Aspectos cognitivos do transtorno obsessivo-compulsivo

This paper describes the most important cognitive models for obsessive-compulsive disorder, i. e., the inference processes (thoughts and believes) underlying the patients'feelings and behaviors. The major models formulated in this area emphasize the following aspects: exacerbated perception of danger (risk evaluation), overimportance of intrusive thoughts, excessive sense of personal responsibility (blame for harm self and others), perfectionism, psychological fusion of thought and action, and illogical inference processes involving confusion between imagination and reality. The knowledge of cognitive aspects brings new perspectives for the psychological treatment of this disorder.

Les patients atteints d'hypertension artérielle: approche de leur vécu

The study aims at exploring the experience of the patients suffering from high blood pressure, analysing the difficulties they evoke and trying to generate similarities. It is a qualitative study, based on the phenomenological method. The interviews highlight the fact that the patients are preoccupied only by the symptoms of high blood pressure. They also show that all the patients live through the disease with a lot of emotions, with feelings of frustration, stress, anxiety and helplessness. A better understanding of the patients' experience must enable the nurses to have better targeted actions.

Psicoterapia grupal no transtorno obsessivo-compulsivo

There are few published papers about group psychotherapy for patients with obsessive-compulsive disorder (OCD), and usually restricted psychoeducational, support or cognitive-behavioral approaches. This article describes the experience of group psychotherapy for OCD patients started in 1996 in Botucatu Medical School - Unesp, São Paulo, Brazil. The two-hour sessions occur once a month, with 6 to 10 female patients, and are based on psychodramatic techniques. Psychotropic prescriptions are given after the sessions. In the beginning, aggressive obsessions were more prominent and were reported with much anguish and shame. Gradually, the themes changed from OCD specific issues (symptoms, pharmacological treatment, outcome, need of exposure and response prevention) to deeper and more personal psychodynamic aspects. The psychodramatic approach (techniques of double, mirror, role inversion, search for prymary scenes) has mostly shown: difficulty in accepting their own human mistakes or negative emotions due to excessive personal demands. This seems to generate guilt, low self-esteem, idealization of others, difficulty in enjoying pleasant situations, fear of taking responsibilities and of losing control (madness/aggressiveness). The group has been considered very important by the patients, since sharing experiences helps to diminish feelings of isolation, shame and guilt, stimulates the exposure to feared situations and enhances self-esteem. The fact that all participants have the same disorder favors group cohesion and provides relief, as they see in the others some of their afflictions and are able to share similar feelings and experiences. Many times the burden of the symptoms are dealt with humor. The confidence in such therapeutic setting is helping the identification and resolution of personal conflicts and contributing to the adherence to pharmacological treatment. The group also provides valuable training experiences for resident physicians in psychiatry.

Formulário do perfil psicossocial do paciente anoftálmico com indicação de prótese ocular

The patient with anophthalmia may present feelings of inferiority and rejection. Knowing his/her needs and expectations contribute to a better technical intervention. Purpose: To elaborate a questionnaire of the psychosocial profile of the patient with anophthalmia with indication of ocular prosthesis. Methods: An exploratory research was used to elaborate the questionnaire, by means of a guided interview followed by writing down what was said by the interviewees, who were adult patients of the Bucco-Maxillo-Facial Prosthesis Center of FOSJC - UNESP. The guided interview was made up of 14 items directly related to the future outline of the profile. Each item of the interview resulted in questions of the questionnaire, which was pretested twice before reaching its final version. Results: The patients reported, in the exploratory research, unpleasant feelings with the loss of the eye; relationship shyness; expectations regarding surgery and prosthesis use; a wish to receive explanations and to hold their opinion about the treatment. The questionnaire of the psychosocial profile of the patient with anophthalmia with indication of ocular prosthesis is, therefore, made of 43 questions divided into 5 blocks in order to aid the comprehension of the inquired aspects and to facilitate both the computation of data and discussion, and also to improve the selection of questions according to the objective of the researcher or professional. Conclusions: It was concluded that the questionnaire was viable, can be used in full or by selecting blocks and provide a panorama of the patient's history related to the problem he/she faces, from the loss of the ocular globe to the confection of the prosthesis.

A identidade do agente comunitário de saúde: Uma abordagem fenomenológica

The structure of Brazil's National Health System (SUS) is being firmed up through programs adding a new element to its multi-professional healthcare teams: Community Healthcare Agents. This study examines psycho-social factors that are significant for the construction of this identity, from the standpoint of these Community Healthcare Agents, using the hermeneutic phenomenology of Paul Ricoeur as its reference methodology. The subjects of this survey were seven Community Healthcare Agents who were asked during interviews (with informed consent and after approval by the Research Ethics Committee) to: 'Tell me about your experience as Community Healthcare Agent'. The analysis of their replies indicated the following topics: previous experience; capacity-building for the job; bonding; building up expertise; gratifying experience; feelings of power(lessness); communications; daily work routines, personal growth; criticisms of the institution; user-agent experiences; and insertion into the social reality. The overall analysis disclosed the phenomenon through the convergence and divergence of the grouping of these topics, viewed from the standpoint of these Community Healthcare Agents and the psycho-social aspects constructing their identity.

Social Panorama of Latin America 1999-2000

Includes bibliography

Utilização do brinquedo terapêutico na assistência à criança hospitalizada

This is an exploratory and descriptive study that was jointly carried out by Nursing Care and Occupational Therapy as part of a Research Project that intended to prepare children for elective surgery at the University of São Paulo's Hospital de Reabilitação de Anomalias Craniofaciais. Objective: using toys as a therapeutic resource for relieving the child's real and unconscious tensions concerning hospitalization for surgical treatment at the HRAC - USP. Method: 44 children participated in the study. An observation form was used to collect data and it was applied at two separate times: the first time was the day before the surgery was to take place and the second on the day of the surgery just before the event. Twenty one variables were elaborated by the researchers to categorize behaviors regarding hospitalization. The resources used were: storytelling, dramatization and demonstration of nursing interventions with puppets dressed in surgical garb (gloves, surgical gown, mask and cap) with medical equipment commonly used in hospital. Results: of the 21 variables analyzed, 8 showed statistically significant differences on the McNemar Test (p<0.05). Conclusion: interactive play enables hospitalized children to interact in the hospital environment, so that they can express feelings and emotions and it contributes to humanized hospital assistance.

Conceptual spaces and consciousness: Integrating cognitive and affective processes

In the book Conceptual Spaces: the Geometry of Thought [2000] Peter Gärdenfors proposes a new framework for cognitive science. Complementary to symbolic and subsymbolic [connectionist] descriptions, conceptual spaces are semantic structures constructed from empirical data representing the universe of mental states. We argue that Gärdenfors' modeling can be used in consciousness research to describe the phenomenal conscious world, its elements and their intrinsic relations. The conceptual space approach affords the construction of a universal state space of human consciousness, where all possible kinds of human conscious states could be mapped. Starting from this approach, we discuss the inclusion of feelings and emotions in conceptual spaces, and their relation to perceptual and cognitive states. Current debate on integration of affect/emotion and perception/cognition allows three possible descriptive alternatives: emotion resulting from basic cognition; cognition resulting from basic emotion, and both as relatively independent functions integrated by brain mechanisms. Finding a solution for this issue is an important step in any attempt of successful modeling of natural or artificial consciousness. After making a brief review of proposals in this area, we summarize the essentials of a new model of consciousness based on neuro-astroglial interactions. © 2011 World Scientific Publishing Company.

Aspectos relacionais, familiares e sociais da relação pai-filho com deficiência física

The survey sought information from the relationship between father and child with disability regarding space, responsibilities and feelings in the parental relationship. Ten fathers, aged 31 to 66 years, with varied educational and professional backgrounds, answered a questionnaire with 19 semi-structured questions grouped into 16 categories of analysis. The conclusion showed that fathers perceive disability differently over time. The information usually comes from a doctor, but when the disability is not very evident, and doesn't cause significant impairment, realization comes over time. The shock of the discovery and behaviors of rejection are major feelings for fathers. Most fathers report differences in roles played by women and men in raising children; they believe that their responsibility is to provide for the family, while the mother's duty is to accompany the child. They feel that they share with the mothers the responsibility for caring for the child and, in general they don't feel they have been accused of being distant. They try to follow the child's treatment. The children are as attached to them as to other family members. To live with a minimum of quality of life they agreed unanimously about the need for greater income and benefits from social welfare. Most recognize that they are afraid of having other children with disabilities. They express low expectations for the total independence of the children, and among the fathers who have more than one child, the majority acknowledged the existence of differential treatment. They attributed the causes to medical errors. Fathers feel much the same as mothers, but they have different ways of demonstrating what they feel.

A sound education: Becoming aware of the sound around us

In this article it is intended to discuss the issue of noise pollution from an unusual point of view: noise pollution is not only the result of sound increase worldwide, but, particularly, the poor quality of our listening habits in modern life as well. In contemporary society we are subject to a considerable amount of stimulus to all our senses: vision, scent, taste and hearing which are becoming more and more insensible due to over exposure in our environment. These increased stimuli make us look for alternatives to reduce our ability to perceive them and be protected from injuries. However, our sensitivity will also decrease. In the specific case of environment noise, over exposure has made us forget the enchantment of certain sounds that used to give us pleasure or evoke good feelings by many ways, making us recall certain good things, bringing particular moments of our lives to our memory or even filling us with strong emotion. The Canadian composer and music educator, R. Murray Schafer, believes that noise pollution is the result of a society who became deaf. Closing our ears to noise protect us from noise pollution but also prevent us from grasping subtleties of listening. Contemporary world does not help us to be aware of sound in the space around us; acquiring this hearing ability is a matter of focus, interest and practice. Sound education exercises are aimed at children, teenagers and adults who want to improve their listening ability to environmental sounds, perceive its proprieties and learn how sound affects us and touches our feelings. The results are easy to accomplish and contribute to our awareness of the sound environment around us and to the conception of the environmental sound as a composition made by everybody and everything through positive actions, strong will and high sensitivity. Copyright © (2011) by the International Institute of Acoustics & Vibration.

The disintegration of patriarchal system expressed by the bourgeois novel's crisis

The Modern Era is marked by a great revolution in the economic, political and social structure, mainly on account of the sprouting of bourgeoisie, which brings the Bourgeois Novel as a new way to express their feelings and conflicts. In this article, one of the bourgeois characteristics, the patriarchal system, will be discussed. However, the focus will be on its dissolution, which is one evidence of the bourgeois novel's crisis. The word 'crisis' can also be understood as transformation. Thus, in order to illustrate this literary revolution undertaken by women, this article analyses To The Lighthouse, by Virginia Woolf. In this novel, it seems that nothing important happens. However the Stream of Consciousness narrative, with the predominance of Indirect Interior Monologue, psychological time and intertextualities, allows for meaning construal grounded in the dichotomy life/dead. The disintegration of the patriarchal structure is seen from the perspective of power relation between the head of the family and his wife. In addition, a reflection on the role of the woman as an artist is carried out.

Psychosocial impact on anophthalmic patients wearing ocular prosthesis

The aim of this study was to assess the improvement in psychosocial awareness of anophthalmic patients wearing ocular prostheses and its relationship with demographic characteristics, factors of loss/treatment, social activity, and relationship between professional and patient. Surveys including a form for evaluation of psychosocial pattern were conducted with 40 anophthalmic patients rehabilitated with ocular prosthesis at the Center of Oral Oncology in the authors' dental school from January 1998 to November 2010. The improvement in psychosocial awareness was assessed by comparing the perception of some feelings reported in the period of eye loss and currently. Wilcoxon tests were applied for comparison of patients' perception between the periods. χ2 tests were used to assess the relationship between the improvement in psychosocial awareness and the variables of the study. In addition, the logistic regression model measured this relationship with the measure of odds ratio. The feelings of shame, shyness, preoccupation with hiding it, sadness, insecurity and fear were significant for improvement in psychosocial awareness. It was concluded that the anophthalmic patients wearing an ocular prosthesis has significant improvement in psychosocial awareness after rehabilitation. © 2012 International Association of Oral and Maxillofacial Surgeons.

Psicologia, metafísica e literatura: A descrição dos sentimentos profundos em Bergson

This paper aims to explore the relation between psychology, metaphysics and literature, through an examination of Bergon's Time and Free Will: An Essay on the Immediate Data of Consciousness, or, more precisely, through the description of deep feelings, which represent in the Essay a privileged moment for understanding the temporal structure of consciousness. However, this study will not be restricted only to Bergson's text and its descriptions of deep feelings (such as aesthetic and moral emotions), which would probably be repetitive. Instead, we shall use a work of literature (Guimarães Rosa's novel, Grande sertão: veredas) to exemplify the possibility of a qualitative description of stream of consciousness, revealing its temporal structure. We hope in this way to clarify the interaction between psychology, metaphysics and literature in the philosophy of Bergson.

What affective neuroscience means for science of consciousness

The field of affective neuroscience has emerged from the efforts of Jaak Panksepp in the 1990s and reinforced by the work of, among others, Joseph LeDoux in the 2000s. It is based on the ideas that affective processes are supported by brain structures that appeared earlier in the phylogenetic scale (as the periaqueductal gray area), they run in parallel with cognitive processes, and can influence behaviour independently of cognitive judgements. This kind of approach contrasts with the hegemonic concept of conscious processing in cognitive neurosciences, which is based on the identification of brain circuits responsible for the processing of (cognitive) representations. Within cognitive neurosciences, the frontal lobes are assigned the role of coordinators in maintaining affective states and their emotional expressions under cognitive control. An intermediary view is the Damasio-Bechara Somatic Marker model, which puts cognition under partial somatic-affective control. We present here our efforts to make a synthesis of these views, by proposing the existence of two interacting brain circuits; the first one in charge of cognitive processes and the second mediating feelings about cognitive contents. The coupling of the two circuits promotes an endogenous feedback that supports conscious processes. Within this framework, we present the defence that detailed study of both affective and cognitive processes, their interactions, as well of their respective brain networks, is necessary for a science of consciousness.© MSM 2013.

Perda e luto: Vivências de mulheres que interromperam a gestação por malformação fetal letal

The scope of this study was to investigate the grieving experiences of women who terminated pregnancies under judicial authorization, due to life-incompatible fetal malformation. Ten women attended in the Fetal Medicine Department of Botucatu Clinical Hospital participated in the study. Data collection was conducted by means of semi-structured interviews forty days after termination. The interviews were recorded and transcribed in full, with the data analyzed from the thematic content analysis perspective. The results revealed that the mothers sought explanations and meanings for the loss, with religious responses and self-blame being very frequent. The reports were marked by feelings of sadness, longing and sensations of emptiness due to the loss of the child, revealing the need of the mothers to dwell on the issue. The mothers were and continued to be linked to their children; the termination of the pregnancy, although being a choice to minimize the pain of an inevitable loss, did not spare the women from experiences of great suffering. The study includes input for the discussion and planning of health approaches and care for women who terminate their pregnancy due to lethal fetal malformation, by means of judicial authorization.