O treino de bio-absorção imagética (TBI) - comparação entre um grupo com tratamento activo (TBI) e um grupo em lista de espera seguido de tratamento activo (TBI) - sua eficácia no tratamento da enxaqueca e suas implicações nas variáveis psicológicas associadas à dor

O trabalho apresentado orientou-se, fundamentalmente, no sentido de avaliar e testar um tratamento psicológico denominado “Treino de Bio-Absorção Imagética” (TBI), no tratamento da enxaqueca. Este tratamento parece-nos de grande relevância no tratamento deste tipo de dor, tendo adquirido boas qualidades terapêuticas em estudos anteriores (1990; 1992 in Pires, 2002). Para cumprir este objectivo, procedeu-se a uma avaliação de variáveis relacionadas com a enxaqueca (i.e. índice de cefaleia, sintomas associados, como as náuseas e tonturas, número de dias livres e de crises e medicação) e de variáveis psicológicas associadas à experiência da dor (stresse, depressão e ansiedade) em vários momentos da investigação (antes, durante e final do tratamento). Pretende-se observar o efeito do TBI nas variáveis enunciadas. As variáveis relacionadas com a enxaqueca foram avaliadas diariamente através de um Diário da Dor (Blanchard & Andrasik, 1985), enquanto que as variáveis psicológicas (ansiedade, depressão e stresse) foram avaliadas, em três vezes, através de escalas de auto-registo: Escala de Auto-Avaliação de Zung, a Escala CES-D (Radloff, L.S. (1977) e Escala DASS (Lovibond & Lovibond (1995), respectivamente. A amostra de sujeitos é constituída por 19 pessoas, com idades compreendidas entre os 17 e os 56 e que sofrem de enxaqueca com ou sem aura, de acordo com os critérios de diagnóstico da IHS (2004). Desta forma, foram formados diferentes grupos: 1) o grupo sujeito ao tratamento psicológico (TBI), 2) o grupo em lista de espera, que posteriormente passa a ser 3) o grupo controlo sobre a condição experimental de associação de estímulo (i.e. frio) seguida do TBI. Os resultados, em geral, demonstram não existirem diferenças significativas entre as diferentes condições (entre grupos) e as semanas de cada condição (dentro dos grupos) nas variáveis em estudo, no entanto, verificou-se que as variáveis psicológicas associadas à dor, tais como o stresse, a depressão e a ansiedade apresentam níveis mais baixos no final do tratamento. Propõe-se, que o TBI poderá ter características terapêuticas no tratamento da enxaqueca, na medida em que se verifica uma redução do stresse, sintomas depressivos e ansiedade, tal como uma auto-avaliação mais positiva em relação à própria experiência enxaquecosa e sua vivência (modos de lidar com a dor mais activos e positivos). Os resultados deste estudo foram limitados, na nossa opinião, por alguns aspectos, como o tamanho da amostra e a sintomatologia clínica apresentada pela amostra. Assim, parece-nos de grande importância, e em especial no âmbito da Psicologia, aprofundar o conhecimento existente acerca deste tratamento, procurando sempre obter um maior corpo de evidência e questionar os principais aspectos que envolvem a experiência da enxaqueca, de modo a torná-la mais adaptativa para a pesso

Pain and Hypnosis

Aquesta tesi es centra en l’estudi de la migranya a un nivell cognitiu i psicofisiològic, així com en l'ús de la hipnosi per al tractament del dolor crònic. A la migranya, s'ha proposat una sensibilització electrodèrmica específica per a paraules relacionades amb el dolor. Encara que no hem trobat una activitat electrodèrmica específica en pacients amb migranya en resposta a estímuls relacionats amb el dolor i emocionals negatius, les persones amb migranya van recordar les paraules emocionals (esbiaixos cognitius) significativament més que les persones sense mal de cap. El catastrofisme relacionat amb el dolor estava relacionat amb el tipus de record. La migranya és una experiència de dolor que implica el processament emocional d'una àmplia gamma d'estímuls. D'interès fonamental és que: (1) el processament cognitiu alterat pot tenir un paper rellevant en el manteniment i la cronificació de la migranya, (2) la relació personal entre els descriptors del dolor, paraules emocionals i migranya, pot provocar una sensibilització condicionada i altament específica. Aquesta tesi també tenia per objecte examinar el valor terapèutic de la hipnosi en el context del dolor crònic. Una revisió sistemàtica sobre l'ús de la hipnosi en nens i adolescents va revelar que la hipnosi és una tècnica eficaç en el control del dolor. De la mateixa manera, una enquesta a internet per als professionals de la salut que utilitzen la hipnosi va mostrar que les tècniques hipnòtiques es seleccionen en funció de l'edat dels pacients, el que revela que els professionals tenen en compte el desenvolupament dels pacients, i que l'eficàcia de les tècniques hipnòtiques depèn, almenys en certa mesura, de l'edat del jove. Finalment, no hem trobat cap influència de les expectatives en la fenomenologia hipnòtica.Esta tesis se centró en la migraña a un nivel cognitivo y psicofisiológico, así como en el uso de la hipnosis para el tratamiento del dolor crónico. En la migraña, se ha propuesto una sensibilización electrodérmica específica para palabras relacionadas con el dolor. Aunque no encontramos una actividad electrodérmica específica en pacientes con migraña en respuesta a estímulos relacionados con el dolor y emocionales negativos, las personas con migraña recordaron las palabras emocionales (sesgos cognitivos) significativamente más que las personas sin dolor de cabeza. El catastrofismo relacionado con el dolor estaba relacionado con el tipo de recuerdo. La migraña es una experiencia de dolor que implica el procesamiento emocional de una amplia gama de estímulos. De interés fundamental resulta que: (1) el procesamiento cognitivo alterado puede tener un papel relevante en el mantenimiento y la cronificación de la migraña, (2) la relación personal entre los descriptores del dolor, palabras emocionales y migraña, puede conducir a una sensibilización acondicionada y altamente específica. Esta tesis también tenía por objetivo examinar el valor terapéutico de la hipnosis en el contexto del dolor crónico. Una revisión sistemática sobre el uso de la hipnosis en niños y adolescentes reveló que la hipnosis es una técnica eficaz en el control del dolor. Del mismo modo, una encuesta en internet para los profesionales de la salud que utilizan la hipnosis mostró que las técnicas hipnóticas se seleccionan en función de la edad de los pacientes, lo que revela que los profesionales tienen en cuenta la etapa de desarrollo de los pacientes, y que la eficacia de las técnicas hipnóticas depende, al menos en cierta medida, de la edad del joven. Por último, no encontramos influencia de las expectativas en la fenomenología hipnótica.This dissertation thesis focused on migraine pain at a cognitive and psychophysiological level, as well as on the use of hypnosis for the management of chronic pain. In migraine, a specific electrodermal sensitization to pain-related words has been proposed. Even though we did not find such a specific electrodermal activity in migraineurs in response to pain-related stimuli and negative emotional words, we did find that migraineurs recalled emotional words (i.e. cognitive biases) significantly more than headache-free controls. We also found that pain catastrophizing was related to memory recall. Migraine is a pain experience that implies emotional processing of a wide range of stimuli. Of fundamental interest is that: (1) altered cognitive processing may have a relevant role in the maintenance and chronification of migraine; (2) the personal relationship between pain descriptors, emotional words and migraineurs, which may lead to highly specific conditioning and sensitization. This dissertation also examined the therapeutic value of hypnosis in the context of chronic pain. A systematic review on the use of hypnosis in children and adolescents revealed that hypnosis was an effective pain control technique. Likewise, an online survey for health care professionals using hypnosis showed that age-tailored hypnotic techniques are endorsed by them. Hypnotic techniques are selected as a function of the age of patients, which reveals that professionals take into account the developmental stage of young patients, and that the efficacy of hypnotic techniques depends, at least to certain extent, on the age of the child. Finally, when testing the value of expectancies in hypnotic responsiveness (following a phenomenological perspective) we did not found any influences of such a construct in explaining the hypnotic phenomenology (i.e., the hypnoidal state and altered state of consciousness)

Mechanisms of hypnosis: toward the development of a biopsychosocial model

Evidence supports the efficacy of hypnotic treatments, but there remain many unresolved questions regarding how hypnosis produces its beneficial effects. Most theoretical models focus more or less on biological, psychological, and social factors. This scoping review summarizes the empirical findings regarding the associations between specific factors in each of these domains and response to hypnosis. The findings indicate that (a) no single factor appears primary, (b) different factors may contribute more or less to outcomes in different subsets of individuals or for different conditions, and (c) comprehensive models of hypnosis that incorporate factors from all 3 domains may ultimately prove to be more useful than more restrictive models that focus on just 1 or a very few factors

Perceived barriers, facilitators and usefulness of a psychoeducational intervention for individuals with chronic musculoskeletal pain and depression in primary care

Background and aimsSelf-management interventions have the potential to improve patient’ pain condition as they involve tasks aimed at managing symptoms and reducing interference with activities, mood and relationships due to pain. However, research on factors that facilitate or hinder pain self-management has overlooked patients with both chronic musculoskeletal pain and depression in primary care settings, also leaving unattended patient views on the usefulness of such programs. Thus, the main aim of this study was to gather meaningful information to help promoting adequate self-management. Specifically, it attempts to identify patients’ perceptions of barriers and facilitators of group-based psychoeducational intervention and to explore its perceived usefulness in promoting self-management.MethodThis qualitative study explored perceived barriers and facilitators of a psychoeducational intervention for the management of chronic musculoskeletal pain and depression previously tested in a Randomized Control Trial. We conducted focus groups and individual interviews with fifteen adult patients with both chronic musculoskeletal pain and depression recruited from primary care centres in Tarragona province (Catalonia, Spain). A content thematic analysis was carried out to examine the data. This study followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines.ResultsFindings revealed that perceived barriers included lack of motivation, time constraints, pain, depression, ineffectiveness of pain-relief strategies and activity avoidance. Facilitators were having a supportive family/friends, the positive effects of self-management, high motivation, being a proactive patient. Peer support and identification, the positive effect of sessions, and free expression were highlighted as key elements of the psychoeducational intervention.ConclusionThe psychoeducational intervention was perceived as useful in promoting self-management practices. Barriers and facilitators in using self-management strategies were related, mainly, to internal personal characteristics of the patients being similar among different cultural backgrounds and distinct chronic conditions.ImplicationsThese findings can help to guide clinicians in the development and implementation of more effective pain self-management interventions for patients with chronic pain and depression by attending to their needs and preferences

Targeting Glutathione and Cystathionine β-Synthase in Ovarian Cancer Treatment by Selenium-Chrysin Polyurea Dendrimer Nanoformulation

The research was funded by iNOVA4Health UID/Multi/04462, a program financially supported by Fundação para a Ciência e Tecnologia/Ministério da Educação e Ciência (FCT-MCTES), through national funds, and co-funded by FEDER under the PT2020 Partnership Agreement. We also acknowledge funding from FCT-MCTES through project DREAM PTDC/MEC-ONC/29327/2017.Ovarian cancer is the main cause of death from gynecological cancer, with its poor prognosis mainly related to late diagnosis and chemoresistance (acquired or intrinsic) to conventional alkylating and reactive oxygen species (ROS)-generating drugs. We and others reported that the availability of cysteine and glutathione (GSH) impacts the mechanisms of resistance to carboplatin in ovarian cancer. Different players in cysteine metabolism can be crucial in chemoresistance, such as the cystine/glutamate antiporter system Xc (xCT) and the H2S-synthesizing enzyme cystathionine β-synthase (CBS) in the pathway of cysteine catabolism. We hypothesized that, by disrupting cysteine metabolic flux, chemoresistance would be reverted. Since the xCT transporter is also able to take up selenium, we used selenium-containing chrysin (SeChry) as a plausible competitive inhibitor of xCT. For that, we tested the effects of SeChry on three different ovarian cancer cell lines (ES2, OVCAR3, and OVCAR8) and in two non-malignant cell lines (HaCaT and HK2). Results showed that, in addition to being highly cytotoxic, SeChry does not affect the uptake of cysteine, although it increases GSH depletion, indicating that SeChry might induce oxidative stress. However, enzymatic assays revealed an inhibitory effect of SeChry toward CBS, thus preventing production of the antioxidant H2S. Notably, our data showed that SeChry and folate-targeted polyurea dendrimer generation four (SeChry@PUREG4-FA) nanoparticles increased the specificity for SeChry delivery to ovarian cancer cells, reducing significantly the toxicity against non-malignant cells. Collectively, our data support SeChry@PUREG4-FA nanoparticles as a targeted strategy to improve ovarian cancer treatment, where GSH depletion and CBS inhibition underlie SeChry cytotoxicity.publishersversionpublishe

Pain and Hypnosis

Documentos apresentados no âmbito do reconhecimento de graus e diplomas estrangeiro

Noções de psicopatologia [Projeto Acessibilidades]

Conteúdos acessíveis à comunidade de utilizadores com necessidades especiais - "Projeto Acessibilidades - UAb".Manual que introduz a história do estudo das perturbações psicológicas seguindo, criticamente, o DSM-5, abordando ainda diversos temas, como o da etiologia, terapêutica e avaliação, incluindo também tópicos sobre psiquiatria biológica e psicofarmacologia, bem como as terapias psicológicas.info:eu-repo/semantics/publishedVersio

Noções de psicopatologia

Manual que introduz a história do estudo das perturbações psicológicas seguindo, criticamente, o DSM-5, abordando ainda diversos temas, como o da etiologia, terapêutica e avaliação, incluindo também tópicos sobre psiquiatria biológica e psicofarmacologia, bem como as terapias psicológicas.info:eu-repo/semantics/publishedVersio

Individuals with hearing impairment/deafness during the COVID-19 pandemic: A rapid review on communication challenges and strategies

This study aimed (a) to identify the communication issues and problems faced by individuals with hearing impairment (HI)/deafness during the COVID-19 pandemic and (b) to describe strategies to overcome the issues/problems and/or prevent their negative impact