Amoras e jabuticabas: raízes e frutos de uma Pedagogia Profunda para todos

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Psychogenic dysphonia: diversity of clinical and vocal manifestations in a case series

Introduction: Psychogenic dysphonia is a functional disorder with variable clinical manifestations.Objective: To assess the clinical and vocal characteristics of patients with psychogenic dysphonia in a case series.Methods: The study included 28 adult patients with psychogenic dysphonia, evaluated at a University hospital in the last ten years. Assessed variables included gender, age, occupation, vocal symptoms, vocal characteristics, and videolaryngostroboscopic findings.Results: 28 patients (26 women and 2 men) were assessed. Their occupations included: housekeeper (n = 17), teacher (n = 4), salesclerk (n = 4), nurse (n = 1), retired (n = 1), and psychologist (n = 1). Sudden symptom onset was reported by 16 patients and progressive symptom onset was reported by 12; intermittent evolution was reported by 15; symptom duration longer than three months was reported by 21 patients. Videolaryngostroboscopy showed only functional disorders; no patient had structural lesions or changes in vocal fold mobility. Conversion aphonia, skeletal muscle tension, and intermittent voicing were the most frequent vocal emission manifestation forms.Conclusions: In this case series of patients with psychogenic dysphonia, the most frequent form of clinical presentation was conversion aphonia, followed by musculoskeletal tension and intermittent voicing. The clinical and vocal aspects of 28 patients with psychogenic dysphonia, as well as the particularities of each case, are discussed. (C) 2014 Associacao Brasileira de Otorrinolaringologia e Cirurgia Cervico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

The Challenges of Psychology at Work in Mental Health: the drugs issue.

This article aims to show that the challenges of psychology in working with mental health in the field of drugs is traversed by both the conceptions molded by biopolitical forces (FOUCAULT) as the decadence of modern democracy (AGAMBEN), and visible features in the current treatment given in Brazil to issue of smoking (SILVA), as well as urbanistic projects such as the case of Luz district in São Paulo (LEITE & CASTRO). In this sense, it leads us to question about what is prohibited, about who actually suffers the punishment, in short, about what do we really take care when we take into account the Unheimlich (FREUD) and other social interdicts (BATAILLE).

Exploring Online Sexually Explicit Material: What is the Relationship to Sexual Coercion?

With the popularity of the Internet, it is easy to access sexually explicit material. Past research has demonstrated that exposure to sexually explicit material in traditional formats (i.e. magazines and videos) may have an influence on male attitudes and behaviors towards females, but these effects appear to be minimal and dissipate over the long term. Though the body of literature examining Internet sexually explicit material is smaller, researchers have found little to no effects on attitudes or aggressive behaviors immediately after exposure. However, research regarding exposure to online sexually explicit material has not included forensically relevant variables. Previous research has suggested that undergraduate males who report engaging in sexually coercive or aggressive behaviors differ in terms of personality, attitudinal, and behavioral variables from individuals who do not report this type of behavior. Therefore, the purpose of this study was to examine the same personality and attitudinal variables that have been studied in previous research, but to extend this research by including behavioral variables related to the viewing of online sexually explicit material. Male undergraduate students were provided with a link to take an online survey examining personality (empathy, sensation-seeking, and psychopathy), attitudinal (rape myth belief, acceptance of interpersonal violence, and hostility towards women) and behavioral (online sexual compulsivity and online behaviors with regard to sexual material) variables. The relationship between these variables and sexually coercive behavior was examined. Results indicate there is a significant relationship between some scales related to empathy and viewing sexually explicit or degrading material. Further results indicated that individuals who identified as having engaged in sexually aggressive behavior endorsed more items related to online sexually compulsive behaviors. Exploratory analyses revealed that the amount, as opposed to the type, of sexually explicit material viewed appears to be more related to adverse outcomes.

Amerindian anthropology and cultural psychology: Crossing boundaries and meeting otherness` worlds

Addressing integrative possibilities between psychology and anthropology, this paper aims to design conceptual linkages between semiotic-cultural constructivist psychology and the anthropological theory of Amerindian perspectivism. From the psychological view, it is the interdependence between the structural and processual dimensions of the personal culture that makes parallels with Amerindian perspectivism fruitful. This anthropological frame proposes an experiment with native conceptions, which I argue similar to what Baldwin (1906) called sembling. Hence, it can be considered an active imitation of otherness` viewpoint in order to approach indigenous worlds. It is supposed that this procedure leads to the emergence of new symbolic elements configuring the cultural action field of each agency in interaction. It is proposed that ""making-believe`` the Amerindian is convergent with the dialogic-hermeneutic approach of semiotic-cultural constructivism. As a result of the present integrative effort, is designed a meta-model that multiplies the genetic process of concrete symbolic objects.

Prevalence of depression and anxiety disorders in hospitalized patients at the dermatology clinical ward of a university hospital

BACKGROUND: The objective of this study was to estimate the prevalence of depression and anxiety disorders in hospitalized patients at the dermatology ward at a university hospital in Sao Paulo, Brazil. OBJECTIVE: To assess the prevalence of mood and anxiety disorders in hospitalized patients at the dermatology ward at a university hospital in Sao Paulo. METHOD: A total of 75 patients, men and women, aged between 18 and 76 years, took part in the research. The study employed a descriptive, cross sectional and correlational method. The data was collected by means of a social demographic questionnaire and the PRIME-MD. RESULTS: It was found that 45.3 percent of the subjects presented with depressive symptoms, and 52 percent presented with symptoms of anxiety and that this survey showed moderate and high significant correlations (p<0,01; r= 0,616) for depression and anxiety. CONCLUSION: These facts could evidence the relationship between physical and psyche, just as the literature presents.

The Clinical Case as a Basis for Research in Fundamental Psychopathology

(The Clinical Case as a Basis for Research in Fundamental Psychopathology) This article discusses aspects that hinder the process of drawing up clinical cases and stresses their importance for research in fundamental psychopathology. The author bases her thinking on several texts by Freud and his followers about the technique and the interpretation of dreams. In these texts, clinical cases are used to express a problem that must be investigated. The grounds for research follow the same logic as that used for interpreting dreams.

Group cognitive-behavioral therapy versus selective serotonin reuptake inhibitors for obsessive-compulsive disorder: A practical clinical trial

Clinical effectiveness of group cognitive-behavioral therapy (GCBT) versus fluoxetine in obsessive-compulsive disorder outpatients that could present additional psychiatric comorbidities was assessed. Patients (18-65 years; baseline Yale-Brown Obsessive-Compulsive-Scale [Y-BOCS] scores >= 16; potentially presenting additional psychiatric comorbidities) were sequentially allocated for treatment with GCBT (n = 70) or fluoxetine (n = 88). Mean Y-BOCS scores decreased by 23.13% in the GCBT and 21.54% in the SSRI groups (p = 0.875). Patients presented a mean of 2.7 psychiatric comorbidities. and 81.4% showed at least one additional disorder. A reduction of at least 35% in baseline Y-BOCS scores and CGI ratings of 1 (much better) or 2 (better) was achieved by 33.3% of GCBT patients and 27.7% in the SSRI group (p = 0.463). The Y-BOCS reduction was significantly lower in patients with one or more psychiatric comorbidities (21.15%, and 18.73%, respectively) than in those with pure OCD (34.62%; p = 0.034). Being male, having comorbidity of Major Depression, Social Phobia, or Dysthymia predicted a worse response to both treatments. Response rates to both treatments were similar and lower than reported in the literature, probably due to the broad inclusion criteria and the resulting sample more similar to the real world population. (C) 2011 Elsevier Ltd. All rights reserved.

BODY DYSMORPHIC DISORDER IN PATIENTS WITH OBSESSIVE-COMPULSIVE DISORDER: PREVALENCE AND CLINICAL CORRELATES

Background The prevalence, sociodemographic aspects, and clinical features of body dysmorphic disorder (BDD) in patients with obsessivecompulsive disorder (OCD) have been previously addressed in primarily relatively small samples. Methods We performed a cross-sectional demographic and clinical assessment of 901 OCD patients participating in the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders. We used the Structured Clinical Interview for DSM-IV Axis I Disorders; Yale-Brown Obsessive-Compulsive Scale; Dimensional Yale-Brown Obsessive-Compulsive Scale (DY-BOCS); Brown Assessment of Beliefs Scale; Clinical Global Impression Scale; and Beck Depression and Anxiety Inventories. Results The lifetime prevalence of BDD was 12.1%. The individuals with comorbid BDD (OCD-BDD; n = 109) were younger than were those without it. In addition, the proportions of single and unemployed patients were greater in the OCD-BDD group. This group of patients also showed higher rates of suicidal behaviors; mood, anxiety, and eating disorders; hypochondriasis; skin picking; Tourette syndrome; and symptoms of the sexual/religious, aggressive, and miscellaneous dimensions. Furthermore, OCD-BDD patients had an earlier onset of OC symptoms; greater severity of OCD, depression, and anxiety symptoms; and poorer insight. After logistic regression, the following features were associated with OCD-BDD: current age; age at OCD onset; severity of the miscellaneous DY-BOCS dimension; severity of depressive symptoms; and comorbid social phobia, dysthymia, anorexia nervosa, bulimia nervosa, and skin picking. Conclusions Because OCD patients might not inform clinicians about concerns regarding their appearance, it is essential to investigate symptoms of BDD, especially in young patients with early onset and comorbid social anxiety, chronic depression, skin picking, or eating disorders. Depression and Anxiety 29: 966-975, 2012. (C) 2012 Wiley Periodicals, Inc.

Clinical Efficacy of a New Automated Hemoencefalographic Neurofeedback Protocol

Among the ongoing attempts to enhance cognitive performance, an emergent and yet underrepresented venue is brought by hemoencefalographic neurofeedback (HEG). This paper presents three related advances in HEG neurofeedback for cognitive enhancement: a) a new HEG protocol for cognitive enhancement, as well as b) the results of independent measures of biological efficacy (EEG brain maps) extracted in three phases, during a one year follow up case study; c) the results of the first controlled clinical trial of HEG, designed to assess the efficacy of the technique for cognitive enhancement of an adult and neurologically intact population. The new protocol was developed in the environment of a software that organizes digital signal algorithms in a flowchart format. Brain maps were produced through 10 brain recordings. The clinical trial used a working memory test as its independent measure of achievement. The main conclusion of this study is that the technique appears to be clinically promising. Approaches to cognitive performance from a metabolic viewpoint should be explored further. However, it is particularly important to note that, to our knowledge, this is the world's first controlled clinical study on the matter and it is still early for an ultimate evaluation of the technique.

Entwicklung und Überprüfung objektiver Testverfahren zur Messung von Angstbewältigungsdispositionen

Für die Entwicklung objektiver Testverfahren zur Messung von Angstbewältigungsdispositionen, d.h. von Tests, deren Meßprinzip für die Probanden nicht durchschaubar ist, wurde das Dot-Probe-Paradigma verwendet. Mit diesem Paradigma läßt sich das Aufmerksamkeitsverhalten gegenüber bedrohlichem Material messen. Es wurde angenommen, daß dieses Paradigma besonders gut für eine objektive Messung der Angstbewältigungsdispositionen Vigilanz und kognitive Vermeidung geeignet ist, da Vigilanz durch verstärkte Aufnahme und Verarbeitung bedrohungsbezogener Information gekennzeichnet ist, während sich kognitive Vermeidung in der Abwendung der Aufmerksamkeit von diesen Reizen zeigt. In drei Studien wurde für verschiedene Versionen des Dot-Probe-Paradigmas überprüft, ob die für den Einsatz als Testinstrument in der Persönlichkeitsdiagnostik notwendigen Gütekriterien erfüllt sind. Dabei wurde festgestellt, daß das Dot-Probe-Paradigma sowohl bei Verwendung von Wörtern als auch von Bildern als Stimuli für klinisch unauffällige Testpersonen keine reliable Messung ermöglicht. Die erhobenen Werte waren weder über eine Woche hinweg stabil, noch waren sie intern konsistent. Infolge der ungenügenden Reliabilität fanden sich in den Studien nur unsystematische Befunde zum Zusammenhang zwischen dem Aufmerksamkeitsverhalten im Dot-Probe-Paradigma und verschiedenen Fragebogenmaßen. Darüber hinaus vermag die mangelnde Reliabilität auch die in der Literatur berichteten inkonsistenten Befunde bei der Untersuchung nicht-klinischer Stichproben mit diesem Paradigma zu erklären. Mögliche Gründe für die mangelnde Reliabilität der Messung werden diskutiert.