Countertransference, Defense Mechanisms, and Vicarious Trauma in Work With Sexual Offenders.

This study aimed to examine the associations between countertransference induced by sex offenders, defense mechanisms, and manifestations of vicarious trauma in forensic psychiatrists and psychologists. A cross-sectional study using a mixed-methods design was performed with 56 Brazilian forensic psychiatrists and psychologists from October 2016 to May 2017. Countertransference, defense mechanisms, and vicarious trauma were assessed with the Assessment of Countertransference Scale, the Defense Style Questionnaire-40, and the Trauma and Attachment Belief Scale (TABS), respectively. Qualitative data analysis based on grounded theory was also performed to explore the influence of sex-offender assessments on the experts' personal and professional lives. Positive and moderate correlations were found between feelings of indifference and the Other-Safety TABS subscale (rho .43, P < .01) and between immature defense mechanisms and TABS total score (rho .45, P < .01). Qualitative data revealed changes in the professionals' identity, worldview, and beliefs related to safety and trust. Specific maladaptive coping strategies, such as feelings of indifference and immature defenses, during the assessment of sex offenders were associated with manifestations of vicarious trauma in forensic psychiatrists and psychologists. These findings indicate the need for awareness and care about the forensic expert's mental health.

First- and last-year medical students: is there a difference in the prevalence and intensity of anxiety and depressive symptoms?

Objective: Medical training is considered a significant stress factor. We sought to assess the prevalence and intensity of anxiety and depressive symptoms in medical students and compare samples of first-year and sixth-year students. Method: This was a cross-sectional study of first- and sixth-year medical students who attended classes regularly. The study instruments were a sociodemographic questionnaire, the Beck Depression Inventory (BDI), and the Beck Anxiety Inventory (BAI). Results: A total of 232 students (110 first-year, 122 sixth-year) completed the questionnaires, for a response rate of 67.4%. Overall 50.4% of respondents were male (56.4% of first-year and 45.1% of sixth-year students). Anxiety symptoms were reported by 30.8% of first-year students and 9.4% of sixth-year students (p < 0.001). Female students were more affected by anxiety. There were no significant between-group differences in depressive symptoms. Conclusion: A higher prevalence of anxiety symptoms was found in first-year medical students as compared with sixth-year students. Strategies should be developed to help medical students, particularly female students, manage these symptoms at the beginning of their medical training. .

First- and last-year medical students: is there a difference in the prevalence and intensity of anxiety and depressive symptoms?

OBJECTIVE: Medical training is considered a significant stress factor. We sought to assess the prevalence and intensity of anxiety and depressive symptoms in medical students and compare samples of first-year and sixth-year students. METHOD: This was a cross-sectional study of first- and sixth-year medical students who attended classes regularly. The study instruments were a sociodemographic questionnaire, the Beck Depression Inventory (BDI), and the Beck Anxiety Inventory (BAI). RESULTS: A total of 232 students (110 first-year, 122 sixth-year) completed the questionnaires, for a response rate of 67.4%. Overall 50.4% of respondents were male (56.4% of first-year and 45.1% of sixth-year students). Anxiety symptoms were reported by 30.8% of first-year students and 9.4% of sixth-year students (p < 0.001). Female students were more affected by anxiety. There were no significant between-group differences in depressive symptoms. CONCLUSION: A higher prevalence of anxiety symptoms was found in first-year medical students as compared with sixth-year students. Strategies should be developed to help medical students, particularly female students, manage these symptoms at the beginning of their medical training.

Defense style changes with the addition of psychodynamic group therapy to clonazepam in social anxiety disorder.

Psychodynamic Group Therapy (PGT) and clonazepam are strategies to reduce symptoms of generalized social anxiety disorder (GSAD). The addition of PGT might lead to changes in defense styles. The objective of this study is to examine changes in defense styles when comparing clonazepam to psychodynamic group therapy plus clonazepam in GSAD during 12 weeks. Fifty-seven patients that met DSM-IV criteria for GSAD participated. social anxiety disorder symptoms were evaluated with the Liebowitz Social Anxiety Scale, and defense styles with the Defense Style Questionnaire. All defense styles changed overtime for both groups, especially mature defense style, which increased independently of the treatment allocation group. Regression analyses found that overtime there was a reduction in neurotic defenses in the combined group, whereas there was an increase in the clonazepam group. Neurotic defense style can change toward greater adaptiveness with the addition of PGT to clonazepam in GSAD, even in 12 weeks.

A pilot study of clonazepam versus psychodynamic group therapy plus clonazepam in the treatment of generalized social anxiety disorder.

BACKGROUND: Both psychodynamic group therapy (PGT) and clonazepam are used as treatment strategies in reducing symptoms of generalized social anxiety disorder (GSAD). However, many individuals remain symptomatic after treatment with PGT or clonazepam. METHOD: Fifty-eight adult outpatients with a diagnosis of GSAD according to DSM-IV were randomized to 12 weeks PGT plus clonazepam or clonazepam. The Clinical Global Impression-Improvement (CGI-I) Scale was the primary efficacy measure. Secondary efficacy measures included the Liebowitz Social Anxiety Scale (LSAS) total score, the World Health Organization Instrument to Assess Quality of Life-Brief (WHOQOL-Bref) Scale and the Beck Depression Inventory (BDI). RESULTS: CGI-I data from 57 patients (intent-to-treat population) showed that patients who received PGT plus clonazepam presented significantly greater improvement than those who received clonazepam (P=0.033). There were no significant differences between the two groups in the secondary efficacy measures. CONCLUSIONS: Our study suggests that the combination of PGT with clonazepam may be a promising strategy for the treatment of GSAD, regarding gains in the global functioning. However the present study failed to detect more specific changes in social anxiety symptomatology between the two groups.

Perfil e prática profissional de psiquiatras no Brasil / Professional profile and practice of psychiatrists in Brazil

Com o objetivo de identificar o perfil profissional de psiquiatras do Brasil, foram escolhidos para estudo cinco Estados representativos de cada regiäo do País (Bahia, Pará, Rio de Janeiro, Säo Paulo, Rio Grande do Sul, além do Distrito Federal). A amostra consistiu de 430 membros da ABP, que responderam a questionário enviado pelo correio. Os dados foram analisados pelo sistema EPI-INFO. Verificou-se que 76,5 por cento dos psiquiatras estudados fazem ou fizeram supervisäo de seu trabalho, 65, 1 por cento participam de grupos de estudo, 51,9 por cento submeteram-se a psicoterapia pessoal, 71,2 por cento foram ou säo pacientes de psicanálise. Quanto à atividade profissional, 30,2 por cento do tempo säo dedicados a instituiçöes públicas, 11,6 por cento a instituiçöes privadas e 48,3 por cento ao consultório particular. Neste, predominam as técnicas psicoterápicas

Perfil e pratica profissional de psiquiatras no Brasil

Com o objetivo de identificar o perfil profissional de psiquiatras do Brasil, foram escolhidos para estudo cinco Estados representativos de cada regiao do Pais (Bahia, Para, Rio de Janeiro, Sao Paulo, Rio Grande do Sul, alem do Distrito Federal). A amostra consistiu de 430 membros da ABP, que responderam a questionario enviado pelo correio. Os dados foram analisados pelo sistema EPI-INFO. Verificou-se que 76,5 por cento dos psiquiatras estudados fazem ou fizeram supervisao de seu trabalho, 65,1 por cento participam de grupos de estudo, 51,9 por cento submeteram-se a psicoterapia pessoal, 71,2 por cento foram ou sao pacientes de psicanalise. Quanto a atividade profissional, 30,2 por cento do tempo sao dedicados a instituicoes publicas, 11,6 por cento a instituicoes privadas e 48,3 por cento ao consultorio particular. Neste, predominam as tecnicas psicoterapicas.

Ambulatorio de psiquiatria do Hospital de Clinicas de Porto Alegre, 1986-caracteristicas demograficas, diagnosticos e tratamentos / Psychiatric outpatient clinic of the Hospital de Clinicas de Porto Alegre, 1986 - demographic characteristics, diagnosis and treatments

Os autores revisaram os prontuarios de todos os pacientes com mais de 17 anos atendidos no Ambulatorio de Psiquiatria doo Hospital de Clinicas de Porto Alegre(num total de 668), em 1986. Objetivando caracterizar a populacao atendida. Encontrou-se que o paciente medio era adulto jovem feminino, branco, casado, de afazeres domesticos, procedente de Porto Alegre, encaminhado por medicos de outras areas do HCPA com diagnostico predominante de quadro nao psicotico e que recebe atendimento individual entre 1 a 4 consultas. A metade dospacientes usava medicacao