20 resultados para Adulthood--Psychological aspects

em BORIS: Bern Open Repository and Information System - Berna - Suiça


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In the present study we introduce a novel task for the quantitative assessment of both originality and speed of individual associations. This 'BAG' (Bridge-the-Associative-Gap) task was used to investigate the relationships between creativity and paranormal belief. Twelve strong 'believers' and 12 strong 'skeptics' in paranormal phenomena were selected from a large student population (n > 350). Subjects were asked to produce single-word associations to word pairs. In 40 trials the two stimulus words were semantically indirectly related and in 40 other trials the words were semantically unrelated. Separately for these two stimulus types, response commonalities and association latencies were calculated. The main finding was that for unrelated stimuli, believers produced associations that were more original (had a lower frequency of occurrence in the group as a whole) than those of the skeptics. For the interpretation of the result we propose a model of association behavior that captures both 'positive' psychological aspects (i.e., verbal creativity) and 'negative' aspects (susceptibility to unfounded inferences), and outline its relevance for psychiatry. This model suggests that believers adopt a looser response criterion than skeptics when confronted with 'semantic noise'. Such a signal detection view of the presence/absence of judgments for loose semantic relations may help to elucidate the commonalities between creative thinking, paranormal belief and delusional ideation.

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INTRODUCTION Fear and anxiety are part of all human experiences and they may contribute directly to a patient's behavior. The Atraumatic Restorative Treatment (ART) is a technique that may be an alternative approach in treating special care patients or those who suffer fear or anxiety. OBJECTIVE the aim of this paper is to review the ART technique as an alternative to reduce pain and fear during dental treatment. MATERIAL AND METHODS A search for the term "atraumatic restorative treatment" was carried out in the MEDLINE search engine. References, from the last 10 years, containing at least one of the terms: "psychological aspects", "discomfort", "fear", "anxiety" or "pain", were selected. RESULTS A total of 120 references were found, from which only 17 fit the criteria. Discussion: All authors agreed that the ART promotes less discomfort for patients, contributing to a reduction of anxiety and fear during the dental treatment. Results also indicated that ART minimizes pain reported by patients. CONCLUSIONS The ART approach can be considered as having favorable characteristics for the patient, promoting an "atraumatic" treatment. This technique may be indicated for patients who suffer from fear or anxiety towards dental treatments and whose behavior may cause the treatment to become unfeasible or even impossible altogether.

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Psychological distress is common in patients with chronic heart failure. The impact of different psychological variables on prognosis has been shown but the comparative effects of these variables remain unclear. This study examines the impact of depression, anxiety, vital exhaustion, Type D personality, and social support on prognosis in chronic heart failure patients. One hundred eleven patients (mean age 57 ± 14 years) having participated in an exercise based ambulatory cardiac rehabilitation program were enrolled in a prospective cohort study. Psychological baseline data were assessed at program entry. Mortality, readmission, and health-related quality of life were assessed at follow up (mean 2.8 ± 1.1 years). After controlling for disease severity none of the psychological variables were associated with mortality, though severe anxiety predicted readmission [HR = 3.21 (95% CI, 1.04-9.93; P = .042)]. Health-related quality of life was independently explained by vital exhaustion, anxiety and either body mass index (physical dimension) or sex (emotional dimension). As psychological variables have a strong impact on health-related quality of life they should be routinely assessed in chronic heart failure patients` treatment.

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Compared to Europe's mean immigrant contingent of 7.3 to 8.6 % Switzerland holds the highest contingent of foreign population with 23.5 %. Therefore it is of utmost importance that physicians have a knowledge of the specific characteristics of immigrant patients. The influence of personality factors (experience, behavior) is not independent from the influence of culturally-related environmental factors (regional differences in diet, pollutants, meanings, etc.). In addition, different cultural groups rate their quality of life differently. Psychological reasons for recurrent abdominal pain are stress (life events), effects of self-medication (laxatives, cocaine) and sexual abuse but also rare infectious diseases are more common among immigrants (e.g. tuberculosis, histoplasmosis, etc.). Migration-specific characteristics are mainly to find in the semiotics of the symptoms: not every abdominal pain is real pain in the abdomen. Finally, it is crucial to make the distinction between organic, functional and psychological-related pain. This can, however, usually only be accomplished in the context of the entire situation of a patient and, depending on the situation, with the support of a colleague from the appropriate cultural group or an experienced interpreter. In this review we limit ourselves to the presentation of the working population of the migrants, because these represent the largest group of all migrants. The specific situation of asylum seekers will also be refrained to where appropriate.

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Purpose: Gender-specific differences exist between male and female infertility patients' mental health, the meaning of infertility in their lives, and the coping strategies used. This systematic review examines whether gender-specific aspects are addressed in psychological intervention studies for infertility and whether infertile women and men benefit equally from such interventions. Methods: Databases were searched to identify relevant articles published between 1978 and 2007 (384 articles). The review included both controlled and uncontrolled psychological intervention studies examining results for infertile women and men separately. Outcome measures (depressive symptoms, anxiety, and mental distress) and gender-specific baseline characteristics (mental distress at pre-assessment, cause of infertility, and medical treatment) were collected. A total of twelve studies were finally included. Results: In 10 of 12 studies, women exhibited higher levels of mental distress than men. Gender-specific aspects were not addressed in the psychological interventions. Examining the efficacy of psychological interventions revealed that women exhibited stronger positive mental health effects in 2 of the 12 studies. Conclusion: Psychological distress before psychological treatment seems more pronounced in women than in men. Therefore psychological interventions for infertile couples should take gender-specific aspects into account. More research is needed to address the gender-specific aspects regarding psychological interventions for infertility.

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OBJECTIVES AND METHODS: Gender differences regarding 17 childhood experiences, thought to have traumatising potential (Traumatic Childhood Experiences = TCE), and pain behaviour in adulthood were assessed using a self-administered, anonymously filled-out questionnaire. Patients were consecutively accrued in the offices of practicing physicians. Three research questions were formulated: 1) Are specific TCE reported more frequently in male and female patients with the diagnosis "Pain Associated with Psychological Factors" (PP), compared to patients with "Pain, explained by Organic Processes" (OP), and "Patients with Diseases without Pain" (OD)? 2) Do PP-men and PP-women differ in reporting TCE?; 3) Are specific TCE correlated with Pain Duration, -Intensity and Number of Operations? RESULTS: 1). TCE occurred more frequently in PP-men and PP-women compared to OP- and OD-patients. 2). The PP-women reported much more TCE-items than the PP-men. 3). Duration and Intensity of adult pain associated with psychological factors correlated with certain TCE-items. CONCLUSIONS: The three research questions can be answered by "yes". In patients with pain which has been impossible to diagnose and/or has resisted conventional forms of therapy, TCE (verbal, physical and sexually abusive) have to be looked for, because they often explain adult pain. Unnecessary examinations and surgery can be avoided and therapies can be tailored for the individual patient.

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Low self-esteem and depression are strongly correlated in cross-sectional studies, yet little is known about their prospective effects on each other. The vulnerability model hypothesizes that low self-esteem serves as a risk factor for depression, whereas the scar model hypothesizes that low self-esteem is an outcome, not a cause, of depression. To test these models, the authors used 2 large longitudinal data sets, each with 4 repeated assessments between the ages of 15 and 21 years and 18 and 21 years, respectively. Cross-lagged regression analyses indicated that low self-esteem predicted subsequent levels of depression, but depression did not predict subsequent levels of self-esteem. These findings held for both men and women and after controlling for content overlap between the self-esteem and depression scales. Thus, the results supported the vulnerability model, but not the scar model, of self-esteem and depression.

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The availability of recombinant human growth hormone (GH) has resulted in investigation of the role of GH in adulthood and the effects of GH replacement in the GH-deficient adult. These studies have led to the recognition of a specific syndrome of GH-deficiency, characterized by symptoms, signs and investigative findings. Adults with long-standing growth hormone deficiency are often overweight, have altered body composition, with reduced lean body mass (LBM), increased fat mass (FM), reduced total body water and reduced bone mass. In addition, there is reduced physical and cardiac performance, altered substrate metabolism and an abnormal lipid profile predisposing to the development of cardiovascular disease. Adults with GH deficiency report reduced psychological well-being and quality of life. These changes may contribute to the morbidity and premature mortality observed in hypopituitary adults on conventional replacement therapy. GH treatment restores LBM, reduces FM, increases total body water and increases bone mass. Following GH therapy, increases are recorded in exercise capacity and protein synthesis, and "favourable" alterations occur in plasma lipids. In addition, psychological well-being and quality of life improve with replacement therapy. GH is well tolerated; adverse effects are largely related to fluid retention and respond to dose adjustment. It is likely that GH replacement will become standard therapy for the hypopituitary adult in the near future. The benefits of GH replacement in the GH-deficient adult have been unequivocally demonstrated in studies lasting up to 3 years. The results of longer term studies are awaited to determine whether these benefits are sustained over a lifetime.

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Psychological and social factors have a deep impact on the treatment of HIV-infection, from the readiness to start antiretroviral therapy to treatment adherence over time. Among psychological factors, anxiety may affect HIV-infected persons in all stages of disease, from the disclosure of HIV diagnosis to the decision to start and maintain treatment. This is a lifelong challenge for both patients and doctors. Psychiatric comorbidities (depression, addiction) may enhance negative psychological effects of HIV. Among social factors, stigma and discrimination may occur in families and at work, leading to a loss of social support resulting in isolation and poverty. This may prevent HIV-positive individuals from seeking medical care. These aspects are particularly important in some groups of patients as injecting drug users and migrants. Acknowledgment and consideration of psychosocial factors are therefore essential for the long term success of antiretroviral therapy.

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A large body of empirical research shows that psychosocial risk factors (PSRFs) such as low socio-economic status, social isolation, stress, type-D personality, depression and anxiety increase the risk of incident coronary heart disease (CHD) and also contribute to poorer health-related quality of life (HRQoL) and prognosis in patients with established CHD. PSRFs may also act as barriers to lifestyle changes and treatment adherence and may moderate the effects of cardiac rehabilitation (CR). Furthermore, there appears to be a bidirectional interaction between PSRFs and the cardiovascular system. Stress, anxiety and depression affect the cardiovascular system through immune, neuroendocrine and behavioural pathways. In turn, CHD and its associated treatments may lead to distress in patients, including anxiety and depression. In clinical practice, PSRFs can be assessed with single-item screening questions, standardised questionnaires, or structured clinical interviews. Psychotherapy and medication can be considered to alleviate any PSRF-related symptoms and to enhance HRQoL, but the evidence for a definite beneficial effect on cardiac endpoints is inconclusive. A multimodal behavioural intervention, integrating counselling for PSRFs and coping with illness should be included within comprehensive CR. Patients with clinically significant symptoms of distress should be referred for psychological counselling or psychologically focused interventions and/or psychopharmacological treatment. To conclude, the success of CR may critically depend on the interdependence of the body and mind and this interaction needs to be reflected through the assessment and management of PSRFs in line with robust scientific evidence, by trained staff, integrated within the core CR team.

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Cimpian & Salomon (C&S) present promising steps towards understanding the cognitive underpinnings of adult essentialism. However, their approach is less convincing regarding ontogenetic and evolutionary aspects. In contrast to C&S's claim, the so-called inherence heuristic, though perhaps vital in adult reasoning, seems an implausible candidate for the developmental and evolutionary foundations of psychological essentialism. A more plausible candidate is kind-based object individuation that already embodies essentialist modes of thinking and that is present in infants and nonhuman primates.

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Introduction: In professional soccer, talent selection relies on the subjective judgment of scouts and coaches. To date, little is known about coaches´ “eye for talent” (Christensen, 2009, p. 379) and the nature of the subjective criteria they use to identify those players with the greatest potential to achieve peak performance in adulthood (Williams & Reilly, 2000). Drawing on a constructivist approach (Kelly, 1991), this study explores coaches´ subjective talent criteria. It is assumed that coaches are able to verbalise and specify their talent criteria, and that these are related to their talent selection decisions based on instinct. Methods: Participants and generation of data. Five national youth soccer coaches (Mage = 55.6; SD = 5.03) were investigated at three appointments: (1) talent selection decision based on instinct, (2) semi-structured inductive interview to elicit each coaches´ talent criteria in detail, (3) communicative validation and evaluation of the players by each coach using the repertory grid technique (Fromm, 2004). Data Analysis: Interviews were transcribed and summarized with regard to each specified talent criterion. Each talent criterion was categorized using a bottom-up-approach (meaning categorization, Kvale, 1996). The repertory grid data was analysed using descriptive statistics and correlation analysis. Results and Discussion: For each coach, six to nine talent criteria were elicited and specified. The subjective talent criteria include aspects of personality, cognitive perceptual skills, motor abilities, development, technique, social environment and physical constitution, which shows that the coaches use a multi-dimensional concept of talent. However, more than half of all criteria describe personality characteristics, in particular achievement motivation, volition and self-confidence. In contrast to Morris (2000), this result shows that coaches have a differentiated view of the personality characteristics required to achieve peak performance. As an indication of criterion validity, moderate to high correlations (.57 ≤ r ≤ .81) are found between the evaluations of the players according to the coaches´ talent criteria and their talent selection decision. The study shows that coaches are able to specify their subject talent criteria and that those criteria are strongly related to their instinctive selection decisions. References: Christensen, M. K. (2009). "An Eye for Talent": Talent Identification and the "Practical Sense" of Top-Level Soccer Coaches. Sociology of Sport Journal, 26, 365–382. Fromm, M. (2004). Introduction to the Repertory Grid Interview. Münster: Waxmann. Kelly, G. A. (1991). The Psychology of Personal Constructs: Volume One: Theory and personality. London: Routledge. Kvale, S. (1996). InterViews: An introduction to Qualitative Research Interviewing. Thousand Oaks: Sage. Morris, T. (2000). Psychological characteristics and talent identification in soccer. Journal of Sports Sciences, 18, 715–726. Williams, A. M., & Reilly, T. (2000). Talent identification and development in soccer. Journal of Sports Sciences, 18, 657–667.

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Data from two large longitudinal studies were used to analyze reciprocal relations between self-esteem and depressive symptoms across the adult life span. Study 1 included 1,685 participants aged 18 to 96 years assessed 4 times over a 9-year period. Study 2 included 2,479 participants aged 18 to 88 years assessed 3 times over a 4-year period. In both studies, cross-lagged regression analyses indicated that low self-esteem predicted subsequent depressive symptoms, but depressive symptoms did not predict subsequent levels of self-esteem. This pattern of results replicated across all age groups, for both affective–cognitive and somatic symptoms of depression, and after controlling for content overlap between the self-esteem and depression scales. The results suggest that low self-esteem operates as a risk factor for depressive symptoms at all phases of the adult life span.