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1.
Sleep Med ; 89: 147-155, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34990921

RESUMO

BACKGROUND: Far from being benign, somnambulistic episodes can be frequent and/or severe and potentially injurious. Episodes may also be accompanied by sleep mentation with variable degrees of retrograde amnesia. The present study investigated how somnambulistic episodes unfold from childhood through adulthood, a topic that remains understudied. METHODS: Adult sleepwalkers with a diagnosis of primary somnambulism and a childhood onset of the disorder (n = 113) were assessed for changes in frequency of their episodes, recall of episode-related sleep mentation and aggressive episodes during childhood, adolescence and adulthood. In addition, sleepwalkers (n = 52) with childhood-onset of sleep terrors were assessed for developmental changes in sleep terror frequency. RESULTS: Results indicate that the frequency of somnambulistic episodes remains unchanged during childhood and adolescence before increasing during adulthood. An opposite trend was observed for sleep terrors. The frequency of aggressive somnambulistic episodes and of sleep mentation associated with somnambulism increased from childhood to adolescence and into adulthood. By contrast, the recall of sleep mentation associated with sleep terrors did not change over time. Additionally, a higher frequency of aggressive somnambulistic episodes predicted a higher frequency of sleep mentation associated with somnambulism. These patterns were similar across men and women. CONCLUSION: Our study demonstrates that in chronic sleepwalkers, sleep mentation associated with somnambulistic episodes increases with age while episodes worsen in frequency and severity from childhood to adulthood. These findings add to the limited literature in the field and provide valuable insights into how key clinical characteristics of somnambulism evolve across the lifespan.


Assuntos
Terrores Noturnos , Sonambulismo , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Terrores Noturnos/epidemiologia , Autorrelato , Sono , Sonambulismo/diagnóstico , Sonambulismo/epidemiologia , Adulto Jovem
2.
Can J Psychiatry ; 66(6): 569-576, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33155838

RESUMO

OBJECTIVE: Victims of child sexual abuse (CSA) present with a higher risk of psychotic disorders. However, the developmental course of psychosis following CSA, such as the age at onset, remains unknown. This study aimed to determine whether the age at onset of psychotic disorders was influenced by sexual abuse, sex, and confounding factors (substance misuse, intellectual disability, and socioeconomic status). METHOD: A prospective matched-cohort design was used, with administrative databases from a child protection agency (CPA) and a public health system. Children who received a substantiated report of CSA at the CPA and whose health data could be retrieved were selected (n = 882) and matched with children from the general population using their date of birth, sex, and geographical area. Survival analysis was performed to estimate the association between sexual abuse, sex, and confounding factors and the age at onset of psychotic disorders. RESULTS: Sexual abuse and substance misuse are significantly associated with the age at onset of psychotic disorders. In the sexually abused group, only substance misuse is associated with the age at onset of psychotic disorders, but this was not significant for the general population. CONCLUSIONS: These findings highlight the importance of prevention of psychotic disorders among sexually abused youth, especially those with a substance misuse diagnosis.


Assuntos
Abuso Sexual na Infância , Transtornos Psicóticos , Adolescente , Idade de Início , Criança , Estudos de Coortes , Humanos , Estudos Prospectivos , Transtornos Psicóticos/epidemiologia
3.
J Interpers Violence ; 36(11-12): NP5784-NP5808, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-30388043

RESUMO

Child sexual abuse (CSA) can severely affect the mental health of children and their parents. While correlates of recovery have been documented in children, factors exacerbating parents' adaptation to their child's unveiling of CSA deserves further attention. Parents' history of abuse has been inconsistently identified as a predictor of their distress in reaction to their child's abuse disclosure. This study proposes a mediation model that explores various processes underlying mother's psychological distress (posttraumatic stress disorder [PTSD], dissociation, and their comorbidity) following their children's unveiling of CSA. It investigates the influence of mother's own CSA, as well as of her exposure to additional forms of past and current victimization, on her reaction to the child's CSA disclosure, while considering coping mechanisms as mediators (avoidance, problem solving, search for social support, and feeling of guilt). Data were collected through self-report measures completed by 298 mothers of children who had recently disclosed CSA. Path analyses revealed that mother's exposure to interparental violence as a child acted as a primary predictor of dissociation and of its comorbidity with PTSD, while a history of CSA was directly and exclusively linked to dissociation. Being exposed to recent partner violence was indirectly related to trauma symptoms, with coping mechanisms acting as mediators. This study outlines the relationship between mother's psychological distress and her cumulative, past, and current exposure to various forms of victimization. Exposure to interparental violence as a child represents a particularly important factor for identifying mothers most in need of support, as it is a significant predictor of dissociation and of its comorbidity with PTSD.


Assuntos
Abuso Sexual na Infância , Maus-Tratos Infantis , Adaptação Psicológica , Criança , Feminino , Humanos , Relações Mãe-Filho , Mães
4.
Health Psychol ; 40(2): 104-112, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32955280

RESUMO

Objective: The present study aimed to determine whether psychiatric comorbidity (i.e., diagnostic comorbidity in eight categories of mental and behavioral disorders) mediates the relationship between childhood sexual abuse (CSA) and diseases of the genitourinary system (International Statistical Classification of Diseases and Related Health Problems, 10th revision) among girls. Method: Using a prospective matched-cohort design, we documented diagnoses given by a physician after a medical consultation or hospitalization for diseases of the genitourinary system, for 661 sexually abused girls and 661 matched controls via administrative databases covering the period between January 1996 and March 2013. Path analyses using negative binomial regressions with CSA as independent variable, psychiatric comorbidity as mediator and genitourinary diseases diagnoses as dependent variables were performed. Results: After controlling for socioeconomic level, prior genitourinary diseases and number of years of medical data, the mediation effect for the path from CSA to genitourinary diseases through psychiatric comorbidity was significant for the urinary system (b = .125, 95% confidence interval [0.057, 0.192]) as well as for the genital system (b = .213, 95% confidence interval [0.141, 0.285]). Psychiatric comorbidity carried 62% of the sexual abuse total effect on the number of diagnoses received for genital diseases, whereas it carried 23% of the sexual abuse total effect on the number of diagnoses received for urinary diseases. Conclusions: Findings suggest that CSA may have an indirect effect on girls' diagnosed genitourinary diseases during a medical consultation or hospitalization through the increased risk for psychiatric comorbidity. Early interventions aimed at addressing psychological distress among sexually abused girls might prevent the emergence of genitourinary diseases years after the abuse. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Abuso Sexual na Infância/psicologia , Transtornos Mentais/etiologia , Adolescente , Criança , Pré-Escolar , Estudos de Coortes , Comorbidade , Estudos Transversais , Feminino , Doenças Urogenitais Femininas , Humanos , Lactente , Transtornos Mentais/epidemiologia , Estudos Prospectivos
5.
Child Abuse Negl ; 111: 104819, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33261843

RESUMO

BACKGROUND: Little is known about the factors associated with psychosis in sexually abused children. Many factors have been associated with both sexual abuse and psychosis, and some mental health disorders have been identified as implied in the relationship between childhood trauma and psychosis. OBJECTIVES: This study aims to identify factors cooccurring with psychotic disorders in sexually abused youth and to determine which predict the development of psychosis in this population. PARTICIPANTS AND SETTING: Children with a corroborated report of sexual abuse (n = 882) at a Child Protection Agency (CPA) between 2000 and 2010 and whose health data could be retrieved from public health databases were selected for this study. METHODS: A prospective matched-cohort design was used, with administrative databases from a CPA and a public health system. Logistic regressions were performed to determine which mental health diagnoses were associated with, and which predicted, psychotic disorders. RESULTS: Logistic regressions revealed that personality disorders were significantly associated with psychotic disorders whereas substance misuse disorders and intellectual disability significantly predicted psychotic disorders. CONCLUSIONS: Psychotic disorders and personality disorders appear concomitantly in sexually abused youth. Having received a substance misuse disorder diagnosis increases the risk of developing a psychotic disorder in sexually abused youth. Health professionals should be aware of those risk factors to help reduce the severity of youth sexual abuse consequences and, ultimately, prevent psychosis.


Assuntos
Abuso Sexual na Infância/psicologia , Saúde Mental/normas , Transtornos Psicóticos/epidemiologia , Adolescente , Criança , Pré-Escolar , Estudos de Coortes , Humanos , Lactente , Modelos Logísticos , Masculino , Estudos Prospectivos , Transtornos Psicóticos/psicologia , Fatores de Risco , Comportamento Sexual
6.
Complement Ther Clin Pract ; 41: 101249, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33120117

RESUMO

BACKGROUND AND PURPOSE: Little data is available on the effect of mindfulness amongst pediatric hematology-oncology professionals. The purpose was to further document change in biological and psychological stress following a mindfulness-based stress reduction (MBSR) program. MATERIALS AND METHODS: We led two pre-post interventional studies (n = 12 and n = 25) and measured changes on hair cortisol concentrations, perceived stress, psychological distress and burnout. RESULTS: Professionals did not change on biological stress (d = 0.04), but improved on self-reported measures (median d = 0.58). Effects were maintained over 3 months for psychological distress, anxiety, depression, and burnout (median d = 0.66). Effects were larger if trainees participated to the retreat and if they reported higher baseline perceived stress. CONCLUSION: In pediatric hematology-oncology professionals, an MBSR program was related with improvements in self-reported stress over 3 months. Components of the program and characteristics of trainees may influence the impact of MBSR.


Assuntos
Hematologia , Atenção Plena , Criança , Humanos , Hidrocortisona , Autorrelato , Estresse Psicológico/terapia
7.
J Child Sex Abus ; 29(7): 749-768, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32045342

RESUMO

Child sexual abuse (CSA) has been strongly associated with a range of psychological and physical problems in childhood and adulthood, such as anxiety, post-traumatic stress disorder (PTSD), and infectious diseases. Despite the strength of these associations, no studies to date have investigated psychobiological processes that might underlie the relationship between CSA and physical health problems occurring during childhood, such as infectious diseases. The goal of the current study is to evaluate PTSD as a potential mediator between CSA and the occurrence of infectious diseases among children and adolescents. Furthermore, we postulate that PTSD plays a specific role as an indicator of chronic stress during childhood, in comparison to other mental disorders, such as anxious and non-anxious disorders (e.g., depression). Via a prospective matched-cohort design, administrative data were used to document PTSD, anxious and non-anxious disorders, and infectious diseases. The sample size was 882 persons with a substantiated report of sexual abuse and 882 matched controls. Negative binomial regressions revealed that CSA is associated with a greater number of anxious diseases diagnoses that, in turn, predict more infectious diseases diagnoses. These findings highlight the importance of preventing and intervening among sexually abused youth with anxious disorder symptoms to limit negative outcomes on physical health.


Assuntos
Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Ansiedade/psicologia , Doenças Transmissíveis/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Transtornos Relacionados ao Uso de Substâncias/diagnóstico por imagem , Adulto , Ansiedade/diagnóstico , Estudos de Casos e Controles , Estudos de Coortes , Doenças Transmissíveis/diagnóstico , Feminino , Nível de Saúde , Humanos , Acontecimentos que Mudam a Vida , Masculino , Estudos Prospectivos , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/psicologia
8.
BMJ Open ; 8(1): e018421, 2018 01 05.
Artigo em Inglês | MEDLINE | ID: mdl-29306887

RESUMO

OBJECTIVES: To assess the feasibility and acceptability of a mindfulness-based stress reduction (MBSR)-based intervention and determine if the intervention is associated with a significant signal on empathy and emotional competencies. DESIGN: Two pre-post proof-of-concept studies. SETTING: Participants were recruited at the University of Montreal's Psychology Department (Study 1) and the CHU Sainte-Justine Department of Hematology-Oncology (Study 2). PARTICIPANTS: Study 1: 12 students completed the 8-week programme (mean age 24, range 18-34). Study 2: 25 professionals completed the 8-week programme (mean age 48, range 27-63). INTERVENTION: Standard MBSR programme including 8-week mindfulness programme consisting of 8 consecutive weekly 2-hour sessions and a full-day silent retreat. OUTCOMES MEASURES: Mindfulness as measured by the Mindful Attention Awareness Scale; empathy as measured by the Interpersonal Reactivity Index (IRI)'s Perspective Taking and Empathic Concern subscales; identification of one's own emotions and those of others as measured by the Profile of Emotional Competence (PEC)'s Identify my Emotions and Identify Others' Emotions subscales; emotional acceptance as measured by the Acceptance and Action Questionnaire-II (AAQ-II) and the Emotion Regulation Scale (ERQ)'s Expressive Suppression subscale; and recognition of emotions in others as measured by the Geneva Emotion Recognition Test (GERT). RESULTS: In both studies, retention rates (80%-81%) were acceptable. Participants who completed the programme improved on all measures except the PEC's Identify Others' Emotions and the IRI's Empathic Concern (Cohen's d median=0.92, range 45-1.72). In Study 2, favourable effects associated with the programme were maintained over 3 months on the PEC's Identify my Emotions, the AAQ-II, the ERQ's Expressive Suppression and the GERT. CONCLUSIONS: The programme was feasible and acceptable. It was associated with a significant signal on the following outcomes: perspective taking, the identification of one's own emotions and emotional acceptance, thus, justifying moving towards efficacy trials using these outcomes.


Assuntos
Inteligência Emocional/fisiologia , Empatia , Pessoal de Saúde/psicologia , Atenção Plena , Estresse Psicológico/prevenção & controle , Adulto , Canadá , Estudos de Viabilidade , Feminino , Humanos , Masculino , Estudo de Prova de Conceito , Estresse Psicológico/psicologia , Adulto Jovem
9.
J Health Psychol ; 22(12): 1563-1569, 2017 10.
Artigo em Inglês | MEDLINE | ID: mdl-26929171

RESUMO

This brief report tests the mediating effect of self-esteem in the relationship between body dissatisfaction and symptoms of depression and anxiety. A sample of 409 adolescents (females = 58.4%) aged between 14 and 18 years completed the Rosenberg Self-Esteem Scale, the Contour Drawing Rating Scale, the Multidimensional Anxiety Scale for Children, and the Center for Epidemiologic Studies Depression Scale. Overall, results for the indirect effects analysis were significant for both anxiety and depression, which confirmed the mediating role of self-esteem. Thus, a negative perception of one's body image has the effect of lowering self-esteem, which in turn increases psychological distress.


Assuntos
Ansiedade/psicologia , Imagem Corporal/psicologia , Depressão/psicologia , Autoimagem , Estresse Psicológico/psicologia , Adolescente , Ansiedade/diagnóstico , Estudos Transversais , Depressão/diagnóstico , Feminino , Humanos , Masculino , Escalas de Graduação Psiquiátrica , Estresse Psicológico/diagnóstico
10.
J Sex Marital Ther ; 43(7): 663-677, 2017 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-27586889

RESUMO

Provoked vestibulodynia (PVD) is a recurrent idiopathic vulvo-vaginal pain associated with negative sexual and psychological consequences. Facilitative partner responses to pain are currently receiving empirical attention because they are positively associated with women's sexual outcomes. However, the mechanisms through which facilitative responses to pain are associated with these outcomes have not been examined. One potential mechanism is sexual assertiveness, which has been found to be associated with better sexual function and satisfaction in women with PVD. The present study examined whether women's sexual assertiveness mediated the association between women's perception of facilitative partner responses and women's sexual function and satisfaction. Women (N = 140) with PVD symptomatology completed self-reported questionnaires evaluating their perception of their partners' facilitative responses, and their own sexual assertiveness, sexual function, and sexual satisfaction. Dependent measures were sexual function measured by the Female Sexual Function Index and sexual satisfaction assessed by the Global Measure of Sexual Satisfaction Scale. Results indicated that women's higher sexual assertiveness mediated the association between their greater perceived facilitative partner responses and their improved sexual function and satisfaction. Findings suggest a potential mechanism through which partner responses may be associated with women's sexual outcomes.


Assuntos
Assertividade , Coito/psicologia , Orgasmo , Parceiros Sexuais/psicologia , Vulvodinia/psicologia , Adaptação Psicológica , Adulto , Feminino , Humanos , Autorrelato
11.
J Child Sex Abus ; 25(7): 757-776, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-27802126

RESUMO

Disclosure of child sexual abuse can be traumatic for nonoffending parents. Research has shown its impact on mothers' mental health, which includes heightened psychological distress, depression, and post-traumatic stress disorder. Very little is known, however, about its impact on their physical health or on fathers' health. The self-perceived mental and physical health of nonoffending parents after child sexual abuse disclosure was compared to determine gender-related differences in this regard. Interviews were conducted with 109 mothers and 43 fathers of 6- to 13-year-old sexually abused children. Bivariate analyses revealed that a fair proportion of parents reported psychological and physical problems after disclosure. However, proportionally more mothers than fathers reported psychological distress, depression, and use of professional services. Fathers were more likely to resort to health services instead of social services and to use medication for depression. Study findings provide leads for health and social service providers for the development of intervention protocols and referral procedures sensitive to gender issues, and they shed new light on specific needs of nonoffending parents.


Assuntos
Abuso Sexual na Infância/psicologia , Saúde Mental , Pais/psicologia , Apoio Social , Transtornos de Estresse Pós-Traumáticos/psicologia , Adaptação Psicológica , Adolescente , Adulto , Criança , Pai/psicologia , Feminino , Nível de Saúde , Humanos , Masculino , Mães/psicologia , Relações Pais-Filho , Revelação da Verdade
12.
J Consult Clin Psychol ; 84(3): 259-68, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26727408

RESUMO

OBJECTIVE: This 13-week randomized clinical trial aimed to compare group cognitive-behavioral therapy (GCBT) and a topical steroid in the treatment of provoked vestibulodynia, the most common form of dyspareunia. METHOD: Participants were 97 women randomly assigned to 1 of 2 treatment conditions and assessed at pretreatment, posttreatment and 6-month follow-up via structured interviews and standard questionnaires pertaining to pain (McGill Pain Questionnaire, 11-point numerical rating scale of pain during intercourse), sexual function (Female Sexual Function Index, intercourse frequency), psychological adjustment (Pain Catastrophizing Scale, Painful Intercourse Self-Efficacy Scale), treatment satisfaction, and participant global ratings of improvements in pain and sexuality. RESULTS: Intent-to-treat multilevel and covariance analyses showed that both groups reported statistically significant reductions in pain from baseline to posttreatment and 6-month follow-up, although the GCBT group showed significantly more pain reduction at 6-month follow-up on the McGill Pain Questionnaire. The 2 groups significantly improved on measures of psychological adjustment, and the GCBT group had significantly greater reductions in pain catastrophizing at posttreatment. Both groups' sexual function significantly improved from baseline to posttreatment and 6-month follow-up, and the GCBT group was doing significantly better at the 6-month follow-up. Treatment satisfaction was significantly higher in the GCBT group, as were self-reported improvements in pain and sexuality. CONCLUSIONS: Findings suggest that GCBT may yield a positive impact on more dimensions of dyspareunia than a topical steroid, and support its recommendation as a first-line treatment for provoked vestibulodynia.


Assuntos
Corticosteroides/uso terapêutico , Terapia Cognitivo-Comportamental , Dispareunia/terapia , Psicoterapia de Grupo , Vulvodinia/terapia , Adaptação Psicológica , Adulto , Catastrofização/tratamento farmacológico , Catastrofização/psicologia , Catastrofização/terapia , Coito/psicologia , Dispareunia/tratamento farmacológico , Dispareunia/psicologia , Feminino , Humanos , Autoeficácia , Autorrelato , Inquéritos e Questionários , Resultado do Tratamento , Vulvodinia/tratamento farmacológico , Vulvodinia/psicologia , Adulto Jovem
13.
J Pediatr ; 171: 202-7, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26795680

RESUMO

OBJECTIVE: To assess body dissatisfaction among children between 9 and 14 years of age and to examine factors (age, sex, body mass index, perceived shape, and self-esteem) associated with wanting a thinner or a larger shape. STUDY DESIGN: Through at-school questionnaires, 1515 preadolescent children (51.2% girls) were asked to fill out the Culture Free Self-Esteem Inventory and the Contour Drawing Rating Scale (body dissatisfaction). Trained assessors then weighed and measured the students individually. RESULTS: Overall, 50.5% of girls wanted a thinner shape compared with 35.9% of boys. More boys wanted a larger shape compared with girls (21.1% vs 7.2%). Most of the preadolescents who were overweight or obese were unsatisfied whereas 58.0% of girls and 41.6% of boys who were underweight were satisfied with their body. Results of a multinomial logistic regression revealed that age, sex, body mass index, perceived shape, and self-esteem were significant correlates of the 4 body dissatisfaction contrasts (wanting a slightly thinner, much thinner, slightly larger, and much larger shape) and explained 50% of the variance. An interaction between sex and perceived shape was found, revealing that girls who perceived themselves as having a larger shape were more likely to desire a thinner shape than boys. CONCLUSIONS: The high prevalence rate of body dissatisfaction among children suggests that current approaches in our society to prevent problems related to body image must be improved. The different results between girls and boys highlight the need to take into account sex differences when designing prevention programs that aim to decrease body dissatisfaction.


Assuntos
Imagem Corporal , Peso Corporal , Sobrepeso/epidemiologia , Obesidade Infantil/epidemiologia , Autoimagem , Magreza/epidemiologia , Adolescente , Índice de Massa Corporal , Criança , Feminino , Humanos , Modelos Logísticos , Masculino , Sobrepeso/psicologia , Obesidade Infantil/psicologia , Satisfação Pessoal , Prevalência , Quebeque , Inquéritos e Questionários , Magreza/psicologia
14.
J Affect Disord ; 189: 336-43, 2016 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-26474374

RESUMO

BACKGROUND: Transition into adulthood is a critical developmental period that may be influenced by adverse life events as well as by protective factors. This study aimed at investigating the effect of different forms of child maltreatment experienced prior to age 14 (i.e., sexual abuse, physical abuse and exposure to intimate partner violence), and of friend support at age 14 on the psychological distress trajectory from age 14 to 24. METHODS: Participants were 605 adolescents from the general population involved in a 10-year longitudinal study. Psychological distress was evaluated at ages 14, 16, 18 and 24. Child maltreatment prior to 14 years was retrospectively assessed at 14 and 24 years while perception of support from friends was evaluated at age 14. RESULTS: Multilevel growth modeling indicated that psychological distress followed a significant decreasing curvilinear trajectory, with participants reporting fewer distressing psychological symptoms after 18 years. All three forms of child maltreatment, as well as their cumulative effect, predicted more psychological distress over 10 years above and beyond the protective effect of support from friends. Higher support from friends at age 14 was related to lower distress at baseline andover 10 years, beyond the effect of child maltreatment. LIMITATIONS: Self-report nature of all measures, attrition, and measures of child maltreatment forms. CONCLUSIONS: Psychological distress decreased during the transition from adolescence to emerging adulthood. Results also revealed the detrimental impact of child maltreatment and the promotive role of friend support, which underscore the importance of early intervention.


Assuntos
Sobreviventes Adultos de Maus-Tratos Infantis/psicologia , Maus-Tratos Infantis/psicologia , Amigos/psicologia , Apoio Social , Estresse Psicológico/psicologia , Adolescente , Feminino , Humanos , Estudos Longitudinais , Masculino , Estudos Prospectivos , Autorrelato , Adulto Jovem
15.
Trials ; 15: 506, 2014 Dec 23.
Artigo em Inglês | MEDLINE | ID: mdl-25540035

RESUMO

BACKGROUND: Provoked vestibulodynia (PVD), a frequent form of chronic genital pain, is associated with decreased sexual function for afflicted women, as well as impoverished sexual satisfaction for women and their partners. Pain and sexuality outcomes for couples with PVD are influenced by interpersonal factors, such as pain catastrophizing, partner responses to pain, ambivalence over emotional expression, attachment style and perceived relationship and sexual intimacy. Despite recommendations in the literature to include the partner in cognitive-behavioral therapy targeted at improving pain and sexuality outcomes, no randomized clinical trial has tested the efficacy of this type of intervention and compared it to a first-line medical intervention. METHODS: This bi-center, randomized clinical trial is designed to examine the efficacy of cognitive-behavioral couple therapy compared to topical lidocaine. It is conducted across two Canadian university-hospital centers. Eligible women diagnosed with PVD and their partners are randomized to one of the two interventions. Evaluations are conducted using structured interviews and validated self-report measures at three time points: Pre-treatment (T1: prior to randomization), post-treatment (T2), and 6-month follow-up (T3). The primary outcome is the change in reported pain during intercourse between T1 and T2. Secondary outcomes focus on whether there are significant differences between the two treatments at T2 and T3 on (a) the multidimensional aspects of women's pain and (b) women and partners' sexuality (sexual function and satisfaction), psychological adjustment (anxiety, depression, catastrophizing, self-efficacy, and quality of life), relationship factors (partner responses and dyadic adjustment) and self-reported improvement and treatment satisfaction. In order to detect an effect size as small as 0.32 for secondary outcomes, a sample of 170 couples is being recruited (27% dropout expected). A clinically significant decrease in pain is defined as a 30% reduction. DISCUSSION: The randomized clinical trial design is the most appropriate to examine the efficacy of cognitive-behavioral couple therapy, a recently developed and pilot-tested psychosocial intervention for couples coping with PVD, in comparison to a frequent first-line treatment option, topical lidocaine. Findings from this study will provide important information about empirically supported treatment options for PVD, and inform future treatment development and research for this patient population. TRIAL REGISTRATION: Clinicaltrials.gov NCT01935063; registration date: 27 August 27 2013.


Assuntos
Anestésicos Locais/uso terapêutico , Dor Crônica/terapia , Terapia Cognitivo-Comportamental , Terapia de Casal , Lidocaína/uso terapêutico , Projetos de Pesquisa , Vulvodinia/terapia , Administração Intravaginal , Adolescente , Adulto , Anestésicos Locais/administração & dosagem , Anestésicos Locais/efeitos adversos , Dor Crônica/diagnóstico , Dor Crônica/fisiopatologia , Dor Crônica/psicologia , Protocolos Clínicos , Feminino , Hospitais Universitários , Humanos , Lidocaína/administração & dosagem , Lidocaína/efeitos adversos , Masculino , Pessoa de Meia-Idade , Nova Escócia , Medição da Dor , Satisfação Pessoal , Quebeque , Comportamento Sexual , Cônjuges/psicologia , Inquéritos e Questionários , Fatores de Tempo , Resultado do Tratamento , Vulvodinia/diagnóstico , Vulvodinia/fisiopatologia , Vulvodinia/psicologia , Adulto Jovem
16.
J Sex Med ; 11(5): 1271-82, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24548305

RESUMO

INTRODUCTION: Provoked vestibulodynia (PVD) is a highly prevalent and taxing female genital pain condition. Despite the intimate nature of this pain and the fact that affective factors such as anxiety have been shown to modulate its manifestations, no study has yet explored the emotional regulation of couples in which the woman suffers from PVD. AIM: Ambivalence over emotional expression (AEE) is an emotional regulation variable that quantifies the extent to which a person is comfortable with the way she or he expresses emotions. We examined whether the dyadic AEE of couples in which the woman suffers from PVD was differentially associated with women's pain and couples' psychological, sexual, and relational functioning. METHODS: Couples (N = 254), in which the woman suffered from PVD, completed the AEE questionnaire. A couple typology of dyadic AEE was created. MAIN OUTCOME MEASURES: Dependent measures for both members of the couple were the global measure of sexual satisfaction scale, the Beck depression inventory II, and the revised dyadic adjustment scale. The female sexual function index and the sexual history form were used to assess the sexual function of women and men, respectively. Women also completed the pain rating index of the McGill pain questionnaire. RESULTS: Couples, in which both partners were considered low on AEE, had the highest scores on sexual satisfaction (P = 0.02) and function (P < 0.01), the lowest depression scores (P < 0.01), and the best dyadic adjustment (P = 0.02). No difference in pain intensity was found between couples. CONCLUSIONS: Findings suggest that, for couples in which the woman suffers from PVD, an emotional regulation that is low in ambivalence in both partners is associated with better psychological, sexual, and relational outcomes. Results indicate that emotional regulation may be important to consider in the assessment and treatment of couples coping with PVD.


Assuntos
Dispareunia/psicologia , Emoções , Parceiros Sexuais/psicologia , Sexualidade/psicologia , Vulvodinia/psicologia , Adaptação Psicológica , Adulto , Ansiedade/etiologia , Feminino , Humanos , Relações Interpessoais , Masculino , Pessoa de Meia-Idade , Medição da Dor , Dor Pélvica/psicologia , Satisfação Pessoal , Estresse Psicológico/etiologia , Inquéritos e Questionários
17.
J Nerv Ment Dis ; 201(9): 767-72, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23995032

RESUMO

This study investigated the relationships between a history of childhood maltreatment, the frequency of disturbing dreams, their associated distress, and the presence of psychopathology in 352 female undergraduate volunteers. Participants completed questionnaires assessing dream recall, bad dream and nightmare frequency, nightmare distress, psychological well-being, and history of childhood trauma. Four groups were investigated based on the type and severity of childhood maltreatments experienced. Women reporting more severe forms of maltreatment reported higher frequencies of disturbing dreams, higher levels of nightmare distress, and greater psychopathology. Results showed that nightmare distress explains frequency of disturbed dreaming beyond the effect of psychopathology and childhood trauma. The results highlight the importance of assessing waking distress associated with disturbing dreams independently from their actual incidence.


Assuntos
Transtornos de Ansiedade/psicologia , Abuso Sexual na Infância/psicologia , Maus-Tratos Infantis/psicologia , Transtorno Depressivo/psicologia , Sonhos/psicologia , Adolescente , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/epidemiologia , Maus-Tratos Infantis/diagnóstico , Maus-Tratos Infantis/estatística & dados numéricos , Abuso Sexual na Infância/diagnóstico , Abuso Sexual na Infância/estatística & dados numéricos , Estudos Transversais , Transtorno Depressivo/diagnóstico , Transtorno Depressivo/epidemiologia , Feminino , Humanos , Rememoração Mental , Modelos Psicológicos , Psicopatologia , Estatística como Assunto , Inquéritos e Questionários , Adulto Jovem
18.
J Sex Med ; 10(8): 2024-35, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23802839

RESUMO

INTRODUCTION: Provoked vestibulodynia (PVD) is the most frequent subtype of vulvodynia. Women report negative consequences of PVD on their sexual and romantic relationships. Researchers have recently highlighted the importance of examining interpersonal factors such as intimacy, and of including both women and their partners in study designs. AIM: The aim of this study was to investigate sexual and relationship intimacy as defined by the Interpersonal Process Model of Intimacy and their associations with sexual satisfaction, sexual function, pain self-efficacy, and pain intensity among women with PVD and their partners. METHODS: Ninety-one heterosexual women (M age = 27.38, SD = 6.04) diagnosed with PVD and their partners (M age = 29.37, SD = 7.79) completed measures of sexual and relationship intimacy, sexual satisfaction, sexual function, pain self-efficacy, and pain intensity. MAIN OUTCOME MEASURES: Dependent measures were the (i) Global Measure of Sexual Satisfaction Scale; (ii) Female Sexual Function Index; (iii) Painful Intercourse Self-Efficacy Scale; and (iv) visual analog scale of pain intensity during intercourse. RESULTS: After controlling for women's age, women's greater sexual intimacy (ß = 0.49, P < 0.001) was associated with women's greater sexual satisfaction and higher pain self-efficacy (ß = 0.39, P = 0.001), beyond the effects of partners' sexual intimacy. Also, women's greater sexual intimacy (ß = 0.24, P = 0.05) and women's greater relationship intimacy (ß = 0.54, P = 0.003) were associated with greater women's sexual function, beyond the effects of partners' sexual and relationship intimacy. CONCLUSIONS: Women's self-reported sexual and relationship intimacy in the couple relationship may promote higher sexual satisfaction, sexual function, and pain self-efficacy, as well as possibly foster greater sexual well-being among women with PVD. The authors discuss implications for the inclusion of emotional and interpersonal aspects of the couple's dynamic in clinical interventions and future research in PVD.


Assuntos
Satisfação Pessoal , Autoeficácia , Parceiros Sexuais/psicologia , Sexualidade , Vulvodinia/fisiopatologia , Adulto , Feminino , Humanos , Masculino , Inquéritos e Questionários , Vulvodinia/psicologia , Adulto Jovem
19.
J Child Sex Abus ; 22(2): 209-30, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23428152

RESUMO

Maternal support offered to sexually abused children following disclosure may be a crucial factor in children's recovery. A person-centered approach was used to examine how profiles of nonoffending mothers could better describe their ability to support their children after disclosure. Cluster analyses based on a total of 226 nonoffending mothers recruited from child protective services yielded four distinctive groups of mothers: resilient, avoidant-coping, traumatized, and anger-oriented reaction. These profiles differed on measures of support, parenting, and variables related to attitude following disclosure. The discussion underscores the relevance of adopting a tailored approach to intervention with mothers of sexually abused children.


Assuntos
Abuso Sexual na Infância/psicologia , Relações Mãe-Filho , Mães/psicologia , Poder Familiar/psicologia , Criança , Feminino , Humanos , Apoio Social
20.
Child Abuse Negl ; 37(2-3): 160-71, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23260113

RESUMO

OBJECTIVE: Explore the psychometric properties of the French Canadian version of the Child and Youth Resilience Measure (CYRM-28, Resilience Research Center, 2009; Ungar et al., 2008) in youth samples. METHOD: Two investigations were conducted. Participants in Study 1 were 589 youth (60% female) in grades 10-12 from 2 urban public high schools. Participants in Study 2 were 246 youth (48% female) from a rural public high school, 28% from First Nations. All participants completed the French CYRM-28 and measures of self-esteem and self-acceptance/mindfulness. Participants in Study 2 completed additional measures evaluating their sense of empowerment, trauma symptoms, family problems, and relationship with parents. RESULTS: Factor analysis identified three components correlated to each other: individual, family and community resilience. Evidence provides initial support for the construct validity of the scale by correlations with measures of self-esteem, self-acceptance/mindfulness, empowerment, trauma symptoms, relationship with parents and differences according to gender and a history of sexual abuse. CONCLUSION: The present results, the first to explore the psychometric properties of the French version of the CYRM-28, provide preliminary data supporting the reliability and validity of a global scale including 27 items. However, our results reveal a different factorial structure compared to previous studies using the CYRM-28. Future studies are needed to further document the validity of the scale.


Assuntos
Adaptação Psicológica , Proteção da Criança , Psicometria/instrumentação , Psicometria/métodos , Adolescente , Canadá , Criança , Análise Fatorial , Feminino , Humanos , Masculino , Transtornos Mentais , Reprodutibilidade dos Testes , Autoimagem , Adulto Jovem
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