Improvements in Compassion and Fears of Compassion throughout the COVID-19 Pandemic: A Multinational Study

During large-scale disasters, social support, caring behaviours, and compassion are shown to protect against poor mental health outcomes. This multi-national study aimed to assess the fluctuations in compassion over time during the COVID-19 pandemic. Respondents (Time 1 n = 4156, Time 2 n = 980, Time 3 n = 825) from 23 countries completed online self-report questionnaires measuring the flows of compassion (i.e., Compassionate Engagement and Action Scales) and fears of compassion toward self and others and from others (i.e., Fears of Compassion Scales) and mental health at three time-points during a 10-month period. The results for the flows of compassion showed that self-compassion increased at Time 3. Compassion for others increased at Time 2 and 3 for the general population, but in contrast, it decreased in health professionals, possibly linked to burnout. Compassion from others did not change in Time 2, but it did increase significantly in Time 3. For fears of compassion, fears of self-compassion reduced over time, fears of compassion for others showed more variation, reducing for the general public but increasing for health professionals, whilst fears of compassion from others did not change over time. Health professionals, those with compassion training, older adults, and women showed greater flows of compassion and lower fears of compassion compared with the general population, those without compassion training, younger adults, and men. These findings highlight that, in a period of shared suffering, people from multiple countries and nationalities show a cumulative improvement in compassion and reduction in fears of compassion, suggesting that, when there is intense suffering, people become more compassionate to self and others and less afraid of, and resistant to, compassion.

Prevalence of dyslipidemia, atherogenic and cardiovascular risk in overweight and obese adolescents

OBJECTIVE

To analyze the lipid profile and cardiovascular risk of overweight and obese adolescents and correlate the findings with anthropometric measurements.

METHODS

This is a cross-sectional study on overweight and obese adolescents of both sexes (aged 14 to 18 years old). The collected variables were sex, weight, height, age, total cholesterol, triglycerides, High-density lipoprotein (HDL) and low-density lipoprotein (LDL). The Atherogenic Index of Plasma and Castelli Risk Indices I and II were calculated. These indices were classified into cutoff points to stratify cardiovascular risk. The anthropometric profile was evaluated by Z score according to Body Mass Index for age. Significance level was considered as p≤0.05.

RESULTS

A total of 146 adolescents participated in the study; the mean age was 16.4±1.1 years and most of them were girls (74.7%) and obese (52.7%). The prevalent dyslipidemias were high triglycerides (47.9%), LDL (26.7%), total cholesterol (37.7%), and low HDL (46.6%). Most adolescents presented increased atherogenic risk according to the Atherogenic Index of Plasma (55.5%); 15.1% presented high cardiovascular risk according to Castelli Risk Index I; and 13.7%, according to Castelli Risk Index II. Boys presented higher values of anthropometric measurements and Castelli Risk Indices I and II in relation to girls - who, conversely, presented higher values of HDL. There was a positive correlation of the Z score with Atherogenic Index of Plasma and a negative correlation with HDL.

CONCLUSIONS

The adolescents of the study presented high prevalence of cardiovascular and atherogenic risk according to the evaluated indices. In addition, the increased cardiovascular risk was correlated with higher Body Mass Index.

Evidências de Validade do Inventário de Compensação de Young (YCI) para a População do Rio Grande do Sul

Resumo O objetivo deste estudo foi examinar a estrutura fatorial e as evidências de validade do Inventário de Compensação de Young (YCI) para a população do Rio Grande do Sul. Contou-se com a participação de 504 adultos da população geral, com média de idade de 34,2 anos (DP = 12,9). Os instrumentos utilizados foram o Questionário de Esquemas de Young - Versão Breve (YSQ-S3), a Escala de Avaliação dos Sintomas (SCL-90-R) e o YCI. Os dados foram coletados através de plataforma online. Realizou-se a análise fatorial exploratória, para verificar a distribuição dos itens em fatores comuns, e a validade convergente, com correlação não paramétrica de Spearman com a SCL-90-R e o YSQ-S3. Foram interpretados quatro fatores: Dominação e Manipulação (α =0,85 ω=0,71); Obsessão e Organização (α =0,75 ω=0,75); Rebeldia e Independência (α =0,73 ω=0,69); e Busca de Reconhecimento (α =0,81 ω=0,91). A validade de construto mostrou-se adequada conforme a teoria. Concluiu-se que a versão adaptada apresenta boas propriedades psicométricas.

Intervenção interdisciplinar reduz o consumo de alimentos ultraprocessados em adolescentes com sobrepeso ou obesidade

Este estudo objetivou avaliar o efeito da intervenção interdisciplinar com abordagem motivacional sobre o consumo de alimentos ultraprocessados em adolescentes com sobrepeso ou obesidade. O método utilizado foi um ensaio clínico randomizado no qual os participantes distribuíram-se em grupo controle (GC) e grupo intervenção (GI). A coleta de dados do consumo alimentar ocorreu mediante o recordatório de 24 horas, obtido no início e ao final das intervenções. Os alimentos consumidos foram categorizados nos quatro grupos da classificação alimentar NOVA conforme o grau de processamento a qual são submetidos. Participaram 42 adolescentes com média de idade de 16,5±1,3 anos, a maioria do gênero feminino (69%). No GI, a média de quilocalorias de alimentos ultraprocessados diminuiu 37,5% após a intervenção; em contrapartida, aumentou o consumo de alimentos processados em ambos os grupos. Concluiu-se que a intervenção interdisciplinar com abordagem motivacional foi eficaz na redução do consumo de alimentos ultraprocessados na população estudada.

The role of social connection on the experience of COVID-19 related post-traumatic growth and stress

BACKGROUND

Historically social connection has been an important way through which humans have coped with large-scale threatening events. In the context of the COVID-19 pandemic, lockdowns have deprived people of major sources of social support and coping, with others representing threats. Hence, a major stressor during the pandemic has been a sense of social disconnection and loneliness. This study explores how people's experience of compassion and feeling socially safe and connected, in contrast to feeling socially disconnected, lonely and fearful of compassion, effects the impact of perceived threat of COVID-19 on post-traumatic growth and post-traumatic stress.

METHODS

Adult participants from the general population (N = 4057) across 21 countries worldwide, completed self-report measures of social connection (compassion for self, from others, for others; social safeness), social disconnection (fears of compassion for self, from others, for others; loneliness), perceived threat of COVID-19, post-traumatic growth and traumatic stress.

RESULTS

Perceived threat of COVID-19 predicted increased post-traumatic growth and traumatic stress. Social connection (compassion and social safeness) predicted higher post-traumatic growth and traumatic stress, whereas social disconnection (fears of compassion and loneliness) predicted increased traumatic symptoms only. Social connection heightened the impact of perceived threat of COVID-19 on post-traumatic growth, while social disconnection weakened this impact. Social disconnection magnified the impact of the perceived threat of COVID-19 on traumatic stress. These effects were consistent across all countries.

CONCLUSIONS

Social connection is key to how people adapt and cope with the worldwide COVID-19 crisis and may facilitate post-traumatic growth in the context of the threat experienced during the pandemic. In contrast, social disconnection increases vulnerability to develop post-traumatic stress in this threatening context. Public health and Government organizations could implement interventions to foster compassion and feelings of social safeness and reduce experiences of social disconnection, thus promoting growth, resilience and mental wellbeing during and following the pandemic.

Adaptação do Acceptance and Action Questionnaire for University Students (AAQ-US) para o Português Brasileiro

Este estudo tem por objetivo realizar a adaptação do Acceptance and Action Questionnaire for University Students (AAQ-US), que avalia a inflexibilidade psicológica no contexto universitário. A amostra contou com 123 estudantes de graduação e pós-graduação, de universidades brasileiras, com idades entre 18 e 44 anos. As evidências de validade baseadas na estrutura interna da escala se deram pelas análises paralelas que indicaram a retenção de um fator, assim como a escala original e pela análise fatorial exploratória. O AAQ-US também apresentou boa consistência interna com α=.87 e Omega de McDonald =.70. Além disso, o AAQ-US apresentou evidências de validade convergente e discriminante, tendo correlações com procrastinação, variáveis de saúde mental e flexibilidade psicológica, como também validade de construto pelo método dos grupos conhecidos. Os resultados deste estudo indicam a validade do AAQ-US para o contexto universitário.

Aderência e Competência de Terapeutas a um Programa para Redução de Estresse Baseado na Terapia de Aceitação e Compromisso

A Integridade do Tratamento (IT) é um conceito que se refere à avaliação da competência e aderência a um tratamento ou intervenção. Aderência e competência podem ser definidas respectivamente como o quanto o terapeuta seguiu o protocolo ou abordagem teórica proposta e o quanto ele foi habilidoso no seu desempenho. Apesar da importância deste dado, a avaliação da IT ainda é frequentemente omitida nas publicações científicas. O objetivo deste artigo foi avaliar aderência e competência de terapeutas em uma intervenção de oito encontros para redução de estresse em universitários baseada na Terapia de Aceitação e Compromisso. Os encontros da intervenção foram gravados e os encontros selecionados para o estudo foram avaliados por três juízes experts em ACT. Para análise dos dados, foi utilizado o coeficiente Fleiss kappa e o teste de Friedman. Os resultados indicaram boa concordância entre os juízes. Os terapeutas mostraram uma ótima aderência ao programa (mínimo 77,8%) e bons níveis de competência (2,7 a 3 numa escala de 0 a 3). Em relação aos processos de flexibilidade psicológica, os níveis de aderência foram maiores para os processos enfocados em cada encontro. Sugere-se estudos futuros com amostras maiores que possibilitem diferentes análises para entender o fenômeno da IT.

Impacts of mindfulness-based interventions in people undergoing hemodialysis: a systematic review

INTRODUCTION

Chronic kidney disease (CKD) is a serious public health problem worldwide, leading to a series of physical and psychological comorbidities, in addition to costly treatments, lifestyle and dietary restrictions. There is evidence that mindfulness-based interventions (MBIs) offer complementary treatment for people with chronic illnesses, including CKD, with the aim of improving overall health, reducing side effects and treatment costs. This review aims to investigate the MBIs impact on people with CKD undergoing hemodialysis, and to identify the methodological quality of the current literature in order to support future studies.

METHODS

We ran searches in five databases (MEDLINE via PubMed, PsycINFO, Embase, Web of Science and Scopus) in July 2020. The papers were selected and evaluated by two reviewers independently, using predefined criteria, including the Cochrane Group's risk of bias tool and its recommendations (CRD42020192936).

RESULTS

Of the 175 studies found, 6 randomized controlled trials met the inclusion criteria, and ranged from 2014 to 2019. There were significant improvements in symptoms of anxiety, depression, self-efficacy, sleep quality, and quality of life (n=3) in the groups submitted to the intervention, in addition to physical measures such as blood pressure, heart rate and respiratory rate (n=1).

CONCLUSIONS

MBIs can offer a promising and safe complementary therapy for people with CKD undergoing hemodialysis, acting on quality of life and physical aspects of the disease.

The generalizability of empirically derived syndromes of collateral-reported elder psychopathology across 11 societies

The purpose of this study was to test whether a syndrome model of elder psychopathology derived from collateral ratings, such as from spouses and adult children, in the United States would be generalizable in 11 other societies. Societies represented South America, Asia, and Europe. The Older Adult Behavior Checklist (OABCL) was completed by collateral informants for 6141 60- to 102-year-olds. The tested model comprised syndromes designated as Anxious/Depressed, Worries, Somatic Complaints, Functional Impairment, Memory/Cognition Problems, Thought Problems, and Irritable/Disinhibited. The model was tested using confirmatory factor analyses in each society separately. The primary model fit index showed a good fit for all societies, while the secondary model fit indices showed acceptable to a good fit for all societies. The items loaded strongly on their respective factors, with a median item loading of 0.69 across the 11 societies. By syndrome, the overall median item loadings ranged from 0.47 for Worries to 0.77 for Functional Impairment. The OABCL syndrome structure was thus generalizable across the tested societies. The OABCL can be used for broad assessment of psychopathology for elders of diverse backgrounds in nursing services and research.

Fears of compassion magnify the harmful effects of threat of COVID-19 on mental health and social safeness across 21 countries

Background

The COVID‐19 pandemic is a massive global health crisis with damaging consequences to mental health and social relationships. Exploring factors that may heighten or buffer the risk of mental health problems in this context is thus critical. Whilst compassion may be a protective factor, in contrast fears of compassion increase vulnerability to psychosocial distress and may amplify the impact of the pandemic on mental health. This study explores the magnifying effects of fears of compassion on the impact of perceived threat of COVID‐19 on depression, anxiety and stress, and social safeness.

Methods

Adult participants from the general population (N = 4057) were recruited across 21 countries worldwide, and completed self‐report measures of perceived threat of COVID‐19, fears of compassion (for self, from others, for others), depression, anxiety, stress and social safeness.

Results

Perceived threat of COVID‐19 predicted increased depression, anxiety and stress. The three flows of fears of compassion predicted higher levels of depression, anxiety and stress and lower social safeness. All fears of compassion moderated (heightened) the impact of perceived threat of COVID‐19 on psychological distress. Only fears of compassion from others moderated the effects of likelihood of contracting COVID‐19 on social safeness. These effects were consistent across all countries.

Conclusions

Fears of compassion have a universal magnifying effect on the damaging impact of the COVID‐19 pandemic on mental health and social safeness. Compassion focused interventions and communications could be implemented to reduce resistances to compassion and promote mental wellbeing during and following the pandemic.

Intervention Protocol Based on Transtheoretical Model of Behavior Change for Metabolic Syndrome

Abstract The present study is the translation and adaptation of an intervention based on the Transtheoretical Model of Change directed to patients at cardiovascular risk. The original 29-session manual was translated into Portuguese, extended to 36 sessions, and applied in a pilot study. The protocol was reduced to 12 sessions through the grouping based on the processes of change. The products of the present study were the processes in each behavior, the versatility of the protocol, the interdisciplinary work, the great cost-benefit, and the potential of effectiveness. Finally, the importance of consistent training in Motivational Interview, Transtheoretical Model and group management for proper use are highlighted, and the costs and benefits of protocols versus more flexible treatments are discussed.

The Effect of Different Interventions for Lifestyle Modifications on the Number of Diagnostic Criteria and Clinical Aspects of Metabolic Syndrome

Background: Lifestyle intervention programs comprise the first-choice therapy to reduce the cardiovascular risk factors in metabolic syndrome (MetS). Our aim was to compare the effects of three lifestyle modification programs on the number of diagnostic criteria and clinical parameters of MetS. Methods: Twelve-week clinical trial, including 125 adults who presented at least three of the criteria defined by the revised NCEP ATP III (National Cholesterol Education Program Adult Panel III) for MetS. Individuals were randomized into three multidisciplinary intervention groups: Standard Intervention (SI), Group Intervention (GI) and Individual Intervention (II). Results: Seventy-one individuals, aged 34-59 years, concluded the study: SI: 20, GI: 25, and II: 26. The GI and II groups presented a significant decrease of body mass index, abdominal circumference, diastolic and systolic arterial pressure after intervention. The number of diagnostic criteria for MetS decreased significantly. Within the GI and II groups, 16.0% and 15.4% of the individuals, respectively, did not meet the criteria for the clinical condition studied at the end of the interventions. In the II group, the percentage of individuals with five criteria reduced 83.5%. In the GI group, the percentage of individuals with five criteria remained the same, but the number of individuals with four criteria presented a 50.0% reduction. Conclusions: Results reinforce that nonpharmacological strategies for changing lifestyle affect the reduction of cardiovascular risk factors existing in MetS. They are also able to remove the population from this clinical condition by decreasing the diagnostic criteria. II or GI lead to a successful treatment of MetS, especially when conducted by multidisciplinary team. Brazilian Registry of Clinical Trials-ReBEC number: RBR-9wz5fc.

Effect of an interdisciplinary intervention with motivational approach on exercise capacity in obese adolescents: a randomized controlled clinical trial

Objective

To evaluate the effect of an interdisciplinary intervention with a motivational approach on exercise capacity and usual physical activity levels in overweight and obese adolescents.

Methods

This is a randomized, controlled clinical trial with single blinding of subjects. Adolescents aged 15 to 18 years with overweight and obesity (body mass index ≥ 85 percentile) were included. The adolescents were randomized into two groups: interdisciplinary intervention or control − traditional approach aiming at lifestyle modifications. The initial evaluations were carried out, including the cardiopulmonary exercise test and the physical activity level measurement by using the International Physical Activity Questionnaire and a pedometer. The evaluations were performed in two moments: time zero (time of inclusion in the study) and after 3 months (end of intervention). There were 12 sessions with weekly meetings.

Results

A total of 37 participants were included, 19 in the Intervention Group. There were no significant differences in the baseline demographic, anthropometric and physical activity characteristics between groups, with mean age of 17.3±1.0 years in the Control Group, and 16.8±0.9 years in the Intervention Group (p=0.14). The motivational intervention did not cause significant differences (p>0.05) in the comparison of the variables of exercise capacity and usual physical activity (questionnaire and pedometer) between groups.

Conclusion

The intervention with a motivational approach did not alter exercise capacity and levels of usual physical activity in overweight and obese adolescents.

Clinical Trial Registry: NCT02455973 and REBEC: RBR-234nb5.

The generalizability of Older Adult Self-Report (OASR) syndromes of psychopathology across 20 societies

OBJECTIVES

As the world population ages, psychiatrists will increasingly need instruments for measuring constructs of psychopathology that are generalizable to diverse elders. The study tested whether syndromes of co-occurring problems derived from self-ratings of psychopathology by US elders would fit self-ratings by elders in 19 other societies.

METHODS/DESIGN

The Older Adult Self-Report (OASR) was completed by 12 826 adults who were 60 to 102 years old in 19 societies from North and South America, Asia, and Eastern, Northern, Southern, and Western Europe, plus the United States. Individual and multigroup confirmatory factor analyses (CFAs) tested the fit of the seven-syndrome OASR model, consisting of the Anxious/Depressed, Worries, Somatic Complaints, Functional Impairment, Memory/Cognition Problems, Thought Problems, and Irritable/Disinhibited syndromes.

RESULTS

In individual CFAs, the primary model fit index showed good fit for all societies, while the secondary model fit indices showed acceptable to good fit. The items loaded strongly on their respective factors, with a median item loading of .63 across 20 societies, and 98.7% of the loadings were statistically significant. In multigroup CFAs, 98% of items demonstrated approximate or full metric invariance. Fifteen percent of items demonstrated approximate or full scalar invariance, and another 59% demonstrated scalar invariance across more than half of societies.

CONCLUSIONS

The findings supported the generalizability of OASR syndromes across societies. The seven syndromes offer empirically based clinical constructs that are relevant for elders of different backgrounds. They can be used to assess diverse elders and as a taxonomic framework to facilitate communication, services, research, and training in geriatric psychiatry.

Psychological inflexibility in overweight and obese people from the perspective of acceptance and commitment therapy (ACT)

PURPOSE

To identify the psychological inflexibility (PI) processes (experiential avoidance, cognitive fusion, poor contact with the present moment, unclear personal values and lack of commitment to action) associated with body mass index (BMI), depression, anxiety and stress symptoms and binge eating in overweight and obese people by drawing on the acceptance and commitment therapy (ACT) framework.

METHODS

A cross-sectional study of 243 people with a BMI of at least 25 and aged from 18 to 60 years old. The following instruments were used: Acceptance and Action Questionnaire II (AAQ-II), Acceptance and Action Questionnaire-Weight (AAQ-W), Valued Living Questionnaire (VLQ), Cognitive Fusion Questionnaire (CFQ-7), Cognitive Fusion Questionnaire-Body Image (CFQ-BI), Mindful Eating Questionnaire (MEQ), Binge Eating Scale (BES) and Depression, Anxiety and Stress Scale (DASS-21). Data were analyzed using one-way ANOVA and t tests.

RESULTS

There were no differences between BMI categories with respect to PI variables, but PI was positively related to the severity of binge eating and to symptoms of depression, anxiety and stress.

CONCLUSION

The development of interventions focused on psychological inflexibility can be useful for the treatment of symptoms associated with overweight and obesity.

LEVEL OF EVIDENCE

Level V, cross-sectional descriptive study.

Effects of a dialectical behavior therapy-based skills group intervention for obese individuals: a Brazilian pilot study

PURPOSE

This pilot study aimed to analyze the effects of an adapted dialectical behavior therapy (DBT) skills training group on problematic and adaptive eating behaviors in Brazilian obese individuals.

METHODS

Thirty-one obese individuals were randomly assigned to 10 sessions of adapted DBT skills training (n = 14) or two months of a waiting list comparison condition (n = 17).

RESULTS

Attrition rates were similar to what's been found in comparable studies, with most dropouts happening at the beginning of the treatment. Results showed improvements in binge eating severity (d = 0.80) and depression (d = 0.82) compared to no treatment condition. After the intervention, adaptive eating and distress outcomes showed an improvement trend, reaching nonclinical levels for most participants in the intervention group. Large to moderate between-group effect sizes were observed, but none of those were statistically significant. Large within-group effect sizes were observed in the intervention group in binge eating severity (d = 1.34), intuitive eating (d = 1.33) and depression (d = 1.12). Medium effect sizes were observed in emotional eating (d = 0.73) and in emotion regulation (d = 0.72). Despite positive outcomes in other variables, mindful eating worsened after the intervention (d = 0.66).

CONCLUSIONS

These results are preliminary and require further replications with larger samples, yet they suggest that the intervention may be useful to improve distress outcomes and adaptive eating among obese people. Implications for clinical practice and recommendations for future research are discussed.

LEVEL OF EVIDENCE

Level I, randomized controlled trial.

COMPARAÇÃO DO CONSUMO ALIMENTAR CALCULADO A PARTIR DE DUAS TABELAS DE COMPOSIÇÃO DE ALIMENTOS

O objetivo do presente trabalho foi comparar o consumo de energia, macronutrientes e micronutrientes calculado a partir de duas tabelas de composição dos alimentos: Tabela Brasileira de Composição de Alimentos (TACO) mais informações de rótulos de alimentos e United States Department of Agriculture Food Composition Databases (USDA). Trata-se de estudo transversal, com dados do consumo alimentar de participantes do estudo principal “Modificação do Estilo de Vida e Risco Cardiovascular”. Os dados foram analisados por meio dos Testes de Kruskal Wallis, Post Hoc de Dunn, e Correlação de Pearson. Foram avaliados 59 Recordatórios de 24 horas e as medianas de 21 entre 29 nutrientes (72,4%) apresentaram diferença estatisticamente significativa (p

Psychometric properties of the Brazilian version of the Difficulties in Emotion Regulation Scale (DERS)

Abstract Introduction: Emotion regulation can be defined as the process by which individuals manage their emotional experience. It has been demonstrated that deficits in this ability are associated with various psychiatric disorders. In this direction, the Difficulties in Emotion Regulation Scale (DERS) was developed to measure difficulties in emotion regulation. Objective: To examine the psychometric properties of the Brazilian Portuguese version of the DERS. Method: A total of 377 individuals from the general population, selected by convenience, completed a sociodemographic form, the adapted Brazilian Portuguese DERS and the Depression Anxiety Stress Scale (DASS-21). Factor structure, reliability, and concurrent validity of the adapted version of the instrument were investigated. Results: The confirmatory factor analysis replicated the six-factor structure originally proposed for the instrument and confirmed the acceptability of a hierarchical model where all DERS subscales loaded on a general emotion dysregulation factor. Internal consistency indicators had adequate values for the general factor and subscales. The positive association between DERS and DASS-21 scores supports the instrument's concurrent validity. Conclusion: These results suggest that the Brazilian version of the DERS is reliable both as a general measure of difficulties in emotion regulation and as a measure of the constituents of this construct. Future research should investigate the psychometric properties of the scale in clinical and nonclinical populations, with equal gender proportions and diverse backgrounds, and preferably employing longitudinal designs.

Problematic and adaptive eating in people with obesity after a DBT-based skills training intervention: 3- and 8-month follow-up and mediation analysis

Background

Dialectical behavior therapy conceptualizes problematic behaviors as attempts to regulate emotions that occur when the individual lacks effective skills with which to manage his or her emotions and cope with distress. Problematic eating behaviors, e.g., binge and emotional eating, may serve to alleviate aversive emotional states, being highly associated with overweight and obesity. Dialectical behavior therapy skills training has been proven effective in reducing binge eating in several clinical studies. However, few studies reveal the effects of DBT on adaptive eating behaviors or the stability of outcomes.

Objectives

This study aimed to test the effect of a brief DBT-based skills training intervention, and the stability of outcomes at 3- and 8-month follow-ups.

Methods

Self-report measures of binge eating, emotional eating, intuitive eating, and mindful eating were taken on 5 timepoints before and after a 10-session DBT skills training intervention (2 baseline measures, 1 post-test, and 2 follow-ups). Data were analyzed using a mixed-model intention-to-treat approach and mediation analysis was conducted with path analysis.

Results

After the intervention, intuitive eating and mindful eating scores were significantly higher than before the intervention, while emotional eating and binge eating scores were lower. The results remained stable during the follow-up period, with minor fluctuations and small trends towards returning to baseline values for binge eating and emotional eating. Mindful eating partially mediated the improvements in all outcomes.

Limitations

Given that results are entirely based on self-report measures and that some instruments showed poor reliability, in addition to the high attrition rates, the results should be interpreted as preliminary.

Conclusions

The results provide evidence that a brief DBT intervention is effective not only in reducing problematic eating but also in increasing adaptive eating, achieving reasonably stable results. Also, the mediation analysis results support the hypothesis that mindful eating partially explains the effects of the intervention on binge and emotional eating. Future research should address the limitations of this study by investigating a more diverse sample, triangulating different measurement strategies, and including other putative mediators.

Entrevista Motivacional para Estudantes da Área da Saúde: Resultados de um Treinamento

Resumo Este estudo procurou avaliar a efetividade de um treinamento em Entrevista Motivacional (EM) para estudantes do último ano de diferentes cursos na área da saúde. Usando um delineamento pré e pós-teste quase-experimental, 60 estudantes receberam um treinamento de oito horas de habilidades básicas da Entrevista Motivacional. As habilidades foram avaliadas por meio de uma vinheta clínica, das Réguas de Confiança e Importância e do Questionário de Resposta Útil, codificado utilizando o Motivational Interviewing Skill Code. O treinamento foi associado com melhora no uso das habilidades básicas da Entrevista Motivacional. Os alunos também aumentaram a percepção da importância em utilizar essas habilidades com os pacientes, mesmo com um treinamento breve.

Is the widely used two-factor structure of the Ruminative Responses Scale invariant across different samples of women?

OBJECTIVES

Although the Ruminative Responses Scale is one of the most widely used measures of rumination, its two-factor structure remains controversial. Taking this into account, we aimed to test the RRS-10 two-factor invariance (Brazilian version) between different samples of women and to study its internal consistency and convergent validity.

METHODS

A sample of 321 women (general population, n = 106; college students, n = 115; and medical population of patients with overweight and obesity, n = 100) participated in the study. The two-factor structure of RRS-10 was assessed by CFA and multigroup analysis using Mplus software. Internal consistency was assessed by Cronbach's alpha and the convergent validity by Pearson correlations.

RESULTS

The two-factor structure of RRS-10 showed a good fit, factorial invariance across three samples, good internal consistency, and adequate convergent validity. Brooding and Reflection subscales were both positively correlated with psychological inflexibility, cognitive fusion, anxiety, depression, and stress symptoms, although Brooding presented significantly stronger associations with these variables than Reflection.

CONCLUSIONS

This study provides further discussion and evidence regarding the RRS-10 two-factor structure, as well as a valid version of RRS-10 to use in Brazil in order to reliably assess rumination in medical and research settings.

PRACTITIONER POINTS

This is the first study to test and confirm the RRS two-factor structure invariance across groups. RRS-10 two-dimensionality was confirmed in medical and non-medical samples of women. Brooding subscale showed significantly stronger relationships with psychopathology and experiential avoidance than Reflection. The study provides evidence that RRS can be used as a valid and sound measure to accurately assess the clinically relevant dimensions of rumination simultaneously across distinct groups.

Ruminal biohydrogenation and abomasal flow of fatty acids in lactating cows fed diets supplemented with soybean oil, whole soybeans, or calcium salts of fatty acids

Ruminants have a unique metabolism and digestion of unsaturated fatty acids (UFA). Unlike monogastric animals, the fatty acid (FA) profile ingested by ruminants is not the same as that reaching the small intestine. The objective of this study was to evaluate whole raw soybeans (WS) in diets as a replacer for calcium salts of fatty acids (CSFA) in terms of UFA profile in the abomasal digesta of early- to mid-lactation cows. Eight Holstein cows (80 ± 20 d in milk, 22.9 ± 0.69 kg/d of milk yield, and 580 ± 20 kg of body weight; mean ± standard deviation) with ruminal and abomasal cannulas were used in a 4 × 4 Latin square experiment with 22-d periods. The experiment evaluated different fat sources rich in linoleic acid on ruminal kinetics, ruminal fermentation, FA abomasal flow, and milk FA profile of cows assigned to treatment sequences containing a control (CON), with no fat source; soybean oil, added at 2.68% of diet dry matter (DM); WS, addition of WS at 14.3% of diet DM; and CSFA, addition of CSFA at 2.68% of diet DM. Dietary fat supplementation had no effect on nutrient intake and digestibility, with the exception of ether extract. Cows fed fat sources tended to have lower milk fat concentration than those fed CON. In general, diets containing fat sources tended to decrease ruminal neutral detergent fiber digestibility in relation to CON. Cows fed WS had lower ruminal digestibility of DM and higher abomasal flow of DM in comparison to cows fed CSFA. As expected, diets containing fat supplements increased FA abomasal flow of C18:0 and total FA. Cows fed WS tended to present a higher concentration of UFA in milk when compared with those fed CSFA. This study suggests that under some circumstances, abomasal flow of UFA in early lactation cows can be increased by supplementing their diet with fat supplements rich in linoleic acid, regardless of rumen protection, with small effects on ruminal DM digestibility.

Transtheoretical model for change in obese adolescents: MERC randomized clinical trial

The randomized controlled trial evaluated the effectiveness of an intervention based on the Transtheoretical Model of Change on anthropometric, metabolic and motivational outcomes in obese adolescents. A total of 135 male and female adolescents were randomized to two groups: intervention group (n = 65) and control group (n = 70). The adolescents were evaluated 1 week before the interventions began and at the end of 12 weeks. There was no statistically significant difference between groups in the outcome variables. Intervention group reported magnitude of effect more expressive on body mass index percentile, waist circumference, waist-to-hip ratio, readiness to change diet and readiness to start exercise.

Transtheoretical model for change in obese adolescents: MERC randomized clinical trial

The randomized controlled trial evaluated the effectiveness of an intervention based on the Transtheoretical Model of Change on anthropometric, metabolic and motivational outcomes in obese adolescents. A total of 135 male and female adolescents were randomized to two groups: intervention group (n = 65) and control group (n = 70). The adolescents were evaluated 1 week before the interventions began and at the end of 12 weeks. There was no statistically significant difference between groups in the outcome variables. Intervention group reported magnitude of effect more expressive on body mass index percentile, waist circumference, waist-to-hip ratio, readiness to change diet and readiness to start exercise.

MAXIMUM HEART RATE MEASURED VERSUS ESTIMATED BY DIFFERENT EQUATIONS DURING THE CARDIOPULMONARY EXERCISE TEST IN OBESE ADOLESCENTS

OBJECTIVE

To compare the values of measured maximum heart rate (HRmax) and maximum heart rate estimated by different equations during the cardiopulmonary exercise test (CPET) in obese adolescents.

METHODS

This is a cross-sectional study. Adolescents aged between 15 and 18 years old, with obesity (BMI Z-score>2.0) were included. Demographic and anthropometric data were collected, followed by CPET, recording HRmax. The highest heart rate reached at peak exercise was considered as HRmax. The comparison between measured and estimated HRmax values was performed using four previous equations. Descriptive statistics and the ANOVA test (Bonferroni post-test) were used.

RESULTS

Fifty-nine obese adolescents were included, 44% of them male. The mean age was 16.8±1.2 years old and the BMI (Z-score) was 3.0±0.7. At peak exercise, the mean HRmax (bpm) was 190.0±9.2, the respiratory coefficient was 1.2±0.1, and the VO2max (mL/kg/min) was 26.9±4.5. When comparing the measured values of HRmax with those estimated by the different formulas, the equations "220-age", "208-0.7 x age" and "207-0.7 x age" were shown to overestimate (p<0.001) the measured HRmax results in obese adolescents. Only the "200-0.48 x age" equation presented similar results (p=0.103) with the values measured in the CPET.

CONCLUSIONS

The findings of the present study demonstrate that the equation "200-0.48 x age" seems to be more adequate to estimate HRmax in obese adolescents.

SALIVARY CORTISOL AND METABOLIC SYNDROME COMPONENT'S ASSOCIATION

BACKGROUND

Actually the lifestyle exposes the population to several risk factors related to alimentary habits and less physical activity that contributes to chronic diseases appearance worldwide.

AIM

To analyze the association between salivary cortisol and the components of metabolic syndrome.

METHODS

This is a cross-sectional study. As part of it, 28 individuals aged 30-59 years presenting three or more of the following findings: CA: ≥88 cm for women and ≥102 cm for men; SBP>130 mmHg and DBP>85 mmHg; GL>100 mg/dl; TG>150 mg/dl; HDL<40 mg/dl for men and <50 mg/dl for women. Was performed analysis of salivary cortisol (by radioimmunoassay) from 25 salivary samples collected throughout the day, for evaluating changes in the circadian rhythm of this hormone (8AM, noon and 8PM).

RESULTS

28 evaluated individuals had a mean age of 51.9±7.5 years, mostly women (64.3%) and a mean of BMI 33.6±3.2 kg/m². The cortisol level from the 8AM averaged 18.7±4.8 ng/dlL. Individuals with FPG>110mg/dl, have significantly lower average levels of cortisol than ones with FPG <110 (12.8±5,2 vs. 17.3±4.2). Significant correlations were HOMA vs. WC (r=0,465; p˂0,005) and TG (r=0,473; p˂0,005), WC vs. FG (r=0,446; p˂0,005) and BMI (r=0,730; p˂0.0001); TG vs. HDL (r=0,441 p˂0,005) and FG (r=0,440; p˂0,005).

CONCLUSION

Morning salivary cortisol in subjects with chronically elevated blood glucose can represent a downregulation of the hypothalamic-pituitary adrenal axis. This is an important finding not yet well investigated.

Blanca Susana Guevara Werlang (15/10/1955–15/11/2013): Um Pouco da História

Resumo: Este artigo tem como objetivo revisitar os feitos e homenagear a professora doutora Blanca Susana Guevara Werlang, cinco anos após seu falecimento. Trata-se de uma importante figura na área da avaliação psicológica e em assuntos ligados à prevenção do suicídio, cujo legado se colhe ainda nos tempos atuais. Sua expressiva e relevante produção abarca principalmente temas ligados ao desenvolvimento e adaptação de instrumentos de avaliação psicológica, nas áreas de intervenção clínica e comportamentos violentos. Blanca foi Bolsista Produtividade do CNPq, Professora Titular da Faculdade de Psicologia da Pontifícia Universidade Católica do Rio Grande do Sul e integrou a Comissão Consultiva em Avaliação Psicológica do Conselho Federal de Psicologia de 2005 até seu falecimento, no ano de 2013.

Weight loss interventions for overweight and obese adolescents: a systematic review

PURPOSE

To determine what factors contribute to the efficacy of non-drug treatments designed to promote weight loss in overweight and obese adolescents.

METHODS

Data sources Medline/PubMed; Psychinfo; EMBASE; Web of Science (ISI); and Cochrane Central Register of Controlled Trials. Study selection Randomized clinical trials of treatments for obesity and overweight in adolescents aged 10-19 years with a minimum duration of 2 months. Data extraction 115 of the 12,948 publications retrieved met eligibility criteria and 26 were included in the final sample. Period of extraction January 2004 to November 2014.

RESULTS

The Delphi list was used to evaluate the methodological quality of the studies (M = 5.58, SD = 1.027). There was considerable variability between the interventions, but they were all multifactorial, with components such as nutritional education, physical activity, family support and psychological therapy. The number of contacts with subjects during the course of the intervention was a predictor of treatment efficacy when the groups were compared. Limitations This systematic review was limited to trials reported in English and by the lack of methodological rigor and shortcomings in reporting in the studies reviewed.

CONCLUSIONS

Multidisciplinary interventions including family support and guided behavior modification appear to be effective methods of reducing BMI in overweight and obese adolescents.

Body-Image Acceptance and Action Questionnaire: Its deleterious influence on binge eating and psychometric validation

Background/Objectives: This study aimed to explore the psychometric properties of BI-AAQ (Body-Image Acceptance and Action Questionnaire) and the body image psychological flexibility role as a mediator in a pervasive path towards binge eating in Brazilian samples. Method: This cross-sectional study was conducted in clinical (overweight or obese women currently in treatment for weight loss; n= 330) and non-clinical (general population; n= 682) groups of women. Results: BI-AAQ has one-factor structure, excellent internal consistency, ability to detect differences between groups and measurement invariance across samples. It was also negatively associated with self-compassion and positively associated with binge eating severity, drive for thinness and self-criticism. Conclusions: This study provides data confirming the robust psychometric properties of BI-AAQ in qualitatively different samples. Furthermore, an additional study conducted in a clinical sample of women with overweight or obesity revealed that body image psychological inflexibility has emerged as a partial and significant mediator of the effect of self-criticism and drive for thinness on binge eating severity.

Lifestyle Intervention on Metabolic Syndrome and its Impact on Quality of Life: A Randomized Controlled Trial

Background

Lifestyle intervention programs can reduce the prevalence of metabolic syndrome (MetS) and, therefore, reduce the risk for cardiac disease, one of the main public health problems nowadays.

Objective

The aim of this study was to compare the effects of three types of approach for lifestyle change programs in the reduction of metabolic parameters, and to identify its impact on the quality of life (QOL) of individuals with MetS.

Methods

A randomized controlled trial included 72 individuals with MetS aged 30-59 years. Individuals were randomized into three groups of multidisciplinary intervention [Standard Intervention (SI) - control group; Group Intervention (GI); and Individual Intervention (II)] during 12 weeks. The primary outcome was change in the metabolic parameters, and secondarily, the improvement in QOL measures at three moments: baseline, 3 and 9 months.

Results

Group and individual interventions resulted in a significant reduction in body mass index, waist circumference, systolic blood pressure at 3 months and the improvement of QOL, although it was significantly associated with the physical functioning domain. However, these changes did not remain 6 months after the end of intervention. Depression and anxiety were significantly associated with worse QOL, although they showed no effect on the response to intervention.

Conclusion

Multidisciplinary intervention, especially in a group, might be an effective and economically feasible strategy in the control of metabolic parameters of MetS and improvement of QOL compared to SI, even in a dose-effect relationship.

Predictors of adherence in a prevention program for patients with metabolic syndrome

The study objectives were (1) comparison of baseline characteristics between individuals with metabolic syndrome, adhering/not adhering to a primary prevention program modificação do estilo de vida e risco cardiovascular; and (2) determination of risk factors for program adherence. The sample included 127 participants with mean age (±standard deviation) of 49.58 (±7.77) years, participating in the modificação do estilo de vida e risco cardiovascular between 2010 and 2012. Results show that program adherence predictors were age (odds ratio: 1.134, 95% confidence interval: 1.106-1.833); practicing physical exercise (odds ratio: 1.322, 95% confidence interval: 1.115-7.589); self-efficacy for regular eating habits (odds ratio: 2.044, 95% confidence interval: 1.184-3.377); low binge eating scores (odds ratio: 1.922, 95% confidence interval: 1.118-3.974); and low isolation and depression scores (odds ratio: 0.721, 95% confidence interval: 0.322-0.917).

[Neuropsychological performance and demographic characteristics in alcoholic patients in treatment]

This study compared the cognitive performance of alcoholics (AG) and participants from the general population (CG) without alcohol dependence. The sample consisted of 141 men, aged 18 and 59. Divided into two groups, 101 alcoholic patients without comorbidities, hospitalized for drug abuse treatment, and 40 healthy individuals from the general population, matched for age and socioeconomic status. The instruments assessed the sociodemographics data and economic classification, alcohol dependence, psychiatric comorbidities, cognitive performance, executive functions, memory and perception. The results showed that the AG group presented severe dependence on alcohol and 92.1% indicated having a family with problems associated with alcohol for only 41.5 % of the CG. At the moment of the evaluation, 59.4 % of the participants of the AG group were abstinent between 8 and 15 days, and the in CG, 43.9%, were more than 60 days alcohol free. The neuropsychological performance verified that there was a decline in cognitive functions in alcoholics’ participants, whereas the AG suggests psychomotor retardation. Thus, it can be inferred that alcohol greatly affects cognitive functions of people who depend on this substance. In addition, there was a greater number of family stories with prevalence of symptoms of anxiety and depression and nicotine addiction in alcoholic patients compared with the general population.

Revisão sistemática sobre tratamentos psicológicos para problemas relacionados ao crack

OBJETIVO: O objetivo deste artigo é apresentar uma revisão sistemática da literatura sobre tratamentos psicológicos oferecidos para usuários de crack. MÉTODOS: Foi realizada uma revisão sistemática por meio de uma busca na literatura internacional e nacional, indexada nas bases de dados Medline, SciELO, Lilacs e Web of Science. Os descritores utilizados foram: crack or crack cocaine or cocaine smokers (crack) and psychosocial treatment or psycotherapy or psychosocial treatment (tratamento psicológico) e a busca incluiu artigos publicados no período de 2001 a 2011. RESULTADOS: No total foram encontrados 155 artigos por meio dos descritores utilizados. Os artigos foram agrupados em três dimensões: tratamentos psicossociais na internação e cuidados continuados, relaxamento respiratório e outras técnicas comportamentais e abordagens fundamentadas na Entrevista Motivacional, Cognitivo-Comportamental e Modelo Transteórico de Mudança. CONCLUSÃO: Com base nos estudos examinados, pode ser formulado um elenco de algumas intervenções que estão sendo estudadas para o tratamento de usuários de crack e algumas apresentam resultados satisfatórios. Os poucos esforços de comparação entre técnicas resultaram em evidências de pouca ou nenhuma diferença, ainda que se registre o benefício para os usuários na aplicação de qualquer delas. Não existe consenso acerca da efetividade no tratamento de usuários de crack. Parece oportuno e necessário o aprofundamento dos estudos nesse campo.

Motivação para mudança: análise fatorial da URICA para hábitos alimentares

O presente estudo objetivou realizar a adaptação da URICA para avaliação da motivação para a mudança de hábitos alimentares e posterior redução da versão de 32 para a de 24 itens, mediante análise fatorial exploratória e de índices de fidedignidade. Trata-se de um estudo de cunho instrumental, realizado com 175 participantes de programas de redução de peso do sul do Brasil. A análise fatorial apontou uma solução de 4 fatores, referentes aos 4 estágios de motivação para a mudança e apresentou um alpha de Cronbach total de 0,842, que variou de 0,813 a 0,940 entre os 4 domínios.

Validação brasileira do questionário de esquemas de Young: forma breve

Esta pesquisa objetivou estudar as propriedades psicométricas da versão brasileira do questionário de esquemas de Young, forma reduzida, e mapear os esquemas cognitivos na amostra, buscando estabelecer correlações entre os níveis de ansiedade, depressão, desajustamento psicossocial e vulnerabilidade com os esquemas iniciais desadaptativos. A metodologia utilizada foi quantitativa, sendo a amostra da pesquisa constituída por 372 participantes. Os instrumentos utilizados foram um Questionário de Dados Sociodemográficos, o Questionário de Esquemas de Young - versão breve - e a Escala Fatorial de Ajustamento Emocional/Neuroticismo. Os resultados achados demonstraram a existência de validade na versão brasileira do Questionário de Esquemas de Young (forma breve) com relação à amostra estudada. Os resultados apontaram para o satisfatório grau de confiabilidade (a=0,955) e para a capacidade de discriminação do questionário, assim como para a validade concorrente com relação à escala fatorial de ajustamento emocional/neuroticismo.

Anxiety and depression symptoms in women with and without binge eating disorder enrolled in weight loss programs

OBJECTIVES: 1) To investigate the association between binge eating scores, anxiety and depression symptoms, and body mass index (BMI), and 2) to assess the presence of differences in severity of anxiety symptoms, severity of depression symptoms, and BMI in women with and without binge eating disorder. METHOD: The sample comprised 113 women aged between 22 and 60 years (39.35±10.85) enrolled in weight loss programs in Porto Alegre, southern Brazil. The following instruments were used: structured interview, Brazilian Economic Classification Criteria, Beck Anxiety Inventory, Beck Depression Inventory, and Binge Eating Scale. Data were analyzed using descriptive and inferential statistics. RESULTS: A positive association was found between binge eating scores and the severity of anxiety symptoms (p < 0.001) and depression symptoms (p < 0.001). No significant association was observed between BMI and binge eating scores (p = 0.341). There were significant differences between women with and without binge eating disorder with regard to severity of anxiety symptoms (p < 0.001) and severity of depression symptoms (p < 0.001). Conversely, no significant differences were observed between the groups concerning BMI (p = 0.103). CONCLUSION: Our findings showed that binge eating is associated with symptoms of anxiety and depression, but not with BMI.

Intensidade de uso de crack de acordo com a classe econômica de usuários internados na cidade de Porto Alegre/Brasil

OBJETIVOS: Investigar se há associação entre intensidade e frequência de uso de crack e o nível econômico de dependentes da droga e verificar se há relação entre classe econômica e intensidade e frequência de uso de crack em homens adultos em internação psiquiátrica. MÉTODO: Estudo transversal quantitativo. Instrumentos: entrevista estruturada, Critérios de Classificação Econômica Brasil e Miniexame do Estado Mental. Tratamento estatístico: análises descritivas e inferenciais (testes de Kolmogorov-Smirnov, Mann-Whitney e Kruskal-Wallis - nível de significância de 5%). RESULTADOS: Duzentos e vinte e um participantes foram divididos em dois grupos: (1) Grupo de maior nível econômico (classes A e B) e (2) Grupo de menor nível econômico (Classes C, D e E). Não houve diferença significativa (p = 0,893 - teste de Mann-Whitney) entre os grupos quanto à intensidade e à frequência de uso de crack. Também não houve relação significativa (p = 0,549 - teste de Kruskal-Wallis) entre classe econômica (A, B, C, D e E) e intensidade e frequência de uso de crack. CONCLUSÃO: Os dependentes de crack de maior e de menor poder aquisitivo não diferiram de forma significativa com relação à intensidade e à frequência de uso da droga. Não houve relação entre classe econômica e intensidade e frequência de uso de crack nesta amostra.

Auto-eficácia para abstinência e tentação para uso de drogas ilícitas: uma revisão sistemática

Estudos sobre o processo de mudança nos comportamentos aditivos abordam a auto-eficácia para abstinência e a tentação para o uso de substâncias como aspectos centrais ao entendimento das adições. Este estudo buscou a revisão sistemática de artigos que avaliaram a auto-eficácia (AE) para abstinência e a tentação para uso de drogas ilícitas. Nas bases de dados PubMed, PsychInfo e LILACS, foram utilizados termos: abstinence, self-efficacy, temptation e scale na busca de publicações que relacionassem os descritores a drogas ilícitas. Dos 13 artigos selecionados, cinco aplicaram o mesmo instrumento, três adaptaram medidas e os demais, diferentes escalas. Grande parte dessas ferramentas apresenta situações para serem avaliadas quanto à tentação para o uso ou auto-eficácia para abstinência de drogas em geral.

Motivação para mudança de comportamento em amostra de jogadores patológicos

OBJETIVO: O objetivo deste trabalho foi conhecer o perfil e avaliar as características de jogadores patológicos que frequentavam clínicas e grupos especializados no tratamento desse problema, quanto à motivação para mudança de comportamento. MÉTODO: Foram avaliados 69 sujeitos com diagnóstico de jogo patológico, segundo critérios diagnósticos do DSM-IV-TR. A amostra foi subdividida em dois grupos, conforme o tipo de tratamento: grupo em tratamento ambulatorial (TA) e grupo de jogadores anônimos (JA). Os instrumentos utilizados foram a University of Rhode Island Change Assessment (URICA), a Régua de Prontidão e a South Oaks Gambling Screen (SOGS). RESULTADOS: A análise dos resultados evidenciou que o grupo TA apresentou escore médio maior do que o do grupo JA tanto no estágio de pré-contemplação quanto no estágio de ação. Comparando os grupos TA e JA com relação ao tempo de abstinência, observou-se que o grupo de JA está associado a um tempo maior de abstinência do que o grupo de ambulatório. CONCLUSÃO: A importância de pesquisar estratégias que favoreçam a compreensão e a adesão aos tratamentos para jogadores patológicos é fundamental. A avaliação da motivação e dos estágios para mudança permite uma direção para o tratamento, auxiliando na elaboração de estratégias terapêuticas.

Coping strategies for craving management in nicotine dependent patients

OBJECTIVE

The aim of this study was to investigate the association between the intensity of craving and the types of coping skills used by nicotine-dependent patients.

METHOD

This was an experimental study. The sample comprised 201 subjects, mean age 38.15 years. The participants were randomly divided into groups of zero, 30 and 60 minutes of nicotine abstinence. The following instruments were administered: the Chart of Sociodemographic Data, the Fagerström Test for Nicotine Dependence, the Questionnaire of Smoking Urges, and the Coping Strategies Inventory.

RESULTS

The most frequently used coping strategies are presented in descending order: accepting responsibility, self-control and distancing. There was a positive correlation between the confrontive coping strategy and the total score on the Questionnaire of Smoking Urges (rs = 0.146; p = 0.045) and the score on Factor 1 (rs = 0.165; p = 0.023).

CONCLUSION

The most intense craving can lead nicotine-dependent individuals to use confrontive coping strategies that make them unable to control their emotions or to face the situations of high risk of relapse. This finding demonstrates that the treatment of smokers should include psychological education about the pitfalls of using these types of strategy and should teach them new types of coping strategies for craving management.

Qualidade de vida e localização da lesão em pacientes dermatológicos

FUNDAMENTOS - O aspecto visível das lesões de pele e seu impacto psicológico interferem na qualidade de vida dos pacientes. OBJETIVOS - Avaliar qualidade de vida e localização da lesão dermatológica, verificar associação entre variáveis e comparar níveis de qualidade de vida em pacientes com lesões na face/ou mãos e pacientes somente com lesões em outras regiões do corpo que não face e/ou mãos. MÉTODO - Estudo transversal, descritivo, de ssociação. Foram avaliados 205 sujeitos através do Questionário Genérico de Qualidade de Vida- SF-36 "The Medical Outcomes Study 36-item Short-Form Health Survey" (SF-36) e do Dermatology Life quality Index, fichas de dados sócio-demográficos e de localização da lesão. RESULTADOS - Não foram observadas diferenças significativas na qualidade de vida entre os dois grupos, mas o número de associações entre SF-36 e DLQI-BRA foi superior no grupo com lesões em face e/ou mãos. Diferenças significativas foram verificadas quando da divisão em cinco grupos. A diferença significativa (p=0,05) foi entre o grupo com lesões somente em face e/ou mãos e o grupo com lesões generalizadas, sendo que este último teve posto médio de 114,06 contra 69,1935 do outro grupo. CONCLUSÕES - Independente da localização da lesão, o sentimento de exposição e os prejuízos a que fica sujeito o paciente dermatológico são semelhantes. As doenças da pele, ao que parece, provocam sentimento de exposição e constrangimento, independente do local do corpo acometido, pois na aproximação mais íntima de outra pessoa está implicada certa exposição.

Localização da lesão e níveis de stress em pacientes dermatológicos

O stress repercute nas doenças de pele. A pele é um órgão visível, que tem importância nas relações interpessoais e pode trazer prejuízos quando lesionada. Neste estudo, avaliou-se stress e localização da lesão dermatológica e a associação entre essas variáveis, comparando níveis de stress em pacientes com lesões no rosto e/ou mãos e pacientes com lesões em outras partes do corpo. Tratou-se de um estudo transversal, descritivo, de associação. Participaram 205 pacientes, que responderam ao Inventário de Sintomas de Stress para Adultos de Lipp, às Fichas de Dados Sócio-Demográficos e de Localização da Lesão. Quanto aos resultados, houve presença de sintomas de stress na maioria dos pacientes; a fase de resistência e a sintomatologia psicológica foram predominantes. Na comparação entre grupos com diferentes localizações de lesão, não houve diferenças significativas quanto aos resultados de stress (p=0,495; p=0,873 e p=0,815). Os achados corroboram a necessidade de um atendimento biopsicossocial aos pacientes.

Adaptação brasileira da University of Rhode Island Change Assessment (URICA) para usuários de substâncias ilícitas

Este estudo apresenta a validação do University of Rhode Island Change Assessment (URICA) para usuários de substâncias psicoativas ilícitas no Brasil. A amostra foi de 214 sujeitos dos sexos masculino (n=194) e feminino (n=20), com faixa etária entre 13 e 44 anos de idade (M=22,93; DP=7,94). A coleta ocorreu em Porto Alegre (RS), em ambulatórios para tratamento da dependência química (n=89) e locais de internação (n=125). As análises estatísticas evidenciaram uma boa consistência interna da escala de 24 itens (a=0,657). A partir de análises estatísticas foi construído o escore T, realizando a normatização brasileira da URICA para drogas ilícitas, que apresentou bons resultados psicométricos, podendo ser usada em estudos que proponham investigar a motivação para mudança de comportamentos-problema.

Efeitos da entrevista motivacional em adolescentes infratores

A entrevista motivacional é uma intervenção breve, que visa estimular a mudança de comportamento. Foi aplicada, nesta pesquisa, em adolescentes usuários de drogas, identificando-se as modificações ocorridas após a mesma. A amostra foi constituída por 50 adolescentes usuários de drogas que cometeram ato infracional. Todos foram avaliados por meio de protocolo padrão, depois submetidos a cinco sessões de entrevista motivacional, e reavaliados posteriormente. Os resultados encontrados na reavaliação foram: o aumento do número de dias de abstinência de maconha e álcool; diminuição da quantidade de uso de álcool, tabaco e maconha; abstinência de cocaína, crack e solventes. Houve também diferenças significativas no estágio motivacional da pré-contemplação e nas crenças cognitivas acerca do uso de substâncias. Os dados evidenciaram que, após a entrevista motivacional, houve mudança no consumo de drogas, nos estágios motivacionais e nas crenças cognitivas em adolescentes infratores usuários de drogas.

Craving e dependência química: conceito, avaliação e tratamento

O craving ou fissura, cuja definição mais comum é o desejo intenso por uma substância, é um conceito controverso entre os pesquisadores da área da dependência química. OBJETIVO: Realizar revisão teórica a respeito do craving nos bancos de dados PsycInfo, Medline, ProQuest e Science Direct. MÉTODO: As palavras-chave utilizadas foram craving, dependence e drug e o período pesquisado foi entre 1995 e 2007. RESULTADOS: Os resultados demonstraram que são encontrados diversos significados para o craving, alguns se restringindo a desejo, e outros, considerando-o não só como desejo, mas como antecipação do resultado positivo do uso da substância, alívio dos sintomas de abstinência ou afeto negativo e intenção de fumar, o que reflete uma visão multidimensional deste construto. A etiologia do craving pode ser explicada por intermédio dos modelos: comportamental, cognitivo ou psicossocial e neurobiológico, porquanto a opção por um destes influencia a avaliação e o manejo. CONCLUSÃO: Conclui-se quanto à multidimensionalidade do craving e quanto à necessidade de que seja utilizado um modelo biopsicossocial que integre os diversos modelos no tratamento de dependentes químicos. Destaca-se a importância da realização de mais estudos para a compreensão do craving em função deste ser um dos principais riscos de recaída.