A Self-Reported Study on Explanatory Variables of Stress in Multiple Sclerosis Patients: Exploring the Effect of Physical Conditions and Emotion Regulation Processes.

BACKGROUND: Multiple sclerosis (MS)-linked stress is frequent, multidetermined and facilitates the onset/exacerbation of MS. However, few explanatory models of stress analysed the joint explanatory effect of emotion regulation and clinical outcomes of MS in those patients. OBJECTIVE: This study explored whether self-reported MS-related conditions (number of relapses, fatigue and global disability) and specific emotion regulation processes (experiential avoidance and self-compassion) explain stress symptoms in MS patients. METHODS: The MS sample comprised 101 patients with MS diagnosis receiving treatment in hospitals and recruited through the Portuguese MS Society. The no-MS sample included 134 age-, sex- and years of education-matched adults without MS recruited from the general Portuguese population. Both samples did not report other neurological disorders. Data were collected using self-response measures. RESULTS: All potential explanatory variables differed significantly between samples, with higher scores found in MS patients. In MS clinical sample, those variables and years of education correlated with stress symptoms and predicted stress symptoms in simple linear regression models. These results allowed their selection as covariates in a multiple linear regression model. Years of education, the number of relapses, fatigue and experiential avoidance significantly predicted 51% of stress symptoms' total variance. CONCLUSIONS: This study provides preliminary evidence on the importance of clinicians and researchers considering the simultaneous contribution of years of education, the number of perceived relapses, fatigue and experiential avoidance as factors that can increase vulnerability to stress in MS patients. Psychological intervention programmes that tackle these factors and associated stress symptomatology should be implemented.

Neuropathic pain, cognitive fusion, and alexithymia in patients with multiple sclerosis: Cross-sectional evidence for an explanatory model of anxiety symptoms.

Multiple sclerosis (MS) presents a high prevalence, a marked increase worldwide, and a relevant impact on patients, public health, and society. Anxiety often cooccurs with MS and can contribute to the worsening of MS symptoms. However, knowledge about predictors of anxiety in Patients with MS (PwMS) is scarce. OBJECTIVE: This preliminary study explored a novel model for anxiety symptoms in PwMS, including neuropathic pain (NeP), cognitive fusion (CF), experiential avoidance (EA), and alexithymia as explanatory factors. METHOD: This cross-sectional study integrated two independent convenience samples: 107 PwMS recruited from the Portuguese Society for Multiple Sclerosis and 97 age- and gender-matched participants without the MS diagnosis (no-MS sample) recruited from the Portuguese general population. Self-report questionnaires that measured the constructs included in the model were administered to both groups. RESULTS: PwMS showed significantly higher values regarding anxiety symptoms and their explanatory variables (NeP, CF, EA, alexithymia) in comparison to non-MS participants. In the MS sample, no correlations were found between anxiety symptoms and sociodemographic and clinical characteristics. NeP, CF, and alexithymia showed significant correlations with anxiety symptoms and significantly explained this symptomatology in simple linear regression models. Thus, these variables were retained in the multiple linear regression model and emerged as significant regressors that together explained 38% of the variance in anxious symptomatology in PwMS. CONCLUSIONS: This preliminary study provides novel evidence on NeP and some maladaptive emotion regulation strategies related to EA/psychological inflexibility, as vulnerability to anxiety in PwMS can be considerably increased by CF and alexithymia. Clinical implications were discussed.

Brazilian Psychiatric Association Consensus for the Management of Acute Intoxication. General management and specific interventions for drugs of abuse.

OBJECTIVE: To present the Brazilian Psychiatric Association's Consensus for the Management of Acute Intoxication. METHODS: A group of experts selected by the Brazilian Psychiatric Association searched for articles in the MEDLINE (by PubMed) and Cochrane Database, limited to human studies and acute intoxication. Groups reviewed these materials for appropriateness to the topic and the quality of the work. To perform a table of agreed recommendations at the end of the systematic review, a survey using the Delphi method was conducted. Three survey rounds were conducted to develop a consensus. RESULTS: Support for intoxication may start with Initial Management: Resuscitation/Life Support/Differential Diagnosis. For that, the group proposed these orders of assessment: A (airway), B (breathing), C (circulation), D.1. (disability), D.2. (differential diagnosis), D.3. (decontamination), D.4. (drug antidotes), E (enhanced elimination). Then, the group of experts presented specific interventions for the main drugs of abuse. CONCLUSIONS: The approach to intoxication with drugs of abuse is complex and requires systematic protocols. The group of experts suggested the adoption of the classic use in welcoming the patient of the A-B-C-D-E technique with constant investigation of this patient until reaching a specific conduct and with the support to remit the picture. The group of experts believes that this document, at this time, can help psychiatric, general, and emergency doctors deal with psychiatric emergency episodes due to acute intoxication.

Primary HPV-DNA screening in women under 30 years of age: health technology assessment / Tamización primaria con prueba ADN-VPH en mujeres menores de 30 años: evaluación de tecnología sanitaria

Background: Primary screening with Human Papilloma Virus (HPV) testing was introduced in Colombia in 2014 for individuals between 30 and 65 years of age. When the result is positive, cytology triage is performed for colposcopy referral. The convenience of initiating HPV-DNA testing for screening at 25 years of age is currently a subject of discussion. Therefore, the objective of this health technology assessment (HTA) is to analyze the available evidence regarding safety, efficacy, cost-effectiveness, values and preferences, ethical dilemmas and considerations pertaining to the implementation of the HPV-DNA test as a cervical screening strategy in women under 30 years of age in the Colombian context. Domains to be assessed: Clinical efficacy and safety 1. Cumulative rate of cervical intraepithelial neoplasia (CIN) grade 2 or high-er after 2 screening rounds. 2. Cumulative rates of invasive cancer of the uterine cervix after 2 screening rounds. 3. Safety: referral to colposcopy. Cost-effectiveness Cost-effectiveness for Colombia. Other domains considered Ethical considerations associated with cervical screening in women under 30 years of age. Organizational and individual considerations. Barriers and facilitators pertaining to the implementation of cervical screening in women under 30 years of age in the Colombian context. Methods: Clinical efficacy and safety assessment A systematic literature search of systematic reviews and clinical trials was conducted in MEDLINE, Embase and CENTRAL. The body of evidence was rated using the GRADE approach. An interdisciplinary team was then convened to create a working group to review the retrieved evidence. This led to the discussion and construction of the conclusions following the guidelines of a formal consensus in accordance with the RAND/UCLA methodology. Economic study Systematic literature research of studies that had assessed cost-effectiveness for Colombia. Results: Clinical outcomes An integrative analysis of 5 randomized clinical trials that met the inclusion critera was performed. Compared with cytology, primary HPV-DNA testing in women under 30 years of age could be associated with a lower frequency of CIN+2 lesions during the first screening round (RR: 1.57; CI: 1.20 to 2.04; low evidence certainty), and a lower incidence of CIN+2 (RR: 0.67; CI: 0.48 to 0.92; low evidence certainty). Moreover, it is associated with a lower frequency of invasive carcinoma at the end of follow-up (RR: 0.19; CI: 0.07 to 0.53; high evidence certainty). Economic results From the financial point of view, the use of HPVDNA testing plus cytology-based triage starting at 25 years of age is perhaps the most cost-effective option for Colombia (incremental cost-effectiveness ratio, COP 8,820,980 in 2013). Other implications Two studies suggest that barriers to implementation attributable to intermediation, public unrest and geographic considerations could be overcome with the use of new screening technologies or strategies. It is important to consider administration and service provision alternatives in order to overcome some acceptability and access barriers. Any cervical screening program must take into consideration ethical principles of nonmaleficence, beneficence, autonomy and equity. Future studies should focus on analyzing new screening techniques with emphasis on the population under 30 years of age. Conclusions: The use of HPV-DNA testing as a screening strategy in women under 30 years of age is a potentially efficacious and cost-effective intervention for Colombia. Future studies should focus on analyzing new screening technologies, with emphasis on the population under 30 years of age.

Antecedentes: A partir del 2014 en Colombia se incorporó la Tamización primaria con prueba de Virus del Papiloma Humano (VPH) desde los 30 hasta los 65 años, cuando la prueba es positiva se hace triage con citología para remisión a colposcopia. Actualmente se discute la conveniencia de iniciar la tamización con prueba de ADN de VPH a partir de los 25 años. De esta manera, el objetivo de esta evaluación de tecnologías sanitarias es analizar la evidencia disponible en torno a la seguridad, efectividad, costoefectividad, valores y preferencias, dilemas éticos y aspectos relacionados con la implementación para el contexto colombiano de la prueba ADN-VPH como estrategia de tamización cervical en mujeres menores de 30 años. Dominios a evaluar: Eficacia clínica y seguridad 1. Tasa acumulada de neoplasia intraepitelial cervical (NIC) grado 2 o más avanzado luego de 2 rondas de tamización. 2. Tasas acumuladas de cáncer invasor de cérvix luego de 2 rondas de tamización. 3. Seguridad: remisión a colposcopia. Costo-efectividad Costo efectividad para Colombia. Otros dominios considerados Aspectos éticos asociados a la tamización cervical en mujeres menores de 30 años. Aspectos organizacionales y del individuo. Barreras y facilitadores relacionados con la implementación en el contexto colombiano de la tamización cervical en mujeres menores de 30 años. Métodos: Evaluación de efectividad y seguridad clínicas Se realizó una búsqueda sistemática de la literatura en MEDLINE, Embase y CENTRAL de revisiones sistemáticas y ensayos clínicos. Se calificó el cuerpo de la evidencia con la aproximación GRADE. Posteriormente, se convocó a un grupo interdisciplinario a una mesa de trabajo en donde se presentó la evidencia recuperada, dando paso a la discusión y a la construcción de las conclusiones, siguiendo los lineamientos de un consenso formal acorde a la metodología RAND/UCLA. Estudio económico Se hizo una búsqueda sistemática de la literatura de estudios que hubieran evaluado el costo-efectividad para Colombia. Resultados: De 7.659 referencias recuperadas se incluyeron 8 estudios. Resultados clínicos Se realizó un análisis integrativo de 5 ensayos clínicos aleatorizados que cumplieron con los criterios de inclusión. Cuando se compara frente a la citología, la tamización primaria con ADN-VPH en mujeres menores de 30 años, podría asociarse con una mayor frecuencia de detección de lesiones NIC2+ durante la primera ronda de cribado (RR: 1.57; IC: 1,20 a 2,04; certeza en la evidencia baja), con una menor incidencia de NIC2+ (RR:0,67; IC: 0,48 a 0,92; certeza en la evidencia baja) y se asocia con una menor frecuencia de carcinoma invasor al término del seguimiento (RR: 0,19; IC: 0,07 a 0,53; certeza en la evidencia alta). Resultados económicos Desde el punto de vista económico, la alternativa de ADN-VPH y triage con citología desde los 25 años quizás representa la alternativa más costo-efectiva para Colombia (razón costo-efectividad incremental $8.820.980 COP año 2013). Otras implicaciones Dos estudios sugieren que las barreras de implementación, atribuibles a circunstancias de intermediación, de orden público y de carácter geográfico, podrían ser solventadas por nuevas tecnologías o estrategias de cribado. Es importante considerar alternativas de forma de administración y de prestación de servicios para solventar algunas barreras de aceptabilidad y acceso. Todo programa de tamización cervical debe contemplar los principios éticos de no maleficencia, beneficencia, autonomía y equidad. Futuros estudios deben enfocarse en analizar nuevas tecnologías de cribado con énfasis en población menor de 30 años. Conclusiones: El uso de la prueba ADN-VPH como estrategia de tamización en mujeres menores de 30 años es una intervención probablemente efectiva y costoefectiva para Colombia. Futuros estudios deben enfocarse en analizar nuevas tecnologías de cribado con énfasis en población menor de 30 años.

Experiential avoidance, uncompassionate self-responding, and peritraumatic depersonalization/derealization: A novel mediation model for war-related PTSD symptomatology.

OBJECTIVE: To explore a novel model for war-related posttraumatic stress disorder (PTSD) symptomatology including emotion regulation processes, namely experiential avoidance (EA) and uncompassionate self-responding (USR), mediating the impact of childhood threat memories, combat exposure distress, combat and noncombat threats, and peritraumatic depersonalization/derealization (PDD) on PTSD symptomatology. METHOD: A sample of 650 male Portuguese Overseas War veterans filled self-report instruments. RESULTS: The model explained 59% of the variance of PTSD symptomatology. Both EA and USR mediated the effects of noncombat threats and PDD on PTSD. Additionally, EA mediated combat exposure distress and USR mediated childhood threat memories. Combat exposure distress, combat and noncombat threats, and PDD showed direct effects on PTSD symptomatology. CONCLUSION: The findings help to better understand the relationship between predictive factors of war-related PTSD in clinical and research settings, providing novel insights on the effects of combat exposure distress, and the different effects of combat and noncombat-related threats on PTSD.

The neurocognitive and functional profile of schizophrenia in a genetically homogenous European sample.

Schizophrenia is a complex heritable brain disorder that entails significant social, neurocognitive, and functional deficits, and significant psychosocial challenges to affected and unaffected family members. In this cross-sectional study, we explore impairments in specific neurocognitive and social cognition processes in patients affected with schizophrenia, unaffected relatives, and in controls to provide a characterization of a genetically homogenous European sample from an endophenotypic and functional standpoint. A sample of 38 affected patients, 28 first-degree relatives, and 97 controls performed a series of computerized and skills-based assessments. Samples were compared across several neurocognitive, social, and functional domains. Significant impairments in episodic memory, executive function, social cognition, complex cognition, sensorimotor domains were found in patients and first-degree relatives. Findings also showed increased processing speed in memory and other complex cognitive processes relevant to autonomous living. A discriminant function analysis yielded 2 functions allowing 79% of correct group classifications based on social cognition and functional skills, neurocognition, and age. The study highlights the importance of resourcing to wide-ranging assessment methodologies, of developing research efforts to further understand the decline of social and neurocognitive processes, and the need for designing more targeted intervention strategies to be implemented both with affected patients and families.

Construct validity, sensitivity and specificity of the USCD Performance-based Skill Assessment 2 in a mixed Portuguese sample.

Assessment batteries of functional capacity provide robust indicators of real-world functioning in major psychiatric illnesses and important information on an individual's ability to live autonomously and pursue relevant psychosocial goals. OBJECTIVES: This study explores the psychometric properties of the Portuguese USCD Performance-based Skill Assessment 2 (UPSA-2-PT) in a mixed sample of Portuguese participants. METHOD: A sample of 110 participants, 37 patients diagnosed with schizophrenia, 27 first-degree relatives of patients and 46 controls were administered the UPSA-2-PT and self-report questionnaires. The UPSA-2-PT reliability was assessed through inter-rater reliability and internal consistency, convergent validity with community integration and a receiver operating curve analysis was conducted to establish scores' sensitivity and specificity. Youden's Index was used to determine an optimal UPSA-2-PT cutoff score. RESULTS: Findings show an excellent inter-rater reliability, good internal consistency and construct validity, consistent with previous studies in Western countries. The UPSA-2-PT also showed a good discriminant ability between patients and controls, and an overall percentage of correct classification of 86.7% based on the 81.59 cutoff. DISCUSSION: Findings are congruous with previous versions, strengthening the body of evidence supporting the construct validity and providing a useful tool for research and clinical purposes to practitioners.

Portuguese version of the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5): Comparison of latent models and other psychometric analyses.

OBJECTIVE: This psychometric study explores the Portuguese version of the Posttraumatic Stress Disorder (PTSD) Checklist (PCL-5). It aims to clarify the best-fitting latent structure among competing PTSD models (Diagnostic and Statistical Manual of Mental Disorders-fifth edition [DSM-5], Dysphoria, Dysphoric Arousal, Anhedonia, Externalizing Behavior, And Hybrid models) and its implications for PTSD measurement. METHOD: Psychometric analyses were conducted in a sample from the general population of firefighters (N = 446), except the temporal stability, which was tested in a subsample of 100 participants. RESULTS: The models presented significant differences in a global fit. The Hybrid model presented the best-fitting structure, but the DSM-5 model showed more favorable reliability and convergent validity in Confirmatory Factor Analyses. The DSM-5 model also proved to be internally consistency, temporally stable, and presented convergent validity. CONCLUSION: The Portuguese version of PCL-5 is reliable and valid. The findings suggest the appropriateness of the DSM-5 model to assess PTSD symptomatology, encouraging its use in clinical, and research settings.

Centro de cidadania LGBT: memórias e experiências no campo das práticas psi em prol da defesa dos direitos humanos / LGBT citizenship center: memories and experiences in the field of psi practices for the defense of human rights / Centro de ciudadanía LGBT: memorias y experiencias en el campo de las prácticas psi en defensa de los derechos humanos

O presente artigo constitui-se num relato de experiências de profissionais da Psicologia vivenciadas nos Centros de Cidadania LGBT do Programa Rio sem Homofobia, no período em que este programa e seus Centros de Cidadania estiveram plenamente ativos e presentes em diferentes pontos do estado do Rio de Janeiro. Este programa é vinculado à Superintendência de Direitos Individuais, Coletivos e Difusos da então Secretaria de Assistência Social e Direitos Humanos do estado do Rio de Janeiro (SUPERDir/SEASDH) e tem como objetivos gerais o combate às homo, lesbo, bi e transfobias, bem como a promoção da cidadania LGBT. A partir de alguns casos por nós acompanhados, discutimos possibilidades de intervenção que se colocassem ao lado do movimento de ampliação da potência de vida dos(as) usuários(as) do serviço, principalmente pela proposta de intervenções interdisciplinares e articuladas com o contexto da demanda e/ou violação. Desta forma, reiteramos a importância de construirmos o campo das práticas psi atravessado por um trabalho em rede pautado por questões relacionadas aos Direitos Humanos, movimento social e políticas públicas...(AU)

This article is a narrative of the experiences of psychology professionals working in the LGBT Citizenship Centers of the Rio without Homophobia Programme, in the period in which this program and its Citizenship Centers were fully active and present in different parts of the state of Rio de Janeiro. This program is linked to the Superintendence of Individual, Collective and Diffuse Rights of the Department of Social Assistance and Human Rights of the state of Rio de Janeiro (SUPERDir/SEASDH) and has as general objectives the combat against homo, lesbo, bi and transphobia, as well as the promotion of LGBT citizenship. From a few cases we monitored, we discussed possibilities for intervention that were placed alongside the movement to increase the potency of life of the users of the service, mainly by the proposal of interdisciplinary interventions and articulations with the context of demand and/or violation. In this way, we reiterate the importance of constructing the field of psi practices through a networked work based on issues related to Human Rights, social movement and public policies...(AU)

Este artículo es un informe de las experiencias de los profesionales de psicología que vivieron en los Centros de Ciudadanía LGBT de Río sin el Programa de Homofobia, durante el período en que este programa y sus Centros de Ciudadanía estuvieron completamente activos y presentes en diferentes partes del estado de Río de Janeiro. Este programa está vinculado a la Superintendencia de Individuos, Colectivos y Difusos de la entonces Secretaría de Asistencia Social y Derechos Humanos del estado de Río de Janeiro (SUPERDir/SEASDH) y tiene como objetivos generales la lucha contra el homo, lesbo, bi y transfobías, así como la promoción de la ciudadanía LGBT. Con base en algunos casos que hemos seguido, discutimos las posibilidades de intervención que se colocarían junto con el movimiento para aumentar el poder de servicio de los usuarios del servicio, principalmente debido a la propuesta de intervenciones interdisciplinarias y articuladas con el contexto de demanda y / o violación Por lo tanto, reiteramos la importancia de construir el campo de las prácticas psi atravesadas por una red basada en temas relacionados con los Derechos Humanos, el movimiento social y las políticas públicas...(AU)

Ecological meta-analysis of bloom-forming planktonic Cyanobacteria in Argentina.

The aim of the present research was to summarize the main reasons that explain the distribution of harmful blooms of cyanobacteria in Argentina. It is a large territory with climates ranging from humid tropical to cold temperate. We performed a meta-analysis of the published data and information in technical reports published from 1945 to 2015, and included additional data from personal non-published studies. A total of 122 water bodies affected by planktonic cyanobacterial blooms were recorded and geo-referenced. The analysis showed that blooms, defined as events exceeding 5000 cells/mL, occurred in different types of water bodies, including shallow lakes, rivers, streams, reservoirs, estuaries and storage facilities. Maximum bloom abundance and species and ecological strategies (dispersive, scum-forming, nitrogen fixer) responsible for each event were related to the geographic and climatologic characteristics and type and origin of water bodies. The Puna and the Andean Patagonia eco-regions were mostly free of blooms. The most impaired aquatic systems were shallow lakes and reservoirs (46.7 and 24.6%, respectively). Deep lakes had no reports of blooms and rivers were mainly affected at the regulated reaches, with intensities generally decreasing downstream the dams. Besides, 74.3% of the blooms reported in Argentina exceeded WHO Alert Level 2 for drinking and bathing waters (100,000 cells/mL). Thirty-nine species, identified by Komárek's polyphasic approach to taxonomy, were responsible for the blooms. Microcystis aeruginosa, Dolichospermum spiroides, Dolichospermum circinale, Raphidiopsis mediterranea and Cylindrospermopsis raciborskii were frequently found participating in either mixed or single species blooms. The species distribution was associated with the eco-region and aquatic system typologies and affected by seasonality and climatological and geographic variables. The eco-strategies of cyanobacterial species showed stronger associations with the qualitative and quantitative indicators used in the meta-analysis, and appeared as useful tools for management measures.

Centro de cidadania LGBT: memórias e experiências no campo das práticas psi em prol da defesa dos direitos humanos / LGBT citizenship center: memories and experiences in the field of psi practices for the defense of human rights / Centro de ciudadanía LGBT: memorias y experiencias en el campo de las prácticas psi en defensa de los derechos humanos

O presente artigo constitui-se num relato de experiências de profissionais da Psicologia vivenciadas nos Centros de Cidadania LGBT do Programa Rio sem Homofobia, no período em que este programa e seus Centros de Cidadania estiveram plenamente ativos e presentes em diferentes pontos do estado do Rio de Janeiro. Este programa é vinculado à Superintendência de Direitos Individuais, Coletivos e Difusos da então Secretaria de Assistência Social e Direitos Humanos do estado do Rio de Janeiro (SUPERDir/SEASDH) e tem como objetivos gerais o combate às homo, lesbo, bi e transfobias, bem como a promoção da cidadania LGBT. A partir de alguns casos por nós acompanhados, discutimos possibilidades de intervenção que se colocassem ao lado do movimento de ampliação da potência de vida dos(as) usuários(as) do serviço, principalmente pela proposta de intervenções interdisciplinares e articuladas com o contexto da demanda e/ou violação. Desta forma, reiteramos a importância de construirmos o campo das práticas psi atravessado por um trabalho em rede pautado por questões relacionadas aos Direitos Humanos, movimento social e políticas públicas.(AU)

This article is a narrative of the experiences of psychology professionals working in the LGBT Citizenship Centers of the Rio without Homophobia Programme, in the period in which this program and its Citizenship Centers were fully active and present in different parts of the state of Rio de Janeiro. This program is linked to the Superintendence of Individual, Collective and Diffuse Rights of the Department of Social Assistance and Human Rights of the state of Rio de Janeiro (SUPERDir/SEASDH) and has as general objectives the combat against homo, lesbo, bi and transphobia, as well as the promotion of LGBT citizenship. From a few cases we monitored, we discussed possibilities for intervention that were placed alongside the movement to increase the potency of life of the users of the service, mainly by the proposal of interdisciplinary interventions and articulations with the context of demand and/or violation. In this way, we reiterate the importance of constructing the field of psi practices through a networked work based on issues related to Human Rights, social movement and public policies.(AU)

Este artículo es un informe de las experiencias de los profesionales de psicología que vivieron en los Centros de Ciudadanía LGBT de Río sin el Programa de Homofobia, durante el período en que este programa y sus Centros de Ciudadanía estuvieron completamente activos y presentes en diferentes partes del estado de Río de Janeiro. Este programa está vinculado a la Superintendencia de Individuos, Colectivos y Difusos de la entonces Secretaría de Asistencia Social y Derechos Humanos del estado de Río de Janeiro (SUPERDir/SEASDH) y tiene como objetivos generales la lucha contra el homo, lesbo, bi y transfobías, así como la promoción de la ciudadanía LGBT. Con base en algunos casos que hemos seguido, discutimos las posibilidades de intervención que se colocarían junto con el movimiento para aumentar el poder de servicio de los usuarios del servicio, principalmente debido a la propuesta de intervenciones interdisciplinarias y articuladas con el contexto de demanda y / o violación Por lo tanto, reiteramos la importancia de construir el campo de las prácticas psi atravesadas por una red basada en temas relacionados con los Derechos Humanos, el movimiento social y las políticas públicas.(AU)

Psychosocial roots of paranoid ideation: The role of childhood experiences, social comparison, submission, and shame.

BACKGROUND: Social experiences have a significant impact on cognitive functioning and appraisals of social interactions. Specifically, recalls of antipathy from parents, submissiveness, and bullying during childhood can have a significant influence on paranoid ideation later in life. METHOD: Multiple hierarchical regression analysis was performed on a sample of 91 patients diagnosed with paranoid schizophrenia in remission and active phase, their first-degree relatives (n = 32) and unaffected controls (n = 64). OBJECTIVES: Exploring the impact of distal (events from childhood) and proximal factors (current cognitive, emotional, and behavioural aspects of social functioning) in the frequency, degree of conviction, and distress resulting from paranoid ideation in the participants from 4 samples. RESULTS: Proximal and distal factors (shame, submissive behaviour, negative social comparison, antipathy from father) predicted several aspects of paranoid ideation. Those variables had a differential impact in affected patients and healthy controls. DISCUSSION: Finding suggests different variables being involved in paranoid ideation, and the specificities of patients with paranoid schizophrenia should be considered in the development of more effective psychotherapeutic interventions.

Correction to: Validation of the Community Integration Scale for Adults with Psychiatric Disorders (CIS-APP-34).

The original version of the article unfortunately contained a typo in the author name.

Validation of the Community Integration Scale for Adults with Psychiatric Disorders (CIS-APP-34).

The current focus on community integration of individuals with psychiatric problems is attracting an increasing interest in the psychological literature, as it is regarded as a favorable factor in the recovery and for the well-being of these individuals. The Community Integration Scale of Adults with Psychiatric Disorders (CIS-APP-34) is a self-report scale developed to assess community integration in several dimensions. The main goal of the current study is to explore the psychometric properties of CIS-APP-34 in a sample of 411 participants with and without a psychiatric illness, with ages between 19 and 91 years old, living in the Azores Islands, Portugal. A confirmatory factor analysis was carried out to confirm the latent structure of the scale, and a five-factor model has presented good fit indices. Further analysis showed that the CIS-APP-34 is a measure with good reliability, validity and discriminant ability.

Biting myself so I don't bite the dust: prevalence and predictors of deliberate self-harm and suicide ideation in Azorean youths

Objective: To characterize non-suicidal self-injury (NSSI) behaviors, methods, and functions as well as suicide ideation in the adolescent population of a Portuguese community in São Miguel Island, Azores. Increasing rates of NSSI behaviors among adolescents have been observed globally, while suicidal behavior has been pointed as a major cause of death during adolescence. Methods: A sample of 1,763 adolescents, aged 14 to 22, was randomly drawn from public and private schools and administered a set of self-report questionnaires. Descriptive and regression analyses were used to look for specific relationships and predictors of NSSI and suicide ideation in this isolated community. Results: Approximately 30% of youths reported at least one NSSI behavior, a rate that is twice as high as most studies carried out in mainland Portugal and in other European countries. Biting oneself was the most frequent form of NSSI, and NSSI behaviors served predominantly automatic reinforcement purposes (i.e., regulation of disruptive emotional states). NSSI and suicide ideation encompassed different distal and proximal risk factors. Conclusions: Exploring and characterizing these phenomena is necessary to provide a better understanding, enhance current conceptualizations, and guide the development of more effective prevention and intervention strategies in youths.

Emotional, Cognitive and Behavioral Reactions to Paranoid Symptoms in Clinical and Nonclinical Populations.

BACKGROUND: Paranoia is a disruptive belief that can vary across a continuum, ranging from persecutory delusions presented in clinical settings to paranoid cognitions that are highly prevalent in the general population. The literature suggests that paranoid thoughts derive from the activation of a paranoid schema or information processing biases that can be sensitive to socially ambiguous stimuli and influence the processing of threatening situations. METHODS: Four groups (schizophrenic participants in active psychotic phases, n=61; stable participants in remission, n=30; participants' relatives, n=32; and, healthy controls, n=64) were assessed with self-report questionnaires to determine how the reactions to paranoia of clinical patients differ from healthy individuals. Cognitive, emotional and behavioral dimensions of their reactions to these paranoid thoughts were examined. RESULTS: Paranoid individuals were present in all groups. Most participants referred to the rejection by others as an important trigger of paranoid ideations, while active psychotics were unable to identify triggering situations to their thoughts and reactions. This may be a determinant to the different reactions and the different degree of invalidation caused by paranoid thoughts observed across groups. CONCLUSIONS: Clinical and nonclinical expressions of paranoid ideations differ in terms of their cognitive, emotional and behavioral components. It is suggested that, in socially ambiguous situations, paranoid participants (presenting lower thresholds of paranoid schema activation) lose the opportunity to disconfirm their paranoid beliefs by resourcing to more maladaptive coping strategies. Consequently, by dwelling on these thoughts, the amount of time spent thinking about their condition and the disability related to the disease increases.

Biting myself so I don't bite the dust: prevalence and predictors of deliberate self-harm and suicide ideation in Azorean youths.

OBJECTIVE:: To characterize non-suicidal self-injury (NSSI) behaviors, methods, and functions as well as suicide ideation in the adolescent population of a Portuguese community in São Miguel Island, Azores. Increasing rates of NSSI behaviors among adolescents have been observed globally, while suicidal behavior has been pointed as a major cause of death during adolescence. METHODS:: A sample of 1,763 adolescents, aged 14 to 22, was randomly drawn from public and private schools and administered a set of self-report questionnaires. Descriptive and regression analyses were used to look for specific relationships and predictors of NSSI and suicide ideation in this isolated community. RESULTS:: Approximately 30% of youths reported at least one NSSI behavior, a rate that is twice as high as most studies carried out in mainland Portugal and in other European countries. Biting oneself was the most frequent form of NSSI, and NSSI behaviors served predominantly automatic reinforcement purposes (i.e., regulation of disruptive emotional states). NSSI and suicide ideation encompassed different distal and proximal risk factors. CONCLUSIONS:: Exploring and characterizing these phenomena is necessary to provide a better understanding, enhance current conceptualizations, and guide the development of more effective prevention and intervention strategies in youths.

Influence of Family and Childhood Memories in the Development and Manifestation of Paranoid Ideation.

Several studies point out to the influence of social experiences on perceptions of the environment and others in cognitive functioning and different aspects of psychopathology. The current study aimed at studying the influence of the psychosocial risk factors in a mixed sample of participants from the general population and affected by paranoid schizophrenia. The extent to which the existence of negative life events and events that are threatening to the inner models of the self (i.e., history of maltreatment, physical, social or psychological abuse) or the memories of these traumatic events occurring during childhood are related to the existence of paranoid beliefs in adulthood was explored. Results suggested that memories of parental behaviours characterized by antipathy from both parental figures, submissiveness and bullying victimization were important predictors of paranoid ideation in adult life. This further emphasizes the need for understanding the family and social dynamics of people presenting paranoid ideations to the development of therapeutic interventions that can effectively reduce the invalidation caused by severe psychopathology, as is the case of schizophrenia. Copyright © 2015 John Wiley & Sons, Ltd. KEY PRACTITIONER MESSAGE: Memories of family dynamics characterized by behaviours of antipathy from both parental figures, submissiveness and bullying victimization are important predictors of paranoid ideation in adult life. The study highlights the importance of exploring subjective recalls of feelings and behaviours associated with early rearing experiences, peer relationships and themes related to social rank theory in the roots of internal models of relationship with the self and others in the general sample, patients diagnosed with schizophrenia and their first-degree relatives. Our findings indicate that schizophrenic patients in active phase differ regarding memories of threat and submission and are more likely to remember childhood experiences perceived as threatening during an active phase than when in remission. It is possible that by changing these internal models and social interaction styles, patients may be able to get involved in more cooperating and affiliative interactions, disconfirming these early beliefs about others being rejecting, critical or hostile towards the self, and more effectively reducing the invalidation caused by positive and negative symptomatology of schizophrenia on social functioning.

Acolhimento e demanda espontânea na atenção básica

Módulo que aborda a importância do acolhimento para a qualificação da atenção básica. Trata este dispositivo transformador de garantia da ampliação do acesso e da qualidade da atenção prestada como uma questão complexa. Discute a necessidade de organizar o acolhimento aos usuários e de conciliar a agenda de consultas programadas com a demanda espontânea. Neste material, são propostas reflexões sobre temas como: acesso, acolhimento, demanda espontânea e processo de trabalho. Além disso, apresenta algumas alternativas de manejo e operacionalização dos conceitos antes citados a partir de situações próximas as do cotidiano de profissionais de saúde da atenção básica.

Mapping non suicidal self-injury in adolescence: Development and confirmatory factor analysis of the Impulse, Self-harm and Suicide Ideation Questionnaire for Adolescents (ISSIQ-A).

Non-suicidal self-injury (NSSI) is the deliberate, self-inflicted destruction of body tissue without suicidal intent and an important clinical phenomenon. Rates of NSSI appear to be disproportionately high in adolescents and young adults, and is a risk factor for suicidal ideation and behavior. The present study reports the psychometric properties of the Impulse, Self-harm and Suicide Ideation Questionnaire for Adolescents (ISSIQ-A), a measure designed to comprehensively assess the impulsivity, NSSI behaviors and suicide ideation. An additional module of this questionnaire assesses the functions of NSSI. Results of Confirmatory Factor Analysis (CFA) of the scale on 1722 youths showed items' suitability and confirmed a model of four different dimensions (Impulse, Self-harm, Risk-behavior and Suicide ideation) with good fit and validity. Further analysis showed that youth׳s engagement in self-harm may exert two different functions: to create or alleviate emotional states, and to influence social relationships. Our findings contribute to research and assessment on non-suicidal self-injury, suggesting that the ISSIQ-A is a valid and reliable measure to assess impulse, self-harm and suicidal thoughts, in adolescence.