Avaliação de estresse e enfrentamento das mães de crianças com cardiopatias congênitas

Pós-graduação em Bases Gerais da Cirurgia - FMB

Aptitude–Treatment interaction effects in psychooncological interventions

Objective: To examine aptitude–treatment interaction (ATI) effects in cancer patients receiving psychoonco- logical interventions (POIs). Method: N=36 cancer patients were treated with POI. Hierarchical linear regression was used to test two interaction effects between patient baseline characteristics (aptitudes) and process analyses of therapy sessions (treatment) on change in mental health during POI. Results: Patients with high emotional distress did best when their therapy reduced arousal, and patients with lower emotional distress benefited most if therapists emphasized arousal induction. The interaction between the coping style of the patient (internalizing vs. externalizing) and the focus of the treatment (emotion vs. behavior) did not predict POI outcomes. Conclusions: The ATI effect of patient's distress and therapist's arousal induction/reduction may help therapists to make differential treatment decisions in POI. Tailoring treatments to cancer patients based on their personal characteristics may enhance the effectiveness of POI.

Visual avoidance in phobia: particularities in neural activity, autonomic responding, and cognitive risk evaluations.

We investigated the neural mechanisms and the autonomic and cognitive responses associated with visual avoidance behavior in spider phobia. Spider phobic and control participants imagined visiting different forest locations with the possibility of encountering spiders, snakes, or birds (neutral reference category). In each experimental trial, participants saw a picture of a forest location followed by a picture of a spider, snake, or bird, and then rated their personal risk of encountering these animals in this context, as well as their fear. The greater the visual avoidance of spiders that a phobic participant demonstrated (as measured by eye tracking), the higher were her autonomic arousal and neural activity in the amygdala, orbitofrontal cortex (OFC), anterior cingulate cortex (ACC), and precuneus at picture onset. Visual avoidance of spiders in phobics also went hand in hand with subsequently reduced cognitive risk of encounters. Control participants, in contrast, displayed a positive relationship between gaze duration toward spiders, on the one hand, and autonomic responding, as well as OFC, ACC, and precuneus activity, on the other hand. In addition, they showed reduced encounter risk estimates when they looked longer at the animal pictures. Our data are consistent with the idea that one reason for phobics to avoid phobic information may be grounded in heightened activity in the fear circuit, which signals potential threat. Because of the absence of alternative efficient regulation strategies, visual avoidance may then function to down-regulate cognitive risk evaluations for threatening information about the phobic stimuli. Control participants, in contrast, may be characterized by a different coping style, whereby paying visual attention to potentially threatening information may help them to actively down-regulate cognitive evaluations of risk.

Development of the Sphere Overlap Scale (SOS) : compartmentalization and the spillover hypothesis

The purpose of this study was to create a scale that could measure compartmentalization. In the first of two studies 311 working undergraduates were asked to indicate agreement with 119 items that measured compartmentalization. The resulting scale's reliability and validity were evaluated by having a second sample of 312 working students complete the items that comprise a sphere overlap scale, two measures of spillover, and a measure of personality, coping, and demoralization. Although the study's original goal was not realized, its procedures were successful in developing a short (10-item) measure of work-to-home spillover whose items loaded on a single factor. Structural equation modeling indicated that SOS items were correlated with existing measures of spillover and could be discriminated from related concepts of personality and coping. The SOS was also more highly correlated with demoralization than existing measures of spillover in hierarchical analyses that controlled for demographic factors, personality characteristics, and coping style. It is concluded that the SOS shows enough promise to warrant the cost of its appraisal as an alternative measure of spillover in a longitudinal study.

Executief Functioneren en Copingstijl van Normaal- en Hogerbegaafde Volwassenen met een Autismespectrumstoornis

Ten eerste wordt nagegaan of volwassenen met ASS beperkt zijn in hun executieve functies Cognitieve Flexibiliteit, Zelfevaluatie, Initiatief nemen, Werkgeheugen en Plannen en Organiseren. Ten tweede wordt onderzocht of beperkingen in het executief functioneren (EF) negatief samenhangen met het gebruik van een probleemgerichte copingstijl (H.1), positief met het gebruik van een emotiegerichte copingstijl (H.2) en positief met gebruik van een passief reactiepatroon (H.3). Daarnaast wordt exploratief onderzocht of leeftijd een modererende invloed heeft op bovengenoemde drie relaties. Volwassenen met een gemiddeld of hoger intelligentieniveau bij wie ASS is vastgesteld hebben een zelfrapportagevragenlijst ingevuld (survey met één meetmoment). Circa 27% van de data is afkomstig uit GGZ-cliëntendossiers, de overige data zijn afkomstig via respondentenwerving (53% non-respons op 182 uitgezette vragenlijsten). Naast enkele biografische gegevens werd gebruik gemaakt van de Brief-A, die beperkingen in het executief functioneren meet en van de Utrechtse Copinglijst (UCL), die het gebruik van zeven copingmechanismen in kaart brengt. Conform H.1 blijken beperkingen in het EF (met name Cognitieve Flexibiliteit) gerelateerd te zijn aan een geringer gebruik van probleemgerichte coping. H.2 wordt niet ondersteund door de bevindingen, aangezien resultaten erop wijzen dat EF geen variantie verklaart in het gebruik van emotiegerichte coping. EF doet dit wel ten aanzien van een passieve reactie, conform H.3. Met name Cognitieve Flexibiliteit en Werkgeheugen spelen hier een betekenisvolle rol. Er is geen significante ondersteuning voor een modererende rol van leeftijd in de drie verbanden.

Comparing Shame in Clinical and Nonclinical Populations: Preliminary Findings

OBJECTIVES: To conduct a preliminary study comparing different trauma and clinical populations on types of shame coping style and levels of state shame and guilt.

METHODS: A mixed independent groups/correlational design was employed. Participants were recruited by convenience sampling of 3 clinical populations-complex trauma (n = 65), dissociative identity disorder (DID; n = 20), and general mental health (n = 41)-and a control group of healthy volunteers (n = 125). All participants were given (a) the Compass of Shame Scale, which measures the four common shame coping behaviors/styles of "withdrawal," "attack self," "attack other," and "avoidance," and (b) the State Shame and Guilt Scale, which assesses state shame, guilt, and pride.

RESULTS: The DID group exhibited significantly higher levels of "attack self," "withdrawal," and "avoidance" relative to the other groups. The complex trauma and general mental health groups did not differ on any shame variable. All three clinical groups had significantly greater levels of the "withdrawal" coping style and significantly impaired shame/guilt/pride relative to the healthy volunteers. "Attack self" emerged as a significant predictor of increased state shame in the complex trauma, general mental health, and healthy volunteer groups, whereas "withdrawal" was the sole predictor of state shame in the DID group.

CONCLUSIONS: DID emerged as having a different profile of shame processes compared to the other clinical groups, whereas the complex trauma and general mental health groups had comparable shame levels and variable relationships. These differential profiles of shame coping and state shame are discussed with reference to assessment and treatment. (PsycINFO Database Record

Estrategias de afrontamiento en estudiantes adolescentes

La adolescencia es una etapa en la que se presentan retos y obstáculos que los adolescentes deben afrontar, para lo cual es necesario que estos cuenten con estrategias de afrontamiento adecuadas. Esta investigación tuvo como objetivo analizar y describir las estrategias de afrontamiento usadas frecuentemente por los estudiantes adolescentes de entre 16 y 18 años. La muestra estuvo conformada por 77 estudiantes de segundo y tercero de bachillerato del Colegio San José de la Salle de la ciudad de Cuenca, sección vespertina. Para la evaluación se utilizó la Escala de Afrontamiento para adolescentes (ACS) elaborada por Frydenberg y Lewis (2000). Los resultados de la investigación señalaron que la estrategia más utilizada por el grupo es buscar diversiones relajantes (Dr) con una media de 73. En relación al género encontramos que la estrategia buscar diversiones relajantes (Dr) es la estrategia más utilizada por hombres y mujeres con un porcentaje de 55,6% y 41,7% respectivamente; sin embargo se evidenció que las mujeres utilizan una mayor gama de estrategias de afrontamiento en relación al estilo de afrontamiento referido a los demás. Y por último se encontró que la preocupación principal del grupo se centra en los ámbitos académico/laboral con un 63,3%.

Attachment style and coping resources as predictors of coping strategies in the transition to parenthood

The relations among adult attachment style, coping resources, appraised strain, and coping strategies were examined in a prospective study of married couples having their first child (N = 92). Attachment and coping resources were measured during the second trimester of pregnancy, and parenting strain and coping strategies were assessed when the babies were about 6 weeks old. Results supported a theoretical model proposing that attachment is predictive of coping resources and appraised strain, and that attachment, resources, and strain are predictive of coping strategies. Results also highlighted the complexity of associations among attachment, stress, and coping: Gender differences in mean scores and predictive associations were obtained, and some interactions were found between resources and strain in predicting coping strategies. The findings support the utility of integrating theories of attachment and coping in explaining couples' adjustment to important developmental transitions.

Risk perception and emotional coping: a pathway for behavioural addiction?

This article summarizes current concepts of the working memory with regard to its role within emotional coping strategies. In particular, it focuses on the fact that the limited capacity of the working memory to process now-relevant information can be turned into an advantage, when the individual is occupied by dealing with unpleasant emotion. Based on a phenomenon known as dual-task interference (DTI), this emotion can be chased by intense arousal due to clearly identifiable external stressors. Thus, risk perception might be used as a 'DTI inductor' that allows avoidance of unpleasant emotion. Successful mastery of risk adds a highly relevant dopaminergic component to the overall experience. The resulting mechanism of implicit learning may contribute to the development of a behavioural addiction. Besides its putative effects in the development of a behavioural addiction, the use of DTI might be of a more general interest for the clinical practice, especially in the field of psychotherapy. © 2013 S. Karger AG, Basel.

The dual role of students with behavioural problems: an analysis of their experiences as bullies and victims /

The present study examined the bullying experiences of a group of students, age 10-14 years, identified as having behaviour problems. A total often students participated in a series of mixed methodology activities, including self-report questionnaires, story telling exercises, and interview style joumaling. The main research questions were related to the prevalence of bully/victims and the type of bullying experiences in this population. Questionnaires gathered information about their involvement in bullying, as well as about psychological risk factors including normative beliefs about antisocial acts, impulsivity, problem solving, and coping strategies. Journal questions expanded on these themes and allowed students to explain their personal experiences as bullies and victims as well as provide suggestions for intervention. The overall results indicated that all of the ten students in this sample have participated in bullying as both a bully and a victim. This high prevalence of bully/victim involvement in students from behavioural classrooms is in sharp contrast with the general population where the prevalence is about 33%. In addition, a common thread was found that indicated that these students who participated in this study demonstrate characteristics of emotionally dysregulated reactive bullies. Theoretical implication and educational practices are discussed.

Action-Emotion Style, Learning Approach and Coping Strategies, in Undergraduate University Students

Action-Emotion Style (AES) is an affective-motivational construct that describes the achievement motivation that is characteristic of students in their interaction with stressful situations. Using elements from the Type-A Behavior Pattern (TABP), characteristics of competitiveness and overwork occur in different combinations with emotions of impatience and hostility, leading to a classification containing five categories of action-emotion style (Type B, Impatient-hostile type, Medium type, Competitive-Overworking type and Type A). The objective of the present research is to establish how characteristics of action-emotion style relate to learning approach (deep and surface approaches) and to coping strategies (emotion-focused and problem-focused). The sample was composed of 225 students from the Psychology degree program. Pearson correlation analyses, ANOVAs and MANOVAs were used. Results showed that competitiveness-overwork characteristics have a significant positive association with the deep approach and with problem-focused strategies, while impatience-hostility is thus related to surface approach and emotion-focused strategies. The level of action-emotion style had a significant main effect. The results verified our hypotheses with reference to the relationships between action-emotion style, learning approaches and coping strategies.

Attachment style, assertive communication, and safer-sex behavior

This research tested the proposition that the effect of attachment security on safer-sex practice may be mediated by communication patterns. One hundred eighty-five undergraduate students completed questionnaire measures of attachment, assertiveness, and attitudes to communication about AIDS. Eight weeks later, they reported on their practice of safer sex in the period since the first testing session. Hierarchical regressions showed that at Step 1, anxiety about relationships (a measure of insecure attachment) was associated with less safer-sex practice, for all outcome measures. Attitudes to communication about AIDS added to the prediction of general reports of safer-sex practice: in line with the mediational model, anxiety about relationships became unimportant as a predictor when communication variables were included. Communication variables failed to add to the prediction of safer sex on the most recent encounter, and both anxiety about relationships and attitudes to communication about AIDS predicted condom use. Some gender differences in patterns of prediction were noted. The results are discussed in terms of attachment style and its links with the negotiation of sexual practice and relationship issues.

Attachment style as a predictor of sexual attitudes and behavior in late adolescence

This research applied attachment theory to the study of sexual attitudes and behaviors in a sample of late adolescents. Four hundred and seventy heterosexual undergraduate students completed questionnaires assessing attachment (discomfort with closeness; anxiety over relationships), relationship history, communication about sex, sexual self-efficacy and locus of control, and attitudes to condoms. Eight weeks later, participants reported on sexual behaviors occurring during the eight-week interval, and perceived risk of these activities. Both discomfort with closeness and anxiety over relationships were associated with external locus of control for sexual outcomes, and with use of drugs before sexual contact. Anxiety over relationships was linked to unsafe sex and to negative attitudes to condoms, but discomfort with closeness was associated with a more cautious approach to sexual risk-taking. Some results were qualified by gender differences, and by differences between the full sample and those who were sexually active. The findings are discussed in terms of attachment style and its links with communication and affect regulation.