Scielo RSS <![CDATA[Trends in Psychiatry and Psychotherapy]]> http://www.scielo.br/rss.php?pid=2237-608920200002&lang=pt vol. 42 num. 2 lang. pt <![CDATA[SciELO Logo]]> http://www.scielo.br/img/en/fbpelogp.gif http://www.scielo.br <![CDATA[Time-driven interventions for affective disorders: on resonance and the Oberth effect]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2237-60892020000200113&lng=pt&nrm=iso&tlng=pt <![CDATA[Childhood trauma and bipolar spectrum: a population-based sample of young adults]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2237-60892020000200115&lng=pt&nrm=iso&tlng=pt Abstract Introduction Childhood trauma has been suggested to be involved in susceptibility to bipolar disorder (BP). However, it remains unclear whether the occurrence of childhood trauma is differently distributed in subthreshold bipolar disorder (SBP). Objective To assess childhood trauma in young adults with SBP, as compared to young adults with BP and population controls (PC). Method This was a cross-sectional, population-based study. The Mini International Neuropsychiatric Interview (MINI) was used to define the groups with BP (subjects with a lifetime or current manic episode or lifetime or current hypomania with a history of a depressive episode), SBP (subjects with a history of hypomanic episode without lifetime or current depressive episode), and subjects without mood disorders (PC). Childhood trauma was assessed using de Childhood Trauma Questionnaire (CTQ). We investigated differences regarding childhood trauma across the three groups (BP, SBP and PC). Result Except for sexual abuse, all subtypes of childhood trauma remained associated with the BP group as compared to PC. Additionally, when we compared SBP and BP, significant differences were found only for emotional abuse. No significant differences were found in relation to childhood trauma between the SBP and PC groups after adjusting for confounding factors. Conclusion These findings suggest that investigating childhood trauma, with a particular focus on emotional abuse, could be considered a preventive measure and potentially improve the prognosis. <![CDATA[The effect of cognitive behavioral counseling on sexual knowledge, motivation to avoid risky sexual relationships, and sexual depression in female university students]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2237-60892020000200122&lng=pt&nrm=iso&tlng=pt Abstract Introduction Misunderstanding of different aspects of sex makes individuals vulnerable to sexual dysfunction, sexually transmitted diseases, mental disorders, and illegal relationships. This study aimed to determine the effect of cognitive behavioral counseling on the sexual self-concept of female students at Kerman University of Medical Sciences. Methods This study is an intervention conducted with female students living in dormitories at Kerman and Rafsanjan Universities of Medical Sciences. The sample size was estimated at 63 students from different fields of study; 31 students from Kerman University of Medical Sciences comprised the experimental group and 32 students from Rafsanjan University of Medical Sciences comprised the control group. Cognitive behavioral group counseling sessions were held every 3 days. The instrument used for collecting pre-test and post-test data was Snell’s Multidimensional Sexual Self-concept Questionnaire. Data analysis was conducted using measures of central tendency, t tests and chi-square tests. Results The two groups were homogenous in terms of demographic factors. Analysis of the results of the intervention revealed significant differences in sexual self-consciousness and motivation to avoid high risk sexual relationships, but there was no significant difference in terms of sexual depression. Discussion Cognitive behavioral group counseling can improve sexual self-concept. Therefore, this type of counseling is recommended from younger ages or at enrollment at university, to help correct development of this important part of identity. <![CDATA[Psychometric properties of the Brazilian Intolerance of Uncertainty Scale – Short Version (IUS-12)]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2237-60892020000200129&lng=pt&nrm=iso&tlng=pt Abstract Introduction The Intolerance of Uncertainty Scale – Short Version (IUS-12) is a measure of trait intolerance of uncertainty. Objective The purpose of the present study was to conduct a cross-cultural adaptation of the IUS-12 for use in Brazil and to investigate the scale’s psychometric properties. Methods The research was conducted via an online research platform with a sample (n = 704; 80.1% female and 19.9% male) from different states in all five regions of Brazil. Participants were adults between 18 and 59 years of age (mean = 26.74; standard deviation = 8.36) who completed the Brazilian version of the IUS-12 online along with other anxiety-related measures. Results Confirmatory factor analysis demonstrated that the original two-dimensional structure fit the sample well. The total score for the scale had good internal consistency (Cronbach’s alpha [α] = 0.88), as did both subscales (i.e. Prospective IU α = 0.79; Inhibitory IU α = 0.86). Conclusions The results demonstrated strong positive correlations with measures of anxiety-related constructs, contributing to the transdiagnostic understanding of IU. The IUS-12 appears to be a useful tool for assessment of IU and its availability has several implications of theoretical importance and practical utility for understanding of psychopathology and uncertainty. <![CDATA[The effectiveness of mindfulness-based cognitive therapy for reducing rumination and improving mindfulness and self-compassion in patients with treatment-resistant depression]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2237-60892020000200138&lng=pt&nrm=iso&tlng=pt Abstract Introduction Depression is one of the most important psychiatric disorders, and the rate of recurrence is high. The heavy cost burden of depression is probably due to treatment-resistant depression. The purpose of this study was to determine the effectiveness of mindfulness-based cognitive therapy (MBCT) in patients with treatment-resistant depression (TRD). Method The present study was a quasi-experimental study conducted with twenty-four patients with treatment-resistant depression. Participants were selected by purposive sampling and randomly assigned to two groups, an experimental group and a control group. The experimental group received MBCT and antidepressants, while the control group received antidepressants only. The Hamilton and Beck Depression Inventory, Self-Compassion Scale, Thought Rumination Scale, and Mindfulness Scale were administered. The treatment program was conducted in eight sessions; with a follow-up period of one month subsequent to treatment termination. Data were analyzed using descriptive statistics (mean and standard deviation) and inferential statistics (analysis of variance for repeated measures and Bonferroni’s post-hoc test). Results The results showed that MBCT significantly reduced depression and ruminative thinking in the experimental group and also improved mediators such as mindfulness and self-compassion. Patients maintained gains over the one month follow-up period (p &lt; 0.01). Conclusion The present study provides additional evidence for the effectiveness of MBCT for TRD. <![CDATA[Modulation of neuropeptide Y levels is impaired in crack withdrawal patients]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2237-60892020000200147&lng=pt&nrm=iso&tlng=pt Abstract Introduction The dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis has a key role in drug addiction susceptibility. In addition to the well-known relationship between cortisol and the HPA axis, other molecules are involved with stress response and could modify the HPA activation, such as the neuropeptide Y (NPY), which has anxiolytic proprieties. There are few studies evaluating the effect of NPY levels on addiction, especially in crack cocaine dependence. Objective To evaluate NPY in crack users during early withdrawal to determine its relationship with drug use and cortisol levels. Methods We analyzed 25 male inpatient crack users. Serum NPY levels were measured at admission and discharge (mean of 24 days). Morning salivary cortisol was measured at admission. Results Serum NPY levels at admission and discharge were very similar. Lower NPY levels at discharge were associated with higher lifetime crack use. Also, a negative correlation was found between morning cortisol and delta NPY (NPY discharge – NPY admission). Conclusion These preliminary findings indicate that crack use influences the modulation of NPY levels and modifies stress response. The NPY pathway may play an important role in the pathophysiology of crack addiction, and the anxiolytic effect of NPY may be impaired in crack users. Future studies should consider NPY as a measurable indicator of the biological state in addiction. <![CDATA[High rates of incarceration due to drug trafficking in the last decade in southern Brazil]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2237-60892020000200153&lng=pt&nrm=iso&tlng=pt Abstract Introduction Drug-related crimes, especially drug trafficking, account for a large part of incarcerations not only in Brazil, but also worldwide. It is not clear whether the change in the drug law has contributed to the increase in the number of drug trafficking prisoners. Few studies have investigated gender differences and the growth of drug trafficking offenses in the Brazilian southern state of Rio Grande do Sul. Objective To investigate the growth of the prison population in the state of Rio Grande do Sul, emphasizing incarcerations for drug trafficking and gender differences. Method This was an ecological study using secondary data collected from official databases of the Brazilian National Penitentiary Department (Departamento Penitenci√°rio [DEPEN]), affiliated with the Brazilian Ministry of Justice. Results Between 2006 and 2015, incarcerations increased by 27% (25% men, 83% women). Incarcerations for drug trafficking accounted for 11% of total arrests in 2006 (11% men, 20% women) and 45% in 2015 (47% men, 91% women), corresponding to an increase of 427% (415% among men, 723% among women). Conclusions Imprisonment for drug trafficking has increased considerably, especially among women. This may be due to factors such as: increase of drug trafficking, increase in the numbers of gangs in the state, and changes in the Brazilian drug law. These results highlight an emerging challenge in public health from the perspective of human rights and gender. <![CDATA[Memory and language impairments are associated with anxiety disorder severity in childhood]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2237-60892020000200161&lng=pt&nrm=iso&tlng=pt Abstract Introduction Children with anxiety disorders have been suggested to possess deficits in verbal fluency, shifting and attention, with inconsistent results regarding working memory and its subcomponents. This study extends previous findings by analyzing the performance of children with anxiety disorders in a wide range of neuropsychological functions. Methods We evaluated 54 children with a primary diagnosis of an anxiety disorder according to diagnostic criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) using subtests of a neuropsychological battery. The severity of anxiety disorders was assessed using the Pediatric Anxiety Rating Scale (PARS). We calculated the frequency of neuropsychological impairments (-1.5 standard deviation of the normative sample). Comparisons between groups were performed based on the severity of anxiety symptoms, as well as in the presence of one vs. more diagnoses of anxiety disorder. Results We found higher impairment in visuospatial working memory (23.1%), semantic memory (27.8%), oral language (35.4%) and word writing (44.4%) in anxious children. Moreover, children with higher anxiety severity presented lower performance in visuospatial working memory, inferential processing, word reading, writing comprehension, copied writing, and semantic verbal fluency (d = 0.49 to 0.96 [Cohen’s d]). The higher the number of anxiety diagnoses, the lower the performance in episodic memory and oral and written language (d = 0.56 to 0.77). Conclusion Our data suggested the presence of memory (visuospatial working memory and semantic memory) and language deficits (oral and writing) in some children with an anxiety disorder. Severity and number of anxiety diagnoses were associated with lower performance in memory and language domains in childhood. <![CDATA[Neither God nor others: a qualitative study of strategies for avoiding suicide among homeless people]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2237-60892020000200171&lng=pt&nrm=iso&tlng=pt Abstract Introduction Drug addiction and alcoholism characterize the existential condition of most homeless people, while the risk of suicide runs in parallel. Objectives Following the Provisional Model (PM), this study aimed to explore the relationships between addiction, suicidal ideation, and religiosity among 13 homeless people, and the roles of bonding ties (within the group) and bridging ties (intergroup). Method The study is rooted in the field of qualitative psychology research. A survey was conducted, analyzing the personal accounts of participants and applying the PM psychological interpretation integrated with theory from literature on drug addiction, religiosity, and suicidal ideation in the field of homelessness. Results Outcomes show that suicidal ideation appears in the first phase of homelessness and is opposed by alcoholism and drug addiction. Religiosity does not help to counteract suicidal ideation or to create bonding relationships. Conversely, drugs and alcohol seem to be more useful for preventing suicide, but also do not help in bonding relationships. Conclusion Our survey only partially confirmed the PM, because the main result was the importance of relationships between suicidal ideation and alcohol/drug abuse during the initial phase of becoming homeless, while the importance of bonding ties deriving from addiction behavior did not emerge. <![CDATA[Personality differences and COVID-19: are extroversion and conscientiousness personality traits associated with engagement with containment measures?]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2237-60892020000200179&lng=pt&nrm=iso&tlng=pt Abstract Introduction In December 2019, an outbreak of the novel coronavirus, the coronavirus disease 2019 (COVID-19) probably occurred in Wuhan, China. By March 2020, the World Health Organization (WHO) had declared a pandemic. Containment measures such as social distancing and hand hygiene were recommended. In this study, we start from the hypothesis that engaging with containment measures in a pandemic situation should be more comfortable for some people than for other people. Thus, individual differences should be associated with engagement with containment measures. Objective To investigate to what extent two personality traits, extroversion and conscientiousness, are associated with engagement with two containment measures (social distancing and handwashing). Methods The sample consisted of 715 Brazilian adults aged 18-78 years, who answered the Big Five Inventory 2 Short (BFI-2-S) and factors from the Dimensional Clinical Personality Inventory 2 (IDCP-2). Results Higher scores for extroversion were associated with lower means for social distancing (p &lt; 0.001) and higher scores for conscientiousness were associated with higher means for social distancing and handwashing (p &lt; 0.05). Conclusion The findings indicate the importance of acknowledging extroversion and conscientiousness traits as relevant to people’s engagement with the measures recommended for COVID-19 containment. <![CDATA[Work Environment Evaluation Instrument (WEEI): development, validation, and association with burnout]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2237-60892020000200185&lng=pt&nrm=iso&tlng=pt Abstract Introduction Physician burnout is considered an epidemic. In 2019, 44% of U.S. physicians reported feeling burned out. The work environment is a central risk factor for this. The aim of this study is to develop and test an instrument to evaluate work environment factors in medical training courses. Method After focus groups, an initial pool of 14 items was generated and tested in a pilot study (n = 66). Face validity was verified, and small adjustments were made. The resulting version was administered to a sample of 115 psychiatry residents. Eleven items were selected based on the correlations between them, principal component analysis, and theoretical reasons, and then tested for internal and construct validity. Results The final version had high reliability (Cronbach’s alpha = 0.898) and comprised three dimensions: relations with the institution; with colleagues; and with preceptors. Both total scores and dimensions correlated significantly with burnout scores (p &lt; 0.01). Cutoffs defining the environment as healthy (&gt;32 points); risky (23-31 points); or toxic (&lt;22 points) were suggested and related to the risk of burnout. Conclusion Several authors have emphasized the importance of approaching institutional factors as an effective strategy for coping with the increased prevalence of burnout. This instrument should contribute to these efforts. <![CDATA[Intragroup differences and similarities in performance on rapid automatized naming tasks in children with ADHD symptoms, children with reading disabilities, and controls]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2237-60892020000200190&lng=pt&nrm=iso&tlng=pt Abstract Introduction Rapid automatized naming (RAN) is the ability to name, as fast as possible, symbols such as letters, digits and figures. The present study aimed to investigate intragroup performance patterns on RAN tasks in children with attention deficit hyperactivity disorder (ADHD) symptoms alone, children with reading disability (RD) alone and controls with typical development. Methods A total of 216 Brazilian children between 8 to 11 years old were selected from public schools located in two Brazilian capitals, namely Porto Alegre and Belo Horizonte, to participate in the study. Mixed 3 (participant group: ADHD symptoms, RD or control group) √ó 3 (type of stimulus: letters, numbers or figures) ANOVAs were performed using response time and number of errors as dependent variables. Only intragroup comparisons are described in this paper. Results The groups with ADHD symptoms and RD showed similar performance results on naming speed. There were no differences between letters and numbers within each group, but we found slower responses in figure naming compared to the other tasks for both groups. Concerning accuracy, children with ADHD symptoms showed a similar number of errors in all three tasks. These patterns were distinct from the performance of the control group. Conclusion Results suggest a shared deficit in naming speed of alphanumeric stimuli in children with ADHD symptoms and those with RD, and impairments in naming digits correctly in children with ADHD symptoms. <![CDATA[Corticotropin-releasing factor receptor signaling and modulation: implications for stress response and resilience]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2237-60892020000200195&lng=pt&nrm=iso&tlng=pt Abstract Introduction In addition to their role in regulation of the hypothalamic-pituitary-adrenal-axis, corticotropin-releasing factor (CRF) and its related peptides, the urocortins, are important mediators of physiological and pathophysiological processes of the central nervous, cardiovascular, gastrointestinal, immune, endocrine, reproductive, and skin systems. Altered regulation of CRF-mediated adaptive responses to various stressful stimuli disrupts healthy function and might confer vulnerability to several disorders, including depression and anxiety. Methodology This narrative review was conducted through search and analysis of studies retrieved from online databases using a snowball method. Results This review covers aspects beginning with the discovery of CRF, CRF binding protein and their actions via interaction with CRF receptors type 1 and type 2. These are surface plasma membrane receptors, activation of which is associated with conformational changes and interaction with a variety of G-proteins and signaling pathways. We also reviewed the pharmacology and mechanisms of the receptor signaling modulatory activity of these receptors. Conclusion This review compiles and presents knowledge regarding the CRFergic system, including CRF related peptides, CRF binding protein, and CRF receptors, as well as some evidence that is potentially indicative of the biological roles of these entities in several physiological and pathophysiological processes. <![CDATA[Factors associated with levels of empathy among students and professionals in the health field: a systematic review]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2237-60892020000200207&lng=pt&nrm=iso&tlng=pt Abstract Objective This study aimed to investigate factors associated with empathy and identify instruments used to measure this ability in professionals and students in the health field. Method A systematic review was performed. Searches were conducted on the PsycINFO, PubMed, Web of Science, and Scopus databases using the keywords “empathy” and “health professional”. We selected 29 articles published in English, with no restriction imposed regarding the year of publication. Results Based on the findings of the articles selected, sociodemographic factors (female gender, being married, being older, having siblings, and having children) are associated with higher levels of empathy. Professional experience (years of practice) and being on the final years of the course also contributed to higher levels of empathy. Different versions of the Jefferson Scale of Empathy were the most prevalent assessment tools employed in the different studies. Conclusion The articles analyzed describe several factors that influence the level of empathy among health professionals and students. Thus, future studies should take sociodemographic factors into account when evaluating levels of empathy in this population. <![CDATA[Corrigendum]]> http://www.scielo.br/scielo.php?script=sci_arttext&pid=S2237-60892020000200216&lng=pt&nrm=iso&tlng=pt Abstract Objective This study aimed to investigate factors associated with empathy and identify instruments used to measure this ability in professionals and students in the health field. Method A systematic review was performed. Searches were conducted on the PsycINFO, PubMed, Web of Science, and Scopus databases using the keywords “empathy” and “health professional”. We selected 29 articles published in English, with no restriction imposed regarding the year of publication. Results Based on the findings of the articles selected, sociodemographic factors (female gender, being married, being older, having siblings, and having children) are associated with higher levels of empathy. Professional experience (years of practice) and being on the final years of the course also contributed to higher levels of empathy. Different versions of the Jefferson Scale of Empathy were the most prevalent assessment tools employed in the different studies. Conclusion The articles analyzed describe several factors that influence the level of empathy among health professionals and students. Thus, future studies should take sociodemographic factors into account when evaluating levels of empathy in this population.