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1.
Front Pharmacol ; 10: 1678, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-32116678

RESUMO

BACKGROUND: Flavonoids have been characterized as a prominent class of compounds to treat thrombotic diseases through the inhibition of thiol isomerases. Syzygium cumini is a flavonoid-rich medicinal plant that contains myricetin and gallic acid. Little is known about the potential antiplatelet properties of S. cumini and its constituent flavonoids. OBJECTIVE: To evaluate the antiplatelet effects and mechanism of action of a polyphenol-rich extract (PESc) from S. cumini leaf and its most prevalent polyphenols, myricetin and gallic acid. METHODS: PESc, myricetin, and gallic acid were incubated with platelet-rich plasma and washed platelets to assess platelet aggregation and activation. In vitro platelet adhesion and thrombus formation as well as in vivo bleeding time were performed. Finally, myricetin was incubated with recombinant thiol isomerases to assess its potential to bind and inhibit these, while molecular docking studies predicted possible binding sites. RESULTS: PESc decreased platelet activation and aggregation induced by different agonists. Myricetin exerted potent antiplatelet effects, whereas gallic acid did not. Myricetin reduced the ability of platelets to spread on collagen, form thrombi in vitro without affecting hemostasis in vivo. Fluorescence quenching studies suggested myricetin binds to different thiol isomerases with similar affinity, despite inhibiting only protein disulfide isomerase (PDI) and ERp5 reductase activities. Finally, molecular docking studies suggested myricetin formed non-covalent bonds with PDI and ERp5. CONCLUSIONS: PESc and its most abundant flavonoid myricetin strongly inhibit platelet function. Additionally, myricetin is a novel inhibitor of ERp5 and PDI, unveiling a new therapeutic perspective for the treatment of thrombotic disorders.

2.
Transfus Apher Sci ; 50(3): 443-50, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24680293

RESUMO

INTRODUCTION: By convention, peripheral blood stem cell products for autologous transplantation are evaluated for quality by CD34(+) cell dose at the time of harvesting. A CD34(+) cell dose in excess of 2.0 × 10(6)/kg of recipient body weight is considered adequate for haematopoietic engraftment. Viable CD34(+) cell numbers are enumerated in most laboratories using the ISHAGE single platform flow cytometric method which utilizes monoclonal antibodies to CD45, CD34 and 7 amino actinomycin D (7AAD) dye exclusion. METHODS: One hundred and six consecutive autologous transplantation procedures underwent viable CD34(+) cell enumeration at the time of harvesting and post thaw prior to re-infusion. Neutrophil and platelet engraftment and markers of haematopoietic support were analyzed. RESULTS: Mean pre-cryopreservation viable CD34(+) numbers were 4.882 × 10(6)/kg. Mean post thaw viable CD34(+) numbers were 3.234 × 10(6)/kg. Mean loss of viable CD34(+) cells with processing and cryo-preservation was 1.648 × 10(6)/kg (33%). For neutrophil engraftment, there was no significant difference between high (⩾ 3.0 × 10(6)/kg) and low (<1.5 × 10(6)/kg) post thaw viable CD34(+) cell counts (p=0.545). For platelet engraftment, there was however a significant difference observed between the high and low pre infusion viable CD34(+) groups (p<0.001). Additionally, significant differences were seen between the post thaw viable CD34(+) cell count and the associated length of hospital admission, days of use of G-CSF post transplantation, use of antibiotics in the post transplantation period and transfusion support in the post transplantation period. CONCLUSION: A significant loss of viable CD34(+) cells occurs during processing, cryopreservation and thawing. Low numbers of viable CD34(+) cells infused post thaw will still result in adequate neutrophil engraftment however may delay platelet engraftment. Low viable CD34(+) cell numbers have significant effects on admission duration and use of haematopoietic supportive measures with consequent effects on healthcare resources.


Assuntos
Antígenos CD34 , Criopreservação , Sobrevivência de Enxerto , Células-Tronco Hematopoéticas , Transplante de Células-Tronco de Sangue Periférico , Adolescente , Adulto , Idoso , Amiloidose/terapia , Autoenxertos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/terapia , Neoplasias/terapia , Neutrófilos , Estudos Retrospectivos
3.
Drug Alcohol Depend ; 115(3): 240-3, 2011 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-21193273

RESUMO

BACKGROUND: In addition to cognitive and emotional processing dysfunction, chronic cocaine users are also impaired at simple sensorimotor tasks. Many diseases characterized by compulsive movements, repetitive actions, impaired attention and planning are associated with dysfunction in frontal-striatal circuits. The aim of this study was to determine whether cocaine users had impaired frontal-striatal connectivity during a simple movement task and whether this was associated with sensorimotor impairment. METHODS: Functional MRI data were collected from 14 non-treatment seeking cocaine users and 15 healthy controls as they performed a finger-tapping task. Functional coupling was quantified by correlating the timecourses of each pair of anatomically connected regions of interest. Behavioral performance was correlated with all functional coupling coefficients. RESULTS: In controls there was a significant relationship between the primary motor cortex and the supplementary motor area (SMA), as well as the SMA and the dorsal striatum during ongoing movement. Cocaine users exhibited weaker fronto-striatal coupling than controls, while the cortical-cortical coupling was intact. Coupling strength between the SMA and the caudate was negatively correlated with reaction time in the users. CONCLUSIONS: The observation that cocaine users have impaired cortical-striatal connectivity during simple motor performance, suggests that these individuals may have a fundamental deficit in information processing that influences more complex cognitive processes.


Assuntos
Transtornos Relacionados ao Uso de Cocaína/fisiopatologia , Transtornos Cognitivos/fisiopatologia , Corpo Estriado/fisiopatologia , Inibidores da Captação de Dopamina/efeitos adversos , Lobo Frontal/fisiopatologia , Movimento/fisiologia , Adulto , Cocaína/efeitos adversos , Cocaína/metabolismo , Transtornos Relacionados ao Uso de Cocaína/metabolismo , Transtornos Cognitivos/metabolismo , Inibidores da Captação de Dopamina/metabolismo , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Córtex Motor/fisiopatologia , Neostriado/fisiopatologia , Tempo de Reação
4.
Ann Neurol ; 67(2): 265-9, 2010 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-20225293

RESUMO

Little is known about the influence of cerebral white matter lesion (WML) location on gait. We applied partial least squares regression in brain magnetic resonance imaging scans (n = 385) to evaluate which WML voxel systems were independently associated with a composite gait score and identified affected tracts using a diffusion tensor imaging template. Bilateral frontal and periventricular WML-affected voxels corresponding to major anterior projection fibers (thalamic radiations, corticofugal motor tracts) and adjacent association fibers (corpus callosum, superior fronto-occipital fasciculus, short association fibers) showed the greatest covariance with poorer gait. WMLs probably contribute to age-related gait decline by disconnecting motor networks served by these tracts.


Assuntos
Encefalopatias/patologia , Mapeamento Encefálico , Transtornos Neurológicos da Marcha/patologia , Marcha/fisiologia , Fibras Nervosas Mielinizadas/patologia , Idoso , Idoso de 80 Anos ou mais , Encefalopatias/complicações , Feminino , Transtornos Neurológicos da Marcha/etiologia , Humanos , Processamento de Imagem Assistida por Computador/métodos , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Análise de Regressão
5.
J Neurosci ; 29(25): 8215-24, 2009 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-19553461

RESUMO

Neural phase signaling has gained attention as a putative coding mechanism through which the brain binds the activity of neurons across distributed brain areas to generate thoughts, percepts, and behaviors. Neural phase signaling has been shown to play a role in various cognitive processes, and it has been suggested that altered phase signaling may play a role in mediating the cognitive deficits observed across neuropsychiatric illness. Here, we investigated neural phase signaling in two mouse models of cognitive dysfunction: mice with genetically induced hyperdopaminergia [dopamine transporter knock-out (DAT-KO) mice] and mice with genetically induced NMDA receptor hypofunction [NMDA receptor subunit-1 knockdown (NR1-KD) mice]. Cognitive function in these mice was assessed using a radial-arm maze task, and local field potentials were recorded from dorsal hippocampus and prefrontal cortex as DAT-KO mice, NR1-KD mice, and their littermate controls engaged in behavioral exploration. Our results demonstrate that both DAT-KO and NR1-KD mice display deficits in spatial cognitive performance. Moreover, we show that persistent hyperdopaminergia alters interstructural phase signaling, whereas NMDA receptor hypofunction alters interstructural and intrastructural phase signaling. These results demonstrate that dopamine and NMDA receptor dependent glutamate signaling play a critical role in coordinating neural phase signaling, and encourage further studies to investigate the role that deficits in phase signaling play in mediating cognitive dysfunction.


Assuntos
Cognição , Proteínas da Membrana Plasmática de Transporte de Dopamina/deficiência , Dopamina/metabolismo , Hipocampo/fisiopatologia , Memória , Neurônios/metabolismo , Córtex Pré-Frontal/fisiopatologia , Receptores de N-Metil-D-Aspartato/deficiência , Transdução de Sinais , Animais , Proteínas da Membrana Plasmática de Transporte de Dopamina/genética , Eletrofisiologia , Potenciais Evocados , Comportamento Exploratório , Hipocampo/metabolismo , Aprendizagem em Labirinto , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Camundongos Transgênicos , Vias Neurais/fisiopatologia , Córtex Pré-Frontal/metabolismo , Receptores de N-Metil-D-Aspartato/genética , Voo Espacial
6.
Neuroimage ; 47(1): 199-203, 2009 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-19344777

RESUMO

Accurate automated segmentation of age-related white matter hyperintensity (WMH) is desirable for topological studies and those involving large samples. We assessed the accuracy of a novel automated method for segmentation of WMH on magnetic resonance imaging (MRI) in a randomly selected population-based sample of older people aged >60 years. The method combined morphological segmentation and statistical classifiers. Validation of this method was performed against expert manual segmentation in a sample of 30 scans, and against semi-automated segmentation in 202 scans. Its performance was also compared with those of other known methods derived from simple thresholding or Gaussian mixture modelling. Automated morphological segmentation combined with an adaptive boosting statistical classifier showed substantial agreement with manual segmentation, with an intraclass correlation coefficient (ICC) of 0.90 (95% confidence interval [CI], 0.80-0.95) for WMH volume and median similarity index (SI) of 0.58 (interquartile range [IQR] 0.50-0.65). The method also showed similarly high levels of agreement with semi-automated segmentation, with ICC 0.92 (95% CI 0.89-0.93) and median SI 0.56 (IQR 0.49-0.66). Its best performance was observed for the highest tertile of WMH volume. Threshold-based and Gaussian mixture model-driven automated segmentation generally did not perform well in this study.


Assuntos
Envelhecimento , Encéfalo/anatomia & histologia , Processamento Eletrônico de Dados/métodos , Imageamento por Ressonância Magnética/métodos , Fibras Nervosas Mielinizadas , Idoso , Idoso de 80 Anos ou mais , Humanos , Pessoa de Meia-Idade
7.
PLoS One ; 4(4): e5238, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19381303

RESUMO

Long-term changes in dopaminergic signaling are thought to underlie the pathophysiology of a number of psychiatric disorders. Several conditions are associated with cognitive deficits such as disturbances in attention processes and learning and memory, suggesting that persistent changes in dopaminergic signaling may alter neural mechanisms underlying these processes. Dopamine transporter knockout (DAT-KO) mice exhibit a persistent five-fold increase in extracellular dopamine levels. Here, we demonstrate that DAT-KO mice display lower hippocampal theta oscillation frequencies during baseline periods of waking and rapid-eye movement sleep. These altered theta oscillations are not reversed via treatment with the antidopaminergic agent haloperidol. Thus, we propose that persistent hyperdopaminergia, together with secondary alterations in other neuromodulatory systems, results in lower frequency activity in neural systems responsible for various cognitive processes.


Assuntos
Proteínas da Membrana Plasmática de Transporte de Dopamina/fisiologia , Dopamina/metabolismo , Hipocampo/fisiologia , Sono REM , Animais , Proteínas da Membrana Plasmática de Transporte de Dopamina/genética , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout
8.
Stroke ; 40(1): 175-80, 2009 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-18927448

RESUMO

BACKGROUND AND PURPOSE: The association between cerebral white matter lesions (WMLs) and the risk of falls in older people is uncertain, with no supporting prospective evidence. We aimed to determine the risk of incident falls associated with WML volume, and the interactions between WML volume, gait, and other sensorimotor factors leading to falls. METHODS: We conducted a prospective, population-based study (n=294, mean age 72.3 years, independently mobile). Volumetric MRI, computerized gait measures, and sensorimotor measures of falls risk were obtained at baseline. Incident falls were recorded prospectively over a 12-month period. Using regression modeling, we estimated the risk of incident falls associated with baseline WML volume. RESULTS: Increasing baseline WML volume was independently associated with any incident fall (P=0.01) and multiple incident falls (P=0.02). The risk of incident falls was doubled in people with lesion volumes in the highest quintile of its distribution compared with the lowest (adjusted relative risk, 2.32; 95% CI, 1.28-4.14). Greater lesion volume was also associated with poorer gait and greater gait variability (both P<0.001). The effect of WML volume on the risk of falls was magnified in people with poorer quadriceps muscle strength (P=0.03) and greater gait variability (P=0.001). CONCLUSIONS: These data provide the first prospective evidence to our knowledge demonstrating that WMLs are strong risk factors for falls in the general older population. WMLs present potential therapeutic targets for interventional trials in falls prevention.


Assuntos
Acidentes por Quedas/mortalidade , Cérebro/patologia , Transtornos Neurológicos da Marcha/epidemiologia , Transtornos Neurológicos da Marcha/patologia , Leucoaraiose/epidemiologia , Leucoaraiose/patologia , Idoso , Idoso de 80 Anos ou mais , Artérias Cerebrais/patologia , Artérias Cerebrais/fisiopatologia , Cérebro/irrigação sanguínea , Cérebro/fisiopatologia , Estudos de Coortes , Comorbidade , Demência Vascular/epidemiologia , Demência Vascular/patologia , Demência Vascular/fisiopatologia , Avaliação da Deficiência , Progressão da Doença , Feminino , Marcha/fisiologia , Transtornos Neurológicos da Marcha/fisiopatologia , Humanos , Incidência , Leucoaraiose/fisiopatologia , Imageamento por Ressonância Magnética , Masculino , Debilidade Muscular/diagnóstico , Debilidade Muscular/epidemiologia , Debilidade Muscular/fisiopatologia , Exame Neurológico , Estudos Prospectivos , Músculo Quadríceps/fisiopatologia , Fatores de Risco
9.
Cogn Behav Ther ; 37(2): 66-75, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18470738

RESUMO

Prior studies have shown that anxiety sensitivity (AS) plays an important role in posttraumatic stress disorder (PTSD) symptom severity. The purpose of this study was to evaluate associations between empirically supported PTSD symptom clusters (i.e. reexperiencing, avoidance, numbing, hyperarousal) and AS dimensions (i.e. psychological concerns, social concerns, somatic concerns). Participants were 138 active-duty police officers (70.7% female; mean age = 38.9 years; mean time policing = 173.8 months) who, as a part of a larger study, completed measures of trauma exposure, PTSD symptoms, AS, and depressive symptoms. All participants reported experiencing at least one event that they perceived as traumatic, and 44 (31.9%) screened positive for PTSD. Officers with probable PTSD scored significantly higher on AS total as well as the somatic and psychological concerns dimensional scores than did those without PTSD. As well, a higher percentage of officers with probable PTSD scored positively on the AS-derived Brief Screen for Panic Disorder (Apfeldorf et al., 1994) compared with those without PTSD. A series of regression analyses revealed that depressive symptoms, number of reported traumas, and AS somatic concerns were significant predictors of PTSD total symptom severity as well as severity of reexperiencing. Avoidance was predicted by depressive symptoms and AS somatic concerns. Only depressive symptoms were significantly predictive of numbing and hyperarousal cluster scores. These findings contribute to understanding the nature of association between AS and PTSD symptom clusters. Implications for the treatment of individuals having PTSD with and without panic-related symptomatology are discussed.


Assuntos
Ansiedade/psicologia , Transtorno de Pânico/psicologia , Polícia , Transtornos de Estresse Pós-Traumáticos/psicologia , Adulto , Estudos de Casos e Controles , Comorbidade , Depressão/psicologia , Feminino , Humanos , Masculino , Transtorno de Pânico/epidemiologia , Prevalência , Análise de Regressão , Saskatchewan/epidemiologia , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/epidemiologia
10.
Physiol Behav ; 92(4): 629-42, 2007 Nov 23.
Artigo em Inglês | MEDLINE | ID: mdl-17588623

RESUMO

The act of eating requires a decision by an animal to place food in its mouth. The reasons to eat are varied and include hunger as well as the food's expected reward value. Previous studies of tastant processing in the rat primary gustatory cortex (GC) have used either anesthetized or awake behaving preparations that yield somewhat different results. Here we have developed a new preparation in which we explore the influences of intra-oral and non-contingent tastant delivery on rats' behavior and on their GC neural responses. We recorded single-unit activity in the rat GC during two sequences of tastant deliveries, PRE and POST, which were separated by a waiting period. Six tastants ranging in hedonic value from sucrose to quinine were delivered in the first two protocols called 4TW and L-S. In the third one, the App L-S protocol, only hedonically positive tastants were used. In the 4TW protocol, tastants were delivered in blocks whereas in the two L-S protocols tastants were randomly interleaved. In the 4TW and L-S protocols the probability of ingesting tastants in the PRE sequence decreased exponentially with the trial number. Moreover, in both protocols this decrease was greater in the POST than in the PRE sequence likely because the subjects learned that unpleasant tastants were to be delivered. In the App L-S protocol the decrease in ingestion was markedly slower than in the other protocols, thus supporting the hypothesis that the decrease in appetitive behavior arises from the non-contingent intra-oral delivery of hedonically negative tastants like quinine. Although neuronal responses in the three protocols displayed similar variability levels, significant differences existed between the protocols in the way the variability was partitioned between chemosensory and non-chemosensory neurons. While in the 4TW and L-S protocols the former population displayed more changes than the latter, in the App L-S protocol variability was homogeneously distributed between the two populations. We posit that these tuning changes arise, at least in part, from compounds released upon ingestion, and also from differences in areas of the oral cavity that are bathed as the animals ingest or reject the tastants.


Assuntos
Comportamento Animal/fisiologia , Córtex Cerebral/fisiologia , Potenciais Evocados/fisiologia , Células Receptoras Sensoriais/fisiologia , Paladar/fisiologia , Administração Oral , Algoritmos , Animais , Cateterismo , Córtex Cerebral/citologia , Ingestão de Alimentos/fisiologia , Aromatizantes/administração & dosagem , Modelos Neurológicos , Neurônios/citologia , Neurônios/fisiologia , Distribuição Aleatória , Ratos , Ratos Long-Evans , Papilas Gustativas/citologia , Papilas Gustativas/fisiologia
11.
Front Neurosci ; 1(1): 161-74, 2007 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-18982126

RESUMO

The gustatory cortex (GC) processes chemosensory and somatosensory information and is involved in learning and anticipation. Previously we found that a subpopulation of GC neurons responded to tastants in a single lick (Stapleton et al., 2006). Here we extend this investigation to determine if small ensembles of GC neurons, obtained while rats received blocks of tastants on a fixed ratio schedule (FR5), can discriminate between tastants and their concentrations after a single 50 muL delivery. In the FR5 schedule subjects received tastants every fifth (reinforced) lick and the intervening licks were unreinforced. The ensemble firing patterns were analyzed with a Bayesian generalized linear model whose parameters included the firing rates and temporal patterns of the spike trains. We found that when both the temporal and rate parameters were included, 12 of 13 ensembles correctly identified single tastant deliveries. We also found that the activity during the unreinforced licks contained signals regarding the identity of the upcoming tastant, which suggests that GC neurons contain anticipatory information about the next tastant delivery. To support this finding we performed experiments in which tastant delivery was randomized within each block and found that the neural activity following the unreinforced licks did not predict the upcoming tastant. Collectively, these results suggest that after a single lick ensembles of GC neurons can discriminate between tastants, that they may utilize both temporal and rate information, and when the tastant delivery is repetitive ensembles contain information about the identity of the upcoming tastant delivery.

12.
Mil Med ; 171(6): 562-6, 2006 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-16808142

RESUMO

It remains to be determined whether patients with comorbid post-traumatic stress disorder (PTSD) and depression use more health care resources than do those without. United Nations peacekeeping veterans from Canada were divided into four groups, i.e., PTSD alone (n = 23), depression alone (n = 167), comorbid PTSD and depression (n = 119), and neither (n = 164), and compared with respect to total number of visits to any health care professional in the past year. Analysis of variance revealed that the groups significantly differed in total visits. Post hoc analyses indicated that veterans with co-occurring PTSD and depression symptoms had more visits than did those in the other groups and that veterans with PTSD symptoms alone and depression symptoms alone had more visits than did those with neither PTSD nor depression. Additional analyses revealed that veterans with co-occurring PTSD and depression symptoms made more visits to general practitioners, specialists, pharmacists, and mental health professionals than did the others. Future research directions and implications for treatment planning are discussed.


Assuntos
Depressão/terapia , Serviços de Saúde/estatística & dados numéricos , Psiquiatria Militar , Transtornos de Estresse Pós-Traumáticos/terapia , Nações Unidas , Veteranos/psicologia , Guerra , Adulto , Análise de Variância , Canadá , Comorbidade , Conflito Psicológico , Depressão/complicações , Feminino , Pesquisas sobre Atenção à Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Visita a Consultório Médico , Autoavaliação (Psicologia) , Transtornos de Estresse Pós-Traumáticos/complicações , Inquéritos e Questionários , Veteranos/estatística & dados numéricos
13.
J Neurosci ; 26(15): 4126-38, 2006 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-16611830

RESUMO

Rapid tastant detection is necessary to prevent the ingestion of potentially poisonous compounds. Behavioral studies have shown that rats can identify tastants in approximately 200 ms, although the electrophysiological correlates for fast tastant detection have not been identified. For this reason, we investigated whether neurons in the primary gustatory cortex (GC), a cortical area necessary for tastant identification and discrimination, contain sufficient information in a single lick cycle, or approximately 150 ms, to distinguish between tastants at different concentrations. This was achieved by recording neural activity in GC while rats licked four times without a liquid reward, and then, on the fifth lick, received a tastant (FR5 schedule). We found that 34% (61 of 178) of GC units were chemosensitive. The remaining neurons were activated during some phase of the licking cycle, discriminated between reinforced and unreinforced licks, or processed task-related information. Chemosensory neurons exhibited a latency of 70-120 ms depending on concentration, and a temporally precise phasic response that returned to baseline in tens of milliseconds. Tastant-responsive neurons were broadly tuned and responded to increasing tastant concentrations by either increasing or decreasing their firing rates. In addition, some responses were only evoked at intermediate tastant concentrations. In summary, these results suggest that the gustatory cortex is capable of processing multimodal information on a rapid timescale and provide the physiological basis by which animals may discriminate between tastants during a single lick cycle.


Assuntos
Córtex Cerebral/fisiologia , Comportamento de Ingestão de Líquido/fisiologia , Tempo de Reação , Paladar/fisiologia , Animais , Mapeamento Encefálico , Eletrofisiologia , Masculino , Ratos , Ratos Long-Evans , Privação de Água
14.
J Trauma Stress ; 19(1): 19-28, 2006 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-16568469

RESUMO

This study sought to investigate the efficacy of prolonged exposure, eye movement desensitization and reprocessing, and relaxation training on trait anger and guilt and on trauma-related anger and guilt within the context of posttraumatic stress disorder (PTSD) treatment. Fifteen PTSD patients completed each treatment and were assessed at posttreatment and at 3-month follow-up. All three treatments were associated with significant reductions in all measures of anger and guilt, with gains maintained at follow-up. There were no significant treatment differences in efficacy or in the proportion of patients who worsened on anger or guilt measures over the course of treatment. Between-treatment effect sizes were generally very small. Results suggest that all three treatments are associated with reductions in anger and guilt, even for patients who initially have high levels of these emotions. However, these PTSD therapies may not be sufficient for treating anger and guilt; additional interventions may be required.


Assuntos
Ira , Dessensibilização Psicológica , Movimentos Oculares/fisiologia , Culpa , Psicoterapia/métodos , Terapia de Relaxamento , Transtornos de Estresse Pós-Traumáticos/psicologia , Transtornos de Estresse Pós-Traumáticos/terapia , Adulto , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Masculino , Índice de Gravidade de Doença , Transtornos de Estresse Pós-Traumáticos/diagnóstico
15.
J Trauma Stress ; 17(6): 467-75, 2004 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-15730065

RESUMO

We present the conceptual basis and empirical evidence for considering avoidance and numbing as distinct posttraumatic stress disorder (PTSD) symptom clusters. The majority of data from factor analytic studies supports the position that avoidance and numbing are distinct symptom clusters. As well, the available data suggest that (a) different treatment modalities have differential effects on reducing avoidance but not numbing, (b) patients with more severe pretreatment numbing have poorer treatment outcomes, (c) avoidance and numbing have different patterns of correlation with depression, and (d) they have different correlations with physiological indices of attention. We conclude that avoidance and numbing are distinct PTSD symptom clusters. This distinction has implications for revising current diagnostic criteria. The recognition of this distinction may lead to advances in understanding and treating PTSD.


Assuntos
Adaptação Psicológica , Atenção , Transtornos de Estresse Pós-Traumáticos/psicologia , Aprendizagem da Esquiva , Diagnóstico Diferencial , Emoções , Humanos , Prognóstico , Transtornos de Estresse Pós-Traumáticos/classificação , Transtornos de Estresse Pós-Traumáticos/diagnóstico
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