin levels, and brain-derived neurotrophic factor expression.@*CONCLUSION@#Research on phytochemicals and PTSD is unevenly distributed across countries/regions, disciplines, and journals. Since 2015, the research paradigm shifted to constitute the mainstream of psychedelic research thus far, leading to the exploration of botanical active ingredients and molecular mechanisms. Other studies focus on anti-oxidative stress and anti-inflammation. Please cite this article as: Gao B, Qu YC, Cai MY, Zhang YY, Lu HT, Li HX, Tang YX, Shen H. Phytochemical interventions for post-traumatic stress disorder: A cluster co-occurrence network analysis using CiteSpace. J Integr Med. 2023; 21(4):385-396.


Subject(s)
Humans , Stress Disorders, Post-Traumatic/drug therapy , Hallucinogens/therapeutic use , Substance-Related Disorders/drug therapy
9.
Journal of Central South University(Medical Sciences) ; (12): 84-91, 2023.
Article in English | WPRIM | ID: wpr-971373

ABSTRACT

OBJECTIVES@#Firefighters are prone to suffer from psychological trauma and post-traumatic stress disorder (PTSD) in the workplace, and have a poor prognosis after PTSD. Reliable models for predicting PTSD allow for effective identification and intervention for patients with early PTSD. By collecting the psychological traits, psychological states and work situations of firefighters, this study aims to develop a machine learning algorithm with the aim of effectively and accurately identifying the onset of PTSD in firefighters, as well as detecting some important predictors of PTSD onset.@*METHODS@#This study conducted a cross-sectional survey through convenient sampling of firefighters from 20 fire brigades in Changsha, which were evenly distributed across 6 districts and Changsha County, with a total of 628 firefighters. We used the synthetic minority oversampling technique (SMOTE) to process data sets and used grid search to finish the parameter tuning. The predictive capability of several commonly used machine learning models was compared by 5-fold cross-validation and using the area under the receiver operating characteristic curve (ROC-AUC), accuracy, precision, recall, and F1 score.@*RESULTS@#The random forest model achieved good performance in predicting PTSD with an average AUC score at 0.790. The mean accuracy of the model was 90.1%, with an F1 score of 0.945. The three most important predictors were perseverance, forced thinking, and reflective deep thinking, with weights of 0.165, 0.158, and 0.152, respectively. The next most important predictors were employment time, psychological power, and optimism.@*CONCLUSIONS@#PTSD onset prediction model for Changsha firefighters constructed by random forest has strong predictive ability, and both psychological characteristics and work situation can be used as predictors of PTSD onset risk for firefighters. In the next step of the study, validation using other large datasets is needed to ensure that the predictive models can be used in clinical setting.


Subject(s)
Humans , Stress Disorders, Post-Traumatic/diagnosis , Firefighters/psychology , Cross-Sectional Studies , Algorithms , Machine Learning
10.
China Journal of Chinese Materia Medica ; (24): 762-769, 2023.
Article in Chinese | WPRIM | ID: wpr-970546

ABSTRACT

This study aimed to explore the effect of Ganmai Dazao Decoction on the ethology of rats with posttraumatic stress disorder(PTSD) and study the related mechanism through the changes in magnetic resonance imaging and protein expression. Sixty rats were randomly divided into 6 groups, namely the normal group, the model group, the low(1 g·kg~(-1)), medium(2 g·kg~(-1)), and high-dose Ganmai Dazao Decoction groups(4 g·kg~(-1)), and the positive control group(intragastric administration with 10.8 mg·kg~(-1) of fluoxetine), with 10 rats in each group. Two weeks after inducing PTSD by single-prolonged stress(SPS) in rats, the positive control group was given fluoxetine hydrochloride capsule by gavage, the low, medium, and high-dose groups were given Ganmai Dazao Decoction by gavage, and both the normal group and the model group were given the same volume of normal saline by gavage, each for 7 days. The open field experiment, elevated cross elevated maze, forced swimming experiment, and new object recognition test were carried out for the behavioral test. Three rats in each group were selected to detect the expression of neuropeptide receptor Y1(NPY1R) protein in the hippocampus by Western blot. Then, the other three rats in each group were selected to use the 9.4T magnetic resonance imaging experiment to observe the overall structural changes in the brain region and the anisotropy fraction of the hippocampus. The results of the open field experiment showed that the total distance and central distance of rats in the model group were significantly lower than those in the normal group, and the total distance and central distance of rats in the middle and high-dose Ganmai Dazao Decoction groups were higher than those in the model group. The results of the elevated cross maze test showed that medium and high-dose Ganmai Dazao Decoction remarkably increased the number of open arm entries and the residence time of open arm of rats with PTSD. The results of the forced swimming experiment showed that the immobility time in the water of the model group rats was significantly higher than that of the normal group, and Ganmai Dazao Decoction hugely reduced the immobility time in the water of rats with PTSD. The results of the new object recognition test showed that Ganmai Dazao Decoction significantly increased the exploration time of new objects and familiar objects in rats with PTSD. The results of Western blot showed that Ganmai Dazao Decoction significantly reduced the expression of NYP1R protein in the hippocampus of rats with PTSD. The 9.4T magnetic resonance examination found that there was no significant difference in the structural image among the groups. In the functional image, the fractional anisotropy(FA value) of the hippocampus in the model group was significantly lower than that in the normal group. The FA value of the hippocampus in the middle and high-dose Ganmai Dazao Decoction groups was higher than that in the model group. Ganmai Dazao Decoction reduces the injury of hippocampal neurons by inhibiting the expression of NYP1R in the hippocampus of rats with PTSD, thereby improving the nerve function injury of rats with PTSD and playing a neuroprotective role.


Subject(s)
Animals , Rats , Ethology , Stress Disorders, Post-Traumatic , Fluoxetine , Hippocampus , Maze Learning
11.
Health Sciences Journal ; : 37-43, 2023.
Article in English | WPRIM | ID: wpr-984414

ABSTRACT

INTRODUCTION@#Increased healthcare demands due to the COVID-19 pandemic have overwhelmed nurses worldwide. Resilience of nurses has been impacted due to many factors (e.g., longer work shifts) causing psychological distress. The study aimed to determine the correlation of burnout, compassion fatigue, and moral injury with resilience among nurses assigned in COVID-19 wards.@*METHODS@#Virtual survey tools were sent to nurses of a public hospital to obtain data. Data were analyzed using JAMOVI and SPSS.@*RESULTS@#Levels of burnout showed moderate burnout in personal burnout (f=44) (65.7%); Moderate burnout in work-telated burnout (f=36) (53.7%); no/low level of burnout in client-related burnout (f=48) (71.6%). Level of compassion fatigue showed job burnout (f=59) (88.1%). Level of moral injury indicated “requiring clinical attention” (f=52) (77.6%). Level of resilience showed medium resilience (f=45) (67.2%). Correlation between burnout and resilience yielded negligible negative correlations between personal burnout and resilience (r=-0.160, p=0.031), work-related burnout and resilience (r=-0.222, p=0.008), and client-related burnout and resilience (r=-0.120, p=0.741). Correlation yielded weak negative correlations between compassion fatigue and resilience (r=-0.254, p=0.038) and between moral injury and resilience (r=-0.318, p=0.009). The linear regression showed no significant correlations between personal burnout and resilience (p=0.063), work-related burnout and resilience (p=0.070), client-related burnout and resilience (p=0.331), compassion fatigue and resilience (p=0.080), moral injury and resilience (p=0.227).@*CONCLUSION@#The findings showed significant correlations between personal burnout and resilience, work- related burnout and resilience, compassion fatigue and resilience, and moral injury and resilience. There were no significant correlations between client-related burnout and resilience. Multiple linear regression indicated burnout, compassion fatigue, and moral injury are not predictive factors for resilience.


Subject(s)
Burnout, Professional , Compassion Fatigue , Stress Disorders, Post-Traumatic
12.
Psicol. ciênc. prof ; 43: e252098, 2023. tab
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1440797

ABSTRACT

Este estudo teve como objetivo identificar o risco de desenvolvimento de transtorno de estresse pós-traumático (TEPT), bem como sua associação com pensamentos ou tentativas suicidas e a saúde mental de policiais militares feridos por arma de fogo, na Região Metropolitana de Belém (RMB), nos anos de 2017 a 2019. A pesquisa contou com a participação de 30 entrevistados, que responderam o Inventário Demográfico e a Lista de verificação de TEPT para o DSM-5 (PCL-5). Para análise dos dados, utilizou-se a técnica estatística Análise Exploratória de Dados e a técnica multivariada Análise de Correspondência. Os resultados revelaram a existência de risco de desenvolvimento do transtorno de forma parcial ou total em uma expressiva parcela da população entrevistada, tendo homens como maioria dos sintomáticos, com média de 38 anos, exercendo atividades operacionais e vitimados em via pública quando estavam de folga do serviço. O ferimento deixou a maioria com sequelas, com destaque para dores crônicas, limitações de locomoção e/ou mobilidade e perda parcial de um membro. E, ainda, policiais sintomáticos apresentaram comportamentos suicidas, relatando já terem pensado ou tentado tirar a própria vida. Desta forma, conclui-se que policiais militares são expostos constantemente a traumas inerentes a sua profissão. Quando há ameaça de vida, como nos casos de ferimentos por arma de fogo, são suscetíveis a sequelas físicas decorrente do ferimento, somadas a sequelas mentais tardias, como o surgimento de sintomatologias de TEPT e ideação suicida.(AU)


This study aimed to identify the risk of developing post-traumatic stress disorder (PTSD) and its associations around suicidal thoughts or attempts and mental health in military police officers injured by firearms, in the Metropolitan Region of Belem (RMB), from 2017 to 2019. The research had the participation of 30 respondents who answered the Demographic Inventory and the PTSD checklist for DSM-5 (PCL-5). For data analysis, we used the statistical technique Exploratory Data Analysis and the multivariate technique Correspondence Analysis. The results revealed the existence of risk of developing partial or total disorder in a significant portion of the interviewed population, with men as most of the symptomatic individuals, with mean age of 38 years, developing operational activities and victimized on public roads when they were off duty. The injuries left most of them with sequelae, especially chronic pain, limited locomotion and/or mobility, and partial loss of a limb. In addition, symptomatic officers showed suicidal behavior, such as reporting they had thought about or tried to take their own lives. Thus, we conclude that military policemen are constantly exposed to traumas inherent to their profession. When their lives are threatened, as in the case of firearm wounds, they are susceptible to physical sequelae resulting from the injury, in addition to late mental sequelae, such as the appearance of PTSD symptoms and suicidal ideation.(AU)


Este estudio tuvo como objetivo identificar el riesgo de desarrollo de trastorno de estrés postraumático (TEPT) y sus asociaciones con pensamientos o tentativas suicidas y la salud mental en policías militares heridos por armamiento de fuego, en la Región Metropolitana de Belém (Brasil), en el período entre 2017 y 2019. En el estudio participaron 30 entrevistados que respondieron el Inventario Demográfico y la Lista de verificación de TEPT para el DSM-5 (PCL-5). Para el análisis de datos se utilizaron la técnica estadística Análisis Exploratoria de Datos y la técnica multivariada Análisis de Correspondencia. Los resultados revelaron que existen riesgos de desarrollo de trastorno de estrés postraumático de forma parcial o total en una expresiva parcela de la población de policías entrevistados, cuya mayoría de sintomáticos eran hombres, de 38 años en media, que ejercen actividades operacionales y fueron victimados en vía pública cuándo estaban de día libre del servicio. La lesión dejó la mayoría con secuelas, especialmente con dolores crónicos, limitaciones de locomoción y/o movilidad y la pierda parcial de un miembro. Aún los policías sintomáticos presentaran comportamiento suicida, tales como relataran qué ya pensaron o tentaron quitar la propia vida. Se concluye que los policías militaran se exponen constantemente a los traumas inherentes a su profesión. Cuando existe amenaza de vida, como en los casos de heridas por armamiento de fuego, son expuestos a secuelas físicas transcurridas de la herida, sumado a secuelas mentales tardías, como el surgimiento de sintomatologías de TEPT y la ideación suicida.(AU)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Young Adult , Pain , Wounds and Injuries , Wounds, Gunshot , Psychic Symptoms , Risk , Psychological Distress , Anxiety , Anxiety Disorders , Phobic Disorders , Prisons , Psychology , Runaway Behavior , Safety , Attention , Sleep Wake Disorders , Stress Disorders, Post-Traumatic , Suicide , Suicide, Attempted , Therapeutics , Violence , Behavioral Symptoms , Work Hours , Burnout, Professional , Adaptation, Psychological , Catatonia , Cognitive Behavioral Therapy , Occupational Health , Self-Injurious Behavior , Civil Defense , Civil Rights , Panic Disorder , Public Sector , Cognition , Efficiency, Organizational , Contusions , Crime Victims , Substance-Related Disorders , Wit and Humor , Crime , Emergency Watch , Civil Protection Program , Civil Protection , Legal Process , Death , Diagnostic and Statistical Manual of Mental Disorders , Aggression , Depression , Dizziness , Dreams , Alcoholism , Escape Reaction , Disease Prevention , Surveillance of the Workers Health , Surveillance of Working Environment , Mental Fatigue , Fear , Catastrophization , Medicalization , Hope , Mindfulness , Criminal Behavior , Trauma and Stressor Related Disorders , Psychological Trauma , Physical Abuse , Cortical Excitability , Work-Life Balance , Occupational Stress , Gun Violence , Disaster Risk Reduction , Kinesiophobia , Psychological Well-Being , Suicide Prevention , Accident Prevention , Guilt , Headache , Health Promotion , Homicide , Sleep Initiation and Maintenance Disorders , Job Satisfaction , Mental Disorders
13.
Hist. ciênc. saúde-Manguinhos ; 30: e2023039, 2023.
Article in Portuguese | LILACS | ID: biblio-1448363

ABSTRACT

Resumo A percepção do papel do trauma psicológico na origem de problemas psiquiátricos aumentou e diminuiu ao longo da história da psiquiatria. Com a concepção do transtorno de estresse pós-traumático (TEPT), entretanto, as sociedades ocidentais presenciaram uma profunda expansão do discurso do traumatismo na interpretação de experiências humanas devastadoras, como catástrofes, genocídios, desastres e epidemias. A partir de revisão bibliográfica integrativa, este artigo analisa alguns dos determinantes históricos e epistemológicos que fundamentam o surgimento da memória traumática e o estabelecimento do trauma como campo semântico que orienta respostas clínicas e estratégias políticas no campo das ciências humanas e da saúde.


Abstract Perceptions of the importance of the role of psychological trauma in the origins of psychiatric problems have oscillated throughout the history of psychiatry. However, since the conception of post-traumatic stress disorder (PTSD), western societies have witnessed a marked expansion of the discourse of trauma in the interpretation of devastating human experiences like catastrophes, genocides, disasters, and epidemics. Through an integrative literature review, this article analyzes some of the historical and epistemological determinants behind the emergence of traumatic memory and the establishment of trauma as a semantic field that orients clinical responses and political strategies in the field of the humanities and the health sciences.


Subject(s)
Stress Disorders, Post-Traumatic , Stress, Psychological , Wounds and Injuries/history , Neurosciences
14.
Psicol. ciênc. prof ; 43: e248137, 2023. tab
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1431128

ABSTRACT

Objetivamos apresentar uma proposta de atendimento psicossocial grupal oferecida para mulheres adultas que cometeram ofensa sexual, cuidadoras e mães. A experiência está sendo desenvolvida no Distrito Federal, Brasil, com pessoas do gênero feminino provenientes de encaminhamento judicial. Carece que os profissionais das áreas da justiça, saúde, serviço social e psicologia avancem no estudo e na compreensão desta temática, de modo a pensarem a atuação e o apoio terapêutico a essas mulheres. O modo de atendimento é focal e breve, com ênfase na criação de um ambiente lúdico como facilitador das interações grupais e da discussão sobre os temas: identidade; confiança nas relações afetivas e sociais; vivência pessoal com violência física e sexual; configuração de gênero; e expressão da sexualidade e futuro. A abordagem individual também se baseia no enfoque dos temas mencionados. O oferecimento de ajuda à mulher cuidadora ou à mãe tem participação ativa na interrupção do circuito abusivo sexual, pois essa violência é extremamente ocultada, ocasionando uma prolongada vulnerabilidade para as vítimas. Ressalta-se o valor do texto indicando a descrição de ação voltada para uma população permanentemente não estudada e evitada em seu reconhecimento. Os limites desta proposta encontram-se na falta de outras iniciativas que possibilitem uma discussão sobre essa experiência.(AU)


We aim to present a proposal of a group psychosocial intervention offered for adult female sexual offenders, caregivers, and mothers. The intervention is being developed at Federal District, Brazil, with female people coming from judicial referrals. Professionals in the areas of justice, health, social work, and psychology need to advance in the study and understanding this theme to think about action and therapeutic support for these women. The intervention is a focal and brief approach, with emphasis on the creation of a ludic environment as a facilitator of group interactions and discussion about the themes: identity; trust in affective and social relationships; personal experience with physical and sexual violence; gender configuration; and sexuality expression and future. The individual approach is also based on focusing on these themes. The offering of help to the female caregiver or the mother has an active participation in the interruption of the sexual offense circuit, since this violence is extremely hidden, bringing a prolonged condition of vulnerability to the victims. The value of this text is highlighted indicating the description of an action directed to a population that is permanently not studied and whose recognition is avoided. The limits of this proposal are found in the absence of other initiatives that would allow a discussion about this experience.(AU)


Este texto presenta una propuesta de atención psicosocial grupal destinada a mujeres adultas que han cometido delito sexual, a cuidadoras y madres. La intervención se está desarrollando en el Distrito Federal (Brasil), con personas del género femenino provenientes de remisiones judiciales. Es necesario que los profesionales de las áreas de justicia, salud, trabajo social y psicología avancen en el estudio y comprensión de esta temática para pensar en el desempeño y apoyo terapéutico de estas mujeres. El servicio es enfocado y breve, con énfasis en la creación de un ambiente lúdico como facilitador de interacciones grupales y discusión sobre los temas: identidad; confianza en las relaciones afectivas y sociales; experiencia personal con violencia física y sexual; configuración de género; y expresión de la sexualidad y el futuro. El enfoque individual también se centra en estos temas. La oferta de ayuda a la mujer cuidadora o a la madre es importante para la interrupción del circuito de abuso sexual, ya que esta violencia es extremadamente oculta y provoca una vulnerabilidad prolongada a las víctimas. Se destaca el valor del texto con la descripción de la acción dirigida a una población que no es objeto de estudios ni reconocida. Los límites de esta propuesta se encuentran en la ausencia de otras iniciativas que permitan un debate sobre esta experiencia.(AU)


Subject(s)
Humans , Female , Adult , Middle Aged , Young Adult , Sex Offenses , Gender Identity , Psychosocial Intervention , Anxiety , Parent-Child Relations , Pedophilia , Perception , Art Therapy , Prejudice , Sex Work , Psychology , Psychopathology , Public Policy , Quality of Life , Rape , Rejection, Psychology , Safety , Sex Education , Shame , Social Environment , Social Justice , Social Problems , Socioeconomic Factors , Stress Disorders, Post-Traumatic , Taboo , Torture , Battered Child Syndrome , World Health Organization , Child Abuse, Sexual , Brazil , Sexually Transmitted Diseases, Viral , Family , Child Abuse , Child Advocacy , Child Welfare , Liability, Legal , Women's Health , Parenting , Sexual Harassment , Coercion , Domestic Violence , Conflict, Psychological , Contraception , Crime Victims , Statistics , Crime , Hazards , Dangerous Behavior , Denial, Psychological , Trust , Aggression , Sexology , Human Rights Abuses , Depression , Fear , Criminals , Sexual Health , Human Trafficking , Criminal Behavior , Physical Abuse , Recidivism , Rights of Prisoners , Androcentrism , Freedom , Adverse Childhood Experiences , Respect , Emotional Abuse , Information Avoidance , Social Deprivation , Psychological Well-Being , Handling, Psychological , Hate , Health Promotion , Human Rights , Incest , Infections , Inhibition, Psychological , Life Change Events , Loneliness , Love , Deception , Malpractice , Masturbation , Narcissism
15.
Psicol. ciênc. prof ; 43: e248295, 2023.
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1431129

ABSTRACT

Este ensaio propõe que a Covid-19 pode operar como um analisador, dentro da perspectiva da análise institucional, iluminando um determinado modo de organização social que promove profundas desigualdades e ameaça a vida em diversos níveis e revelando as condições sociais, institucionais e políticas de produção de sofrimento no corpo profissional de Enfermagem. A pandemia desvelou um conjunto de marcas relacionadas à profissão, agravadas pela crise sanitária, reforçando a naturalização das relações de cuidado atribuídas ao feminino, bem como um conjunto de clivagens e hierarquias internas à profissão a partir da sinergia de marcadores da diferença, como gênero, cor/raça, classe e geração. Além disso, este trabalho mostra a presença de uma necropolítica nas respostas à pandemia que banaliza a vida e permite morrer determinados grupos sociais. A ideia de "profissionais de linha de frente" é criticada em suas metáforas bélicas, mas tomada como figura de linguagem em sua potência para afirmar que existem corpos que, pelas marcas sociais e históricas e pela interdependência do cuidado, são mais presentes e exigidos e, portanto, mais vulneráveis à doença e ao sofrimento dela decorrente.(AU)


The essay proposes that Covid-19 can operate as an analyzer, within the perspective of institutional analysis, illuminating a certain mode of social organization that promotes profound inequalities and threatens life at various levels, revealing the social, institutional and political conditions for the production of suffering in the professional nursing body. The pandemic would unveil a set of marks related to the profession, aggravated by the sanitary crisis, reinforcing the naturalization of the care relations attributed to the feminine, as well as a set of cleavages and internal hierarchies to the profession from the synergy of markers of difference as gender, color/race, class and generation. The work shows the presence of necropolitics in responses to the pandemic, which trivializes life and allows certain social groups to die. The idea of "front-line professionals" is criticized in its war metaphors, but taken as a figure of speech in its potency to affirm that there are bodies that by social and historical marks, and by the interdependence of care, are more present and demanded, and therefore more vulnerable to disease and the resulting suffering.(AU)


El ensayo propone que el Covid-19 puede funcionar como analizador, desde la perspectiva del análisis institucional, revelando las condiciones sociales, institucionales y políticas de producción de sufrimiento de enfermeras. La pandemia revela algunas marcas relacionadas con la profesión, agravadas por la crisis de salud, reforzando la naturalización de la atribución del cuidado a lo femenino y un conjunto de jerarquías internas de la profesión. El trabajo también muestra la presencia de una necropolítica en las respuestas a la pandemia. La idea de "profesionales de primera línea" es criticada, pero tomada como una figura del lenguaje en su potencia para afirmar que hay cuerpos que, por las marcas sociales e históricas y por la interdependencia del cuidado, están más presentes y demandados, y por lo tanto más vulnerables a la enfermedad.(AU)


Subject(s)
Humans , Female , Nursing , Psychological Distress , Gender Identity , Self-Testing , COVID-19 , Oxygen Inhalation Therapy , Pain , Patient Care Team , Patient Discharge , Patients , Politics , Primary Health Care , Psychology , Quality Assurance, Health Care , Quality of Life , Race Relations , Salaries and Fringe Benefits , Social Change , Social Isolation , Social Sciences , Socioeconomic Factors , Stress Disorders, Post-Traumatic , Women, Working , Behavior and Behavior Mechanisms , Population Characteristics , Nursing Theory , Occupational Risks , Burnout, Professional , Virus Diseases , Vaccines , Nursing Research , Accidents, Occupational , Carrier State , Mental Health , Mortality , Models, Nursing , Occupational Health , Workload , Professional Autonomy , Long-Term Care , Health Care Quality, Access, and Evaluation , Immunization Programs , Disease Transmission, Infectious , Continuity of Patient Care , Feminism , Critical Care , Disaster Vulnerability , Health Risk , Access to Information , Delivery of Health Care , Air Pollution , Health Care Economics and Organizations , Emergencies , Employment , Environment and Public Health , Essential Public Health Functions , Health Status Disparities , Ethics, Professional , Surveillance of the Workers Health , Program of Risk Prevention on Working Environment , Air Contamination Effects , Evidence-Based Nursing , Fear , Remuneration , Early Medical Intervention , Medicalization , Ambulatory Care , Personal Protective Equipment , Psychosocial Support Systems , Occupational Stress , Burnout, Psychological , Patient Care , Caregiver Burden , Models, Biopsychosocial , COVID-19 Serological Testing , Gender Equity , Vaccine Development , Community Resources , Intersectional Framework , Systemic Racism , Social Vulnerability , Humanitarian Crisis , Working Conditions , Post-Acute COVID-19 Syndrome , Accident Prevention , Health Occupations , Health Services , Health Services Accessibility , Helping Behavior , Hierarchy, Social , Hospitalization , Hospitals , Humanism , Life Support Care , Masks , Muscle Tonus , Night Care , Nursing Care , Nursing, Practical , Nursing, Team , Occupational Diseases
16.
Psicol. ciênc. prof ; 43: e248738, 2023. tab, graf
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1431135

ABSTRACT

A recuperação de vítimas de queimaduras é longa e dolorosa e afeta diversas esferas da vida do paciente. A resiliência, que se refere à capacidade humana de enfrentar e se adaptar a eventos adversos, exerce grande importância no processo de recuperação da queimadura. Logo, este trabalho objetiva avaliar a capacidade de resiliência de pacientes queimados, no momento da admissão e da alta hospitalar, em um hospital de emergência e urgência de Goiânia. Trata-se de um estudo descritivo, quantitativo e transversal que utiliza a Escala de Resiliência de Connor-Davidson (CD-RISC) como instrumento de mensuração. Na admissão hospitalar, a média da resiliência foi de 71,35, tendo sido observada uma relação significativa entre o fator Amparo da escala CD-RISC e a presença do(a) companheiro(a). O escore de resiliência encontrado nesta pesquisa é consistente com outros achados da literatura científica internacional e nacional referente à expressão da resiliência em vítimas de queimaduras e outros adoecimentos. A relação entre o fator Amparo e a presença de um(a) companheiro(a) enfatiza a importância da rede de apoio familiar na reabilitação do paciente queimado.(AU)


The recovery of burned patients is long and painful and impacts on different areas of people's lives. Resilience, which refers to the human capacity to face and adapt to adverse events, plays a major role in the process of recovery from burns. Therefore, the present study aims to assess the resilience of burned patients, on admission and hospital discharge, in an emergency and urgency hospital in Goiânia. This is a descriptive, quantitative and cross-sectional study that uses the Connor-Davidson Resilience Scale (CD RISC) as a measuring instrument. At hospital admission, the mean resilience was 71.35, with a significant association between the Support factor on the CD RISC scale and the presence of a partner. The resilience score found in the present study is consistent with other findings in the international and national scientific literature regarding the expression of resilience in victims of burns and other illnesses. The relationship between the Support factor and the presence of a partner emphasizes the importance of the family support network in the rehabilitation of the burned patient.(AU)


La recuperación de los pacientes quemados es larga y dolorosa e impacta en diferentes esferas de la vida de las personas. La resiliencia, que se refiere a la capacidad humana para enfrentar y adaptarse a eventos adversos, juega un papel importante en el proceso de recuperación de las quemaduras. Por tanto, el presente estudio tiene como objetivo evaluar la resiliencia de los pacientes quemados, en el momento del ingreso y el alta, en un hospital de emergencia y urgencia en Goiânia. Se trata de un estudio descriptivo, cuantitativo y transversal que utiliza la Escala de Resiliencia Connor-Davidson (CD RISC) como instrumento de medida. Al ingreso hospitalario, la resiliencia media fue de 71,35, con associación significativa entre el factor Amparo de la escala CD RISC y la presencia de pareja. El puntaje de resiliencia encontrado en el presente estudio es consistente con otros hallazgos en la literatura científica nacional e internacional sobre la expresión de resiliencia en víctimas de quemaduras y otras enfermedades. La relación entre el factor Amparo y la presencia de pareja enfatiza la importancia de la red de apoyo familiar en la rehabilitación del paciente quemado.(AU)


Subject(s)
Humans , Female , Adolescent , Adult , Young Adult , Social Support , Burns , Resilience, Psychological , Anxiety Disorders , Pain , Preceptorship , Prejudice , Psychological Phenomena , Psychology , Recovery Room , Rehabilitation Centers , Safety , Self Concept , Skin , Social Perception , Stress Disorders, Post-Traumatic , Suicide , General Surgery , Surgery, Plastic , Tissues , Baths , Wounds and Injuries , Behavior , Behavior and Behavior Mechanisms , Technical Cooperation , Unified Health System , Body Image , Traumatology , Burn Units , Burns, Chemical , Burns, Electric , Accidents, Home , Accidents, Occupational , Accidents, Traffic , Explosive Wastes , Inflammable Wastes , Mental Health , Morbidity , Cicatrix , Nursing , Panic Disorder , Employment, Supported , Statistics, Nonparametric , Human Body , Intuition , Wit and Humor , Hydrogels , Counseling , Critical Care , Disaster Vulnerability , Personal Autonomy , Death , Stress Disorders, Traumatic, Acute , Depression , Discrimination, Psychological , Education , Empathy , Humanization of Assistance , User Embracement , Ethics , Breakthrough Pain , Activation, Metabolic , Physical Appearance, Body , Trauma and Stressor Related Disorders , Psychological Trauma , Accidental Injuries , Psychological Distress , Social Comparison , Functional Status , Self-Compassion , Accident Prevention , Health Services Accessibility , Helping Behavior , Homicide , Amputation, Traumatic , Hospitalization , Individuality , Intensive Care Units , Interpersonal Relations , Life Change Events , Mental Disorders , Negativism , Nursing Assistants , Nursing Care
17.
Rio de Janeiro; s.n; 2023. 136f p.
Thesis in Portuguese | LILACS | ID: biblio-1532201

ABSTRACT

O Transtorno de Estresse Pós-Traumático (TEPT) é uma condição debilitante que impacta significativamente a qualidade de vida dos seus portadores. Dentre vários fatores de risco para o TEPT, as reações peritraumáticas (RP), como a imobilidade tônica peritraumática (ITP), dissociação (DP) e reações físicas de pânico (RFP), estão entre as mais investigadas. No entanto, a maioria dos estudos avaliou essas RP separadamente, e o elo entre elas e o TEPT ainda não foi bem compreendido. Portanto, essa tese teve como objetivos: (i) estimar simultaneamente o efeito das três RP sobre o TEPT utilizando um instrumento validado; e (ii) avaliar se há efeito indireto da ITP sobre o TEPT mediado pelo sentimento de culpa/vergonha. Utilizamos modelagem de equações estruturais para analisar dados de 3211 participantes do Rio de Janeiro e de São Paulo. Tratamos as RP como variáveis latentes, selecionando desconfundidores específicos para cada reação. Nossas exposições foram as RP, sendo TEPT o desfecho. Calculamos odds ratios e intervalos de confiança de 95%. Utilizamos o Bayesian Information Criterion para comparar o ajuste de modelos não aninhados. Quando analisadas separadamente, todas as RP alcançaram significância estatística. No entanto, apenas DP (ORDP=1,8; IC95%:1,3-2,4) e RFP (ORRFP=2,5; IC95%:1,8-3,4) permaneceram estatisticamente significativas quando incluímos as três reações em um modelo com seus respectivos desconfundidores e correlações entre elas. Os resultados sugeriram um possível efeito da ITP sobre o TEPT (ORITP=1,4; IC95%:1,0-1,9). As interações entre as RP não foram estatisticamente significativas. Ao investigarmos o sentimento de culpa/vergonha como mediador entre ITP e TEPT, o efeito indireto alcançou apenas significância estatística limítrofe (ORITP(TNIE)=1,1; IC95%:1,0-1,2). Os efeitos direto (ORITP(PNDE)=1,3; IC95%: 0,8-1,8) e total (ORITP(TE)=1,4; IC95%:0,9-1,9) para ITP perderam significância quando todas as RP, seus desconfundidores e correlações entre elas fizeram parte do mesmo modelo. As demais RP, no entanto, permaneceram estatisticamente significativas (ORDP=1,7; IC95%:1,3-2,3 e ORRFP=2,5; IC95%:1,8-3,4). Nossos resultados mostraram que a DP e as RFP aumentaram o risco de TEPT mesmo quando consideradas em conjunto. A ITP pode ter efeito sobre o risco de TEPT, mas esse achado deve ser interpretado com cautela devido a significância limítrofe dessa RP em nosso modelo final. Também não identificamos uma mediação significativa entre ITP e TEPT pelos sentimentos de culpa/vergonha. Contudo, a significância limítrofe encontrada para o efeito indireto demanda investigações adicionais. Nossos achados reforçam a ideia de que as reações peritraumáticas devem ser analisadas e compreendidas como ocorrências simultâneas. Também seria oportuno que estudos envolvendo culpa/vergonha, ITP e TEPT focalizassem traumas caracterizados por aprisionamento e impossibilidade de escapar, dado que estas experiências são apontadas como mais susceptíveis para desencadear a ITP. (AU)


Posttraumatic stress disorder (PTSD) is a debilitating condition that greatly impacts quality of life. Among several PTSD risk factors, peritraumatic reactions (PR) such as peritraumatic tonic immobility (PTI), dissociation (PD) and physical panic reactions (PPR) are some of the most investigated. However, several studies have assessed these PR separately, and the pathway connecting them to PTSD is not well understood. Therefore, this thesis aimed to: (i) simultaneously estimate the effect of the three PR on PTSD using a validated instrument; and (ii) assess if there is an indirect effect of PTI on PTSD mediated by feelings of guilt/shame. We used structural equation modelling to analyse data from 3211 participants from Rio de Janeiro and São Paulo. We treated the PR as latent variables and selected specific confounders for each reaction. Our exposures were the PR, and PTSD was the outcome. We calculated odds ratios and 95% confidence intervals for each analysis. We also employed the Bayesian Information Criterion to compare the goodness of fit between non-nested models. Separately, all PR achieved statistically significant results. However, only PD (ORPD=1.8; 95%CI:1.3-2.4) and PPR (ORPPR=2.5; 95%CI:1.8-3.4) remained statistically significant when all three were included in a model with their respective confounders and correlations among all PR. Our findings suggested a possible effect of PTI on PTSD (ORPTI=1.4; 95%CI:1.0-1.9). Interactions between the PR were not statistically significant. When we investigated feelings of guilt/shame as the mediator between PTI and PTSD, the indirect effect achieved a borderline statistical significance (ORPTI(TNIE)=1.1; 95%CI:1.0-1.2). Direct (ORPTI(PNDE)=1.3; 95%CI:0.8-1.8) and total (ORPTI(TE)=1.4; 95%CI:0.9-1.9) effects lost their significance when all PR, their confounders and correlations were included in the same model. The other PR remained statistically significant (ORPD=1.7; 95%CI:1.3-2.3 and ORPPR=2.5; 95%CI:1.8-3.4). Our findings showed PD and PPR to increase the risk of PTSD even when considered in tandem. PTI could have an effect on PTSD, but this must be considered cautiously, as this PR only reached borderline significance in our final model. Feelings of guilt/shame did not significantly mediate PTI's effect on PTSD. However, a borderline statistical significance in the indirect effects warrants further investigation. Our findings reinforce the hypothesis that peritraumatic reactions should be analysed and understood as simultaneous occurrences, not as separate entities. It would also be appropriate for studies concerning guilt/shame, PTI and PTSD to focus on traumas characterized by imprisonment and feelings of inescapability, given that these experiences are allegedly more likely to trigger PTI. (AU)


Subject(s)
Humans , Stress Disorders, Post-Traumatic , Immobility Response, Tonic , Dissociative Disorders , Emotions , Quality of Life/psychology , Negotiating , Latent Class Analysis , Life Change Events
18.
Psicol. ciênc. prof ; 43: e263877, 2023.
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1529224

ABSTRACT

A violência sexual e o aborto legal são temas tabus em nossa sociedade. No campo da saúde, a(o) psicóloga(o) atua em fases distintas, seja na avaliação psicológica do pedido pelo aborto legal, que culminará ou não em sua aquiescência; seja no momento posterior à solicitação, no atendimento em enfermarias ou ambulatorial. Partindo de relato de experiência, este artigo tem como objetivo refletir sobre as possibilidades e desafios da atuação psicológica no atendimento em saúde para pessoas em situação de gestação decorrente de violência sexual e que buscam pelo aborto legal. Para tanto, dividimos o artigo em três momentos. No primeiro deles, será possível encontrar dados conceituais, estatísticos e históricos sobre ambos os temas, trazendo recortes nacionais e internacionais. No segundo, trazemos apontamentos sobre o que chamamos de "eixos norteadores", ou seja, dialogamos com aspectos fundamentais para o trabalho nesta seara, sendo eles gênero, família, sexualidade e trauma. Por fim, no terceiro, aprofundamos a reflexão sobre o atendimento psicológico atrelado aos conceitos já discutidos, analisando de forma crítica principalmente um dos pontos mais espinhosos da atuação: a avaliação para aprovação (ou recusa) do pedido pelo aborto. Apoiamo-nos no referencial psicanalítico e defendemos que esta atuação psicológica é primordialmente uma oferta de cuidado, comprometido com as demandas das pessoas atendidas e com a promoção de saúde mental, e consideramos que o papel da psicologia é essencial para o reconhecimento do sofrimento e dos efeitos do abandono socioinstitucional na vida do público atendido.(AU)


Sexual abuse and legal abortion are taboo subjects in our society. On the health area, the psychologist works on different fields, such as psychological evaluation from the request of legal abortion, that will end or not on its approval, and also in a further moment, either the care on wards or ambulatorial treatment. Relying on a case report, this article aims to contemplate the possibilities and challenges from psychological work on healthcare to pregnant women from sexual violence and seek legal abortion. For this purpose, we divide this article in three moments. On the first, it will find definitions, statistics, and historical data about both issues, including national and international information. On the second, we bring notes called 'guiding pillar,' that is, we interact with fundamental aspects from this area, such as gender, family, sexuality, and trauma. On the third one, in-depth discussions we dwell on psychological care tied to the concepts previously addressed, critically analyzing one of the hardest moments of working in this area: the evaluation to approve (or refuse) the request for abortion. We lean over psychoanalytic thoughts and argue that this psychological work is primarily an offer of care, committed to the needs from those who seek us and to promoting good mental health and, also, we consider that psychology is essential to acknowledge the suffering and the effects of social and institutional neglect on the lives of the people seen.(AU)


La violencia sexual y el aborto son temas tabús en nuestra sociedad. En el campo de la salud, el(la) psicólogo(a) actúa en diferentes fases: en la evaluación psicológica de la solicitud del aborto legal, que culminará o no en su obtención, y/o en el momento posterior a la solicitud en la atención en enfermería o ambulatorio. Desde un reporte de experiencia, este artículo pretende reflexionar sobre las posibilidades y los desafíos de la Psicología en la atención en salud para personas en estado de embarazo producto de violencia sexual y que buscan un aborto legal. Para ello, este artículo está dividido en tres momentos. En el primer, presenta datos conceptuales, estadísticos e históricos sobre los dos temas, trayendo recortes nacionales e internacionales. En el segundo, comenta los llamados "ejes temáticos", es decir, se establece un diálogo con aspectos fundamentales para el trabajo en este ámbito, como género, familia, sexualidad y trauma. Por último, en el tercer, profundiza en la reflexión sobre la atención psicológica asociada a los conceptos discutidos, analizando de forma crítica uno de los puntos más espinosos de la actuación: la evaluación para la aprobación (o negativa) de la solicitud de aborto. Se utilizó el referencial psicoanalítico y se argumenta que esta atención psicológica es sobre todo una forma de cuidado, comprometida con las demandas de las personas atendidas y la promoción de la salud mental, y el papel de la Psicología es esencial para reconocer el sufrimiento y los efectos del abandono socioinstitucional en la vida del público atendido.(AU)


Subject(s)
Humans , Female , Pregnancy , Psychology , Sex Offenses , Health , Abortion, Legal , Patient Care Team , Pedophilia , Pleasure-Pain Principle , Poverty , Pregnancy Maintenance , Prejudice , Prisons , Psychoanalysis , Public Policy , Punishment , Rape , Rehabilitation , Religion , Reproduction , Safety , Sexual Behavior , Sex Education , Social Class , Social Environment , Social Identification , Social Problems , Social Sciences , Stress Disorders, Post-Traumatic , Obstetric Surgical Procedures , Surgical Procedures, Operative , Taboo , Violence , Unified Health System , Risk Groups , Brazil , Pregnancy , Sex Counseling , Sexually Transmitted Diseases , Abortion, Criminal , Residence Characteristics , Maternal Mortality , Mental Health , Health Education , Vital Statistics , Women's Health , Acquired Immunodeficiency Syndrome , Gestational Age , HIV , Intersectoral Collaboration , Practice Guideline , Coronavirus , Battered Women , Confidentiality , Sexuality , Feminism , Crime Victims , Crime , Criminology , Hazards , Disaster Vulnerability , Cultural Characteristics , Personal Autonomy , Dangerous Behavior , Judiciary , Criminal Liability , Public Defender Legal Services , Public Attorneys , Death , Stress Disorders, Traumatic, Acute , Prenatal Nutritional Physiological Phenomena , Parturition , Vulnerable Populations , Aggression , Sexology , Human Rights Abuses , Racial Groups , Fetal Mortality , Pregnancy, Unplanned , Reproductive Rights , Erotica , PAHO Ethics Review Committee , Violence Against Women , Fear , Pleasure , Embryonic and Fetal Development , Human Trafficking , Psychological Trauma , Psychosocial Support Systems , Social Construction of Ethnic Identity , Social Construction of Gender , Androcentrism , Embarrassment , Sexual Trauma , Developmental Disability Nursing , Emotional Abuse , Gender Equity , Homicide , Interpersonal Relations , Anencephaly , Jurisprudence , Life Change Events , Men , Age Groups
19.
Article in Spanish | LILACS, BDENF, CUMED | ID: biblio-1508168

ABSTRACT

Introducción: La alta prevalencia de trastornos mentales como el estrés, en situaciones estresantes prolongadas inducidas por una pandemia, demanda su detección y valoración oportuna; para ello se requieren instrumentos contextualizados y con adecuadas propiedades métricas. Objetivo: Validar el Cuestionario sobre el Trastorno de Estrés Postraumático y Prevalencia de Sintomatología de Estrés Postraumático en población peruana. Métodos: Estudio de tipo instrumental, realizado en la región Ica del Perú, de junio a noviembre del 2021, en 412 participantes adultos. El proceso incluyó traducción al español, evaluación del contenido por jueces y prueba piloto. La validez de constructo se evaluó mediante el Análisis Factorial Exploratorio y el ajuste con Análisis Factorial Confirmatorio, que incluyó el Método de Estimación de Mínimos Cuadrados no Ponderados Robustos; se evaluó la confiabilidad con el Omega de McDonald y comparó la sintomatología del trastorno de estrés postraumático con variables generales. Resultados: Se obtuvo una versión de dieciocho ítems, agrupados en cuatro factores que explicaron el 70,78 por ciento de la varianza total y un ajuste aceptable [x2/gl = 1,54; NFI y CFI = 0,99; SRMR = 0,052; RMSEA = 0,036 (IC90 por ciento: 0,26-0,46)]. Los ítems discriminan de forma satisfactoria; así como la escala según variable sexo, estado civil y los que tienen familiar fallecido por COVID-19. La consistencia interna fue adecuada para la escala global (ω = 0,924) y sus dimensiones (EDA = 0,740; IEAN = 0,882; A = 0,786 y CE = 0,811). Conclusión: La nueva versión peruana del instrumento posee propiedades métricas aceptables; por tanto, se recomienda su uso para valorar el trastorno de estrés postraumático y estudios de validación(AU)


Introduction: The high prevalence of mental disorders such as stress, in prolonged stressful situations induced by a pandemic, demands their timely identification and assessment; in order to do this, contextualized instruments with adequate metric properties are required. Objective: To validate the Questionnaire on Posttraumatic Stress Disorder and Prevalence of Posttraumatic Stress Symptomatology in a Peruvian population. Methods: An instrumental study was conducted in the region of Ica, in Peru, from June to November 2021, with 412 adult participants. The process included translation into Spanish, content assessment by judges, and pilot testing. Construct validity was evaluated by exploratory factor analysis; and fit, with confirmatory factor analysis, which included the robust unweighted least squares estimation method. Reliability was evaluated with McDonald's Omega, while the posttraumatic stress disorder symptomatology was compared with general variables. Results: The obtained version included 18 items, grouped into four factors that explained 70.78 percent of the total variance. Also, an acceptable fit was obtained [x2/gl=1.54; NFI and CFI=0.99; SRMR=0.052; RMSEA=0.036 (90 percent CI: 0.26-0.46)]. The items discriminate satisfactorily, as does the scale according to sex, marital status and those with a family member who died from COVID-19. Internal consistency was adequate for the global scale (ω = 0.924) and its dimensions (EDA=0.740; IEAN = 0.882; A=0.786 and CE=0.811). Conclusion: The new Peruvian version of the instrument has acceptable metric properties; therefore, its use is recommended for assessing posttraumatic stress disorder and validation studies(AU)


Subject(s)
Humans , Stress Disorders, Post-Traumatic/epidemiology , Delivery of Health Care , COVID-19/epidemiology , Peru , Psychometrics/methods
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