Anorexia nervosa and family relationships: perceived family functioning, coping strategies, beliefs, and attachment to parents and peers

This ex post facto study explored the differences in perceived family characteristics between a group of 34 female patients with anorexia nervosa and 34 females without eating pathology. All participants filled out the following self-report scales: FACES II, F-COPES, IPPA and the Family Beliefs Questionnaire. The results showed that, in contrast with participants without pathology, patients perceived their families as less cohesive and less capable of redefining stressful events in order to make them more manageable. However, they perceived their families as being more able to acquire and accept help, and presented more family beliefs related to a sense of an individual responsibility/self-blaming. In addition, patients seemed to trust less their mothers and peers and to communicate less with their peers, and to show more detachment to mothers, fathers, and peers. Of all studied variables, detachment from friends and mother, as well as perceived higher family capacity to seek out community resources and accept help were the most important variables to the discrimination between groups.Este estudio ex post facto ha explorado las diferencias entre la percepción de características familiares de 34 mujeres jóvenes con anorexia nerviosa y 34 mujeres jóvenes sin patología alimentaria. Todas las participantes completaron los siguientes instrumentos de auto-respuesta: FACES II, F-COPES, IPPA y el Cuestionario de Creencias Familiares. Los resultados demostraron que, en comparación con el grupo de mujeres sin patología alimentaria, las pacientes consideran a sus familias menos unidas y menos capaces de redefinir de una forma más aceptable las experiencias y situaciones de estrés. Sin embargo, consideran a sus familias más capaces de buscar y aceptar ayuda, y presentan más creencias familiares relacionadas con la responsabilidad individual/auto-censura. En comparación con el grupo sin patología alimentaria, las pacientes parecen confiar menos en sus madres y amigos, parecen comunicarse menos con los amigos, y tienden a demostrar una mayor alienación en relación a la madre, al padre y a los amigos. De todas las variables en estudio, la alienación en relación a los amigos y a la madre, así como la mayor capacidad para buscar y aceptar ayuda fueron las variables más importantes para discriminar los grupos

The pathological gambler and his spouse: how do their narratives match?

This case study compares the narratives of a pathological gambler and his spouse concerning family, marital and individual matters. It does so through identifying each of the key players’ narratives individually (analysis of self-report questionnaires) and interactively (couples therapy sessions analysis). The results show that the gambler has a rather more positive view of gambling-related issues than does his spouse, and this fact is most apparent when it comes to marital and family issues. The gambler’s perspective is less positive when it comes to non-relationship issues (financial and professional issues). A few hypotheses are put forward to explain these results and these are summarized in three effects: denial, idealization/guilt relief, and disappointment/retaliation. Some implications for clinical practice are also identified, such as the need to set therapy objectives which are truly shared by both members of the couple, as well as guidelines for future research, such as studies focused on gender differences.Cette étude compare les récits d’un joueur pathologique et de sa conjointe concernant des questions familiales, conjugales et individuelles. La démarche a consisté à cerner chaque récit individuellement (analyse de questionnaires d’auto-évaluation) et en interaction avec l’autre (analyse de séances de thérapies de couple). Les résultats indiquent que le joueur a une perception plus positive des problèmes liés au jeu que sa conjointe et que cette caractéristique est plus marquée lorsqu’il est question des enjeux conjugaux et familiaux. La perception du joueur est cependant moins positive lorsqu’il est question d’enjeux non relationnels (enjeux financiers et professionnels). Les quelques hypothèses proposées pour expliquer ces résultats peuvent être résumées par les trois effets suivants : le déni, l’idéalisation/le soulagement de la culpabilité, la déception/les représailles. L’étude signale également les conséquences des résultats dégagés sur la pratique clinique, comme la nécessité d’établir des objectifs de thérapie qui sont véritablement partagés par les deux partenaires du couple, et dresse des lignes de conduite pour des recherches futures, par exemple sur les différences entre les hommes et les femmes

Family and systems therapy and training in Portugal

"Author's personal copy"The history of systemic family therapy in Portugal since its appearance until the present is discussed. Some data on systemic family therapists' training is provided in the context of the Portuguese Society of Family Therapy and Academic Institutions. In Portugal, family therapy has been extended to various contexts, including medical and community services. Finally, future directions for family and systems therapy practice and training in Portugal are provided emphasizing the importance of family interventions as an important resource to empower families living with health chronic conditions. The Portuguese Family Therapy Society, every 2 years, organizes a scientific Iberian conference with Portuguese and Spanish speakers. This allows the exchange of clinical experience and research about family and systems theory

Crise económica e dificuldades familiares: Duas faces da mesma moeda?

The media have promoted the idea that the economic crisis is strongly associated with a decline in mental health and with family important consequences. However, this seems to be a “truth” poorly studied in Portugal, despite being almost dogmatically assumed.Thus, this study analyses a sample of people (N = 287) which perceives the economic crisis as its main family problem, according to the following variables: family difficulties (SCORE-15), quality of family life (QOL), marital adjustment (DAS), marital satisfaction(EASAVIC), congruence (EC) and psychopathological symptoms (BSI). The results show that, although the crisis affects the quality of life, participants are resilient in terms of their family functioning, thus being conjugality the most affected relational area. Though theyare sadder and more worried, the participants show themselves emotionally healthy. This study has some limitations, such as the sample characteristics, but nevertheless it contributes to fill the gap in scientific evidence concerning the impact of the economic crisis onthe Portuguese families by means of a more psychosocial and less pathological approach.Os meios de comunicação têm promovido a ideia de que a crise económica está fortemente associada a uma deterioração da saúde mental e a consequências familiares importantes. No entanto, esta parece ser uma “verdade” muito pouco estudada em Portugal, apesar de ser quase dogmaticamente assumida. Assim, este estudo analisa uma amostra de pessoas (N = 287) que considera a crise económica o seu principal problema familiar, atendendo às seguintes variáveis: dificuldades familiares (SCORE-15), qualidade da vida familiar (QV),ajustamento conjugal (DAS), satisfação conjugal (EASAVIC), congruência (CE) e sintomas psicopatológicos (BSI). Os resultados mostram que, apesar de a crise afetar a qualidade de vida, os participantes são resilientes em termos do funcionamento familiar, sendo a conjugalidade, a área relacional mais prejudicada. Embora mais tristes e preocupados, os participantes mostram-se emocionalmente saudáveis. Este estudo apresenta algumas limitações, como as características da amostra. Apesar disso, contribui para preencher a lacuna de evidências científicas sobre o impacto da crise económica nas famílias portuguesas, através de uma abordagem mais psicossocial e despatologizante

Risco de crédito

Mestrado em Mathematical FinanceEm resposta à crise da década de 70, os países do G10 criaram o Comité de Basileia, que fornece a regulamentação referente ao capital mínimo para os riscos incorridos. Este projeto resulta de um estágio no Banco Carregosa cujos objetivos são:validar o modelo económico de risco de crédito e verificar se reúne as condições para ser considerado um modelo multi-factor Vasicek; testar a adaptação ao modelo de Pedersen & Krogsgaard (2008); e analisar a rapidez e precisão do novo modelo. Estas propostas surgem da postura de melhoria contínua da instituição, em concreto, para uma gestão de riscos mais resiliente e realista. Procurou-se analisar, exaustivamente, o modelo utilizado e as possíveis adaptações pela integração do modelo estocástico de taxas de juro, da média reversível de índices de alavancagem dinâmicos, da antecipação de incumprimento e de saltos ao risco. Da análise feita ao modelo utilizado e às suas adaptações, assinala-se que os resultados gerados pelo modelo utilizado são sólidos e robustos. No entanto os resultados gerados pelas suas adaptações são demasiado fracos e muito sensíveis ao valor dos parâmetros adotados. Este estudo entende-se, também, pertinente, no contexto da crescente regulamentação e importância da análise do risco, num enquadramento de reduzido conhecimento disponível e de histórico comparável.In response to the 70’s crisis, G10´s countries formed the Basel´s Committee that provides regulation about minimum capital to the risk incurred. This project is the outcome of an internship at Carregosa Bank (Banco Carregosa), and it has multiple purposes. Firstly, it is aimed to validate the economic model of credit risk and to verify if it satisfies the conditions to qualify as a multi-factor Vasicek model. It intends to test the adaptation of Pedersen & Krogsgaard (2008) model, and lastly to analyse the speed and accuracy of the new model. These proposals arise from an approach of continuous improvement of the institution, specifically for management of more resilient and realistic risks. There was an extensive analysis of the used model and the possible adaptations by the incorporation of the stochastic model of interest rates, mean reverting leverage ratios, early default and jump risks. Analysing the used model and its possible adaptations, it can be pointed out that the obtained results by the used model are strong and sound. Although, the obtained results by its adaptations are too weak and highly sensitive to the values of the adopted parameters. The study is also relevant in the context of increasing regulation and the importance of risk analysis in a framework of reduced knowledge available and comparable history.info:eu-repo/semantics/publishedVersio

Programa de educação parental “Em Equilíbrio”: Estudo crítico-reflexivo

This study presents a critical reflection on the parents’ education program “Em Equilíbrio”, implemented within an inter-institutional network, following a logic of selective intervention, with the overall aim of promoting the development of parenting skills. The results obtained point to the program´s impact on key factors of parenting and family dynamics related to the prevention of antisocial behavior and child abuse. The study concludes that there is a good fit between the goals of the program and its implementation methodology. Its main asset is the promotion and involvement of the family’s formal network and the aspects to improve are the objectivity of the participants’ selection process, availability of supervision, centrality of intervention and the evaluation model.O presente estudo apresenta uma reflexão crítica sobre o programa de educação parental “Em Equilíbrio”, implementado numa rede interinstitucional, numa lógica de intervençãoseletiva, tendo como objetivo geral a promoção do desenvolvimento de competênciasparentais. Os resultados alcançados apontam para o impacto do programa em fatores-chave da parentalidade e dinâmica familiar, relacionados com a prevenção do comportamento antissocial e dos maus tratos infantis. O estudo conclui que existe um bom ajustamentoentre os objetivos do programa e a sua metodologia de implementação. A sua principal mais-valia é a dinamização e envolvimento da rede formal das famílias e os aspetos a melhorar são a objetividade da seleção dos participantes, disponibilidade de supervisão, a centralidade interventiva e o modelo de avaliação

Jogo patológico em 3D: Variáveis familiares, conjugais e individuais

This work integrates and articulates the main results of the project “Pathological gambling in 3D: Family, marital and individual variables”, presented in five scientific articles. Theresults show that pathological gamblers are a heterogeneous group with different severities of the gambling problem, revealing a positive relationship between increasing severity of pathological gambling and the amount and intensity of individual, marital and family difficulties associated. The order in which these difficulties appear seems to put family difficulties and differentiation of the self in the last place and marital and individual difficulties in the first one. There is little consensus regarding the marriage and family areas between gambler(s) and their spouse(s), whereby the perspective of the former is less marked by deficit or more optimistic than the latter’s. The articulation of these data has led to a comprehensive reflection on the theme, systematized by the reformulation of the Integrative Systemic Model of Pathological Gambling.Este trabalho integra e articula os principais resultados do projeto “Jogo patológico em 3D: Variáveis familiares, conjugais e individuais”, dispersos por cinco artigos científicos. Os resultados indicam que os jogadores patológicos constituem um grupo heterogéneo com diferentes severidades do problema jogo, revelando-se uma relação positiva entre o aumento da gravidade do jogo patológico e da quantidade e intensidade de dificuldadesindividuais, conjugais e familiares associadas. A ordem pela qual estas dificuldades se fazem notar parece colocar as dificuldades familiares e a diferenciação do self em último lugar e as dificuldades conjugais e individuais em primeiro. As áreas conjugal e familiar são pouco consensuais entre jogador(es) e cônjuge(s), sendo a perspetiva do(s) primeiro(s) menos marcada pelo défice ou mais otimista do que a do(s) segundo(s). A articulação destes dados conduziu a uma reflexão integradora sobre o tema, sistematizada através da reformulação do Modelo Sistémico Integrador do Jogo Patológico

Necessidades dos familiares de doentes terminais em cuidados paliativos: Revisão crítica da literatura

Terminal illness and death are critical events that interfere in the family system. The knowledge about illness and death’s impact on the family is, still, scarce. Therefore, a critical review of literature was conducted with the general goal of determining the impact of terminal illness on the family and which are the family’s support needs. The findings suggest that terminal illness is one of the most difficult experiences for the family system and an inadequate or non-existent approach to the family’s problems can put that system in risk. Therefore, palliative care aims at the integration of the family in the care plan. However, the empirical production about this topic is insufficient, which compromises the development of new efficient family approaches that are sensitive to family needs. By this way, it is important to have more research that aims to determine the family needs of terminally ill patients and develop new family intervention strategies.A doença terminal e a morte são acontecimentos críticos que interferem no sistema familiar. Considerando a escassez de literatura sobre o assunto, procedeu-se a uma revisão crítica da literatura, com o objetivo geral de determinar o impacto que a doença terminal tem na família e quais as suas necessidades de suporte. Concluiu-se que a doença terminal constitui uma das experiências mais difíceis para o sistema familiar e que uma abordagem formal inadequada dos problemas emergentes o pode colocar em risco. Por isto, os cuidados paliativos visam a integração da família no plano de cuidados. Todavia, verificou-se que a produção empírica neste âmbito é insuficiente, comprometendo o desenvolvimento de modalidades de intervenção eficazes e sensíveis às necessidades que emergem na família. Urge desenvolver mais estudos que visem determinar as necessidades das famílias do doente terminal e desenvolver estratégias de intervenção dirigidas a essas mesmas famílias

Cuidados paliativos oncológicos em contexto de internamento e domiciliário: Necessidades, morbilidade psicológica e luto antecipatório nos familiares do doente terminal e impacto na qualidade de vida familiar

Terminal cancer has a profound impact on family and its’ elements. Therefore, palliative care foresees a family support. However, there are not many studies that aim to determine the family needs within palliative care. The present study aims to determine family needs, psychological morbidity and anticipatory grief of terminal patients’ relatives, distinguishing two care contexts (hospice and home care), and examine the influence of unmet needs, anticipatory grief, psychological morbidity and care setting on the perceived family quality of life. For such, an exploratory study was conducted with a sample of 40 terminal cancer patients’ relatives in palliative care. It was found that psychosocial needs are lesser satisfied in home-based palliative care. Regardless the context of care, patients’ relatives report clinically significant levels of psychological morbidity and anticipatory grief with impact on family perceived quality of life. Unmet needs, psychological morbidity and anticipatory grief seem to influence on the perceived family quality of life. This study demonstrates the importance of attending patients’ relatives in palliative care, in a holistic and multidisciplinary approach.A doença oncológica na fase terminal tem um importante impacto na família e seus elementos. Por este motivo, os cuidados paliativos pressupõem o suporte à família. No entanto, são escassos os estudos que visam determinar as necessidades das famílias em cuidados paliativos. O presente estudo teve como objetivos determinar quais as necessidades dos familiares dos doentes terminais, a presença de morbilidade psicológica e experiência de luto antecipatório, distinguindo dois contextos de prestação de cuidados (internamento e domicílio), e examinar a influência de uma satisfação inadequada das necessidades, luto antecipatório e contexto de prestação de cuidados na perceção de qualidade de vida familiar. Para tal, procedeu-se a um estudo exploratório junto de uma amostra de 40 familiares de doentes oncológicos terminais em cuidados paliativos. Verificou-se que as necessidades de suporte psicossocial são menos satisfeitas em contexto de cuidados domiciliários. Independentemente do contexto de prestação de cuidados, os familiares apresentam níveis clinicamente significativos de morbilidade psicológica e luto antecipatório com impacto na perceção da qualidade de vida familiar. A satisfação inadequada das necessidades, a presença de morbilidade psicológica e a experiência de luto antecipatório influenciam a perceção de qualidade de vida familiar. Este estudo vem demonstrar a importância de atender às necessidades dos familiares em cuidados paliativos, numa perspetiva holística e multidisciplinar