The moderating role of hair cortisol in the association of early and recent stress with stress-related phenotypes

Background: Increased hair cortisol concentrations (HCC) have been found in clinical samples of schizophrenia, first episode psychosis and clinical risk for psychosis, but evidence of such is scarce in schizotypy. High HCC are supposed to reflect elevated chronic stress. However, HCC were not directly associated with adversity measures and stress-related phenotypes in previous research. This study tested whether HCC moderated the association between a comprehensive range of psychosocial stressors with several stress-related phenotypes in a sample of nonclinical young adults. It was expected that stressors, either distal (i.e., early-life) or recent, would be associated with subclinical features, particularly for those with elevated HCC, reflecting the effects of a potential biological sensitization to stress. Methods: The sample comprised 132 nonclinical young adults belonging to the Barcelona Longitudinal Investigation of Schizotypy Study (BLISS). Participants completed a questionnaire of childhood adversity and two complementary measures of recent life events, tapping threatening vs. more general life events. Both the frequency and subjective impact (positive vs. negative) of general life events were also assessed. Psychotic (i.e., schizotypy, suspiciousness) and non-psychotic (i.e., depression, anxiety) subclinical features as well as appraisals of perceived stress were examined. Hierarchical linear regressions and simple slope analyses were computed. Results: HCC moderated the effects of both early and recent stress on suspiciousness as well as the effects of recent life events on perceived stress, such that those with higher HCC presented increased suspiciousness and perceived stress at higher levels of stress exposure. Positive, but not negative, recent life events were associated with decreased perceived stress and depression, and these associations were moderated by low HCC, indicating a buffering effect for those with a non-impaired HPA axis. Conclusion: In line with the neural diathesis-stress model, results highlight the role of the interplay between the HPA axis and exposure to stressful experiences in exacerbating psychosis features and extend evidence to the nonclinical expression of the psychosis continuum. In addition, findings support the protective effect of positive experiences in decreasing stress appraisals and affective disturbances, which is consistent with emerging research about the relevance of positive factors in reducing the likelihood of psychopathological outcomes

Deconstructing the relationships between self-esteem and paranoia in early psychosis : an experience sampling study

No studies have examined the association between self-esteem and paranoia developmentally across the critical stages of psychosis emergence. The present study fills this gap and extends previous research by examining how different dimensions, measures, and types of self-esteem relate to daily-life paranoia across at-risk mental states for psychosis (ARMS) and first episode of psychosis (FEP) stages. Furthermore, the moderation effects of momentary anxiety and momentary perceived social support on the association between momentary self-esteem and paranoia were examined. This study used a multilevel, cross-sectional design. One-hundred and thirteen participants (74 ARMS and 39 FEP) were assessed repeatedly over seven consecutive days on levels of momentary paranoia, self-esteem, anxiety and perceived social support using experience sampling methodology. Measures of trait and implicit self-esteem were also collected. Global momentary and trait self-esteem, and their positive and negative dimensions, were related to daily-life paranoia in both ARMS and FEP groups. Conversely, implicit self-esteem was not associated with daily-life paranoia in either group. Anxiety negatively moderated the association between positive self-esteem and lower paranoia, whereas both feeling close to others and feeling cared for by others strengthened this association. However, only feeling cared for by others moderated the association between negative self-esteem and higher paranoia. Different types, measures and dimensions of self-esteem are differentially related to paranoia in early psychosis and are influenced by contextual factors in daily-life. This yields a more complex picture of these associations and offers insights that might aid psychological interventions

The Role of Schizotypy in the Study of the Etiology of Schizophrenia Spectrum Disorders

Alres ajuts: Fundació La Marató de TV3 (091110)Schizotypy provides a useful construct for understanding the development of schizophrenia spectrum disorders. As research on the epidemiology of psychotic symptoms and clinical risk for psychosis has expanded, conceptual challenges have emerged to comprehend the nature and borders of the space comprised between personality variation and psychosis. Schizotypy is considered in light of these more recent constructs. It is suggested that rather than being superseded by them due to their higher specificity and predictive power for transition to psychosis, schizotypy integrates them as it constitutes a dynamic continuum ranging from personality to psychosis. The advantages of schizotypy for studying schizophrenia etiology are discussed (eg, it facilitates a developmental approach and the identification of causal, resilience, and compensating factors and offers a multidimensional structure that captures etiological heterogeneity). An overview of putative genetic, biological, and psychosocial risk factors is presented, focusing on communalities and differences between schizotypy and schizophrenia spectrum disorders. The found notable overlap supports etiological continuity, and, simultaneously, differential findings appear that are critical to understanding resilience to schizophrenia. For example, discrepant findings in genetic studies might be interpreted as suggestive of sets of independent genetic factors playing a differential role in schizotypy and schizophrenia: some would influence variation specifically on schizotypy dimensions (ie, high vs low schizotypy, thereby increasing proneness to psychosis), some would confer unspecific liability to disease by impacting neural properties and susceptibility to environmental factors (ie, high vs low resilience to disorder) and some might contribute to disease-specific characteristics. Finally, schizotypy's promise for studying gene-environment interactions is considered

Curso de Licenciatura em Terapia Ocupacional

O objetivo fundamental deste caderno, para a UC de Análise e Adaptação de Atividades II, é permitir que o aluno consiga analisar as tarefas e ocupações relacionadas com as diferentes áreas de desempenho ocupacional, tendo em conta as competências de desempenho e os fatores inerentes ao cliente, de forma a identificar e selecionar as atividades e ocupações adaptadas e graduadas, relevantes e significativas, que suportam os objetivos da intervenção. Este Caderno nº 1 está direcionado para intervir junto de pessoas com moderado grau de incapacidade psicossocial por doença mental grave e estabilizados clinicamente. O programa apresentado deverá ser aplicado após uma adequada contextualização da intervenção clínica. Pretende-se, desta forma, favorecer o processo de recuperação, com recurso à intervenção ocupacional no âmbito das Atividades da Vida Diária e, desta forma, facilitar ainda mais a integração comunitária e consequentemente, a qualidade de vida dos participantes.N/

Family environmental factors in at-risk mental states for psychosis

Altres ajuts: Acord transformatiu CRUE-CSICThe family environment represents an important psychosocial factor that impacts psychosis prognosis, but little is known about its effect on the at-risk stages of psychosis. This study presents a comprehensive review and summarizes the state of the art of study on the wide range of family factors related to family functioning in the At-Risk Mental State (ARMS) for psychosis, as well as family interventions in ARMS individuals. Publications were retrieved by an extensive search on MEDLINE, PsycINFO and SCOPUS (1990-2020). Expressed Emotion is the most studied variable in ARMS literature, but there is scarce evidence of the role of other significant family factors at the ARMS stage. Overall, high Expressed Emotion did not appear to be reactive to ARMS patients' poor clinical status. However, initial evidence has suggested that relatives' beliefs about the disorder may play a significant role, either as mediators of these relationships or as predictors of Expressed Emotion. Available literature yet to yield a consistent pattern of findings on the association between Expressed Emotion or other family functioning indicators and negative outcomes, but some longitudinal studies highlight the greater potential for the protective effects of positive family environments at the ARMS stage. Family-based interventions have demonstrated benefits for both ARMS individuals and family dynamics. An increased focus on the impact of the at-risk stage of illness on relatives' mental well-being is required to provide family support based on their needs and to clarify the mechanisms leading to dysfunctional family dynamics during the critical ARMS period

Curso de Licenciatura em Terapia Ocupacional

Um dos objetivos desta Unidade Curricular passa por selecionar teorias, modelos e métodos de prática que vão ao encontro das necessidades ocupacionais do indivíduo com perturbação mental. Desta forma, as Técnicas de Relaxamento, popularmente utilizadas na intervenção ocupacional no âmbito da Saúde Mental são recursos terapêuticos de extrema importância para permitir o desenvolvimento de competências que suportem a participação ocupacional e, consequentemente, a funcionalidade do indivíduo.N/

Curso de Licenciatura em Terapia Ocupacional

O objetivo fundamental deste primeiro caderno para a UC de Análise e Adaptação de Atividades III, é permitir que o aluno consiga analisar as tarefas e ocupações relacionadas com as diferentes áreas de desempenho ocupacional, tendo em conta as competências de desempenho e os fatores inerentes ao cliente, de forma a identificar e selecionar as atividades e ocupações adaptadas e graduadas, relevantes e significativas, que suportam os objetivos da intervenção. Desta forma, apresenta-se um exemplo de programa de intervenção no âmbito da estimulação sensorial e cognitiva para idosos, com o objetivo de aplicar os conteúdos teórico-práticos integrados em contexto de sala. No entanto, caso o aluno pretender utilizar este Caderno nº 1, deverá realizar as adaptações pertinentes, conforme avaliação prévia efetuada aos clientes ou potenciais utilizadores.N/

Programas de Intervenção em Comportamentos Aditivos

A Unidade Curricular Optativa de “Programas de Intervenção em Comportamentos Aditivos”, visa a aquisição de conhecimentos gerais no âmbito dos comportamentos aditivos, de forma o aluno integrar conceitos específicos, estratégias e ferramentas para a elaboração de planos de intervenção preventivos, em contexto comunitário, com base na evidência científica atual. Neste segundo recurso pedagógico para esta Unidade Curricular, apresenta-se o exemplo de um programa fictício de Intervenção em Comportamentos Aditivos (cocaína), a implementar junto de estudantes do Ensino Secundário.N/

Programas de Intervenção em Comportamentos Aditivos

A Unidade Curricular Optativa de “Programas de Intervenção em Comportamentos Aditivos”, visa a aquisição de conhecimentos gerais no âmbito dos comportamentos aditivos, de forma o aluno integrar conceitos específicos, estratégias e ferramentas para a elaboração de planos de intervenção preventivos, em contexto comunitário, com base na evidência científica atual. Neste primeiro recurso pedagógico, apresenta-se o exemplo de um programa fictício de Intervenção em Comportamentos Aditivos (nicotina), a implementar junto de alunos do Ensino Secundário.N/

Coordenar o serviço de terapia ocupacional com qualidade

Trabalho apresentado para obtenção do título de especialista em terapia e reabilitação – área de terapia ocupacional. Instituto Politécnico de Beja. Escola Superior de Saúde, 2012.Foi no ano 2005 que recebi o convite para desenvolver funções de Terapeuta Ocupacional na Casa de Saúde São João de Deus, após outros anos de exercício profissional na APPACDM – Braga e na Casa de Saúde do Bom Jesus. O desafio era grande: iniciar e coordenar, com rigor técnico e clínico, o Serviço de Terapia Ocupacional da Instituição. Nunca antes um terapeuta tinha exercido funções na Casa de Saúde. Até à data, só alguns utentes desenvolviam ocupações em alguns dos ateliês e/ou valências ocupacionais, mas não existia uma planificação, organização e implementação das intervenções. Inicialmente houve um desconhecimento generalizado de quais as funções de um terapeuta. Contudo, e ao longo destes anos, foram desmitificadas algumas ideias erradas relativas à profissão, existindo neste momento, um posicionamento técnico ajustado às características da Terapia Ocupacional e com reconhecimento por parte da equipa de colaboradores da Casa de Saúde