Estilo terapêutico e orientação teórica: estudo comparativo com o Therapeutic Identity Questionnaire / Therapeutic style and theoretical orientation: comparative study using the Therapeutic Identity Questionnaire / Estilo terapéutico y orientación teórica: estudio comparativo con el Therapeutic Identity Questionnaire

O estudo das variáveis relativas ao terapeuta é um tema de relevância empírica no âmbito da investigação sobre o processo e resultados terapêuticos. O objetivo deste estudo é verificar se há diferenças nas respostas dadas às três subescalas em avaliação na versão em língua portuguesa do Therapeutic Identity Questionnaire (ThId) (fatores curativos, estilo terapêutico e pressupostos de base) em função da orientação teórica, dos anos de experiência e da realização de terapia pessoal dos 34 terapeutas em estudo, e avaliar as características psicométricas do instrumento. Em conclusão, a versão em língua portuguesa do ThId apresenta boas qualidades psicométricas e revelase útil para detectar diferenças de estilo e atitude terapêutica entre clínicos de diferentes orientações teóricas, mesmo em amostras dereduzida dimensão.

The study of therapist variables is a matter of empirical relevance in the realm of the research on therapeutic process and outcome.The goal of this study is to ascertain the differences regarding the responses given to the 3 subscales of the Portuguese version of the Therapeutic Identity Questionnaire (ThId) in evaluation (curative factors, therapeutic style and basic assumptions) in relation to theoretical orientation, years of experience and previous personal therapy among the 34 therapists enrolled in the study, along side the psychometric evaluation of the instrument. In conclusion, the Portuguese version of ThId displays good preliminary psychometricqualities and empirical use fulness to capture differences in style and attitude between clinicians of different theoretical models, evenin reduced samples.

El estudio de las variables relacionadas con el terapeuta es tema de prominencia empírica en la investigación sobre proceso y resultados terapéuticos. El objetivo de este estudio es verificar si hay diferencias en las respuestas a las tres subescalas en evaluación en la versión en lengua portuguesa del Therapeutic Identity Questionnaire (ThId) (factores curativos, estilo terapéutico y supuestos de base) atendiendo ala orientación teórica, años de experiencia y realización de terapia personal de los 34 terapeutas participantes, y evaluar las características psicométricas del instrumento. En conclusión, la versión en lengua portuguesa del ThId tiene buenas propiedades psicométricas y esútil para detectar diferencias de estilo y actitud terapéutica entre clínicos de diferentes orientaciones teóricas, incluso en muestras dedimensión reducida.

Estilo terapêutico e orientação teórica: estudo comparativo com o Therapeutic Identity Questionnaire / Therapeutic style and theoretical orientation: comparative study using the Therapeutic Identity Questionnaire / Estilo terapéutico y orientación teórica: estudio comparativo con el Therapeutic Identity Questionnaire

O estudo das variáveis relativas ao terapeuta é um tema de relevância empírica no âmbito da investigação sobre o processo e resultados terapêuticos. O objetivo deste estudo é verificar se há diferenças nas respostas dadas às três subescalas em avaliação na versão em língua portuguesa do Therapeutic Identity Questionnaire (ThId) (fatores curativos, estilo terapêutico e pressupostos de base) em função da orientação teórica, dos anos de experiência e da realização de terapia pessoal dos 34 terapeutas em estudo, e avaliar as características psicométricas do instrumento. Em conclusão, a versão em língua portuguesa do ThId apresenta boas qualidades psicométricas e revelase útil para detectar diferenças de estilo e atitude terapêutica entre clínicos de diferentes orientações teóricas, mesmo em amostras dereduzida dimensão.(AU)

The study of therapist variables is a matter of empirical relevance in the realm of the research on therapeutic process and outcome.The goal of this study is to ascertain the differences regarding the responses given to the 3 subscales of the Portuguese version of the Therapeutic Identity Questionnaire (ThId) in evaluation (curative factors, therapeutic style and basic assumptions) in relation to theoretical orientation, years of experience and previous personal therapy among the 34 therapists enrolled in the study, along side the psychometric evaluation of the instrument. In conclusion, the Portuguese version of ThId displays good preliminary psychometricqualities and empirical use fulness to capture differences in style and attitude between clinicians of different theoretical models, evenin reduced samples.(AU)

El estudio de las variables relacionadas con el terapeuta es tema de prominencia empírica en la investigación sobre proceso y resultados terapéuticos. El objetivo de este estudio es verificar si hay diferencias en las respuestas a las tres subescalas en evaluación en la versión en lengua portuguesa del Therapeutic Identity Questionnaire (ThId) (factores curativos, estilo terapéutico y supuestos de base) atendiendo ala orientación teórica, años de experiencia y realización de terapia personal de los 34 terapeutas participantes, y evaluar las características psicométricas del instrumento. En conclusión, la versión en lengua portuguesa del ThId tiene buenas propiedades psicométricas y esútil para detectar diferencias de estilo y actitud terapéutica entre clínicos de diferentes orientaciones teóricas, incluso en muestras dedimensión reducida.(AU)

Role of the disease in the psychological impact of pre-symptomatic testing for SCA2 and FAP ATTRV30M: Experience with the disease, kinship and gender of the transmitting parent.

To identify possible factors affecting the psychological impact of pre-symptomatic testing for spinocerebellar ataxia type 2 (SCA2) and familial amyloid polyneuropathy (FAP ATTRV30M), we studied (1) the effect of previous experience with the disease in the family, (2) kinship with the closest affected relative and (3) gender of affected parent, when adapting to test results; as well as (4) differences in the course of psychological wellbeing in 63 subjects ( 28 at-risk for FAP ATTRV30M, and 35 at risk for SCA2), who pursued predictive testing for these diseases, in Cuba and in Portugal. Our research shows that individuals with little or no experience with the disease in their family exhibited more anxiety; at-risk subjects for SCA2 or FAP ATTRV30M who had a first degree relative with the disease showed lower levels of anxiety and depression during pre-symptomatic testing. Also those with an affected mother had lower levels of depression, either immediately, or one year after receipt of test results. Adaptation to pre-symptomatic testing results differed for subjects at-risk for the two different conditions. Unlike the FAP ATTRV30M families, carriers for SCA2 reported pathological levels of depression immediately after-testing (3 weeks), although those levels had returned to normal levels at 6 months. Subjects at-risk for FAP ATTRV30M tended to have less anxiety than those tested for SCA2, at the one-year follow-up. Overall, depression levels improved over time, while anxiety remained more constant. A longer awareness of the disease in the family, closer kinship, and a transmitting mother all lessened the impact of pre-symptomatic testing, as expressed by the post-test levels of anxiety and depression.

Psychological Follow-up of Presymptomatic Genetic Testingfor Spinocerebellar Ataxia Type 2 (SCA2) in Cuba

Presymptomatic testing for spinocerebellar ataxia type 2 (SCA2) in Cuba started five yearsago. We have now investigated the psychological impact of test results on 150 individuals at5O percent risk for SCA2. In a prospective study, psychological instruments were used to evaluatedepression, anxiety and family functioning (1) before testing and (2) one year after disclosureof the test result. One year after, anxiety and depression levels decreased both in carriersand non-carriers, but anxiety decreased significantly more in carriers. Pathological levelsof anxiety were seen mostly in members of dysfunctional families, but decreased more inthem than in other consultands. Presymptomatic testing thus seems to have been especiallybeneficial for these testees, possibly due to a greater gain from the psychosocial supportreceived. It would be pertinent to evaluate now the impact of other psychosocial variablesand perform longer-term longitudinal studies...(AU)

Psychological follow-up of presymptomatic genetic testing for spinocerebellar ataxia type 2 (SCA2) in Cuba.

Presymptomatic testing for spinocerebellar ataxia type 2 (SCA2) in Cuba started five years ago. We have now investigated the psychological impact of test results on 150 individuals at 50% risk for SCA2. In a prospective study, psychological instruments were used to evaluate depression, anxiety and family functioning (1) before testing and (2) one year after disclosure of the test result. One year after, anxiety and depression levels decreased both in carriers and non-carriers, but anxiety decreased significantly more in carriers. Pathological levels of anxiety were seen mostly in members of dysfunctional families, but decreased more in them than in other consultands. Presymptomatic testing thus seems to have been especially beneficial for these testees, possibly due to a greater gain from the psychosocial support received. It would be pertinent to evaluate now the impact of other psychosocial variables and perform longer-term longitudinal studies.

Cocaine addiction and family dysfunction: a case-control study in southern Brazil.

Family-related factors play a crucial role in the onset, development, and maintenance of drug misuse and addiction. To investigate the hypothesis that families with a cocaine addicted son display more dysfunction than control families, we applied the Personal Authority in the Family System and the Self-Report Measure of Family Functioning to 67 case triads (child-father-mother) in which the son was an inpatient with a primary diagnosis of cocaine abuse or dependence and to 67 matched control triads from the community (Pelotas, Brazil) in 2000. Case children, mothers, and fathers were significantly more likely to present nuclear family triangulation than their matched control subjects. In addition, case triads had a significantly greater chance of perceiving family functioning as enmeshment. These results suggest both structural and functional differences in these families. We argue for the need of interventions in the family as a whole and for further research in this area.

As máscaras da dor mental: ocultação/desocultação no processo psicanalítico / The masks of mental pain: occultation and disclosure in the psychoanalytic process

A partir do desafio colocado por Freud de progredirmos na clarificação conceitual dos afetos dolorosos, e após uma breve revisão da literatura psicanalítica sobre o tema, a autora propõe uma definição do conceito de dor mental e um modelo de compreensão da sua gênese a partir do pensamento de Freud. Propõe, ainda, uma distinção entre os conceitos de dor mental e de sofrimento psíquico. Analisa os mecanismos de ocultação e de desocultação da dor mental no processo psicanalítico, através de material clínico de vários pacientes. Finalmente tece considerações sobre a técnica de abordagem da dor mental na clínica (AU)

Entre o corpo e a mente: para uma compreensão da dor mental e do sofrimento psíquico

O objectivo deste artigo é contribuir para a expansão do conhecimento psicanalítico em torno da questão do sofrimento psíquico e da dor mental, conceitos que a autora pretende discriminar e aprofundar. Baseada na revisão desses conceitos na literatura psicanalítica, com destaque para o obra de Freud, a autora examina as fronteiras conceptuais entre dor corporal, sofrimento psíquico e dor mental, discute a questão da continuidade vs. discontinuidade soma psique e fornece argumentos para a necessidade de reconhecer clinicamente a dor mental dos pacientes. Apresenta material clínico como qual pretende fundamentar a sua contribuição pessoal para o que designa por 'dor sem nome'. Por fim, tendo por base a sua experiência e pesquisa clínica, propõe uma distinção conceptual entre sofrimento psíquico e dor mental e fornece pistas para um modelo teórico e clínico de compreensão da dor mental(AU)