946 resultados para omsorg Keywords: Borderline personality disorder


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This paper focuses on the positive mirroring (admiration, acceptance, and approval) that Heinz Kohut posits as the primary healing agency in work with clients with narcissistic personality disorder. Donald Capps has demonstrated the pastoral significance of Kohut's theory. Capps' work is extended through an analysis of the role love plays in mirroring. It is suggested that mirror love has agapic, erotic, and philial elements. The loving action of the counselor is viewed as an image of the love of the triune God.

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OBJECTIVE: To analyze differences in the variables associated with severity of suicidal intent and in the main factors associated with intent when comparing younger and older adults. DESIGN: Observational, descriptive cross-sectional study. SETTING: Four general hospitals in Madrid, Spain. PARTICIPANTS: Eight hundred seventy suicide attempts by 793 subjects split into two groups: 18-54 year olds and subjects older than 55 years. MEASUREMENTS: The authors tested the factorial latent structure of suicidal intent through multigroup confirmatory factor analysis for categorical outcomes and performed statistical tests of invariance across age groups using the DIFFTEST procedure. Then, they tested a multiple indicators-multiple causes (MIMIC) model including different covariates regressed on the latent factor "intent" and performed two separate MIMIC models for younger and older adults to test for differential patterns. RESULTS: Older adults had higher suicidal intent than younger adults (z = 2.63, p = 0.009). The final model for the whole sample showed a relationship of intent with previous attempts, support, mood disorder, personality disorder, substance-related disorder, and schizophrenia and other psychotic disorders. The model showed an adequate fit (chi²[12] = 22.23, p = 0.035; comparative fit index = 0.986; Tucker-Lewis index = 0.980; root mean square error of approximation = 0.031; weighted root mean square residual = 0.727). All covariates had significant weights in the younger group, but in the older group, only previous attempts and mood disorders were significantly related to intent severity. CONCLUSIONS: The pattern of variables associated with suicidal intent varies with age. Recognition, and treatment of geriatric depression may be the most effective measure to prevent suicidal behavior in older adults.

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Personality is one of the most controversial and intriguing theme in Psychology. In a general way, it could be understood as a set of rigid patters of feelings, thoughts, and behaviors from an individual. The aim of this investigation was describe how Brazilian researches in Psychology that use cognitive, behavioral, and cognitive-behavioral therapy referential have been approaching the subject Personality in their work. We also intended to determine the frequency of publications on Personality Disorders to compare this data with the bibliographical production on Anxiety and Mood Disorders. Moreover, we tried to describe how the Personality construct - and even Personality Disorders construct - has been addressed in the work on the Anxiety and Mood Disorders chosen for this review. The PePSIC Periódicos Eletrônicos em Psicologia - e SciELO.ORG - Scientific Electronic Library Online - databases were used for research. We investigated 53 journals, including two specific Cognitive Therapies and Behavioral-Cognitive Therapy (TCC) periodicals. Within each journal, we undertook a systematic survey on publications on the themes: Personality, Personality Disorder, Panic Disorder, Social Phobia, Obsessive-Compulsive Disorder (OCD), Generalized Anxiety Disorder, Major Depression, Dysthymia and Bipolar Disorder. A preliminary research has resulted in 218 articles. A second filter has obtained 81 articles in which we the focused on this review. There were found thirty-eight articles on Anxiety Disorders, twenty-five on Mood Disorders and eighteen on Personality Disorders. It was found that 90% of the papers on Anxiety Disorders make no reference to the term Personality or make it in a discrete way. This number rises to 96% to Personality Disorder group. Analyzing the specific journals on TCC we verified that 97% of the articles on Anxiety and Humor disorders do not cite the term Personality or cite but not explore it. This results point to the low rate of studies addressing the Personality and personality disturbs. Then, we can suggest that the difficulty on treating this Axis II disturbs has been worsened by lack of knowledge produced on the subject, either for lack of interest among researchers or because of the methodological obstacles found on this field.

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Objectives: to identify factors associated with admission after suicide spectrum behaviors. Methods: Patient's characteristics, the nature of their suicidal behavior, admission rates between centres, and factors associated with admission have been examined in suicide spectrum presentations to emergency departments in three Spanish cities. Results: Intent of the suicidal behavior had the greatest impact on hospitalization. Older age, living alone, self-harm method not involving drug overdose, previous history of suicide spectrum behaviors and psychiatric diagnosis of schizophrenia, mood or personality disorder were independently associated with being admitted. There was a three-fold between-centre difference in the rate of hospitalization. Conclusions: widespread differences in the rate of hospitalization were primarily accounted for by characteristics of the individual patients and their suicidal behavior.

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Bakgrund: Patienter med emotionell instabil personlighetsstörning upplevs som en svårbehandlad patientgrupp inom heldygnsvården. Omvårdnadspersonalens kunskap kring bemötande och behandling av denna patientgrupp är varierande vilket gör att vården ser olika ut. Detta kan resultera i ett ökat lidande hos patienten och frustration i personalgruppen. Syfte: Studiens syfte var att beskriva faktorer som bidrar till stabilare mående hos patienter med emotionellt instabilt personlighetsstörning under heldygnsvård. Metod: Som metod har använts en kvalitativ design med induktiv ansats. Studien baserades på sex intervjuer där informanterna var patienter med diagnosen emotionellt instabil personlighetsstörning. Intervjuerna analyserades med hjälp av kvalitativ innehållsanalys. Resultat: Resultatet visade att bemötandet och engagemang hos personal var av stor vikt. Struktur och delaktighet var andra viktiga faktorer för att nå ett stabilare mående. Det framkom att heldygnsvården kunde bidra med ett avbrott i vardagen och att meningsfulla aktiviteter under vårdtiden var en annan viktig faktor. Slutsats: Patienterna upplevde att bli bemött som en individ av engagerad personal och att få vara delaktig i sin vård som två viktiga faktorer i processen mot ett stabilare mående. Heldygnsvårdens struktur och miljöombytet stod för återhämtning och en möjlighet att återfå rutiner. Det framkom även en önskan om fler meningsfulla aktiviteter såsom fysisk aktivitet och psykoedukation för att på bästa sätt ta tillvara på vårdtiden.

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The global financial crisis has had innumerate outcomes around the globe. Whilst most of these are generally perceived to be negative, there are outcomes which could be considered positive for society. One such outcome is the spotlight that the financial crisis has shone on corruption within organisations and in particular, the role that destructive leaders play in the promotion of negative behaviours within organisations. This interest in identifying so-called ‘dark-side’ traits in leaders is a positive step both academically and practically. Academically, there is a limited research examining individuals with ‘dark-traits’ within organisations (Mahmut, Homewood & Stevenson, 2008). Practically, most leader derailment can be attributed to ‘dark-side’ traits and leaders with such traits are implicated in a host of issues for organisations including poor staff morale and satisfaction, bullying, poor levels of productivity, high staff turnover, unethical behaviour and even white collar crime (e.g. Boddy,2010; 2011; Lesha & Lesha, 2012; O’Boyle, Forsyth, Banks & McDaniel, 2012; Sanecka, 2013). This paper focuses on one of the ‘dark-side’ traits; psychopathy. Psychopathy is a personality disorder characterised by guiltlessness, incapacity to experience love, impulsivity, shallow emotions, superficial charm and an inability to learn from experience (Cleckley, 1941, 1982). Research has found that individuals with high levels of psychopathy can be found working within organisations and experiencing some degree of career success (e.g. Babiak, Neumann & Hare, 2010; Board & Fritzon, 2005; Boddy, 2010; Lilienfeld, Latzman, Watts, Smith & Dutton, 2014). These individuals are theoretically thought to be attracted to careers which offer power, status and monetary rewards. In particular, the finance industry has been suggested as an ideal work place for the organisational psychopath. Some authors go as far as attribute organisational psychopaths a key role in the financial crisis (Boddy, 2011). However, little research has been conducted to explore whether levels of psychopathy in employees differ across industries and what careers might be most attractive to individuals with high levels of psychopathy. This paper presents the results of a large scale survey of 265 alumni of universities in the Central England region of the UK. The survey was conducted to assess the link between levels of three factors of psychopathy (Egotism, Callousness and Antisocialism) with occupation as defined by Holland’s RIASEC model. Participants completed Brinkley, Diamond, Magaletta & Heigel’s (2008) revision of Levenson’s Self-Report Psychopathy Scale and responded to questions regarding their current occupation. Logistic regression analyses were conducted to assess whether levels of Egotism, Callousness and Antisocialism were predictive of occupation. The results showed that when compared to individuals who occupy job roles within the Social sector of Holland’s model, individuals with higher levels of psychopathy were more likely to be employed within Realistic, Investigative, Enterprising and Conventional roles. When comparing Social and Realistic roles, more Egotistical individuals were likely to be employed within Realistic roles. When comparing those employed in Social roles to Investigative, Enterprising and Conventional roles, individuals with higher levels of Antisocialism were more likely to be employed within the latter three occupations than within Social roles. This suggests that individuals with psychopathy do gravitate towards certain career paths. Social roles where job incumbents are required to be caring and interact with others to a large extent appear to be unattractive to individuals with high levels of psychopathy. Social roles are also associated with lower monetary rewards and are generally less prestigious (Henley, 2001). These individuals instead seek out occupations where there are higher levels of risk, power and reward. Roles in the Realistic category include those which include high levels of risk e.g. fighter pilot, fireman etc., (Cohen, Meir, Segal & Amar, 2003). Investigative careers hold the highest level of prestige and ranking. Enterprising roles include management positions where power is wielded over subordinates and sales roles, where customers can be manipulated (ACT, 2009). Conventional roles include those within the finance industry, which include some of the most financially lucrative positive available (Babiak & Hare, 2006). The above suggests that individuals with higher levels of psychopathy may be seeking to satisfy their self-centred natures by selecting careers which provide them with high levels of reward in one way or another. Alternatively, these individuals may select roles where their traits can be accepted. The importance of Antisocialism in predicting occupation may be testament to the importance of finding a career which ‘fits’ such traits. Antisocialism is generally associated with negative outcomes in the workplace (Ettner, MacLean & French, 2010). Therefore, finding environments tolerant of antisocial tendencies may be a priority for individuals with high levels of these traits. The results suggest that Enterprising, Investigative and Conventional work environments may be tolerant of Antisocialism in employees and Realistic environments tolerant of Egotism. Academically, the results show that there is value in studying ‘dark-side’ characteristics in organisations. Individuals with higher levels of psychopathic traits, do not appear to randomly enter employment. Instead, they appear to gravitate to careers which meet their needs and/or tolerate their traits. It is important to further explore what industries and positions are particularly attractive to individuals with higher levels of psychopathy and what makes them attractive to these individuals. Such knowledge is important for practitioners to be able to advise organisations as to the likely level of risk they face of employing organisational psychopaths and to enable organisations which are particularly attractive to highly psychopathic employees to design selection systems which detect undesirable traits in candidates. Furthermore, organisations can examine their culture to assess whether traits such as antisocialism are tolerated (or even rewarded) and what the implications of this are.

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Dissertação de Mestrado apresentada no Instituto Superior de Psicologia Aplicada para obtenção de grau de Mestre na especialidade de Psicologia Clínica

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In this study we apply the versatile/specialist offender debate to the research of intimate partner violence. We propose the existence of two types of imprisoned male batterers: the generalist and the specialist batterer. The individual, family, and community characteristics of these types of batterers are further explored in 110 imprisoned males in the Penitentiary of Villabona (Spain). As for the individual characteristics, results indicate that the generalist batterer present higher levels of psychopathology (specially antisocial and borderline personality), sexist attitudes, and substance dependence. Specialist batterers presented higher levels of conflict in their family of origin. Finally, generalist batterers reported coming from more socially disordered communities and showed lower levels of participation and integration in these communities than the specialist batterer. These results suggest that the classical distinctions among batterers based on psychopathology and context of violence (whether general or family only) might be of little utility when applied to imprisoned male batterers.

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La presente investigación tuvo como propósito fundamental describir los rasgos de personalidad presentes en pacientes hospitalizados en clínicas de rehabilitación por abuso o dependencia de sustancias, además de poder establecer la presencia de los síndromes clínicos y la medida de los mismos en la muestra de estudio. Se realizó una investigación exploratoria – descriptiva con un enfoque cuantitativo, para lo cual se aplicó el Inventario Clínico Multiaxial de Millon (MCMI- III), que se encarga de evaluar 11 patrones clínicos de personalidad, 3 escalas de patología grave de personalidad y 10 síndromes clínicos. Este estudio se realizó con 50 varones en rehabilitación, 10 de los cuales fueron excluidos por no cumplir los criterios de inclusión. Los resultados obtenidos mostraron alteraciones en la personalidad de la población relacionada con el consumo de sustancias, presentando una mayor prevalencia del trastorno antisocial de la personalidad, seguida de los trastornos narcisista y paranoide respectivamente. Por su parte, los rasgos de personalidad de mayor prevalencia correspondieron a rasgos antisociales, narcisistas y paranoides.

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Objective: We compared temperament and character traits in children and adolescents with bipolar disorder (BP) and healthy control (HC) subjects. Method: Sixty nine subjects (38 BP and 31 HC), 8-17 years old, were assessed with the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime. Temperament and character traits were measured with parent and child versions of the Junior Temperament and Character Inventory. Results: BP subjects scored higher on novelty seeking, harm avoidance, and fantasy subscales, and lower on reward dependence, persistence, self-directedness, and cooperativeness compared to HC(all p < 0.007), by child and parent reports. These findings were consistent in both children and adolescents. Higher parent-rated novelty seeking, lower self-directedness, and lower cooperativeness were associated with co-morbid attention-deficit/hyperactivity disorder (ADHD). Lower parent-rated reward dependence was associated with co-morbid conduct disorder, and higher child-rated persistence was associated with co-morbid anxiety. Conclusions: These findings support previous reports of differences in temperament in BP children and adolescents and may assist in a greater understating of BP children and adolescents beyond mood symptomatology.

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Background: Prevalence and clinical correlates of depersonalization symptoms have been associated with panic disorder. Personality traits might increase the likelihood of experiencing depersonalization symptoms or depersonalization disorder in panic patients. Aims: The objectives of this study are to establish the prevalence of depersonalization symptoms during the panic attack and in depersonalization disorder and to examine the personality factors associated with the presence of depersonalization in patients with panic disorder. Methods: The sample comprised 104 consecutive adult outpatients with panic disorder, diagnosed according to the Semistructured Clinical Interview for DSM-IV (Axis I/II disorders). Participants were assessed with the Cambridge Depersonalization Scales, the Temperament and Character Inventory, and the Panic and Agoraphobia Scale. Results: Forty-eight percent of the sample had depersonalization symptoms during the panic attack, whereas 20% of patients had a depersonalization disorder. Women presented more depersonalization disorders than did men (P = .036). Patients with panic disorder with depersonalization disorder had a more severe panic disorder (P = .002). Logistic regression analysis showed that self-transcendence trait (odds ratio, 1.089; 95% confidence interval, 1.021-1.162; P = .010) and severity of panic (odds ratio, 1.056; 95% confidence interval, 1.005-1.110; P = .032) were independently associated with depersonalization disorder. Conclusions: A high prevalence of depersonalization symptoms and depersonalization disorder was confirmed in patients with panic disorder, supporting a dosage effect model for understanding depersonalization pathology. Self-transcendence trait and severity of panic disorder were reported as risk factors for depersonalization disorder. (C) 2011 Elsevier Inc. All rights reserved.

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CD30+ cutaneous lymphoproliferative disorders (CLPDs) are usually characterized by a benign clinical course. The prognostic value of cytotoxic markers in these lymphomas has not been evaluated in large series. We describe a case of borderline CD30+ CLPD with cytotoxic phenotype, presenting in a 22-year-old male patient as an ulcer on the forearm. He reported having had similar ulcers on the buttock and thigh that spontaneously regressed over the course of 1 year. The lesion resolved with a single course of clarithromycin; a subsequent lesion, too, responded to clarithromycin, and no recurrences or systemic involvement have been documented in the 9-month follow-up. A conservative approach in the management of CD30+ CLPD is recommended. We believe that the anti-inflammatory and apoptotic effects of clarithromycin on T cells may have hastened the remission process.

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The personality and neuropsychological factors associated with relational aggression were examined in a group of30 grade 6,7, and 8 girls identified through cluster analysis as being highly, yet almost exclusively, relationally aggressive and a group of 30 nonaggressive matched controls. Parents of the students in both groups completed the Coolidge Personality and Neuropsychological Inventory (1998), a 200- item DSM-IV -TR aligned, parent-as-respondent, standardized measure of c.hildren' s psychological functioning. It was found that high levels of relational aggression, in the absence of physical and verbal aggression, were associated with symptoms of DSM-IV - TR Axis I oppositional defiant disorder and conduct disorder and a wide variety of personality traits associated with DSM-IV -TR Axis II paranoid, borderline, narcissistic, histrionic, schizotypal, and passive aggressive personality disorders. Implications of these findings for theory, practice, and further research are discussed.

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Cross-cultural comparisons may increase our understanding of different models of substance use treatment and help identify consistent associations between patients' characteristics, treatment conditions, and outcomes.