A Díada amígdala-cocaína como paradigma neurobiológico num modelo de neurotoxicologia do desenvolvimento

Dissertação de Mestrado em Psiquiatria e Saúde Mental apresentada à Faculdade de Medicina da Universidade do Port

Estudo de propriedades psicométricas do Questionário de Trauma de Infância – Versão breve numa amostra portuguesa não clínica

Neste trabalho apresentam-se os resultados da adaptação do Questionário de Trauma de Infância –forma breve (CTQ-SF) em população portuguesa. As propriedades psicométricas do instrumento foram estudadas numa amostra não clínica de 746 sujeitos adultos, tendo-se testado a estrutura de cinco fatores, inicialmente proposta pelos autores do questionário. A fiabilidade teste-reteste foi analisada num grupo de 29 sujeitos. As subescalas apresentam coeficientes de consistência interna a variar entre .84 para a escala total, .79 para a negligência emocional, .77 para o abuso físico, .71 para o abuso emocional e sexual, e .47 para a negligência física. A subescala de negligência física apresenta baixa consistência interna, replicando resultados anteriores de outros estudos, salientando a necessidade de uma possível revisão desta subescala. A exposição a negligência emocional e ao abuso verbal aparecem como as formas mais frequentes de maltrato de infância em adultos. O CTQ-SF apresenta características de validade aceitáveis, com exceção da subescala de negligência física. Futuros trabalhos com o instrumento deverão incluir medidas mais eficazes na detecção da negligência física.

Vulnerability Factors Associated with Lifetime Posttraumatic Stress Disorder among Veterans 40 Years after War

Vulnerability factors for posttraumatic stress disorder (PTSD) development are still controversial. Our aim was to study the vulnerability factors for the development of war-related PTSD over a period of 40 years after exposure. A cross-sectional, observational study was carried out on 61 male traumatized war veterans, taking into consideration adverse childhood experiences (ACE), attachment orientations, number of non-war-related traumatic events, and war experiences. Lifetime PTSD was assessed by using the Clinician-Administered PTSD Scale. Insecure attachment styles were significantly associated with lifetime PTSD and even after adjustment for war exposure this was still significant. Non-war-related traumatic events were not associated with lifetime PTSD, whereas ACE were associated with lifetime PTSD. War-related experiences were also associated with lifetime PTSD, except for injury or disease. The results for our sample show that, 40 years after war, the intensity of war-related experiences and ACE were significantly and independently associated with the development of lifetime PTSD. Insecure attachment was significantly associated with lifetime PTSD, which, in turn, are both positively associated with war exposure. These findings may have implications for patient care, as they constitute a strong argument that attachment-focused therapies could well be necessary 40 years after trauma

General practitioners’ own traumatic experiences and their skills in addressing patients’ past history of adversities: a cross-sectional study in Portugal

Addressing trauma has been found to be important for primary care patients, as it can improve their health-related outcomes. We aimed to assess how Portuguese general practitioners’ (GPs) past history of traumatic events (TEs) and adverse childhood experiences (ACEs) influence their clinical communication skills when addressing their patients’ past history of adversities. An online survey was circulated by email to GPs’ associations and through GPs’ social media groups. A sample of 143 GPs participated in this study. GPs’ exposure to ACEs and TEs was assessed using the Childhood Trauma Questionnaire-Short Form and the Life Events Checklist for the DSM-5. To evaluate clinical communication skills, we adapted the Self-confidence Scale and used the Jefferson Scale of Physician Empathy. GPs identified barriers to addressing trauma routinely, including a lack of time (86.7%) and a fear of causing further patient suffering (56.6%). GPs’ exposure to TEs and ACEs was positively correlated with scores in some dimensions of self-confidence and empathy (r values varying from 0.170 to 0.247). GPs exposed to traumatic experiences felt more confident when addressing their patients’ adversities and were more empathic when conducting therapeutic relationships. This study shows that GPs with a history of traumatic experiences are able to address their patients’ adversities; however, they lack proper training and better patient care conditions, such as more time and more resources available for patient guidance.info:eu-repo/semantics/publishedVersio

Emotion Recognition Ability Test Using JACFEE Photos: A Validity/Reliability Study of a War Veterans' Sample and Their Offspring.

Emotion recognition is very important for social interaction. Several mental disorders influence facial emotion recognition. War veterans and their offspring are subject to an increased risk of developing psychopathology. Emotion recognition is an important aspect that needs to be addressed in this population. To our knowledge, no test exists that is validated for use with war veterans and their offspring. The current study aimed to validate the JACFEE photo set to study facial emotion recognition in war veterans and their offspring. The JACFEE photo set was presented to 135 participants, comprised of 62 male war veterans and 73 war veterans' offspring. The participants identified the facial emotion presented from amongst the possible seven emotions that were tested for: anger, contempt, disgust, fear, happiness, sadness, and surprise. A loglinear model was used to evaluate whether the agreement between the intended and the chosen emotions was higher than the expected. Overall agreement between chosen and intended emotions was 76.3% (Cohen kappa = 0.72). The agreement ranged from 63% (sadness expressions) to 91% (happiness expressions). The reliability by emotion ranged from 0.617 to 0.843 and the overall JACFEE photo set Cronbach alpha was 0.911. The offspring showed higher agreement when compared with the veterans (RR: 41.52 vs 12.12, p < 0.001), which confirms the construct validity of the test. The JACFEE set of photos showed good validity and reliability indices, which makes it an adequate instrument for researching emotion recognition ability in the study sample of war veterans and their respective offspring

Loglinear Poisson Model for the Frequencies of Observed and Intended Expression Categories for Each Individual, Adjusted for Expected Frequencies, Assuming Independence between Both Factors. Stratified by Education, Age, and Gender.

<p>RR = relative risk; CI = confidence interval;</p><p>* p value for the interaction;</p><p>^# not shown because all veterans were male.</p><p>Loglinear Poisson Model for the Frequencies of Observed and Intended Expression Categories for Each Individual, Adjusted for Expected Frequencies, Assuming Independence between Both Factors. Stratified by Education, Age, and Gender.</p

Reliability between Images of Each Intended Expression, Pooled and Stratified by Veterans and Offspring.

<p>Reliability between Images of Each Intended Expression, Pooled and Stratified by Veterans and Offspring.</p

Example of the data collapsed according to the frequencies of the chosen and intended expression categories for each individual.

<p>Example of the data collapsed according to the frequencies of the chosen and intended expression categories for each individual.</p

Number and Percentage of Chosen Emotions per Intended Emotional Expression.

<p>Number and Percentage of Chosen Emotions per Intended Emotional Expression.</p

Loglinear Poisson Model for the Frequencies of Chosen and Intended Expression Categories for Each Individual, Adjusted for Expected Frequencies, Assuming Independence between Both Factors.

<p>RR = relative risk; CI = confidence interval;</p><p>* p value for the interaction.</p><p>Loglinear Poisson Model for the Frequencies of Chosen and Intended Expression Categories for Each Individual, Adjusted for Expected Frequencies, Assuming Independence between Both Factors.</p