Prevalence of psychiatric co-morbidity in treatment-seeking problem gamblers: A systematic review and meta-analysis

OBJECTIVE: The aim of this paper was to systematically review and meta-analyse the prevalence of co-morbid psychiatric disorders (DSM-IV Axis I disorders) among treatment-seeking problem gamblers. METHODS: A systematic search was conducted for peer-reviewed studies that provided prevalence estimates of Axis I psychiatric disorders in individuals seeking psychological or pharmacological treatment for problem gambling (including pathological gambling). Meta-analytic techniques were performed to estimate the weighted mean effect size and heterogeneity across studies. RESULTS: Results from 36 studies identified high rates of co-morbid current (74.8%, 95% CI 36.5-93.9) and lifetime (75.5%, 95% CI 46.5-91.8) Axis I disorders. There were high rates of current mood disorders (23.1%, 95% CI 14.9-34.0), alcohol use disorders (21.2%, 95% CI 15.6-28.1), anxiety disorders (17.6%, 95% CI 10.8-27.3) and substance (non-alcohol) use disorders (7.0%, 95% CI 1.7-24.9). Specifically, the highest mean prevalence of current psychiatric disorders was for nicotine dependence (56.4%, 95% CI 35.7-75.2) and major depressive disorder (29.9%, 95% CI 20.5-41.3), with smaller estimates for alcohol abuse (18.2%, 95% CI 13.4-24.2), alcohol dependence (15.2%, 95% CI 10.2-22.0), social phobia (14.9%, 95% CI 2.0-59.8), generalised anxiety disorder (14.4%, 95% CI 3.9-40.8), panic disorder (13.7%, 95% CI 6.7-26.0), post-traumatic stress disorder (12.3%, 95% CI 3.4-35.7), cannabis use disorder (11.5%, 95% CI 4.8-25.0), attention-deficit hyperactivity disorder (9.3%, 95% CI 4.1-19.6), adjustment disorder (9.2%, 95% CI 4.8-17.2), bipolar disorder (8.8%, 95% CI 4.4-17.1) and obsessive-compulsive disorder (8.2%, 95% CI 3.4-18.6). There were no consistent patterns according to gambling problem severity, type of treatment facility and study jurisdiction. Although these estimates were robust to the inclusion of studies with non-representative sampling biases, they should be interpreted with caution as they were highly variable across studies. CONCLUSIONS: The findings highlight the need for gambling treatment services to undertake routine screening and assessment of psychiatric co-morbidity and provide treatment approaches that adequately manage these co-morbid disorders. Further research is required to explore the reasons for the variability observed in the prevalence estimates.

South African adolescents' beliefs about depression

PURPOSE: This study explores the depression literacy in adolescents in South Africa. METHOD: A semi-structured questionnaire was administered to 2,050 students from disadvantaged secondary schools in Johannesburg region. RESULT: A total of 90.9% reported depression as an illness, and 41.4% considered it a sign of weakness. Parents and siblings followed by friends and teachers were the preferred support options. The indicators of depression identified were socialisation pattern changes (24.6%), sad mood (23.6%), sleeping and eating pattern changes (18.3%), irritable behaviour (12.5%) and other health risk behaviours (9.7%). CONCLUSION: The majority considered depression an illness. An improvement in adolescent mental health literacy will increase access to help when needed.

Nonparametric discovery of online mental health-related communities

People are increasingly using social media, especially online communities, to discuss mental health issues and seek supports. Understanding topics, interaction, sentiment and clustering structures of these communities informs important aspects of mental health. It can potentially add knowledge to the underlying cognitive dynamics, mood swings patterns, shared interests, and interaction. There has been growing research interest in analyzing online mental health communities; however sentiment analysis of these communities has been largely under-explored. This study presents an analysis of online Live Journal communities with and without mental health-related conditions including depression and autism. Latent topics for mood tags, affective words, and generic words in the content of the posts made in these communities were learned using nonparametric topic modelling. These representations were then input into a nonparametric clustering to discover meta-groups among the communities. The best performance results can be achieved on clustering communities with latent mood-based representation for such communities. The study also found significant differences in usage latent topics for mood tags and affective features between online communities with and without affective disorders. The findings reveal useful insights into hyper-group detection of online mental health-related communities.

Affective instability and the course of bipolar depression: results from the STEP-BD randomised controlled trial of psychosocial treatment

BACKGROUND: Little is known about predictors of recovery from bipolar depression. AIMS: We investigated affective instability (a pattern of frequent and large mood shifts over time) as a predictor of recovery from episodes of bipolar depression and as a moderator of response to psychosocial treatment for acute depression. METHOD: A total of 252 out-patients with DSM-IV bipolar I or II disorder and who were depressed enrolled in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD) and were randomised to one of three types of intensive psychotherapy for depression (n = 141) or a brief psychoeducational intervention (n = 111). All analyses were by intention-to-treat. RESULTS: Degree of instability of symptoms of depression and mania predicted a lower likelihood of recovery and longer time until recovery, independent of the concurrent effects of symptom severity. Affective instability did not moderate the effects of psychosocial treatment on recovery from depression. CONCLUSIONS: Affective instability may be a clinically relevant characteristic that influences the course of bipolar depression.

Depressive symptomatology, weight status and obesogenic risk among Australian adolescents: a prospective cohort study

OBJECTIVES: Adolescence is a period of increased risk for mental health problems and development of associated lifestyle risk behaviours. This study examined cross-sectional and longitudinal associations between obesogenic risk factors, weight status, and depressive symptomatology in a cohort of Australian adolescents.

DESIGN: Prospective cohort study.

SETTING: The study used repeated measures data from the Australian Capital Territory (ACT) It's Your Move project, an Australian community-based obesity prevention intervention. Intervention effect was non-significant therefore intervention and comparison groups were combined in this study.

PARTICIPANTS: Total sample was 634 secondary school students (female n=338, male n=296) with mean age 13 years (SD=0.6) at baseline (2012) and 15 years (SD=0.6) at follow-up (2014) recruited from 6 government secondary schools in the ACT.

PRIMARY AND SECONDARY OUTCOMES MEASURES: Primary outcome was depressive symptomatology measured by Short Mood and Feelings Questionnaire. Secondary outcomes were weight status, physical activity, screen time and diet related measures.

RESULTS: Increased physical activity was associated to lower depressive symptomatology among males (OR=0.35, p<0.05). Sweet drink (OR=1.15, p<0.05) and takeaway consumption (OR=1.84, p<0.05) were associated with higher levels of depressive symptomatology among females at follow-up. Males who were classified as overweight or obese at baseline, and remained so over the study period, were at increased risk of depressive symptomatology at follow-up (b=1.63, 95% CI 0.33 to 2.92). Inactivity among males over the 2-year study period was predictive of higher depressive symptomatology scores at follow-up (b=2.55, 95% CI 0.78 to 4.32). For females, those who increased their consumption of takeaway foods during the study period were at increased risk for developing depressive symptomatology (b=1.82, 95% CI -0.05 to 3.71).

CONCLUSIONS: There are multiple, probably complex, relationships between diet, physical activity and outcomes of obesity and mental health as well as between the outcomes themselves. Healthier diets and increased physical activity should be foundations for healthier body weight and mental health.

Sleep restriction across a simulated firefighting deployment: the impact on acute stress responses

 This research demonstrated how exposure to physical work and restricted sleep can trigger an increase in firefighters’ immune and hormonal stress responses. The work also explored psychophysiological interactions between responses, with findings that suggest when sleep restricted, firefighters’ show a worsening in mood which relates to elevated hormonal and immune changes.

Leptin in bipolar disorder: a systematic review and meta-analysis

BACKGROUND: Bipolar disorder (BD) is a psychiatric disorder associated with increased rates of obesity and inflammation. Leptin is an adipokine that is mainly produced by the white adipose tissue in response to insulin. It stimulates the immune system, increasing the production of pro-inflammatory cytokines. There is currently uncertainty regarding possible alterations in peripheral leptin levels across the mood states in BD. METHODS: This study comprises a between-group meta-analysis comparing serum and plasma leptin levels in people with BD in mania, depression or euthymia and healthy controls. We conducted a systematic search for all possibly eligible-English and non-English peer-reviewed articles. We calculated the effect size (ES) utilizing Hedges' adjusted g using random effects. RESULTS: Eleven studies were included in the meta-analyses, providing data on 1118 participants. Serum and plasma leptin levels were not altered in subjects with BD when compared to healthy controls in mania (g=-0.99, 95% CI -2.43 to 0.43, P=0.171), in depression (g=0.17, 95% CI -0.45 to 0.79, P=0.584), or in euthymia (g=0.03, 95% CI -0.39 to 0.46, P=0.882). However, we did observe a stronger association between leptin levels and both age and BMI in patients with BD in euthymia compared to healthy controls, such that the greater the age of the individuals, the greater the difference in leptin levels between BD and controls; and the higher the BMI, the greater the difference in leptin levels between BD and controls. CONCLUSIONS: Our meta-analysis provides evidence that leptin levels are not altered in BD across the mood spectrum compared to healthy controls. The disproportionate increase of leptin levels with increase in BMI in BD speaks in favour of a potential inflammatory role of white adipose tissue in BD and a disproportionate increase of leptin levels with increase in age.

Using an animated pedagogical agent to interact affectively with the student

This work proposes an animated pedagogical agent that has the role of providing emotional support to the student: motivating and encouraging him, making him believe in his self-ability, and promoting a positive mood in him, which fosters learning. This careful support of the agent, its affective tactics, is expressed through emotional behaviour and encouragement messages of the lifelike character. Due to human social tendency of anthropomorphising software, we believe that a software agent can accomplish this affective role. In order to choose the adequate affective tactics, the agent should also know the student’s emotions. The proposed agent recognises the student’s emotions: joy/distress, satisfaction/disappointment, anger/gratitude, and shame, from the student’s observable behaviour, i. e. his actions in the interface of the educational system. The inference of emotions is psychologically grounded on the cognitive theory of emotions. More specifically, we use the OCC model which is based on the cognitive approach of emotion and can be computationally implemented. Due to the dynamic nature of the student’s affective information, we adopted a BDI approach to implement the affective user model and the affective diagnosis. Besides, in our work we profit from the reasoning capacity of the BDI approach in order for the agent to deduce the student’s appraisal, which allows it to infer the student’s emotions. As a case study, the proposed agent is implemented as the Mediating Agent of MACES: an educational collaborative environment modelled as a multi-agent system and pedagogically based on the sociocultural theory of Vygotsky.

A crise do casamento contemporâneo: um estudo psicossocial

A atual família nuclear urbana e a instituição do casamento passam por momentos difíceis. Profundas mudanças sócio-econômicas levaram o casamento contemporâneo a um estado de crise caracterizado pelo aumento do número de separações a tal ponto que aproximadamente, cinquenta por cento das uniões, nos dias de hoje, tendem à ruptura em poucos anos. Na primeira parte de nosso trabalho expomos os fatores aparentemente responsáveis por essa situação. Assim, a diminuição da religiosidade, a modernização e a industrialização, o encurtamento das famílias, a excessiva e acrítica valorização do amor como base única do casamento e solução para todos os males, o aumento da longevidade, ·a revolução sexual, um estilo de vida que privilegia um individualismo exarcebado, a emancipação feminina, a menor integração social na comunidade e o isolamento excessivo seriam .as principais causas da crise e da configuração do que denominamos - pelo fechamento e isolamento resultantes - de família. Com os objetivos de testar uma série de hipóteses relacionadas à propensão ao divórcio e de contrastar o que pensam os estudiosos da área com o que as pessoas no seu dia a dia consideram como causas da crise, expomos na segunda parte de nosso trabalho os resultados de pesquisa realizada com quatrocentos sujeitos de classe media, distribuídos em quatro condições: jovens solteiros, casados, separados e casados idosos (metade do sexo masculino, metade do feminino). Através de questionários criados para esse fim, comparamos as avaliações pessoais em função das diferenças de estado civil, faixa etária e sexo, nos quatro grupos - outra de nossas metas. Abordamos também a aplicação de alguns princípios da psicologia social a nossa área de estudos. Para tanto incluímos nos questionários perguntas tendo como embasamento teórico (a) as hipóteses de Jones e Nisbett sobre perspectivas divergentes na atribuição de causalidade entre atores e observadores, (b) a percepção de ineqüidades existentes na relação entre homens e mulheres e suas consequências (tópicos em justiça distributiva) e (c) a divisão de poder no casamento. As conclusões de nosso trabalho estão na última seção, onde são sumarizadas e relacionadas como exposto na primeira parte as hipóteses que confirmamos: a hipervalorização do amor, principalmente entre os mais jovens, a crescente secularizaçao e suas implicações, o movimento feminista, o espírito individualista reinante e o grande número de relações extramaritais são alguns dos principais fatores que contribuem para a dissolução das uniões. Verificamos ainda, além de distintas visões do casamento por parte de homens e mulheres, a relação entre a percepção de inequidades no casamento e insatisfação conjugal, a existência de perspectivas divergentes em termos de atribuição causal entre atores e observadores e uma divisão mais igualitária de poder entre casais jovens.

Alasdair Gray`s 1982 Janine (1984): a postmodernist scottish novel

Alasdair Gray is now an established figure in the Scottish literary scene and has numerous claims to be considered an important voice writing in English. First Lanark: A Life in Four Books (1981) and then 1982 Janine (1984) contributed to the recognition of Gray as one of the founding fathers of the new Scottish writing and as a figure of importance in international contemporary fiction due to his innovative, experimental and postmodernist novels. As the title of this dissertation - “Alasdair Gray’s 1982 Janine (1984): A Postmodernist Scottish Novel” - suggests, it aims at analysing the author’s second novel, 1982 Janine (1984), in a thematic and formal perspective, in order to justify the choice of the terms - Postmodernist and Scottish - to classify this novel. 1982 Janine projects a world through Jock McLeish’s mind and is a powerful stream-of-consciousness narrative. Jock is an alcoholic who lives a personal crisis and, therefore, tries to escape from his depressing reality through sexual fantasies and political diatribes. During a single night in a Scottish hotel room, he drinks and dreams, and spends the whole night alone with his fantasies and fears, his memories and hopes. In Chapter 11, the most daring experimental section of the novel, Jock attempts to commit suicide by taking an overdose of tablets with alcohol but fails. Following this, he decides to review his life and make for a new beginning; the novel thus closing with an optimistic note. Also, the narrative is based on a constant interweaving of sex fantasy with political satire, that is, it is through his protagonist that Gray manages to convey the state of Scotland as well as the concerns and aspirations of the Scottish people and then, proceed to a political and social critique. This dissertation appears structured in three chapters. In Chapter I - “Alasdair Gray: A Postmodernist Scottish Writer” - I present Gray as a powerful postmodernist writer who also sees himself as a Scottish author, and more particularly as a Glaswegian, who concentrates on Scottish subject matter in his literary work. In a first section, I offer a brief survey of the Scottish literary scene from the fourteenth to the twentieth century, in order to understand Gray’s choice of setting and themes and to check his influence or indebtedness to previous Scottish authors. As 1982 Janine is also a good example of selfconscious experimental writing, in a second section, I present various seminal fictional works that introduced and developed experimentalism in British fiction, in order to evaluate the influence of modernist developments in form and technique on recent experimental writing. The third section consists of an introduction to Gray’s work for he is not only a novelist, but also an artist, a playwright, a poet, an activist and a scholar. Chapter II - “Postmodernist Features in 1982 Janine” - aims at listing and examining the postmodernist devices that the novel includes, in what content and form are concerned. On the one hand, the use of a developed type of the modernist stream of consciousness, the presence of a protagonist who feels entrapped in a specific system, the quest for freedom, the incoherence and fragmentation of time, the nonchronological order of the narrative, the blending of fantasy and “reality”, as well as the importance of the Scottish material are definitely current aspects within postmodernist literature that can be found in Gray’s novel. On the other hand, the handling of literary self-conscious devices, such as typographical experimentation, presence of metafiction and intertextuality, and inclusion of an Epilogue, are likewise among recurrent postmodernist features. As the title - “A Narratological Analysis of 1982 Janine” - evidences, Chapter III offers a description of the mechanics of the narrative and its functioning in order to better understand the narrative technique of postmodernist fiction. This study is based primarily on Gérard Genette’s theoretical framework and terminology, presented in Narrative Discourse: An Essay in Method, an analytical tool that allows me to provide a more objective and scientific analysis. Hence, I follow the Genettian division of narrative discourse in Time, Mood and Voice while examining the novel. Finally, I proceed to a description of the intertextual relationships 1982 Janine establishes with other texts.

Inteligência emocional dos professores e vulnerabilidade ao stress em contexto escolar

Investigações recentes revelam que o stress é considerado um dos indicadores de mau-estar docente (Jesus, 2005). Para lidar com estas novas realidades, os professores necessitam de controlar/lidar com o stress e as suas emoções nas circunstâncias mais adversas. Desta forma, o principal objectivo deste estudo foi perceber de que forma a percepção emocional e a inteligência emocional são importantes para gerir problemas de stress ocupacional. Para tal, utilizaram-se quatro instrumentos diferentes: O teste de regulação emocional de Berkeley (Gross & John, 2003), o teste de expressividade Emocional de Berkeley (Gross & John, 2003), a escala de meta-conhecimento dos estados emocionais a Trait Meta-Mood Scale” (TMMS 24) (Salovey & Mayer 1990) e a escala de avaliação do grau de vulnerabilidade ao stress a 23QVS (Serra, 2000). Estes testes foram aplicados numa sessão única a 292 professores dos 2.º e 3.º Ciclos do Ensino Básico, do distrito do Funchal, sendo 64,7% do sexo feminino e 35,3% do sexo masculino de diferentes grupos disciplinares. Analisou-se a influência de algumas variáveis como o género, a idade, estado civil, número de filhos, habilitações, anos de serviço, nível de ensino que lecciona e o grupo disciplinar na explicação da percepção emocional, da inteligência emocional e da vulnerabilidade ao stress. Realizaram-se igualmente os estudos correlacionais das diferentes medidas utilizadas. Os resultados mostraram que os professores que apresentam maiores capacidades para clarificar e regular as suas próprias emoções são aqueles que apresentam menor vulnerabilidade ao stress. Para finalizar destacaremos as implicações que este estudo traz para a intervenção em contextos educativos.

Inteligência emocional, engagement e burnout em professores do 2º e 3º Ciclos e Secundário da RAM

Este estudo teve como objetivos compreender a inteligência emocional e o engagement como fator de proteção face ao burnout, bem como estudar as relações entre a inteligência emocional, o engagement e o burnout. Mayer e Salovey (1997) definem a inteligência emocional como a capacidade de perceber, avaliar e de expressar as emoções, baseada em quatro níveis: capacidade de perceber, usar, conhecer e regular as emoções para facilitar o pensamento. O engagement é um construto recente a nível mundial, integrado na corrente da psicologia positiva. O oposto ao engagement é o Burnout, expressão inglesa para designar aquilo que deixou de funcionar por exaustão de energia (França, 1987, citado por, Carlotto,2012). A amostra foi constituída por 250 professores do 2º ciclo (26.4%), 3º ciclo (57.2%) e Secundário (16.4 %), do género feminino (70.4%) e do masculino (29.6%), da Região Autónoma da Madeira (RAM). Como instrumentos, utilizámos um Questionário de Dados Sócio-Demográficos e Profissionais, o Trait Meta-Mood Scale (TMMS-24), o Questionário de Expressividade e o de Regulação Emocional de Berkeley, o Questionário de Engagement e o Inventário de Burnout de Maslach (MBI). Para confirmar a relação estatística entre a inteligência emocional, o engagement e o burnout foi realizado um teste de correlação de Spearman entre as variáveis. Encontrámos correlações significativas entre a atenção emocional e o vigor, na dedicação, na absorção e na realização profissional. Relativamente à inteligência emocional dos professores, revelou-se como adequada em ambos os sexos nas três dimensões do construto. No que concerne ao engagement, os professores revelaram valores altos de vigor, dedicação e absorção. Concluiu-se que quanto maior a reparação das emoções, o vigor e a dedicação, menor é a exaustão emocional. Por outro lado, quanto maior a reavaliação das emoções, maior a exaustão emocional.

Prevalência e fatores associados à dor em bailarinos profissionais

To investigate the prevalence and factors associated to painful symptomatology in professional ballet dancers. Methodos: An analytical transversal cut study was performed with 141 professional ballet dancers in the main capital cities of the Brazilian Northeast. McGill`s Pain Questionnaire and the Wisconsin Brief Pain Inventory, both validated for Portuguese, were used to assess painful symptomatology. Descriptive statistical analysis of the results was carried out, followed by Student`s t-test and Pearson s correlation with pvalue < 0.05. Results: High pain tolerance levels were observed in 70.2% of the subjects, where the intensity varied from moderate to severe. Pain in the lumbar region was present in 85.8% of the individuals. Positive correlations were verified between the degree of pain intensity and activities how to dance (60,3%), general activities (32,6%), sleep (28,4%), mood (27,7%), march (20,6%) and relations with others (16,3%). Conclusions: High pain prevalence was found in professional ballet dancers in the main capital cities of the northeast, and the most affected area was the lumbar followed by knees, neck, hip and feet, with substantial interference of pain symptoms in several activities of the personal and professional lives of these people

Batidas intensas : corpo e sociabilidade nas festas de música eletrônica em Natal

The significance of the body in electronic music parties as a sign for communicating and socializing among participants is the focus of this work. Qualitative research undertaken in this study seeks to investigate how sociability happens at raves and nightclubs in Natal/RN. Sociability is understood here as a play expression involving the dimensions of music, dance and party; the body, seen from a transdisciplinary approach, is understood as a symbolic instance, with its own meanings, as a result and a producer of social and as a cross between the cultural and the biological. The body has a communicative potential, is primary media. An intersection point between nature and culture, it serves as the seat of emotions and sociability, since it is through it that social relations are made. In electronic music parties, the body is interpreted based on its communication signs: clothing, accessories, body movements, tactile contact, body language, interactions between the public and dj, the dj and the public, gestures, expressive speech of emotions. Through such signs, body communication and a sense of community among participants develop sociability in the festive place and change the mood of the dancers. The Natal s electronic music parties young goer interacts on parties, adopts cheerful and receptive positions towards the other, maintains physical contact, values dance as a form of communication and lists happiness as the main feeling aroused in electronic music festivals. To achieve this result, a plurimetodological approach was used, which consisted of various methodological devices and various techniques of investigation: ethnographic observation, individual and informal interview techniques, photographic record of the scene, in-depth interview and application thirty questionnaires to patrons of electronic music parties