THE TERMINATION PHASE: THERAPISTS’ PERSPECTIVE ON THE THERAPEUTIC RELATIONSHIP AND OUTCOME

The termination phase of treatment is recognized as a significant aspect of the therapy process and yet remains vastly understudied in psychotherapy literature. In the present study, therapists’ perspectives were used to examine how three elements of the therapy relationship (working alliance, real relationship and transference) during the termination phase relate to perceived client sensitivity to loss, termination phase evaluation and overall treatment outcome. Self-report data was gathered from 233 therapists, recruited from two Divisions of the American Psychological Association. Therapists completed measures for their work with a client with whom they could identify a termination phase of treatment. Results revealed that the working alliance and real relationship during the termination phase related positively to termination phase evaluation and overall treatment outcome, whereas negative transference during the termination phase related negatively to overall treatment outcome. Therapists’ perceptions of client sensitivity to loss related positively to both negative and positive transference during the termination phase. Post-hoc analyses revealed only the working alliance during the termination phase uniquely predicted overall treatment outcome in a model with the three therapy relationship elements examined together. On the other hand, all three therapy relationship variables during the termination phase uniquely predicted termination phase evaluation, when examined together. Limitations and implications of these findings are discussed, and recommendations for future study are suggested.

Prevalencia del bruxismo de vigilia y sus factores asociados estudiantes universitarios de la Facultad de Odontología de la Universidad de Cuenca 2015

El propósito de la presente investigación fue establecer la prevalencia de Bruxismo probable de Vigilia y sus factores asociados. Materiales y métodos: se evaluaron 284 pacientes mediante un cuestionario de autoreporte más la examinación clínica y la aplicación de la escala validada DASS-21 que mide estrés, ansiedad, y depresión. Resultados: los datos revelaron una prevalencia de 52.1% de Bruxismo de vigilia y una alta asociación con la variable estrés (OR: 3.148 IC 95%: 1.9 - 5.1), ansiedad (OR: 3.222 IC 95%: 1.9 - 5.4) y depresión (OR: 3.284 IC 95%(2.0 - 5.3) con esta parafunción, a la vez no se encontró una asociación significativa entre bruxismo de vigilia con edad (OR: 1.400 IC 95%: O.8 - 2.2) y sexo (OR: 1.260 IC 95%(0.7 - 2.0)

The meaning, antecedents and outcomes of employee engagement:a narrative synthesis

The claim that high levels of engagement can enhance organizational performance and individual well-being has not previously been tested through a systematic review of the evidence. To bring coherence to the diffuse body of literature on engagement, the authors conducted a systematic synthesis of narrative evidence involving 214 studies focused on the meaning, antecedents and outcomes of engagement. The authors identified six distinct conceptualizations of engagement, with the field dominated by the Utrecht Group's ‘work engagement’ construct and measure, and by the theorization of engagement within the ‘job demands–resources’ framework. Five groups of factors served as antecedents to engagement: psychological states; job design; leadership; organizational and team factors; and organizational interventions. Engagement was found to be positively associated with individual morale, task performance, extra-role performance and organizational performance, and the evidence was most robust in relation to task performance. However, there was an over-reliance on quantitative, cross-sectional and self-report studies within the field, which limited claims of causality. To address controversies over the commonly used measures and concepts in the field and gaps in the evidence-base, the authors set out an agenda for future research that integrates emerging critical sociological perspectives on engagement with the psychological perspectives that currently dominate the field.

Lost in translation? The potential psychobiotic Lactobacillus rhamnosus (JB-1) fails to modulate stress or cognitive performance in healthy male subjects

Background: Preclinical studies have identified certain probiotics as psychobiotics a live microorganisms with a potential mental health benefit. Lactobacillus rhamnosus (JB-1) has been shown to reduce stress-related behaviour, corticosterone release and alter central expression of GABA receptors in an anxious mouse strain. However, it is unclear if this single putative psychobiotic strain has psychotropic activity in humans. Consequently, we aimed to examine if these promising preclinical findings could be translated to healthy human volunteers. Objectives: To determine the impact of L. rhamnosus on stress-related behaviours, physiology, inflammatory response, cognitive performance and brain activity patterns in healthy male participants. An 8 week, randomized, placebo-controlled, cross-over design was employed. Twenty-nine healthy male volunteers participated. Participants completed self-report stress measures, cognitive assessments and resting electroencephalography (EEG). Plasma IL10, IL1β, IL6, IL8 and TNFα levels and whole blood Toll-like 4 (TLR-4) agonist-induced cytokine release were determined by multiplex ELISA. Salivary cortisol was determined by ELISA and subjective stress measures were assessed before, during and after a socially evaluated cold pressor test (SECPT). Results: There was no overall effect of probiotic treatment on measures of mood, anxiety, stress or sleep quality and no significant effect of probiotic over placebo on subjective stress measures, or the HPA response to the SECPT. Visuospatial memory performance, attention switching, rapid visual information processing, emotion recognition and associated EEG measures did not show improvement over placebo. No significant anti-inflammatory effects were seen as assessed by basal and stimulated cytokine levels. Conclusions: L. rhamnosus was not superior to placebo in modifying stress-related measures, HPA response, inflammation or cognitive performance in healthy male participants. These findings highlight the challenges associated with moving promising preclinical studies, conducted in an anxious mouse strain, to healthy human participants. Future interventional studies investigating the effect of this psychobiotic in populations with stress-related disorders are required.

Niveles de actividad física y su relación con los desórdenes musculo esqueléticos en profesores de educación física en Bogotá - Colombia.

La actividad física regular desempeña un papel fundamental en la prevención y control de los desórdenes musculo esqueléticos, dentro de la actividad laboral del profesor de educación física. Objetivo: El propósito del estudio fue determinar la relación entre los niveles de actividad física y la prevalencia de los desórdenes musculo esqueléticos, en profesores de educación física de 42 instituciones educativas oficiales de Bogotá-Colombia. Métodos. Se trata de un estudio de corte transversal en 262 profesores de educación física, de 42 instituciones educativas oficiales de Bogotá - Colombia. Se aplicó de manera auto-diligenciada el Cuestionario Nórdico de desórdenes músculos esqueléticos y el Cuestionario IPAQ versión corta para identificar los niveles de actividad física. Se obtuvieron medidas de tendencia central y de dispersión para variables cuantitativas y frecuencias relativas para variables cualitativas. Se calculó la prevalencia de vida y el porcentaje de reubicación laboral en los docentes que habían padecido diferentes tipo de dolor. Para estimar la relación entre el dolor y las variables sociodemográficas de los docentes, se utilizó un modelo de regresión logística binaria simple. Los análisis fueron realizados en SPSS versión 20 y se consideró como significativo un valor p < 0.05 para el contraste de hipótesis y un nivel de confianza para la estimación de parámetros. Resultados: El porcentaje de respuesta fue del 83.9%, se consideraron válidos 262 registros, 22.5% eran de género femenino, la mayor cantidad de docentes de educación física se encuentraon entre 25 y 35 años (43,9%), frente a los desórdenes musculo esqueléticos, el 16.9% de los profesores reporto haberlos sufrido alguna vez molestias en el cuello, el 17,2% en el hombro, 27,9% espalda, 7.93% brazo y en mano el 8.4%. Los profesores con mayores niveles de actividad física, reportaron una prevalencia menor de alteraciones musculo esqueléticas de 16,9 % para cuello; 27.7% para dorsal/lumbar frente a los sujetos con niveles bajos de actividad física. La presencia de los desórdenes se asoció a los años de experiencia (OR 3.39 IC95% 1.41-7.65), a pertenecer al género femenino (OR 4.94 IC95% 1.94-12.59), a la edad (OR 5.06 IC95% 1.25-20.59), y al atender más de 400 estudiantes a cargo dentro de la jornada laboral (OR 4.50 IC95% 1.74-11.62). Conclusiones: En los profesores de Educación Física no sé encontró una relación estadísticamente significativa entre los niveles de actividad física y los desórdenes musculo esqueléticos medidos por auto reporte.

Aproximaciones a mindfulness en la psicología contemporánea

Este trabajo es una revisión de literatura que abarca una selección de artículos disponibles en bases de datos especializadas y publicados en el periodo comprendido entre los años 2006 a 2016 para artículos científicos y entre los años 2000 a 2016 para libros. En total se revisaron: 1 tesis doctoral, 1 tesis magistral, 111 artículos y 9 libros o capítulos de libros. Se presentan diversas definiciones de mindfulness y formas de conceptualizarla, sus mecanismos de acción, sus enfoques psicoterapéuticos predominantes, los efectos de su práctica estable, sus principales campos de acción y la importancia de la formación de los docentes que imparten la práctica. Finalmente se presentan algunas conclusiones acerca del diálogo entre la literatura psicológica sobre mindfulness y algunas de las concepciones de la tradición budista en torno a la meditación.

Emotional contagion in consecutive interpreting: An empirical study with novice interpreters

It has recently been noticed that interpreters tend to converge with their speakers’ emotions under a process known as emotional contagion. Emotional contagion still represents an underinvestigated aspect of interpreting and the few studies on this topic have tended to focus more on simultaneous interpreting rather than consecutive interpreting. Korpal & Jasielska (2019) compared the emotional effects of one emotional and one neutral text on interpreters in simultaneous interpreting and found that interpreters tended to converge emotionally with the speaker more when interpreting the emotional text. This exploratory study follows their procedures to study the emotional contagion potentially caused by two texts among interpreters in consecutive interpreting: one emotionally neutral text and one negatively-valenced text, this last containing 44 negative words as triggers. Several measures were triangulated to determine whether the triggers in the negatively-valenced text could prompt a stronger emotional contagion in the consecutive interpreting of that text as compared to the consecutive interpreting of the emotionally neutral text, which contained no triggers—namely, the quality of the interpreters’ delivery; their heart rate variability values as collected with EMPATICA E4 wristbands; the analysis of their acoustic variations (i.e., disfluencies and rhetorical strategies); their linguistic and emotional management of the triggers; and their answers to the Italian version of the Positive and Negative Affect Schedule (PANAS) self-report questionnaire. Results showed no statistically significant evidence of an emotional contagion evoked by the triggers in the consecutive interpreting of the negative text as opposed to the consecutive interpreting of the neutral text. On the contrary, interpreters seemed to be more at ease while interpreting the negative text. This surprising result, together with other results of this project, suggests venues for further research.

Mechanisms Predisposing Penile Fracture And Long-term Outcomes On Erectile And Voiding Functions.

Purpose. To determine the mechanisms predisposing penile fracture as well as the rate of long-term penile deformity and erectile and voiding functions. Methods. All fractures were repaired on an emergency basis via subcoronal incision and absorbable suture with simultaneous repair of eventual urethral lesion. Patients' status before fracture and voiding and erectile functions at long term were assessed by periodic follow-up and phone call. Detailed history included cause, symptoms, and single-question self-report of erectile and voiding functions. Results. Among the 44 suspicious cases, 42 (95.4%) were confirmed, mean age was 34.5 years (range: 18-60), mean follow-up 59.3 months (range 9-155). Half presented the classical triad of audible crack, detumescence, and pain. Heterosexual intercourse was the most common cause (28 patients, 66.7%), followed by penile manipulation (6 patients, 14.3%), and homosexual intercourse (4 patients, 9.5%). Woman on top was the most common heterosexual position (n = 14, 50%), followed by doggy style (n = 8, 28.6%). Four patients (9.5%) maintained the cause unclear. Six (14.3%) patients had urethral injury and two (4.8%) had erectile dysfunction, treated by penile prosthesis and PDE-5i. No patient showed urethral fistula, voiding deterioration, penile nodule/curve or pain. Conclusions. Woman on top was the potentially riskiest sexual position (50%). Immediate surgical treatment warrants long-term very low morbidity.

[adherence To Statin Treatment And Associated Factors In Female Users From The Unified Health System (sus)].

To identify the adherence rate of a statin treatment and possible related factors in female users from the Unified Health System. Seventy-one women were evaluated (64.2 ± 11.0 years) regarding the socio-economic level, comorbidities, current medications, level of physical activity, self-report of muscular pain, adherence to the medical prescription, body composition and biochemical profile. The data were analyzed as frequencies, Chi-Squared test, and Mann Whitney test (p<0.05). 15.5% of women did not adhere to the medical prescription for the statin treatment, whose had less comorbidities (p=0.01), consumed less quantities of medications (p=0.00), and tended to be younger (p=0.06). Those patients also presented higher values of lipid profile (CT: p=0.01; LDL-c: p=0.02). Musculoskeletal complains were not associated to the adherence rate to the medication. The associated factors to adherence of dyslipidemic women to statin medical prescription were age, quantity of comorbidities and quantity of current medication.

[the Perception Of Behavior Related To Mindfulness And The Brazilian Version Of The Freiburg Mindfulness Inventory].

Mindfulness is a practice and a form of consciousness which has been the basis for innovative interventions in care and health promotion. This study presents mindfulness, describes and discusses the process of cultural adaptation of The Freiburg Mindfulness Inventory (FMI) to Brazilian Portuguese. From the original version of this pioneering instrument for assessing mindfulness two translations and two back-translations were made. These were evaluated by a committee of 14 experts (Buddhists, linguists, health professionals), who helped to create two versions for the first pre-test, based on which suggestions were made by a sample of 41 people of the population through interviews. Considering the difficulties in understanding the concepts that are unfamiliar to the Brazilian culture, a new version was prepared with additional explanations, which underwent a further evaluation of the experts and a second pre-test with 72 people. This process aimed at addressing the limitations and challenges of evaluating mindfulness in a country of western culture through a self-report instrument based on Buddhist psychology. With appropriate levels of clarity and equivalence with the original instrument, the Freiburg Mindfulness Inventory adapted for Brazil is presented.

Burden Of Focal Cryoablation Versus Brachytherapy Versus Active Surveillance In The Treatment Of Very Low-risk Prostate Cancer: A Preliminary Head-to-head Comprehensive Assessment.

Focal cryoablation (FC), brachytherapy (B) and active surveillance (AS) were offered to patients diagnosed with very low-risk prostate cancer (VLRPC) in an equal access protocol. Comprehensive validated self-report questionnaires accessed patients' erectile (IIEF-5) and voiding (IPSS) functions, Beck scales measured anxiety (BAI), hopelessness (BHS) and depression (BDI), SF-36 reflected patients' quality of life added to the emotional thermometers including five visual analogue scales (distress, anxiety, depression, anger and need for help). Kruskal-Wallis or ANOVA tests and Spearman's correlations were obtained among groups and studied variables. Thirty patients were included, median follow-up 18 months (15-21). Those on AS (n = 11) were older, presented higher hopelessness (BHS) and lower general health perceptions (SF-36) scores than patients opting for FC (n = 10) and B (n = 9), P = 0.0014, P = 0.0268 and P = 0.0168 respectively. Patients on B had higher IPSS scores compared to those under FC and AC, P = 0.0223. For all 30 included patients, Spearman's correlation (rs ) was very strong between BHS and general health perceptions (rs  = -0.800, P < 0.0001), and weak/moderate between age and BHS (rs  = 0.405, P = 0.026) and age and general health perceptions (rs  = -0.564, P = 0.001). The sample power was >60%. To be considered in patients' counselling and care, current study supports the hypothesis that even VLRPC when untreated undermines psychosocial domains.

Validação de escalas para avaliação do amor patológico

CONTEXTO: Diversas metodologias foram desenvolvidas para validar instrumentos psicométricos. No entanto, na literatura científica, há escassez de instrumentos para avaliar os relacionamentos amorosos. OBJETIVO: O presente trabalho tem como objetivo validar para o português o conteúdo dos instrumentos autoaplicáveis Love Attitudes Scale (Escala de Atitudes do Amor - Hendrick et al., 1998), Relationship Assessment Scale (Escala de Avaliação do Relacionamento - Hendrick, 1988) e Adult Attachment Types (Tipos de Apego do Adulto - Hazan et al., 1987), levando em consideração o contexto cultural brasileiro e, consequentemente, possibilitando que o estudo do amor patológico seja viável na população brasileira. MÉTODOS: Tal processo envolveu quatro etapas: (1) tradução para o português, (2) retrotradução, (3) apresentação da versão corrigida para profissionais de saúde mental e estudantes universitários e (4) aplicação da versão final em amostra da população-alvo utilizando uma escala analógico-visual. RESULTADOS: As escalas foram facilmente compreendidas e discriminaram significativamente indivíduos com amor patológico de voluntários saudáveis. CONCLUSÃO: Nossos resultados mostram que a versão brasileira desses instrumentos é válida e pode ser usada em investigações envolvendo relacionamentos amorosos.

Adversidade familiar e problemas comportamentais entre adolescentes infratores e não-infratores

O presente estudo comparou adolescentes infratores e não-infratores com relação a dois aspectos: grau de adversidade familiar e grau de concordância entre a autopercepção e a percepção dos pais sobre problemas de comportamento dos jovens. Participaram deste estudo 40 adolescentes, 23 atendidos no Centro de Atenção e Apoio ao Adolescente (UNIFESP) e 17 adolescentes considerados infratores sob intervenção da Vara da Infância e da Juventude da comarca de Santos. Os instrumentos utilizados foram o Child Behavior Checklist (CBCL), Youth Self Report (YSR) e o Índice de Adversidade Familiar de Rutter. O Índice de Adversidade Familiar do grupo de adolescentes infratores foi significativamente maior. Os resultados apontaram ainda que, embora a diferença não tenha sido estatisticamente significante, a porcentagem dos escores de discordância nas percepções sobre problemas de comportamento foi maior entre os adolescentes infratores e seus pais.

ESPECTRA: Searching the Bipolar Spectrum in Eating Disorder patients

Background: Bipolar Disorder (BD) is a chronic, recurrent and highly prevalent illness. Despite the need for correct diagnosis to allow proper treatment, studies have shown that reaching a diagnosis can take up to ten years due to the lack of recognition of the broader presentations of BD. Frequent comorbidities with other psychiatric disorders are a major cause of misdiagnosis and warrant thorough evaluation. Methods/Design: ESPECTRA (Occurrence of Bipolar Spectrum Disorders in Eating Disorder Patients) is a single-site cross-sectional study involving a comparison group, designed to evaluate the prevalence of bipolar spectrum in an eating disorder sample. Women aged 18-45 years will be evaluated using the SCID-P and Zurich criteria for diagnosis and the HAM-D, YOUNG, SCI-MOODS, HCL-32, BIS-11, BSQ, WHOQoL and EAS instruments for rating symptoms and measuring clinical correlates. Discussion: The classificatory systems in psychiatry are based on categorical models that have been criticized for simplifying the diagnosis and leading to an increase in comorbidities. Some dimensional approaches have been proposed aimed at improving the validity and reliability of psychiatric disorder assessments, especially in conditions with high rates of comorbidity such as BD and Eating Disorder (ED). The Bipolar Spectrum (BS) remains under-recognized in clinical practice and its definition is not well established in current diagnostic guidelines. Broader evaluation of psychiatric disorders combining categorical and dimensional views could contribute to a more realistic understanding of comorbidities and help toward establishing a prognosis.

The International LAM Registry: A Component of an Innovative Web-Based Clinician, Researcher, and Patient-Driven Rare Disease Research Platform

Background: A relative friability to capture a sufficiently large patient population in any one geographic location has traditionally limited research into rare diseases. Methods and Results: Clinicians interested in the rare disease lymphangioleiomyomatosis (LAM) have worked with the LAM Treatment Alliance, the MIT Media Lab, and Clozure Associates to cooperate in the design of a state-of-the-art data coordination platform that can be used for clinical trials and other research focused on the global LAM patient population. This platform is a component of a set of web-based resources, including a patient self-report data portal, aimed at accelerating research in rare diseases in a rigorous fashion. Conclusions: Collaboration between clinicians, researchers, advocacy groups, and patients can create essential community resource infrastructure to accelerate rare disease research. The International LAM Registry is an example of such an effort.