113 resultados para dissociative


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We studied the similarities and differences between Brazilian Spiritistic mediums and North American dissociative identity disorder (DID) patients. Twenty-four mediums selected among different Spiritistic organizations in Sao Paulo, Brazil, were interviewed using the Dissociative Disorder Interview Schedule, and their responses were compared with those of DID patients described in the literature. The results from Spiritistic mediums were similar to published data on DID patients only with respect to female prevalence and high frequency of Schneiderian first-rank symptoms. As compared with individuals with DID, the mediums differed in having better social adjustment, lower prevalence of mental disorders, lower use of mental health services, no use of antipsychotics, and lower prevalence of histories of physical or sexual childhood abuse, sleepwalking, secondary features of DID, and symptoms of borderline personality. Thus, mediumship differed from DID in having better mental health and social adjustment, and a different clinical profile.

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Les troubles dissociatifs se présentent souvent par une clinique neurologique atypique impliquant une démarche diagnostique complexe à l'interface de la neurologie et de la psychiatrie. La restitution du diagnostic aux patients et leur prise en charge nécessitent une étroite collaboration interdisciplinaire. Les connaissances actuelles sont encore limitées, mais ce domaine est enrichi par des études récentes en neurosciences cliniques. Cet article présente les principaux aspects des troubles dissociatifs et formule un concept de prise en charge. Dissociative disorders often have an atypical neurological presentation requiring a complex diagnostic process at the interface between neurology and psychiatry. A strong interdisciplinary collaboration is needed for diagnosis restitution and patient treatment. Current knowledge is still scarce but recent studies in clinical neuroscience enrich this field. This article presents the main aspects of dissociative disorders and suggests a treatment framework

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Although medicine is practised in a secular setting, religious and spiritual issues have an impact on patient perspectives regarding their health and the management of any disorders that may afflict them. This is especially true in psychiatry, as feelings of spirituality and religiousness are very prevalent among the mentally ill. Clinicians are rarely aware of the importance of religion and understand little of its value as a mediating force for coping with mental illness. This book addresses various issues concerning mental illness in psychiatry: the relation of religious issues to mental health; the tension between a theoretical approach to problems and psychiatric approaches; the importance of addressing these varying approaches in patient care and how to do so; and differing ways to approach Christian, Muslim, and Buddhist patients. This is the first book to specifically cover the impact of religion and spirituality on mental illness.

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L’existence d’un sous-type dissociatif de schizophrénie a été suggérée par plusieurs auteurs pour rendre compte des présentations symptomatologiques d’un groupe de personnes dont le diagnostic principal est dans le spectre de la schizophrénie mais qui présentent aussi des symptômes dissociatifs (Ross, 2004; Şar et al., 2010; Van der Hart, Witztum, & Friedman, 1993). D’origine traumatique, ce type de portrait clinique où symptômes psychotiques et dissociatifs s’entremêlent aurait été décrit il y a déjà plus d’un siècle (Janet & Raymond, 1898) mais serait disparu dans les années ’30, assimilé au concept de « schizophrénie » (Rosenbaum, 1980). C’est dans un nouveau contexte nosographique que le concept de schizophrénie dissociative refait surface. En effet, la nosographie psychiatrique a pris un tournant en 1980 lorsque l’approche préconisée par le DSM est devenue descriptive plutôt que basée sur des conceptualisations psychanalytiques. Du coup, les affections d’alors ont été divisées en troubles dont les symptômes ont tendance à se manifester ensemble (Cooper, 2004) et la comorbidité entre les troubles a augmenté. Étant donné la comorbidité fréquemment rapportée entre les troubles psychotiques et dissociatifs, la similarité phénoménologique de leurs symptômes, ainsi que leur possible étiologie traumatique, Ross (2004) a proposé une série de critères permettant de diagnostiquer une schizophrénie dissociative. L’objectif principal de cette thèse est donc d’établir si la schizophrénie dissociative, telle que définie par Ross (2004), existe. Le premier article porte sur la problématique et le contexte théorique ayant mené à la question de recherche. Il vise à faire un survol des enjeux entourant la question de la schizophrénie dissociative et rend compte des écrits scientifiques sur la symptomatologie similaire entre les troubles psychotiques et dissociatifs, sur leur étiologie traumatique et sur les études sur la dissociation et la schizophrénie. Le deuxième article est quant à lui un article empirique rendant compte de la méthodologie utilisée pour répondre à la question de recherche. En effet, aucune étude jusqu’ici n’a testé systématiquement les critères de la schizophrénie dissociative. Nos résultats démontrent que 24% de notre échantillon (N=50) pourrait recevoir le diagnostic de schizophrénie dissociative avec les critères proposés par Ross (2004). Toutefois, ces critères posant problème, une modification a été proposée et une prévalence de 14% a alors été trouvée. Des vignettes cliniques sont présentées afin de comparer nos participants avec ceux rapportés ailleurs. Les liens entre symptômes psychotiques et dissociatifs sont discutés en essayant de conceptualiser la schizophrénie dissociative de différentes manières, soit comme une nouvelle entité clinique, comme un trouble comorbide ou dans un contexte nosographique psychodynamique.

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Electron impact ionization of dinitrogen pentoxide for incident electron energies up to about 25 eV has been investigated by use of a crossed beams quadrupole mass spectrometer system. The experiments reported in this paper detected the fragmentation products NO2+, NO+, O+, N+, and NO3+. No stable N2O5+ ion was observed. The NO3+ fragment, for which we determine an appearance energy 13.25 +/- 0.30 ev, has not been observed previously. This appearance energy is close to the calculated threshold.

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Electron attachment was studied in gaseous dinitrogen pentoxide, N2O5, for incident electron energies between a few meV and 10 eV. No stable parent anion N2O5- was observed but several anionic fragments (NO3-, NO2-, NO-, O-, and O-2(-)) were detected using quadrupole mass spectrometry. Many of these dissociative pathways were found to be coupled and provide detailed information on the dynamics of N2O5 fragmentation. Estimates of the cross sections for production of each of the anionic fragments were made and suggest that electron attachment to N2O5 is amongst the most efficient attachment reactions recorded for nonhalogenated polyatomic systems. (C) 2004 American Institute of Physics.

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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

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A low energy electron may attach to a molecule, forming a metastable resonance, which may dissociate into a stable anion and a neutral radical. Chloromethane has been a good target for dissociative electron attachment studies, since it is a small molecule with a clear dissociative ‘sigma*’ shape resonance. We present potential energy curves for CH3Cl and its anion, as a function of the C-Cl distance. Due to the resonant nature of the anion, a correct description requires a treatment based on scattering calculations. In order to compute elastic cross sections and phase shifts we employed the Schwinger multichannel method, implemented with pseudopotentials of Bachelet, Hamann and Schlüter, at the static-exchange plus polarization approximation. At the equilibrium geometry, the resonance was found arround 3.3 eV, in accordance to experience. The incoming electron is captured by a ‘sigma*’ orbital located at the C-Cl bond, which will relax in the presence of this extra electron. We took this bond as the reaction coordinate, and performed several scattering calculations for a series of nuclear conformations. The phase shift obtained in each calculation was fitted by a two component function, consisting in the usual Breit-Wigner profile, which captures the resonant character, and a second order polynomial in the wave number, which accounts for the background contribution. That way, we obtained position and width of the resonance, which allowed us to build the potential energy curve. For larger distances, the anion becomes stable and usual electronic structure calculations suffice. Furthermore, the existence of a dipole-bound anion state is revealed when we employed a set of very diffuse functions. The knowledge on the behaviour of the neutral and anionic electronic states helps us in elucidating how the dissociation takes place.

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While many tend to think of memory systems in the brain as a single process, in reality several experiments have supported multiple dissociations of different forms of learning, such as spatial learning and response learning. In both humans and rats, the hippocampus has long been shown to be specialized in the storage of spatial and contextual memory whereas the striatum is associated with motor responses and habitual behaviors. Previous studies have examined how damage to hippocampus or striatum has affected the acquisition of either a spatial or response navigation task. However even in a very familiar environment organisms must continuously switch between place and response strategies depending upon circumstances. The current research investigates how these two brain systems interact under normal conditions to produce navigational behavior. Rats were tested using a task developed by Jacobson and colleagues (2006) in which the two types of navigation could be controlled and studied simultaneously. Rats were trained to solve a plus maze using both a spatial and a response strategy. A cue (flashing light) was employed to indicate the correct strategy on a given trial. When no light was present, the animals were rewarded for making a 90º right turn (motor response). When the light was on, the animals were rewarded for going to a specific goal location (place strategy). After learning the task, animals had a sham surgery or dorsal striatum or hippocampus damaged. In order to investigate the individual role of each brain system and evaluate whether these brain regions compete or cooperate for control over strategy, we utilized a within-animal comparisons. The configuration of the maze allowed for the comparison of behavior in individual animals before and after specific brain areas were damaged. Animals with hippocampal lesions showed selective deficits on place trials after surgery and learned the reversal of the motor response more rapidly than striatal lesioned or sham rats. Unlike previous findings regarding maze learning, animals with striatal lesions showed deficits in both place and response trials and had difficulty learning the reversal of motor response. Therefore, the effects of lesions on the ability to switch back and forth between strategies were more complex than previously suggested. This work may reveal important new insight on the integration of hippocampal and striatal learning systems, and facilitate a better understanding of the brain dynamics underlying similar navigational processes in humans.

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It has been argued that hallucinations which appear to involve shifts in egocentric perspective (e.g., the out-of-body experience, OBE) reflect specific biases in exocentric perspective-taking processes. Via a newly devised perspective-taking task, we examined whether such biases in perspective-taking were present in relation to specific dissociative anomalous body experiences (ABE) - namely the OBE. Participants also completed the Cambridge Depersonalization Scale (CDS; Sierra and Berrios, 2000) which provided measures of additional embodied ABE (unreality of self) and measures of derealization (unreality of surroundings). There were no reliable differences in the level of ABE, emotional numbing, and anomalies in sensory recall reported between the OBE and control group as measured by the corresponding CDS subscales. In contrast, the OBE group did provide significantly elevated measures of derealization ("alienation from surroundings" CDS subscale) relative to the control group. At the same time we also found that the OBE group was significantly more efficient at completing all aspects of the perspective-taking task relative to controls. Collectively, the current findings support fractionating the typically unitary notion of dissociation by proposing a distinction between embodied dissociative experiences and disembodied dissociative experiences - with only the latter being associated with exocentric perspective-taking mechanisms. Our findings - obtained with an ecologically valid task and a homogeneous OBE group - also call for a re-evaluation of the relationship between OBEs and perspective-taking in terms of facilitated disembodied experiences. © 2013 Braithwaite, James, Dewe, Takahashi, Medford and Kessler.