Factor analysis of the self-report Dysexecutive (DEX-S) Questionnaire

The self-rating Dysexecutive Questionnaire (DEX-S) is a recently developed standardized self-report measure of behavioral difficulties associated with executive functioning such as impulsivity, inhibition, control, monitoring, and planning. Few studies have examined its construct validity, particularly for its potential wider use across a variety of clinical and nonclinical populations. This study examines the factor structure of the DEX-S questionnaire using a sample of nonclinical (N = 293) and clinical (N = 49) participants. A series of factor analyses were evaluated to determine the best factor solution for this scale. This was found to be a 4-factor solution with factors best described as inhibition, intention, social regulation, and abstract problem solving. The first 2 factors replicate factors from the 5-factor solutions found in previous studies that examined specific subpopulations. Although further research is needed to evaluate the factor structure within a range of subpopulations, this study supports the view that the DEX has the factor structure sufficient for its use in a wider context than only with neurological or head-injured patients. Overall, a 4-factor solution is recommended as the most stable and parsimonious solution in the wider context.

Selective processing of masked and unmasked verbal threat material in anxiety: Influence of an immediate acute stressor

Attentional biases for threat were investigated using a computerised version of the emotional Stroop task. The study examined the influence of state and trait anxiety by employing a student sample assigned to high trait anxious (HTA; n = 32) or low trait anxious (LTA; n = 32) groups on the basis of questionnaire scores, and state anxiety was manipulated within participants through the threat of electric shock. Threatening words that were either unrelated (e.g., cancer, danger) or related to the threat of shock (e.g., electrocute, shock) were presented to participants both within and outside of awareness. In the latter condition a backward masking procedure was used to prevent awareness and exposure thresholds between the target and mask were individually set for each participant. For unmasked trials the HTA group showed significant interference in colour naming for all threat words relative to control words when performing under the threat of shock, but not in the shock safe condition. For the masked trials, despite chance performance in being able to identify the lexical status of the items, HTA participants showed facilitated colour naming for all threat words relative to control items when performing under threat of shock, but this effect was not evident in the shock safe condition. Neither valence of the items nor the threat of shock influenced colour naming latencies in either exposure mode for the LTA group.

DESEMPENHO EM TESTES DE ATENÇÃO VISUAL E INTERFERÊNCIA DE ESTÍMULOS AUDITIVOS DE MOVIMENTO EM INDIVÍDUOS COM E SEM MEDO DE ALTURA

Desordens da ansiedade, especialmente a agorafobia e a desordem do pânico foram associadas a anormalidades das funções vestibulares. Evidências de que o controle do equilíbrio pode exigir habilidades atencionais também foram relatadas. Utilizando o medo de altura como modelo clínico onde sintomas ansiosos coexistem com anormalidades com a percepção espacial e controle do equilíbrio, este estudo investigou o desempenho em testes de atenção visual em voluntários normais com altos e baixos escores obtidos do Questionário de Acrofobia. O teste de rastreio visual foi realizado em 30 indivíduos (15 em cada grupo) enquanto ouviam dois tipos diferentes de estímulos auditivos. Na condição volume um som de 900 Hz era apresentado em ambos ouvidos durante 2 segundos seguidos de mais 2 segundos de silêncio. Na condição balanço , o mesmo som era apresentado durante 2 segundos ao ouvido direito seguido por 2 segundos ao ouvido esquerdo. Estímulos auditivos de movimento provocaram maior desconforto em ambos os grupos, mas nos indivíduos com maiores escores de acrofobia estes estímulos foram associados a um pior desempenho no teste visual. Embora muito limitado pela amostra experimental, este estudo sugere que o medo de altura pode estar associado à dependência visual para manutenção do equilíbrio e que poderia piorar o desempenho nos testes visuais devido à competição dos recursos neuro-cognitivos. Implicações experimentais e clínicas destes achados preliminares exigem outras pesquisas.

O LÚDICO VIA FÁBULAS EM ATENDIMENTO PSICOTERAPÊUTICO: UM ESTUDO DE CASO CLÍNICO DE MOBBING

Esta pesquisa verifica a validade da utilização de fábulas em processo psicoterapêutico de paciente de Mobbing acometida de depressão e síndrome de pânico. Desenvolve-se por meio de estudo de caso avaliativo-interventivo evolutivo prolongado, com um total de 116 sessões semanais. Inicialmente realiza o diagnóstico clínico elaborado a partir do desenho da figura humana, extraído do teste projetivo House Tree and Person, de entrevista inicial semi-dirigida, e de coleta de relatos verbais e observações feitas durante os primeiros atendimentos. As sessões são realizadas com utilização ocasional de fábulas, associada ou não a técnicas de relaxamento de Schultz e Jacobson, com interpretação de sonhos e recomendação de filmes. O objetivo é verificar se as fábulas contribuem de forma positiva para o paciente compreender com mais facilidade as interpretações do psicoterapeuta, se diminui sua resistência ao falar dos seus conteúdos e se amplia à consciência simbólica. O primeiro momento interventivo tem a duração de aproximadamente 16 meses, o segundo, de 04 meses, quando é solicitado o segundo desenho e o terceiro processa-se em 09 meses, quando é solicitado o último desenho. No primeiro momento é proporcionado à paciente um ambiente facilitador com sustentação emocional (Holding), buscando resgatar sua ilusão, numa visão winnicottiana. Revela-se uma situação de Mobbing acompanhada de depressão manifesta e síndrome do pânico; com alto nível de exigência pessoal e profissional; grande passividade nos relacionamentos e na dinâmica do casal. Ao final desse momento, já consegue começar a desviar sua auto-agressividade para o meio externo de maneira mais positiva e socialmente aceita. No segundo momento predomina o encontro e aceitação de seu verdadeiro jeito de ser; enxerga o quanto estava se deixando prejudicar; mostra-se mais confiante, comunica-se e enfrenta melhor suas dificuldades afetivas. No terceiro momento demonstra estar segura e feliz. Cuida de sua aparência e sente prazer em ser notada socialmente. Demonstra ter aprendido a se defender em situações de confronto, com maior autonomia e verbaliza estar muito feliz com as mudanças, sorri com freqüência. A análise evolutiva dos desenhos confirmam esta boa evolução. A utilização de fábulas foi muito bem aceita pela paciente, que conseguiu por meio da leitura simbólica contida nas mesmas, aproximar-se de sua problemática e aprender a lidar com ela de forma mais saudável. Os resultados também indicam que a utilização de relaxamento associado à leitura das fábulas contribuiu para sua assimilação mais abrangente e profunda. O estudo ilustra a evolução do caso por meio de 24 vinhetas, devidamente analisadas em relação aos momentos descritos.(AU)

Liposome-based cationic adjuvant formulations (CAF):past, present, and future

The use of liposomes as vaccine adjuvants has been investigated extensively over the last few decades. In particular, cationic liposomal adjuvants have drawn attention, with dimethyldioctadecylammonium (DDA) liposomes as a prominent candidate. However, cationic liposomes are, in general, not sufficiently immunostimulatory, which is why the combination of liposomes with immunostimulators has arisen as a strategy in the development of novel adjuvant systems in recent years. One such adjuvant system is CAF01. In this review, we summarize the immunological properties making CAF01 a promising versatile adjuvant system, which was developed to mediate protection against tuberculosis (TB) but, in addition, has shown promising protective efficacy against other infectious diseases requiring different immunological profiles. Further, we describe the stabilization properties that make CAF01 suitable in vaccine formulation for the developing world, which in addition to vaccine efficacy, are important prerequisites for any novel TB vaccine to reach global implementation. The encouraging nonclinical data led to a preclinical vaccine toxicology study of the TB model vaccine, Ag85B-ESAT-6/CAF01, that concluded that CAF01 has a satisfactory safety profile to advance the vaccine into phase I clinical trials, which are scheduled to start in 2009.

Self-attentional processes in anxiety:an experimental study

Self-attention research has demonstrated a relationship between dispositional self-focus, anxiety proneness and fear arousal. In addition, the effect of self-focus manipulations on approach-avoidance tasks involving a feared stimulus are strikingly similar to the effects obtained from manipulation of other cognitive factors such as perceived self-efficacy. A number of experiments were designed to explore the relationship between self-focused attention and ffilxiety. Data from the experiments demonstrate that self-attention influences a variety of cognitive variables which have been considered as central factors in anxiety. Concomitants of self-focus are increased awareness of physiological arousal and overestimation of such arousal, the identification of self-discrepancies, cognitive failures and performance deficits and the activation of physical threat concepts in memory. These factors are conceptualised as central in the negative evaluation of physiological arousal and coping resources in anxiety. Clinically anxious individuals typically have high scores in dispositional self-consciousness and body-consciousness. In patients suffering from generalised anxiety or panic disorders maladaptive self-focusing tendencies can be related to specific life stressors which render aspects of the self salient. An analysis of the ideational component of anxiety revealed three subcomponents; negative social ideation (worry about other people's reaction to the self), negative somatic ideation (worry about physical symptoms and health) and obsessional ideation (the experience of uncontrollable and repetitive thoughts) which were differentially associated with measures of dispositional self-focus. The frequency and content of an.xious w-orry is associated with specific self-focusing tendencies. It is proposed that the 'attentional style' of the individual is an important determinant of the nature and intensity of their affective response in a threatening situation. A self-attentional model of anxiety is proposed and the complex interaction between self-focus and other cognitive factors in anxiety such as appraisal of arousal and coping resources and perceived levels of self-efficacy is discussed. The model presents new directions for research and therapeutic intervention in anxiety.

Attitudes towards emotional expression mediate the relationship between childhood invalidation and adult eating concern

Previous research has suggested that invalidating childhood environments are positively related to the symptoms of eating disorders. However, it is unclear how childhood environments might impact upon the development of eating disorder symptoms. This study examined the relationship between parental invalidation and eating disorder-related attitudes in a nonclinical sample and tested the mediating effect of attitudes towards emotional expression. Two hundred women, with a mean age of 21 years, completed measures of invalidating childhood environments, attitudes towards emotional expression, and eating pathology. Eating concerns were positively associated with recollections of an invalidating parental environment. The belief that the expression of emotions is a sign of weakness fully mediated the relationship between childhood maternal invalidation and adult eating concern. Following replication and extension to a clinical sample, these results suggest that targeting the individual's attitude towards emotional expression might reduce eating attitudes among women who have experienced an invalidating childhood environment. © 2012 John Wiley & Sons, Ltd and Eating Disorders Association.

Visual hallucinations in the psychosis spectrum and comparative information from neurodegenerative disorders and eye disease

Much of the research on visual hallucinations (VHs) has been conducted in the context of eye disease and neurodegenerative conditions, but little is known about these phenomena in psychiatric and nonclinical populations. The purpose of this article is to bring together current knowledge regarding VHs in the psychosis phenotype and contrast this data with the literature drawn from neurodegenerative disorders and eye disease. The evidence challenges the traditional views that VHs are atypical or uncommon in psychosis. The weighted mean for VHs is 27% in schizophrenia, 15% in affective psychosis, and 7.3% in the general community. VHs are linked to a more severe psychopathological profile and less favorable outcome in psychosis and neurodegenerative conditions. VHs typically co-occur with auditory hallucinations, suggesting a common etiological cause. VHs in psychosis are also remarkably complex, negative in content, and are interpreted to have personal relevance. The cognitive mechanisms of VHs in psychosis have rarely been investigated, but existing studies point to source-monitoring deficits and distortions in top-down mechanisms, although evidence for visual processing deficits, which feature strongly in the organic literature, is lacking. Brain imaging studies point to the activation of visual cortex during hallucinations on a background of structural and connectivity changes within wider brain networks. The relationship between VHs in psychosis, eye disease, and neurodegeneration remains unclear, although the pattern of similarities and differences described in this review suggests that comparative studies may have potentially important clinical and theoretical implications. © 2014 The Author.

Increased risk of diabetes mellitus among persons with psychotic symptoms:results from the WHO World Health Survey

OBJECTIVE: To analyze with a symptom-based approach the relationship between psychosis and diabetes mellitus in the general population. METHOD: Nationally representative samples from the World Health Organization (WHO) World Health Survey, totaling 224,743 randomly selected adults 18 years and older from 52 countries worldwide, were interviewed to establish the presence of psychotic symptoms and diabetes mellitus. Presence of psychotic symptoms was established using questions pertaining to positive symptoms from the psychosis screening module of the Composite International Diagnostic Interview. Presence of diabetes was established with a response of "yes" to the question, "Have you ever been diagnosed with diabetes (high blood sugar)?" The World Health Survey was conducted between 2002 and 2004. RESULTS: An increasing number of psychotic symptoms was related to increasing likelihood of diabetes mellitus (OR = 1.27; 95% CI, 1.24-1.30). As compared to no symptoms, at least 1 psychotic symptom substantially elevated the risk (OR = 1.71; 95% CI, 1.61-1.81). In people with a lifetime diagnosis of schizophrenia or psychosis, the prevalence of diabetes was higher in those with current psychotic symptoms (7.3% vs 5.2%; OR = 1.65; 95% CI, 1.21-2.26), suggesting that the persistence of symptoms over time could play a central role. After controlling for different potential confounders, there was a clear increase in the probability of having diabetes as the number of psychotic symptoms increased. The relationship between psychotic symptoms and diabetes was tested with multiple mediation models and path analyses for categorical outcomes. Only body mass index appeared as a relevant mediator in a model with a good fit (ie, χ21 = 3.2, P = .0742; comparative fit index = 0.999). CONCLUSIONS: Psychotic symptoms are related to increased rates of diabetes mellitus in nonclinical samples, independent of several potential confounders-including a clinical diagnosis of psychosis or schizophrenia, previous antipsychotic treatment, depression, lifestyle, and individual or country socioeconomic status. The findings highlight the worldwide relevance of the problem and the importance of identifying the specific paths of this association.

Assessment of anxiety sensitivity in depressed, older patients and its relation to hypochondriacal concerns

Anxiety disorders in older adults are often overlooked as part of other mental disorders or as part of medical illnesses. Theoretically, anxiety sensitivity is a common component in anxiety disorders, a personality construct and a fundamental fear. Anxiety sensitivity was assessed in a sample of older adults: 53 depressed, M age = 78.8 years; and 53 healthy controls, M age = 70.9 years. This study examined whether anxiety sensitivity: (1) explained unique variance beyond that explained by trait anxiety, (2) was observed in the depressed group in levels similar to individuals who suffer from non-panic, anxiety disorders, and (3) correlated with current number of medical illnesses, previous number of medical illnesses, and hypochondriasis. The results indicated that anxiety sensitivity: predicted hypochondriasis better than trait anxiety, was present in the depressed group similarly to individuals suffering from non-panic, anxiety disorders, and was strongly associated with hypochondriacal concerns. ^

International education and the post-9/11 syndrome: A study of international educators in selected Miami-area colleges

This dissertation investigated the relationship between the September 11, 2001 terrorist attacks and the internationalization agenda of U.S. colleges and universities. The construct, post-9/11 syndrome, is used metaphorically to delineate the apparent state of panic and disequilibrium that followed the incident. Three research questions were investigated, with two universities in the Miami-area of South Florida, one private and the other public, as qualitative case studies. The questions are: (a) How are international student advisors and administrators across two types of institutions dealing with the post-9/11 syndrome? (b) What, if any, are the differences in international education after 9/11? (c) What have been the institutional priorities in relation to international education before and after 9/11? Data-gathering methods included interviews with international student/study abroad advisors and administrators with at least 8 years of experience in the function(s) at their institutions, document and institutional data analysis. The interviews were based on the three-part scheme developed by Schuman (1982): context of experience, details of experience and reflection on the meaning of experiences. Taped interviews, researcher insights, and member checks of transcripts constituted an audit trail for this study. Key findings included a progressive decline in Fall to Fall enrollment of international students at UM by 13.05% in the 5 years after 9/11, and by 6.15% at FIU in the seven post-9/11 years. In both institutions, there was an upsurge in interest in study abroad during the same period but less than 5% of enrolled students ventured abroad annually. I summarized the themes associated with the post-9/11 environment of international education as perceived by my participants at both institutions as 3Ms, 3Ts, and 1D: Menace of Anxiety and Fear, Menace of Insularity and Insecurity, Menace of Over-Regulation and Bigotry, Trajectory of Opportunity, Trajectory of Contradictions, Trajectory of Illusion, Fatalism and Futility, and Dominance of Technology. Based on these findings, I recommended an integrated Internationalization At Home Plus Collaborative Outreach (IAHPCO) approach to internationalization that is based on a post-9/11 recalibration of national security and international education as complementary rather than diametrically opposed concepts.

Assessment of anxiety sensitivity in depressed, older patients and its relation to hypochondriacal concerns

Anxiety disorders in older adults are often overlooked as part of other mental disorders or as part of medical illnesses. Theoretically, anxiety sensitivity is a common component in anxiety disorders, a personality construct and a fundamental fear. Anxiety sensitivity was assessed in a sample of older adults: 53 depressed, M age = 78.8 years; and 53 healthy controls, M age = 70.9 years. This study examined whether anxiety sensitivity: (1) explained unique variance beyond that explained by trait anxiety, (2) was observed in the depressed group in levels similar to individuals who suffer from non-panic, anxiety disorders, and (3) correlated with current number of medical illnesses, previous number of medical illnesses, and hypochondriasis. The results indicated that anxiety sensitivity: predicted hypochondriasis better than trait anxiety, was present in the depressed group similarly to individuals suffering from non-panic, anxiety disorders, and was strongly associated with hypochondriacal concerns.

Personalidade e sua relação com transtornos de ansiedade e de humor: Uma análise da produção científica brasileira na abordagem cognitivo-comportamental

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.

Politics vs economics: unintended consequences of Governments’ interventions in airlines’ markets

Overlaying theories of market inefficiencies and/or failure onto airline economics indicates that the industry encounters at least seven of the indicators which have triggered interventions by national, multi-national or supranational governments (NMSGs) trying to resolve political, social or environmental problems. The NMSGs’ interventions aimed to resolve lack of competition, fill missing markets, and neuter the presence of negative externalities, free riders, social inequalities and moral panic. Desk research showed that their interventions (many lacking preliminary economic analysis) either intentionally solved and/or unintentionally triggered market inefficiencies or failures. It is possible that some of the interventions could eventually make advanced world airlines subsidise their advancing world competitors.

Shame, Dissociation, and Complex PTSD Symptoms in Traumatized Psychiatric and Control Groups: Direct and Indirect Associations With Relationship Distress

Objectives: Elevated shame and dissociation are common in dissociative identity disorder (DID) and chronic posttraumatic stress disorder (PTSD) and are part of the constellation of symptoms defined as complex PTSD. Previous work examined the relationship between shame, dissociation, and complex PTSD and whether they are associated with intimate relationship anxiety, relationship depression, and fear of relationships. This study investigated these variables in traumatized clinical samples and a nonclinical community group.

Method: Participants were drawn from the DID (n = 20), conflict-related chronic PTSD (n = 65), and nonclinical (n = 125) populations and completed questionnaires assessing the variables of interest. A model examining the direct impact of shame and dissociation on relationship functioning, and their indirect effect via complex PTSD symptoms, was tested through path analysis.

Results: The DID sample reported significantly higher dissociation, shame, complex PTSD symptom severity, relationship anxiety, relationship depression, and fear of relationships than the other two samples. Support was found for the proposed model, with shame directly affecting relationship anxiety and fear of relationships, and pathological dissociation directly affecting relationship anxiety and relationship depression. The indirect effect of shame and dissociation via complex PTSD symptom severity was evident on all relationship variables.

Conclusion: Shame and pathological dissociation are important for not only the effect they have on the development of other complex PTSD symptoms, but also their direct and indirect effects on distress associated with relationships.