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Anciano, D. "Psychological aspects of headache." Thesis, University of York, 1985. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.356831.
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Sjöstrand, Christina. "Clinical and genetic aspects on cluster headache /." Stockholm, 2005. http://diss.kib.ki.se/2005/91-7140-363-9/.
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Adams, Robert John Trenaman. "Health-related quality of life and psychological aspects of asthma /." Title page, contents and introduction only, 1998. http://web4.library.adelaide.edu.au/theses/09MD/09mdt792.pdf.
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Tang, Ho-ming Raymond. "Empathy and psychological adjustment in Chinese children with asthma." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1996. http://hub.hku.hk/bib/B29789497.
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Hamilton, Blake Alexander. "Assessment of at-risk mental states for psychosis in young aboriginal and non-aboriginal people using the CAARMS." Thesis, The University of Sydney, 2008. http://hdl.handle.net/2123/8767.
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Shapiro, Cheri Joan 1964. "Breathing patterns associated with hyperventilation: Thoracic vs. abdominal." Thesis, The University of Arizona, 1988. http://hdl.handle.net/10150/291752.
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The present study was designed to investigate the hypothesis that individuals with the Hyperventilation Syndrome (HVS) are predominantly thoracic breathers. An analogue population was used to examine the breathing patterns of likely (N = 16) as opposed to unlikely (N = 16) hyperventilators. The relative thoracic as opposed to abdominal contribution to total respiratory volume was assessed during periods of quiet breathing and mild stress. Differences in thoracic contribution to total respiratory volume were not found between the likely and unlikely hyperventilators, nor between the quiet and mild stress conditions. A significant effect for sex existed, with females demonstrating a greater thoracic contribution to total respiratory volume than males. A significant group by sex interaction occurred, with likely male hyperventilators displaying a significantly lower thoracic contribution to total respiratory volume than both likely and unlikely females. Results are discussed in terms of application to the HVS, and future avenues of research are suggested.
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Broyles, Susan Elizabeth. "The relationship of chronic tension headache to individual and family stressors." Diss., Virginia Polytechnic Institute and State University, 1989. http://hdl.handle.net/10919/54771.
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Tension, or muscle contraction, headache is by definition associated with life stress. However, there has been relatively little empirical research on the role of naturally occurring stressors in causing tension headache. The current investigation sought to examine some psychological variables hypothesized to be related to chronic tension headache, particularly psychosocial factors. The temporal relationship of headache activity and stress was a major focus. A second purpose of the study was to investigate the family as a particularly salient environmental source of stress for the headache sufferer. Experimental subjects were 18 family pairs, with one member diagnosed as having chronic tension headache. Control subjects were 15 family pairs in which one member had recently sustained an orthopedic injury, resulting in pain. All subjects kept a 14-day diary, monitoring mood swings, the occurrence of stressful events, headache and other somatic complaints. Subjects participated in a semi-structured interview and completed questionnaires concerning depression, anxiety, physical complaints, life hassles, previous illness experiences, and family life. Analyses revealed moderate correlation between targets' average headache activity and average diary ratings of their own hassles and their families' hassle. Additionally, correlations between targets' average headache activity and their own average mood ratings and physical symptom ratings approached significance. Concerning temporal relationships, analyses revealed mild-to-moderate isomorphic correlations between target headache activity and diary ratings of target hassles. Cross-lagged correlations indicated daily headache fluctuations were also mildly-to-moderately related to target hassles from the previous day and the following day. Temporal results are discussed in terms of potential cause and consequence. Implications are discussed in terms of support for a multi-component model of chronic tension headache.Ph. D.
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Figura, Andrea. "Psychological and psychosomatic aspects of bariatric surgery for the treatment of obesity in adults." Doctoral thesis, Humboldt-Universität zu Berlin, 2018. http://dx.doi.org/10.18452/19115.
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Das Krankheitsbild der Adipositas hat sich weltweit zu einem relevanten Gesundheitsproblem entwickelt. Die bariatrische Chirurgie wird zunehmend als wirkungsvolle Behandlung bei schwer ausgeprägter Adipositas eingesetzt. Jedoch ist über die Rolle psychologischer Variablen im bariatrischen Behandlungsverlauf noch wenig bekannt. Die vorliegende Dissertation untersucht Einfluss und Veränderung patientenberichteter Gesundheitsmerkmale in der chirurgischen Adipositastherapie. Dazu werden in einer naturalistischen Beobachtungsstudie Patienten mit schwerer Adipositas vor und im Durchschnitt zwei Jahre nach einer bariatrischen Operation (OP) befragt. Ziele der Arbeit sind 1) die Charakterisierung adipöser Patienten vor OP hinsichtlich bio-psycho-sozialer Variablen; 2) die Identifikation möglicher Einflussvariablen auf den gewichtsbezogenen Behandlungserfolg nach OP; 3) die Untersuchung von Auswirkungen der OP auf das Essverhalten; und 4) die Analyse von Veränderungen in der essstörungsbezogenen Psychopathologie und in der gesundheitsbezogenen Lebensqualität nach OP. Die Ergebnisse der bariatrischen Patienten werden im Vergleich zu denen konservativ behandelter Patienten betrachtet. Die Ergebnisse zeigen, dass Patienten mit bariatrischem Behandlungswunsch eine somatisch und psychisch belastete Patientengruppe darstellen. Die bariatrische OP führt im zweiten postoperativen Jahr zu einer nachhaltigen und klinisch bedeutsamen Gewichtsreduktion. Der präoperative Body-Maß-Index, das Bildungsniveau und aktives Problembewältigungsverhalten sind mit dem Gewichtsverlust nach OP assoziiert. Im Vergleich zur konservativen Behandlung berichten die Patienten, die sich der OP unterziehen, über stärker ausgeprägte Verbesserungen in ihrem Essverhalten und eine Steigerung ihrer Lebensqualität. Auf Basis der Befunde wird ein routinemäßiges Monitoring der somatischen und psychischen Situation der Patienten nach bariatrischer OP empfohlen, um die gezeigten Behandlungserfolge optimal zu sichern.Obesity has become a relevant global health problem. Bariatric surgery is an effective treatment for severe obesity. However, while the number of operations performed continues to increase, the role of psychological variables throughout the bariatric surgery pathway remains uncertain. The present dissertation investigates the patient-reported health status as it impacts and results from bariatric surgery. In a naturalistic observational study, patients with severe obesity are assessed before and, on average, two years after the surgical treatment. Main aims are 1) to characterize obese patients prior to bariatric surgery in terms of biological, psychological and socio-demographic variables; 2) to identify possible predictors for the postoperative weight-related treatment success after bariatric surgery; 3) to examine changes in eating behaviors; and 4) to analyze changes in eating-related psychopathology and in health-related quality of life (HRQoL). The outcomes of surgical patients are compared with those of conservatively treated patients for the same follow-up period. The findings show that bariatric surgery candidates represent a vulnerable patient group with high physical and psychological burden. In the second postoperative year after bariatric surgery, a sustainable and clinically meaningful weight reduction is achieved. The preoperative body mass index, education level and active coping behavior are associated with weight loss after surgery. Compared with conservative treatment, patients who undergo bariatric surgery report not only greater improvements in their eating behavior and eating-related psychopathology but also an increase in their HRQoL. Based on the results, the provision of a routine monitoring of the somatic and psychological situation of patients following bariatric surgery is recommended to secure longer-term treatment success.
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Aboussafy, David 1969. "Stress, coping, self-efficacy and asthma control : clinic, diary and laboratory studies." Thesis, McGill University, 1999. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=35553.
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Asthma has not declined in morbidity and mortality despite significant advances in medical treatment. A literature review was conducted and a program of research was devised with the goal of improving understanding of why many appropriately treated and educated asthmatics are unable to gain adequate control of their asthma. A review of the literature found that psychological stress was a poorly understood trigger for asthmatic symptoms and a possible factor in poor asthma control. A clinic visit study of adult asthmatics found: (1) life event stress was associated with asthma quality of life but not ventilatory function, (2) asthma self-efficacy was strongly related to asthma quality of life and ventilatory function, (3) style of coping with stress appeared to buffer the effects of stress on asthma, and (4) evidence for a stress-responsive asthmatic subgroup. A subsequent longitudinal daily diary study found: (1) concurrent stress and daily asthma symptoms were strongly associated, (2) daily bronchodilator use appeared to be determined by pre-diary beliefs about disease severity and controllability, (3) stress could precede (within one day) increases in asthma symptoms and decreases in airflow, and (4) clinically significant decreases in peak flow were often preceded by large increases in perceived stress. A laboratory study found: (1) exposure of asthmatics to specific passive and asthma-related stressors resulted in decreased airflow and that these decreases are associated with a concurrent increase in vagal (parasympathetic) tone, (2) an active stressor that resulted in increased sympathetic arousal did not result in decreased airflow, (3) relaxation resulted in parasympathetic arousal and decreased airflow, and (4) asthma self-efficacy was associated with parasympathetic reactivity. In sum, the program of research has generated findings that help explain how stress, coping and self-efficacy contribute to asthma control led to concrete suggestions to improve c
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Southard, Douglas R. "Co-variation of blood pressure and mood in the natural environment." Diss., Virginia Polytechnic Institute and State University, 1985. http://hdl.handle.net/10919/53607.
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Current clinical diagnostic procedures may lead to an V over-identification of hypertension. The lack of a comprehensive assessment may also lead to difficulty in timing cognitive-behavioral interventions to coincide with periods when blood pressure is most elevated. The goals of the current study were (a) to determine if a laboratory relaxation procedure would be capable of discriminating those individuals who generally have elevated blood pressure from those who react with increased blood pressure specifically to laboratory assessment, and (b) to identify "markers" of emotional states which would enable individuals to determine when their blood pressure was elevated.
Fifty-one undergraduate students at Virginia Tech volunteered to participate in a two-hour laboratory session consisting of baseline blood pressure measurements, a relaxation procedure and a battery of psychological questionnaires assessing anger, anxiety and Type A. This was followed by a two-day self-monitoring period consisting of approximately twelve self-reports of mood state concurrent with blood pressure measured by a portable, semi-automatic monitor.
Results suggested that blood pressure response to the laboratory relaxation procedure was associated with the difference between average ambulatory blood pressure and laboratory blood pressure for diastolic A blood pressure only. Anger arousal and anger expression were unrelated to either average ambulatory blood pressure or high versus low ambulatory blood pressure readings. Perceptions of the environment as hostile and demanding did discriminate between high versus low systolic blood pressure and diastolic blood pressure readings. A cluster of negative moods discriminated between high and low systolic blood pressure readings. A cluster of moods characteristic of the Type A behavior pattern also discriminated high versus low systolic blood pressure readings as well as high versus low heart rate readings.
One of the clearest findings of the study was the relationship between the type of analysis used and the probability of finding an association between psychological variables and blood pressure. In general, across subject analysis yielded fewer significant relationships than analyses emphasizing within subject variation. Exploring this further, two case studies are presented which illustrate statistical procedures for analyzing the relationship between blood pressure and mood in single case designs.Ph. D.
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Lilly, Debra L. "Anger expression and blood pressure : the influence of self- consciousness." Virtual Press, 1992. http://liblink.bsu.edu/uhtbin/catkey/862263.
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The validity of the Self-Consciousness Scale (SCS) for use with adolescents was investigated. Also, a path model of blood pressure based on the cognitive social learning theory was tested using sets of biological (i.e., family history of hypertension and age), psychological (i.e., public self-consciousness, private self-consciousness, suppressed anger and outwardly expressed anger), and lifestyle (i.e., relative weight and smoking) variables.Subjects were 169 female and 124 male adolescents from the southeastern United States. Parents provided information about the subjects' family history of hypertension and health. Subjects completed the SCS and Anger Expression Scale and a health questionnaire. Subjects' blood pressures, weights, and heights were assessed. Data from all subjects were used for the SCS analyses. Data from 36 subjects who reportedly had health problems or used drugs with cardiovascular effects were excluded from the path model analyses.The SCS data were factor analyzed. Based on the initial analysis, four items were excluded from the data. The subsequent factor analysis suggested that the SCS is a valid measure of the dimensions of self-consciousness in adolescents. Test-retest reliabilities and internal consistencies of the SCS showed reasonable reliability. Comparisons of the SCS scores between college students and adolescents and between female and male adolescents were made.The path model was tested separately for males and females on both systolic blood pressure (SBP) and diastolic blood pressure (DBP), using hierarchical multiple regression analyses of sets. Although the variables collectively explained a significant amount of variance in DBP and SBP for both sexes, few had significant direct and total effects on DBP and SBP, and none had indirect effects on DBP or SBP. Sex differences emerged in the variables' effects on DBP and SBP and the variables' effects on other variables. DBP and SBP increased as relative weight increased for both sexes. No other variables influenced SBP or DBP for males or SBP for females. Females with a positive family history of hypertension had higher DBPs. Females' DBPs decreased as private self-consciousness increased. The implications of the findings and suggestions for future research are discussed.Department of Counseling Psychology and Guidance Services
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Marerro, Magaly V. (Magaly Victoria). "Primary Care Screening for Psychological Factors." Thesis, North Texas State University, 1986. https://digital.library.unt.edu/ark:/67531/metadc331793/.
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The Behavioral Medicine Questionnare (BMQ) is a 44- item instrument administered via a computer CRT display or pencil and paper. The BMQ was designed to help primary care physicians treating spinal disorders to screen for emotional factors which warrant further psychological evaluation. The test is composed of three scales: Anxiety, Depression, and Somatization. Concurrent validity for each scale was determined through comparisons with subject (n = 133) scores on clinician judgement ratings, pain drawings, and the MMPI. The psychometric properties of the test were supported through statistical analysis. Significant correlations were found between the BMQ, MMPI, and clinician ratings, with the latter showing relationships of lesser strength. The only significant correlation to subject generated pain drawings was to the BMQ depression scale. Analysis indicated the need for seperate norms for males and females. Further research is needed to facilitate measurement and interpretation of the BMQ.
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Broderick, Daniel J. "Mitral valve prolapse syndrome : a proposed treatment through respiratory rebalancing." Virtual Press, 1996. http://liblink.bsu.edu/uhtbin/catkey/1027110.
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Mitral Valve Prolapse Syndrome (MVPS) is a benign psychosomatic cardiac condition that can severely impair one's quality of life. Symptoms targeted in this study include, atypical chest pain, palpitations, anxiety, panic, and shortness of breath.This study was undertaken to examine the effects of a diaphragmatic breathing intervention on the symptoms and underlying mechanism of dysautonomia in a small group of symptomatic females with MVPS. The intervention was based on both yoga theory and cardiorespiratory empirical studies.Seven of eight participant's completed the nine week study using a single subject multiple baseline design across subjects. Participant's began a respiratory retraining intervention, in a weekly staggered pair start, after the first week of baseline measurement. Respiratory training consisted of a four week training in diaphragmatic breathing with home practice three times a day.Autonomic, behavioral, and cognitive systems were assessed. Dependent measures included State and Trait Anxiety, Anxiety Sensitivity, a Symptom Checklist, and Respiratory Sinus Arrhythmia (RSA). RSA is a current noninvasive measure of parasympathetic tone. Data on thoracic and abdominal respiratory predominance, respiration rate, diet, exercise, and adherence were also gathered.Data were analyzed via visual inspection of trends and phase average changes. Treatment effect sizes were calculated for standardized measures to indicate the meaningfulness of change.Two of the seven participants demonstrated a decrease in total symptom frequencies over the course of intervention. One participant demonstrated a weekly progression of lowered state anxiety scores from baseline through intervention. In terms of phase averages, three participants showed a lowering of state anxiety. All seven participants demonstrated lowered trait anxiety scores from pre to post intervention. Two of the seven participants demonstrated a meaningful pre to post intervention decrease in anxiety sensitivity. Respiratory training was effective in stabilizing abdominal respiration. Results regarding vagal tone could not be determined due to unreliable ECG data.In general, results were poor with several inconsistencies. Adherence rates were low and it did not appear that a therapeutic level of change in respiration rate was achieved. Controlling respiration rate may be a critical factor in the therapeutic effectiveness of respiratory retraining interventions.Department of Counseling Psychology and Guidance Services
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Williams, Julie M. "Coping with asthma : investigation and intervention using the self-regulation model." Thesis, University of St Andrews, 1995. http://hdl.handle.net/10023/2800.
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The Self-Regulation Model (Leventhal, Nerenz & Steele, 1984) highlights the roles of patients' illness representations, coping, emotional reactions and appraisal of coping in the progression of chronic disease. This thesis incorporates previous literature on adherence, panic-fear and selfmanagement interventions into the model in order to (a) investigate coping with asthma and (b) develop an intervention aimed at improving asthmatic control. New measures of asthmatic control and illness representations of the consequences of having asthma were developed in order to operationalise the model. A cross-sectional study investigated factors influencing asthmatic control in a sample of 35 adult asthma sufferers recruited through a single general practice. Coping was poor, adherence being low and less than 50% of participants reporting current Peak Flow monitoring or medical contact during the previous 12 months. Good coping appeared to be a response to poor asthmatic control, rather than prophylactic. Good asthmatic control was associated with low perceived consequences, recent medical contact, moderate panic-fear and low general avoidance coping. These results imply that asthmatic control may be improved by encouraging sufferers to maintain regular contact with outpatient services and to implement prophylactic coping. Since epidemiological and clinical evidence suggested asthmatic control to be poor in young adults, an intervention was developed to improve asthmatic control in this group by modifying illness representations, coping and panic-fear. The intervention was evaluated in a randomised controlled study of 50 student asthma sufferers identified initially through an epidemiological screening of 2,979 students. It led to increased Preventer medication use and Peak Flow monitoring and decreased distress over the condition. However, the coping process changed and asthmatic control improved even in the control group, perhaps because self-monitoring of asthmatic control for the study constituted a change in coping. This unanticipated result was entirely compatible with the Self-Regulation Model. The thesis dearly demonstrates value of the Self-Regulation Model in understanding asthma self-management and developing clinical interventions.
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Weist, Mark D. "Empirical validation of treatment targets for the management of diabetes in children." Diss., Virginia Tech, 1991. http://hdl.handle.net/10919/39865.
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Losinsky, Rory. "Cognitive-behavioural treatment of essential hypertension in an urban Xhosa woman: a case study." Thesis, Rhodes University, 1991. http://hdl.handle.net/10962/d1002519.
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Essential hypertension has a complex and multiple biological, psychological and social aetiology and remains one of the most serious physical disorders affecting the Black population of South Africa today. Pharmacological treatment has been the predominant approach to blood pressure reduction, but considering that the greater part of essential hypertension has its origin in biobehavioural and cognitive functioning a non-pharmacological treatment approach to essential hypertension is receiving extensive interest both in research and therapeutic practice. This study attempted to implement a specific cognitive-behavioural treatment "package' which was tailored to the emergent aetiology in an urban Xhosa woman suffering from Mild hypertension who was on antihypertensive medication and to evaluate the treatment using a single case-study methodology. A combination of relaxation training and cognitive-behavioural modification was provided over a fifteen week period and evaluated both quantitatively and qualitatively. It was found that a combination of over-weight, occupational stress and anger could have contributed and/or caused the patient's hypertension. The results also show a significant reduction in blood pressure during the treatment phase as well as a reduction in weight, experienced anxiety and angry emotion, and by the end of the study the patient's blood pressure had been reduced to normal levels. Finally the feasibility of using such a treatment approach is discussed in relation to the South African context and the case study method is evaluated as a research tool in light of the findings.
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Bouteloup, Margaux. "Céphalées primaires et variables individuelles : attachement, mentalisation et économie psychosomatique." Electronic Thesis or Diss., Bourgogne Franche-Comté, 2019. http://www.theses.fr/2019UBFCC015.
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L'Organisation Mondiale de la Santé (OMS) classe les céphalées parmi les vingt premières causes d'invalidité dans le monde. L'INSERM évalue que 15% de la population générale est concernée. De nombreuses études ont mis en avant l’implication de facteurs psychologiques tels que l’anxiété, la dépression ou le stress dans l’étiopathogénie de la migraine (Lantéri-Minet et al., 2007). La théorie psychosomatique considère la migraine comme une somatisation qui doit être pensée en fonction de l’économie psychosomatique générale du sujet (Debray, 1997 ; Marty, 1951). Par ailleurs, quelques travaux sur les modalités d'attachement des patients douloureux chroniques et des patients migraineux mettent notamment en avant une corrélation entre la qualité de l'attachement et la perception/expression de la douleur, la relation médecin/malade et l'adhésion du sujet aux soins (Maunder, Hunter, 2008, Mistycki, Guédeney, 2007 ; Wearden, Lamberton, Crook, Walsh, 2005). Deux recherches auprès de patients migraineux au CHRU de Besançon ont été conduites : une étude quantitative (N=101) et une recherche quantitative-qualitative longitudinale (N=32). Nos résultats quantitatifs mettent en avant que les patients migraineux présentent un profil psychologique spécifique et différent de la population générale sur l’ensemble des indicateurs mesurés (anxiété, dépression, stress, soutien social, détresse psychologique et alexithymie), et ce que la symptomatologie migraineuse soit chronique ou épisodique. Une très grande majorité des patients rencontrés présentent un profil d’attachement insécure et des capacités de mentalisation incertaines. Les études de cas permettent d’affiner ces résultats et d’apprécier la place de la symptomatologie migraineuse dans le fonctionnement global de chaque sujet. Les résultats nous conduisent à proposer une modélisation de l’évaluation de la place du symptôme migraineux dans l’économie psychosomatique globale, celle-ci rapportée au contexte inter-subjectif, groupal et sociétal dans lequel le sujet s’inscrit. Cette modélisation permettra de proposer la meilleure option thérapeutique à chaque patient afin d’aboutir à une prise en charge individualisée au cas par casAccording to World Health Organization, headaches are one of the first twenty causes of disability in the world and affect 15 % of the world population. A lot of psycho-medical researches have raised the links between headaches and depression, anxiety or stress (Lantéri-Minet et al., 2007). Psychosomatic theory considers migraine as a somatization which must be thought according to the general psychosomatic functioning of each person (Debray, 1997; Marty, 1951). In addition, some promising but general work on attachment theory in chronic pain and migraine show a correlation between attachement and perception/expression of pain doctor/patient relationship and the subject's commitment to care (Maunder, Hunter, 2008 ; Mistycki, Guédeney, 2007; Wearden, Lamberton, Crook, Walsh, 2005).Two researches with migraine patients at the Besançon Hospital were conducted: a quantitative study (N=101) and a quantitative-qualitative longidunal study (N=32).Our quantitative results highlight that migraine patients have a specific psychological profile, different from the general population on all indicators measured (anxiety, depression, stress, social support, psychological distress and alexithymia), and that is the same results that the symptomatology is chronic or episodic. A majority of patients have an insecure attachment profile and uncertain mentalization’s abilities. The case studies help to refine these results and to appreciate the place of migraine in the psychosomatic functioning of each person.The results lead us to propose a modeling of the evaluation of the place of migraine in the global psychosomatic functioning. This must be related to the inter-subjective, groupal and societal context in which the subject fits. This modeling will make it possible to propose the best therapeutic option to each patient, to arrive at an individualized care in case by case
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Bodnar, Sallyjane E. "Family therapy and creative visualisation : an adjunctive treatment for allergies in children." Thesis, University of British Columbia, 1990. http://hdl.handle.net/2429/29188.
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The purpose of the study was to explore the use of Creative Visualization in the context of Family Therapy for treatment of a family of a child with allergies. Based on a single-case research design, the study included pre- and posttest measures; baseline, continuous, and follow-up self-report of symptoms; plus examination of physician's clinical records to determine the efficacy of the intervention. A further purpose of the study was to explore the possible usefulness of a test being developed on the basis of the Psychosomatic Family Model, the Leuven Family Assessment, as an outcome measure.
The subject family was an intact family with one adolescent daughter whose most important allergic symptom was poorly controlled asthma, at least partially due to noncompliance
with medical advice.
The measures included the Leuven Family Assessment, a measure based on the Psychosomatic Family Model, which has been developed for use with families of children with eating disorders; the Family Adaptability and Cohesion Scale (FACES III), a measure based on the Circumplex Family Model, which is a well-accepted measure of family functioning; symptom self-report; and consultation with the child's physician to report hospital admissions and emergency room visits.
The baseline period was two weeks, the intervention consisted of two weeks of Relaxation Training and eight weekly meetings for combined Family Therapy and Creative Visualization, and the follow-up consisted of telephone contact with the symptomatic adolescent beginning fourteen weeks after the last family therapy session and continuing for eight weeks.
Post-therapy results show a trend toward expected changes in family structure and functioning and marked improvement in the asthmatic symptoms of the adolescent.
Creative Visualization is an intervention tool well worth further exploration in the context of family therapy; and the Leuven Family Assessment merits further investigation and development as an outcome measure.Education, Faculty of
Educational and Counselling Psychology, and Special Education (ECPS), Department of
Graduate
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Ho, Tin-hung Rainbow, and 何天虹. "Psychophysiological effects of psychosocial interventions: an example of breast cancer patients in Hong Kong." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2005. http://hub.hku.hk/bib/B31049060.
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Sardas, Isabela. "Cultural Differences in Pain Experience and Behavior among Mexican, Mexican American and Anglo American Headache Pain Sufferers." Thesis, University of North Texas, 1995. https://digital.library.unt.edu/ark:/67531/metadc279369/.
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Review of previous research on cultural differences in pain experience and/or pain behavior revealed that cultural affiliation affects pain perception and response. Unfortunately, the many inconsistent findings in the literature on cultural differences in pain experience and behavior have made interpretations and comparisons of results problematic. These inconsistent findings could be attributed to variations in acculturation level among cultural groups. The purpose of this study was to investigate cultural differences in pain experience (assessed by McGill Pain Questionnaire, the Box Scale, the Headache Pain Drawing, and the Headache Questionnaire) and pain behavior (measured by determining medication use and interference of daily functioning due to headaches) among Mexican (n = 43), Mexican American (n = 36), and Anglo American (n = 50) female chronic headache pain sufferers. The contribution of acculturation to differences in pain experience and behavior among cultural groups was measured by the Acculturation Rating Scale for Mexican Americans. The three cultural groups of women significantly differed on pain experience and pain behavior. Specifically, Mexican women experienced their headache pain more intensely, severely, and emotionally than Mexican American and Anglo American women. Furthermore, Mexican women were more willing to verbally express their pain than the other two groups. As for pain behavior, Mexican women took more medication and reported more severe inhibition of daily activities due to headaches than Mexican American and Anglo American women. Ethnic identity, ethnic pride, and language preference were factors in the acculturation process which contributed the most to women's chronic pain experience and behavior. The greatest variability occurred within the Mexican American group of women who perceived themselves as being more Mexican in attitudes and/or behaviors, but more similar to Anglo American in their pain experience and pain behavior. Results are explained using biocultural multidimensional pain theory, social learning theory, and acculturation theory.
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Figura, Andrea [Verfasser], Thomas [Gutachter] Fydrich, Bernd [Gutachter] Löwe, and Matthias [Gutachter] Rose. "Psychological and psychosomatic aspects of bariatric surgery for the treatment of obesity in adults / Andrea Figura ; Gutachter: Thomas Fydrich, Bernd Löwe, Matthias Rose." Berlin : Humboldt-Universität zu Berlin, 2018. http://d-nb.info/1185495436/34.
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Harper, Christopher Scott. "Family-Supportive Supervisory Behaviors as a Moderator of the Relationship between Job Strain and Workers' Blood Pressure." PDXScholar, 2011. https://pdxscholar.library.pdx.edu/open_access_etds/198.
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Cardiovascular disease is one of the leading causes of death in industrialized nations. Research indicates that job strain may be significantly related to cardiovascular disease in employees with little to no social support. Using the JDC-S model developed by Karasek (1979) and elaborated upon by Johnson and Hall (1988), the family-supportive supervisory behaviors (FSSB) measure created by Hammer et al., (2009), and the blood pressure wrist monitor device Omron317T, this study examined FSSB as a moderator of the relationship between job strain, job demands, job control and workers' blood pressure on work and non-work days. Sixty-nine grocery store workers from a Midwest grocery store chain participated in this study, fifty-six of which were included in the analyses. Though none of the interactions were significant at the .05 level, results indicate that FSSB is significantly related to a number of blood pressure readings at the grand centered mean of job strain, job control, and job demands.
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Lai, Josanna Yuk-Lin. "Is keeping in or letting out anger good for your heart?" Thesis, University of British Columbia, 1990. http://hdl.handle.net/2429/30099.
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Given the presumed importance of cardiovascular reactivity and the role of anger in the development of hypertension and coronary heart disease, this study is the first to jointly examine three related areas (i.e. gender effects, anger direction preference, and opportunity/no opportunity to aggress following an anger Inducing situation). The present study tested the following hypotheses: a) that cardiovascular reactivity would vary as a function of subjects' gender and direction preference; b) that the rate of cardiovascular recovery would vary as a function of anger direction preference and opportunity/no opportunity to aggress; c) that the subjective feelings of anger after harassment would vary as a function of gender, anger direction preference, and opportunity/no opportunity to aggress; and d) that the evaluation of experimenter's competency and performance would vary as a function of anger preference. 56 females and 49 males executed a math task while being harassed for "poor performance". Next, they were randomly assigned to either write a negative evaluation of the frustrator or to copy a neutral paragraph and then to circle some letters in another paragraph. Heart rate and blood pressure were measured intermittently throughout. Subjects' preferred mode of anger expression (i.e. anger-in versus anger-out) had been previously assessed and cross validated by self as well as peer evaluations. Results indicated that gender was a better predictor than anger direction preference for cardiovascular reactivity to harassment. Complex patterns of recovery were detected with Intriguing sex differences. Results on male diastolic recovery were consistent with a matching hypothesis of anger direction preference but only for anger-out males. In addition, subjective anger for males was related to opportunity/no opportunity conditions, whereas females did not show such a relationship. Female anger-ln's showed quicker systolic recovery than anger-out's. Lastly, the evaluation of experimenter's competency and performance did not vary as a function of anger preference. Therapeutic implications of the findings within the context of anger control as well as trends for future research are discussed.Arts, Faculty of
Psychology, Department of
Graduate
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Robinson, Tanya Marie. "A critical assessment of the experiences and perceptions of the couple in an unconsummated marriage." Thesis, Stellenbosch : University of Stellenbosch, 2005. http://hdl.handle.net/10019.1/1097.
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Thesis (PhD (Social Work))—University of Stellenbosch, 2005.It is generally accepted that the inability to consummate a marriage causes couples great distress, and can finally lead to divorce. Limited research has been done on the unconsummated marriage in South Africa. International studies have pointed out that the unconsummated marriage is a reality and a prevalent problem. While medical and therapeutic intervention is available, many people still suffer in silence and feel embarrassed about their condition. The purpose of this study was to gain a better understanding of the emotional and psycho-social experiences and perceptions of the couple in an unconsummated marriage. In order to achieve this goal, the objectives of the study were to explore the experiences of the couple in an unconsummated marriage in order to obtain the couple’s perception of their marriage; to present a literature overview on the subject of marriage within the context of the family life cycle; to describe the nature and causes of an unconsummated marriage; to critically describe approaches and models that may be used for the assessment of an unconsummated marriage; and to reflect on the implications of the emotional and psycho-social experiences and perceptions of the couple in an unconsummated marriage within a postmodern systemic framework. The purpose of the literature study was to provide a context for the research study. The researcher conducted an extensive literature review in order to establish and refine the research subject and to guide the empirical study. An exploratory study was executed and the purposive non-probability sampling method utilised. The sample for this study was obtained from Intercare Medical Centre, Johannesburg and The Square Medical Centre, Umhlanga between April 2004 and November 2004. Ten couples that have not consummated their marriage were included in the sample. An interview schedule with open-ended questions was used to conduct joint interviews with the couples. The empirical study enabled the researcher to draw certain conclusions. The main conclusion was that males and females in an unconsummated marriage experience and perceive control-related problems; negative feelings towards their own and their partner’s body; a fear of engaging in an intimate relationship and other phobias; a feeling of sin and moral dilemma; feelings of guilt and shame; the manifestation of depression and apathetic attitudes; personal distress and psychological problems; a feeling of serious regret and sadness; self-blame, self-destructive behaviour, mutilation and suicidal thoughts and episodes; and lastly, a lack of information on how to be sexually intimate with a partner. A number of recommendations flowed from the findings. The main recommendation was that healthcare professionals such as social workers should be better educated about the phenomenon of the unconsummated marriage in order to make a correct diagnosis and deliver high quality medical and therapeutic intervention.
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Beletti, Claudia Thomé. "Indicadores de sobrecarga emocional em pacientes portadores de cefal?ia cr?nica di?ria." Faculdade de Medicina de São José do Rio Preto, 2007. http://bdtd.famerp.br/handle/tede/38.
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Previous issue date: 2007-10-30Chronic daily headache (CDH) can be studied according to the psychosomatic perspective. Considering that CDH is a heterogeneous group of headaches and that some comorbidity and emotional factors can trigger the pain such as stress, anxiety and depression; a study that takes into account the emotional overload and its impact on the affected people's lives is very important. Objective: This research aims to investigate the presence of emotional overload in patients with CDH, and the possible reasons which may impair the symptoms as well as to know which are the psychological, social and existential aspects developed by these people. Casuistic and Method: The subjects of this study were 40 patients of both genders, over 18 years of age, who attended the headache clinic of Hospital de Base, Medical School of S?o Jos? do Rio Preto. A semi-structured interview as reference to the Psychosomatic Psychoanalytic Investigation was used. Results: The sample comprised 10% of males and 90% of females, the ages ranging from 24 to 64 years old. Since the majority of interviews were made up of open questions, it was decided to divide the answers into categories. The most frequent categories when they knew the meaning of getting sick were: psychical suffering (35.53%); physical suffering (23.68%); damage at work (19.74%) and social damage (10.52%). Regarding the question about factors related with pain, the main categories were: nervousness (23.16%); preoccupation (15.79%) and tension (11.58%). The question on how the pain was developed, the most frequent categories were: the attempt at self-cure (27.36%), different kinds of pain (16.98%) and affected by emotions (13.2%). The question on the consequences of the pain, the majority reported the interruption of their activities. The length-time of the disease varied between 2 and 40 years with headaches. It was also observed, if the patients with CDH had diagnosis hypotheses regarding their pains or a "personal insight" on the disease. Among them, psychical factors could trigger the pain with 48.84%, and 34.88% of them did not have hypothesis regarding their headaches. Conclusions: In conclusion, there is some emotional overload in patients with CDH, and the typical performance of the psychosomatic disorders and the operating mind control is directly related with the patient?s complaints. It was also observed aspects of depression associated with the emotional functioning of these people.
A cefal?ia cr?nica di?ria (CCD) pode ser estudada de acordo com a perspectiva psicossom?tica. Considerando-se que a CCD ? um grupo heterog?neo de cefal?ias e que algumas comorbidades e fatores emocionais est?o associados como precipitantes da dor, tais como o estresse, a ansiedade e a depress?o; um estudo que leve em conta a sobrecarga emocional e qual o impacto na vida das pessoas afetadas reveste-se de import?ncia. Objetivo: A presente pesquisa visa investigar presen?a de sobrecarga emocional de pacientes portadores de CCD, e os poss?veis motivos agravadores de sintomas, bem como conhecer quais os percursos psicol?gicos, sociais e existenciais desenvolvidos por esses indiv?duos. Casu?stica e M?todo: S?o sujeitos deste estudo 40 pacientes de ambos os sexos, maiores de 18 anos, atendidos no ambulat?rio de cefal?ias do Hospital de Base de S?o Jos? do Rio Preto. Foi utilizado um roteiro de entrevista semi-estruturada, tendo como refer?ncia a Investiga??o Psicossom?tica Psicanal?tica. Resultados: A amostra foi composta por 10% dos sujeitos do sexo masculino e 90% do sexo feminino, com idades variando entre 24 e 64 anos. Por se tratar de entrevistas compostas, em sua maioria por quest?es abertas, optou-se por distribuir as respostas em categorias. Ao conhecer o significado de adoecer, as categorias que mais apareceram foram: sofrimento ps?quico (35,53%); sofrimento f?sico (23,68%); preju?zo no trabalho (19,74%) e preju?zo social (10,52%). Quanto ao questionamento com os fatores que relacionavam a dor, as principais categorias foram: o nervosismo (23,16%); preocupa??o (15,79%) e tens?o (11,58%). Na investiga??o de como se desenvolvia a dor, o que mais se verificou foram: tentativas de auto-cura (27,36%); diferentes tipos de dor (16,98%) e provocadas pelas emo??es (13,2%). A quest?o referente ?s conseq??ncias acarretadas pela dor mostrou que a grande maioria descreveu interromper as atividades. O tempo de doen?a variou entre dois e mais de quarenta anos de dores de cabe?a. Foi observado, ainda, se os portadores de CCD t?m hip?teses diagn?sticas a respeito das suas dores ou ?insight? pessoal sobre a doen?a. Entre elas, fatores ps?quicos poderiam desencadear a dor com 48,84% e 34,88% n?o t?m hip?tese a respeito das suas dores de cabe?a. Conclus?es: Pode-se concluir que existe sobrecarga emocional em pacientes portadores de CCD, e que o funcionamento caracter?stico dos transtornos psicossom?ticos e do pensamento operat?rio est? diretamente relacionado com suas queixas. Tamb?m foram observados aspectos de depress?o relacionados ao funcionamento emocional desses indiv?duos.
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Meyer, Joana Ladeira [UNESP]. "Avaliação do padrão de metilação de regiões promotoras dos genes ESR1, ESR2 e PGR na endometriose profunda intestinal." Universidade Estadual Paulista (UNESP), 2011. http://hdl.handle.net/11449/92428.
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A endometriose é uma doença inflamatória estrógeno-dependente que afeta de 5 a 10% das mulheres em idade reprodutiva. É caracterizada pela presença de tecido endometrial fora da cavidade uterina e está associada à dismenorreia, dor pélvica e infertilidade. Os níveis de expressão dos receptores nucleares SF1 (fator esteroidogênico 1), estrógeno e progesterona estão alterados no tecido endometriótico comparado ao endométrio normal. Estudos prévios relataram que os genes codificadores dos receptores dos hormônios esteróides ESR1 (receptor de estrógeno 1), ESR2 (receptor de estrógeno 2) e progesterona (PGR) apresentam promotores alternativos que são modulados epigeneticamente por alterações na metilação do DNA, que ocorre preferencialmente nas ilhas CpG presentes nestas regiões. Em células endometriais normais foi observada uma associação entre a presença de metilação e ausência de expressão dos genes SF1 e ESR2 (receptor de estrógeno â) enquanto a perda da metilação foi correlacionada com níveis aumentados de expressão gênica na endometriose peritoneal e ovariana. Com base nestas evidências, o presente trabalho investigou o padrão de metilação dos genes PGR (promotores A e B), ESR1 (promotores A e B) e uma região intragênica ao ESR2. O promotor B do gene PGR e a ilha CpG localizada na 5’UTR do gene ESR2 foram avaliadas em 44 amostras de endometriose profunda intestinal pela técnica de MSP (Methylation-Specific Polymerase Chain Reaction). Em sete destas, também foi possível a investigação na amostra pareada de endométrio eutópico. O padrão de metilação dos promotores A e B do gene ESR1 e o promotor A do gene PGR...
Endometriosis is an estrogen-dependent inflammatory disease which affects 5 to 10% of women of reproductive age. This disease is characterized by the presence of endometrial tissue outside the uterine cavity and is associated with dysmenorrhea, pelvic pain, and infertility. Abnormal expression levels of SF1 (steroidogenic factor 1), estrogen and progesterone nuclear receptors were detected in the endometriotic tissue compared to the normal endometrium. Previous studies have reported that genes encoding the steroid hormone receptors ESR1 (estrogen receptor 1), ESR2 (estrogen receptor 2) and progesterone (PGR) are characterized by alternative promoters epigenetically regulated by DNA methylation at CpG islands co-localized in these regions. In normal endometrial cells, it was observed an association between DNA methylation and absence of expression of the genes SF1 and ESR2 (estrogen receptor â), while loss of DNA methylation was correlated with increased expression levels of these genes in peritoneal and ovarian endometriosis. Based on these findings, this study investigated the methylation pattern of the PGR (promoters A and B), ESR1 (promoters A and B) genes and an intragenic region of the gene ESR2. The promoter B of PGR gene and the CpG island mapped at 5 'UTR of the ESR2 gene were evaluated in 44 samples of intestinal deep endometriosis by MSP (methylation-specific polymerase chain reaction). In seven cases, paired samples of eutopic endometrium from the same patients were also evaluated, the methylation patterns of the ESR1 gene (promoters A and B) and the promoter region A of the PGR gene were investigated in 37 samples of endometriosis. The MSP method is based on the DNA modification by sodium bisulfite, which converts unmethylated cytosines to uracil. Subsequently, the target region... (Complete abstract click electronic access below)
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Lash, Steven Joseph. "Gender differences in cardiovascular reactivity: effects of the gender relevance of the stressor." Diss., Virginia Tech, 1991. http://hdl.handle.net/10919/39928.
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Previous research suggests that sex differences in cardiovascular reactivity (CVR) are a function of differences in cognitive appraisal of stressors as masculine-relevant or feminine-relevant tasks. Two studies were conducted to examine the role of the appraised gender relevance of stressors as a mediator of sex differences in CVR. In the first study the CVR of male and female college students (N = 95) to the cold-pressor test (CPT) was compared under masculine-relevant and gender-neutral stressor instructions during an anticipation phase, a stressor phase, and a recovery phase. Men were expected to show greater CVR than women to the masculine-relevant CPT, but not to the gender-neutral CPT. Results supported this prediction for systolic blood pressure (SBP) and heart rate (HR) reactivity, but not diastolic blood pressure (DBP) reactivity. In the second study the CVR of male and female college students (N = 121) to the CPT was compared under masculine-relevant and female-relevant stressor instructions during an anticipation phase, a stressor phase, and a recovery phase. Men were predicted to show greater CVR than women to the masculine-relevant CPT while women were expected to show greater CVR to the feminine-relevant CPT. Results supported these predictions for SBP, but not HR reactivity. The results for DBP were mixed. Men did not show greater DBP reactivity than women to the masculinerelevant CPT, but women showed greater DBP reactivity than men to the feminine-relevant CPT. The potential influence of sex differences in cognitive appraisal of situations on CVR and coronary heart disease is discussed.Ph. D.
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DeAraugo, Jodi. "The effect of website, face-to-face, and combined programs on physiological, psychological, and lifestyle risk variables for cardio-vascular disease." Thesis, University of Ballarat, 2005. http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/43348.
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Although a multitude of preventative programs have been utilised worldwide to modify cardiovascular risk factors, none have included internet based interventions. Study 1 aimed to compare internet based (n = 21), face-to-face (n = 27), and combined (n = 21) treatment groups with a naturally occurring control group (n = 24) on physiological, psychological, and lifestyle risk variables for cardiovascular disease across 6-months, and to determine if there were relationships between changes in the psychological and physiological variables over time. Results indicated that the internet based group had significantly greater social reciprocity than the face-to-face group. Significant time effects were noted for heart rate, stress, depression, anxiety, reciprocity, anger expression-out, anger expression-in, anger control-out, and anger control-in. Results also demonstrated that increases in reciprocity and anxiety, and decreases in anger expression-out, were related to increases in heart rate. "In contrast, less anger suppression was a significant predictor of greater systolic blood pressure. However, there were no significant results for group, time, or predictive value for the other psychological, physiological, and lifestyle risk variables. A follow-up study examined the effects of unstructured (n = 13) and highly structured (n =14) internet based programs on physiological, psychological, and lifestyle risk variables for coronary heart disease over 6-months. It also investigated if there were relationships between changes in the psychological and physiological variables over time. Participants stages of change were assessed in relation to psychological and lifestyle risk variables. Results showed that the unstructured group scored significantly higher on anger-expression-out than the highly structured group and that the unstructured groups alcohol usage significantly reduced over time. The remaining psychological, physiological and lifestyle risk variables did not produce significant group, time, or predictive changes. The stage of change results indicated no significant group or time effects. Results indicated that greater angry reaction scores were predictive of higher heart rate and increased stress scores were predictive of higher diastolic blood pressure. The critical psychological variables predictive of poorer cardiovascular functioning should be targeted in future interventions.Doctor of Psychology (Clinical)
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Bosco, Abelardo. "Cefaleia em crianças : sinal de vulnerabilidade ao stress : estudo comparativo em dois hospitais publicos." [s.n.], 2006. http://repositorio.unicamp.br/jspui/handle/REPOSIP/311489.
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Orientadores: Elisabete Abib Pedroso de Souza, Maria Valeriana de Leme Moura-RibeiroTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
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Resumo: Este estudo teve como objetivo avaliar o stress em crianças com cefaléia do tipo tensional e migrânea atendidas nos hospitais públicos HC/UNICAMP e Complexo Ambulatorial Ouro Verde. Também buscou relacionar a cefaléia com fatores psicossociais, ansiedade, depressão, variáveis demográficas e da própria doença. Foram selecionadas 60 crianças, considerando-se como critérios de inclusão : faixa etária entre 7 e 12 anos, estarem frequentando regularmente a escola, evolução do quadro de cefaléia igual ou superior a 6 meses, não apresentarem antecedentes de afecções neurológicas. Foram excluidos pacientes com processos infecciosos agudos, traumatismo crânio-encefálico recente, epilepsia, e transtorno psiquiátrico ou deficiência mental evidentes. O estabelecimento diagnóstico das categorias de cefaléia do Tipo Tensional ou Migrânea, seguiu os critérios propostos pela Sociedade Internacional de Cefaléia ( 2004). A amostra foi homogênea com relação à idade, gênero, escolaridade, renda familiar, tipo e idade de início da cefaléia. Os sujeitos do HC//UNICAMP mostraram sintomas de cefaléia mais freqüentes (=9/mês) que os do Complexo Ambulatorial Ouro Verde. Os instrumentos utilizados foram: Protocolo de Investigação Psicológica para Crianças com Cefaléia - versões para pais e crianças; Inventário de Sintomas de Stress Infantil ¿ ISS (Lipp et al, 1998); Escala de Auto-Avaliação para Crianças (Amaral e Barbosa, 1990); Inventário de Ansiedade Traço-Estado - Forma C ( Biaggio,1983); Escala de Reajustamento Social (Elkind, 1981). Os resultados mostraram presença de sintomas de stress e de estressores psicossociais bem como a associação entre stress e migrânea significativamente maior no grupo do HC/UNICAMP do no Complexo Ambulatorial Ouro Verde. Ansiedade-traço e ansiedade-estado, assim como depressão estiveram presentes em ambos os grupos, mas não evidenciaram índices de significância inter-grupos. Houve associação significativa entre migrânea, stress e depressão para ambos os grupos. A exposição das crianças aos estressores psicossociais relacionados às contingências do contexto familiar ¿ preocupação, superproteção dos pais, dificuldade de relacionamento com os pais ¿ e também do contexto escolar - descritas como dificuldades de aprendizagem e repetências ¿ foram significativamente mais importantes para a amostra do HC/UNICAMP. Uma análise de contingências sobre a cefaléia para ambos os grupos mostrou que os antecedentes assistindo tv, realizando tarefas escolares, trabalhando e brincando, e o conseqüente interromper atividades na queixa, foram significativamente mais importantes para o controle do sintoma junto à amostra do HC/UNICAMP , enquanto que os conseqüentes faltar e sair mais cedo da escola foram significativos para as crianças do Complexo Ambulatorial Ouro Verde. Os relatos mostraram que o contexto familiar e escolar, atitudes parentais e relacionamentos interpessoais são importantes estressores na infância, tanto na cefaléia tensional como na migrânea, e que a dicriminação do stress e seus determinantes colabora no diagnóstico e tratamento da cefaléia na infância
Abstract: The purpose of this study was to assess stress in children suffering from tension and migraine headaches, treated at public hospitals such as HC/UNICAMP and Ouro Verde Ambulatory Complex. We also tried to associate headaches with anxiety, depression, illness and demographic factors. The study sample consisted of 60 children who fulfilled the selection criteria: age between 07 and 12 years; regular school attendance; evolution of headache symptoms during a period of six months or more; no antecedents of neurological disorders. Patients with acute infectious processes, recent cranio-encephalic trauma, epilepsy and psychiatric disorders or evident mental deficiency were excluded. The criteria used for tension or migraine headaches are specified by the International Headache Society (2004). The study sample was homogeneous in relation to age, sex, schooling, family income, type of headache and age at onset. The subjects at HC/UNICAMP demonstrated more frequent symptoms (=9/ month) than those at the Ouro Verde Complex. The tools used were: a protocol for a Psychological Investigation of Children with Headaches ¿ for parents and children; Stress Inventory for Children (Lipp, 1987); Self-assessment Scale for Children (Amaral, 1989), State-Trait Anxiety Inventory, form C (Spielberger, 1970; Biaggio, 1983), Social Readjustment Scale (Elkind, 1981). The results revealed the presence of stress symptoms, psychosocial stressors and a significant relationship between stress and migraine in the HC/UNICAMP group. Trait anxiety and state anxiety as well as depression were present in both groups, but with no inter-group significance. A significant association was observed regarding stress, migraine and depression at both hospitals, HC/UNICAMP and Ouro Verde Ambulatory Complex. Exposure of the children to psychosocial stressors related to the family context such as parent¿s preoccupation and overprotection, difficult parent-child relationships as well as difficulties at school regarding learning and failures were significantly more important in the HC/UNICAMP group. An analysis of the data on headaches in both groups demonstrated that antecedents such as watching TV, school homework, working, playing and consequently interrupting activities due to the complaint, were significantly more important for symptom control in the HC/UNICAMP sample, while the consequences of being absent and leaving school earlier were significant for the children at the Ouro Verde Ambulatory complex. These reports demonstrate that school and family context, parental attitudes and interpersonal relationship are important childhood stressors for tension and migraine headaches. Identifying stress and its determinants helps in the diagnosis and treatment of headaches
Doutorado
Ciencias Biomedicas
Doutor em Ciências Médicas
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王雪萊 and Xuelai Shelley Wang. "Post-myocardial infarction depression, inflammatory markers and cardiac prognosis in Chinese patients." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2007. http://hub.hku.hk/bib/B39556980.
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Roepke, Nancy Jo. "Psychological interventions used by athletic trainers in the rehabilitation of the injured athlete." Diss., The University of Arizona, 1993. http://hdl.handle.net/10150/186288.
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Recent research suggests that psychological techniques may facilitate injured athletes' rehabilitation, yet little is known about the psychological techniques trainers currently employ and how they view these interventions. In this study, 206 athletic trainers assigned Likert scale ratings to 11 psychological techniques indicating how much they valued a specific technique, how skillfully they employed it, and how often they utilized it. Trainers also responded to an open ended question asking how they would deal with the psychological aspects of an injury described in a short scenario. Results revealed a tentative model for the way trainers view psychological techniques. Categories of techniques included techniques involving the modification of physical and psychological states (goal setting, pain management, relaxation, imagery, and breathing techniques), techniques involving verbal cognitive techniques (communicating openly, changing negative self talk, emotional counseling, and crisis counseling), and non-recommended techniques (encouraging heroism and screening negative information). The study explored trainers' perceptions of each of the 11 psychological techniques in depth and discussed these findings. The study found that although trainers highly value psychological interventions in their work with injured athletes, they assigned low ratings to the techniques they knew little about. However, as exposure to sport psychology information increased, ratings assigned to the techniques that modify physical and psychological states also increased. Similarly, the longer trainers had worked in their field, the more highly they valued the verbal cognitive interventions. In contrast, neither exposure to sport psychology information or athletic training experience proved predictive of ratings assigned to the non-recommended psychological techniques. These findings suggest the importance of introducing skills training for psychological techniques early in the athletic trainers' educational curriculum so that trainers can gain awareness of the efficacy of certain psychological techniques and skill at using these techniques. Moreover, trainers could benefit from course work explaining potential negative consequences of employing harmful or ineffectual psychological interventions.
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Graff, Leanne Marie, and Karin Yakira. "Depression and diabetes in adolescents." CSUSB ScholarWorks, 2003. https://scholarworks.lib.csusb.edu/etd-project/2278.
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Sacramento, Augusta Renata Almeida do. "Percepção da intervenção psicológica grupal por mulheres com vitiligo." Pontifícia Universidade Católica de São Paulo, 2017. https://tede2.pucsp.br/handle/handle/19873.
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES
The proposal of this thesis, based on psychosomatic theoretical literature, was to present the perception of women with vitiligo about a group psychological intervention on their coexistence with the disease. The participants were evaluated in two moments, with the use of the following instruments: semi-structured interview and group psychological intervention. The intervention was carried out in five encounters, with a sample of 12 women, of the State of Sergipe, divided into Group A (n=8) and B (n=4), aged between 20 and 72 years old, who live with the disease in the range of 5 to 58 years old. The intervention included the use of three resources: word, body, and art. The data were analyzed and grouped into five main themes: 1) perception of self; 2) perception of the disease; 3) perception of the relationship with the disease; 4) perception of friendly, lovely and family relations; 5) perception of group psychological clinical intervention. The overall results indicate, for all participants, different expressions of psychological suffering associated with the illness by vitiligo, pointing to a not recognized grieving process. Women complain that there is no social validation of clinical condition presented and, at the same time, it does not seem to allow the personal recognition of losses arising with the pathology. There was either the need for guidance to the family because one realizes that living with vitiligo has the potential to affect not only the people with the disease, but also their family members, in addition to the love and friendship relational contexts. We observed that the intervention allowed the participants to express the anguish and to recognize the limitations and defensive behaviors due to the illness, being perceived by them in a positive way, therefore, revealing itself as a useful resource in the care of patients with vitiligo, striving for the development of resiliency. Bring these issues to debate can contribute to the minimization of individual and collective effects, by the reduction of discrimination and stigmatization associated with the diagnosis, which can contribute to a more satisfying prognosis and improvements to the quality of life of the public
A proposta desta tese, sustentada no referencial teórico da psicossomática, foi apresentar a percepção de mulheres com vitiligo acerca de uma intervenção clínica psicológica grupal na sua convivência com a doença. As participantes foram avaliadas em dois momentos, com a utilização dos seguintes instrumentos: entrevista semiestruturada e intervenção clínica psicológica grupal. A intervenção foi realizada em cinco encontros, com uma amostra de 12 mulheres, do estado de Sergipe, divididas em grupo A (n=8) e B (n=4), com idades entre 20 e 72 anos, que convivem com a doença no intervalo de 5 a 58 anos. A intervenção contou com a utilização de três recursos: palavra, corpo e arte. Os dados foram analisados e agrupados em cinco eixos temáticos: 1) percepção de si; 2) percepção da doença; 3) percepção da relação com a doença; 4) percepção das relações de amizade, amorosas e familiares; 5) percepção da intervenção clínica psicológica grupal. Os resultados gerais indicam, para todas as participantes, diferentes expressões de sofrimento psicológico associadas ao adoecimento por vitiligo, que apontam para um processo de luto não reconhecido. As mulheres se queixam de que não há uma validação social da condição clínica apresentada e, ao mesmo tempo, isso parece não possibilitar o reconhecimento pessoal das perdas advindas com a patologia. Verificou-se, ainda, a necessidade de orientações à família, pois se percebe que a vivência com vitiligo tem o potencial de afetar não somente as pessoas com a doença, mas também seus familiares, além dos contextos relacionais amorosos e de amizade. Observamos, igualmente, que a intervenção permitiu às participantes a expressão de angústias e o reconhecimento de limitações e comportamentos defensivos devido à doença, sendo percebida por elas de forma positiva, revelando-se, portanto, como um útil recurso no cuidado a pacientes com vitiligo, com vistas ao desenvolvimento da resiliência. Trazer ao debate essas questões pode colaborar com a minimização de efeitos individuais e coletivos, pela redução da discriminação e estigmatização associadas ao diagnóstico, o que pode contribuir para um prognóstico mais satisfatório e melhorias para a qualidade de vida desse público
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Pierson, Wanda Jane. "A study of the effect of stress incontinence and bladder retraining on older women's perceived self-esteem." Thesis, University of British Columbia, 1988. http://hdl.handle.net/2429/27730.
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The purpose of this descriptive study was to determine the existence of a relationship between perceptions of global self-esteem and stress incontinence episodes in a group of older women participating in a bladder retraining protocol.
A convenience sample of fifteen older women was obtained. The participants constituted a group of well older women who ranged in age from 63 years to 82 years. All participants were living in the community and experiencing urinary incontinence.
The University of British Columbia Model for Nursing was the conceptual framework which guided the focus of the study. The model views the individual as a behavioural system composed of nine interrelated and interdependent subsystems. This study focused on the interrelationship of the excretory and ego-valuative subsystems. The theory of self-efficacy, as outlined by Bandura provided the method by which this study was operationalized. Self-efficacy is the product of personal efficacy—an individual's judgement of the effectiveness of an executed course of action in achieving a desired outcome. The enactive, persuasive, and emotive modes of influence were utilized to provide efficacy information.
Data were collected on three occasions using four instruments. The first instrument involved collection of selected demographic variables and was completed during the initial interview. A continence assessment and the Rosenberg self-esteem scale were completed during the initial and final interviews. An interview guide was used during a telephone contact. The telephone contact occurred four days following the first interview; the final interview occurred fourteen days after the first.
The data were summarized, compared and described using measures of central tendency and frequency distributions. Paired t-tests were performed on selected variables to determine if there was a difference between pre and post intervention interview score. These tests demonstrated no significant differences in scores.
Study findings indicated that at the end of the two week trial 53% of the women were able to identify a change in their voiding habits. Four of the participants (26.7%) stated that they were completely continent at the completion of the two week trial and four other participants (26.7%) indicated that $ some type of positive change had occurred. Three women (20%) identified a negative change in their continence status.
Global self-esteem scores, as measured by the Rosenberg self-esteem scale, remained relatively stable during the two week trial period. Scores appeared to be unaffected by a change in continence status. This may be due to the many successful normalizing strategies subjects had developed to hide the evidence of the symptom of urinary incontinence.Applied Science, Faculty of
Nursing, School of
Graduate
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Meyer, Joana Ladeira. "Avaliação do padrão de metilação de regiões promotoras dos genes ESR1, ESR2 e PGR na endometriose profunda intestinal /." Botucatu : [s.n.], 2011. http://hdl.handle.net/11449/92428.
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Orientador: Cláudia Aparecida RainhoBanca: Roberta Guembarovisk
Banca: Celia Regina Nogueira
Resumo: A endometriose é uma doença inflamatória estrógeno-dependente que afeta de 5 a 10% das mulheres em idade reprodutiva. É caracterizada pela presença de tecido endometrial fora da cavidade uterina e está associada à dismenorreia, dor pélvica e infertilidade. Os níveis de expressão dos receptores nucleares SF1 (fator esteroidogênico 1), estrógeno e progesterona estão alterados no tecido endometriótico comparado ao endométrio normal. Estudos prévios relataram que os genes codificadores dos receptores dos hormônios esteróides ESR1 (receptor de estrógeno 1), ESR2 (receptor de estrógeno 2) e progesterona (PGR) apresentam promotores alternativos que são modulados epigeneticamente por alterações na metilação do DNA, que ocorre preferencialmente nas ilhas CpG presentes nestas regiões. Em células endometriais normais foi observada uma associação entre a presença de metilação e ausência de expressão dos genes SF1 e ESR2 (receptor de estrógeno â) enquanto a perda da metilação foi correlacionada com níveis aumentados de expressão gênica na endometriose peritoneal e ovariana. Com base nestas evidências, o presente trabalho investigou o padrão de metilação dos genes PGR (promotores A e B), ESR1 (promotores A e B) e uma região intragênica ao ESR2. O promotor B do gene PGR e a ilha CpG localizada na 5'UTR do gene ESR2 foram avaliadas em 44 amostras de endometriose profunda intestinal pela técnica de MSP (Methylation-Specific Polymerase Chain Reaction). Em sete destas, também foi possível a investigação na amostra pareada de endométrio eutópico. O padrão de metilação dos promotores A e B do gene ESR1 e o promotor A do gene PGR... (Resumo completo, clicar acesso eletrônico abaixo)
Abstract: Endometriosis is an estrogen-dependent inflammatory disease which affects 5 to 10% of women of reproductive age. This disease is characterized by the presence of endometrial tissue outside the uterine cavity and is associated with dysmenorrhea, pelvic pain, and infertility. Abnormal expression levels of SF1 (steroidogenic factor 1), estrogen and progesterone nuclear receptors were detected in the endometriotic tissue compared to the normal endometrium. Previous studies have reported that genes encoding the steroid hormone receptors ESR1 (estrogen receptor 1), ESR2 (estrogen receptor 2) and progesterone (PGR) are characterized by alternative promoters epigenetically regulated by DNA methylation at CpG islands co-localized in these regions. In normal endometrial cells, it was observed an association between DNA methylation and absence of expression of the genes SF1 and ESR2 (estrogen receptor â), while loss of DNA methylation was correlated with increased expression levels of these genes in peritoneal and ovarian endometriosis. Based on these findings, this study investigated the methylation pattern of the PGR (promoters A and B), ESR1 (promoters A and B) genes and an intragenic region of the gene ESR2. The promoter B of PGR gene and the CpG island mapped at 5 'UTR of the ESR2 gene were evaluated in 44 samples of intestinal deep endometriosis by MSP (methylation-specific polymerase chain reaction). In seven cases, paired samples of eutopic endometrium from the same patients were also evaluated, the methylation patterns of the ESR1 gene (promoters A and B) and the promoter region A of the PGR gene were investigated in 37 samples of endometriosis. The MSP method is based on the DNA modification by sodium bisulfite, which converts unmethylated cytosines to uracil. Subsequently, the target region... (Complete abstract click electronic access below)
Mestre
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Cordeiro, Vanessa Nazário. "A dor crônica: experiência de pacientes em tratamento de fibromialgia." Universidade Católica de Pernambuco, 2018. http://tede2.unicap.br:8080/handle/tede/1025.
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From centuries past to the present, pain and its symbolic value have not lost their vigor in scientific discussions. Chronic pain, here represented by fibromyalgia, is characterized by the prolongation of painful sensation in the body for more than six months. Fibromyalgia is known for the sensation of pain, without there being an organic substrate to back up its clinical / biomedical diagnosis. In the scientific literature, the tendency to approach fibromyalgia within positivist parameters is perceived in the scientific literature, which, in this case, has as main objective to attenuate the symptom aiming at the control of pain. What are the possible effects of this tendency that supposedly pervades the subject of pain, about what refers to their meanings and their relations? This research aimed to understand the experience of pain, from the perspective of patients in the treatment of fibromyalgia, based on the Systemic Theory reference. Specifically, we sought to understand conceptions and feelings about pain in patients diagnosed and treated with fibromyalgia; to understand the conditions of possibility to the experience with the pain, in the reconstruction of the process of discovery and diagnosis; to identify the perception of the subjects about the ways in which pain has been approached by health professionals; to analyze the ways in which the family is organizing in the face of pain, based on the understanding of family structure and its interrelation with pain and treatment. In this qualitative research, five women were diagnosed with fibromyalgia for at least one year. The in-depth interview was used as the main technique, contextualized by field diary, aiming at records of intersubjective aspects arising from interviews. The content analysis of Minayo in its thematic aspect aided in the understanding of the material constructed in the field. In the first theme emotional components related to / influencing the experience of pain were perceived; the presence of traumatic events (with regard to losses, for example) in the first manifestations of pain; adopted behaviors of suppression to the pain, at the same time that occurred movement of resistance to the change and a search to the homeostasis. In the second theme, it was observed the maintenance of beliefs that the disease manifests itself in an exclusively emotional and / or physical instance; medication as the main therapy offered to silence the pain; difficulty in dealing with subjective issues; little demand for space that aims at a treatment beyond physical pain. None of the participants showed interest in a psychotherapeutic space. Finally, in the third theme it was observed that, in general, women occupy a central position in their families; they feel little understood. It was also observed family relations that were negatively feedbacks, facilitating the maintenance of the symptom, the families adopt behaviors that reverberate in a maintenance of dysfunctional homeostasis. This dysfunctional pattern is characterized as a movement of continuous rigidity, with few opportunities for change and consequently few transitions within the systems, leaving the conditions of possibility to the true experience. With this research it is estimated to contribute to an integral assistance, reflecting on the nuances involved in the complexity of the pain experience and family relationships that permeate the context of fibromyalgia and its treatment.
Desde séculos passados até hoje a dor e seu valor simbólico não perderam vigor nas discussões científicas. A dor crônica, aqui representada pela fibromialgia, é caracterizada pelo prolongamento da sensação dolorosa no corpo por mais de seis meses. A fibromialgia é conhecida pela sensação de dor, sem que haja um substrato orgânico para respaldar o seu diagnóstico clínico/biomédico. Percebe-se na literatura científica a tendência em abordar a fibromialgia dentro de parâmetros positivistas que, neste caso, têm como principal objetivo atenuar o sintoma visando ao controle da dor. Quais os possíveis efeitos dessa tendência que supostamente perpassa o sujeito da dor, sobre o que remete aos seus significados e às suas relações? Nesta pesquisa buscou-se compreender a experiência da dor, na perspectiva de pacientes em tratamento de fibromialgia, com base no referencial da Teoria Sistêmica. De forma específica, buscou-se conhecer concepções e sentimentos sobre dor, em pacientes diagnosticados e em tratamento com fibromialgia; compreender as condições de possibilidade à experiência com a dor, na reconstrução do processo de descoberta e diagnóstico; identificar a percepção dos sujeitos sobre os modos como a dor vem sendo abordada pelos profissionais de saúde; analisar os modos como a família vem se organizando perante a dor, com base na compreensão da estrutura familiar e sua inter-relação com a dor e o tratamento. Nesta pesquisa de natureza qualitativa participaram cinco mulheres diagnosticadas com fibromialgia há pelo menos um ano. Utilizou-se a entrevista em profundidade como técnica principal, contextualizada por diário de campo visando registros de aspectos intersubjetivos advindos das entrevistas. A análise de conteúdo de Minayo em sua vertente temática auxiliou na compreensão do material construído em campo. No primeiro tema perceberam-se componentes emocionais relacionados a/influenciando a experiência da dor; a presença de eventos traumáticos (no que concerne a perdas, por exemplo) nas primeiras manifestações de dores; condutas adotadas de supressão à dor, ao mesmo tempo em que ocorria movimento de resistência à mudança e uma busca à homeostase. No segundo tema percebeu-se a manutenção de crenças de que a doença manifesta-se em uma instância exclusivamente emocional e/ou física; a medicação como principal terapêutica ofertada para silenciar a dor; dificuldade de profissionais em lidar com questões de ordem subjetiva; pouca procura por espaço que vise um tratamento para além da dor física. Nenhuma das participantes demonstrou interesse por um espaço psicoterápico. Por fim, no terceiro tema foi observado que, de modo geral, as mulheres ocupam uma posição central em suas famílias; sentem-se pouco compreendidas. Também foi observado relações familiares que se retroalimentavam negativamente, facilitando a manutenção do sintoma, as famílias adotam condutas que repercutem numa manutenção de homeostase disfuncional. Esse padrão disfuncional caracteriza-se como um movimento de rigidez contínuo, com poucas oportunidades de mudança e consequentemente de poucas transições dentro dos sistemas, afastando as condições de possibilidade à verdadeira experiência Com esta pesquisa estima-se contribuir para uma assistência integral, refletindo sobre as nuances envolvidas na complexidade da experiência da dor e as relações com a família que perpassam o contexto da fibromialgia e seu tratamento.
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Burgess, Carolyn E. "Sexual Function in Women Following Treatment for Cervical Dysplasia and Microinvasive Cervical Carcinoma." Thesis, North Texas State University, 1985. https://digital.library.unt.edu/ark:/67531/metadc331592/.
Full textAbstract:
One hundred women aged 20 to 50 were asked to compare their sexual experience before diagnosis and following treatment for benign and malignant cervical disease. The subjects were divided into five groups: three groups had definite cervical intraepithelial neoplasia (CIN), (Class II or III). Two groups were treated with cryotherapy, and one with hysterectomy. One group had a provisional diagnosis of CIN I, but received no treatment. Subjects in the last group had microinvasive cervical carcinoma and were also treated with hysterectomy. All subjects had ovarian function; all were sexually active at the time of treatment. They were interviewed at least six months post-cryotherapy and 15 months post-hysterectomy. All subjects completed a variant version of the Derogatis Sexual Function Inventory (DSFI).
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Costa, Renata Soraya Coutinho da. "As dores corporias na fibromialgia: reflexões psicanalíticas." Universidade Católica de Pernambuco, 2009. http://www.unicap.br/tede//tde_busca/arquivo.php?codArquivo=370.
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A fibromialgia pode ser conceituada como uma enfermidade reumatológica caracterizada pela presença de pontos dolorosos anatomicamente definidos, dor crônica, fadiga, distúrbio do sono e depressão entre outros achados. Controvérsias cercam a etiologia e os fatores desencadeantes e agravantes dessa síndrome que acomete preferencialmente mulheres entre 30 e 60 anos. O presente estudo se propõe aprofundar a análise dos sintomas fibromiálgicos e
sua relação com a unidade do corpo psicossomático, sob um ponto de vista transdisciplinar. Trata-se de uma pesquisa psicanalítica, na qual analisamos diários de campo e histórias de vida de três pacientes do sexo feminino atendidas no ambulatório de fisioterapia do Hospital da Polícia Militar de Pernambuco. Buscamos, através do arsenal teórico freudiano, distinguir um corpo próprio da psicanálise. Para nos auxiliar nessa empreitada contamos com as contribuições de outros autores contemporâneos com trabalhos relevantes tais como: Paul-Laurent Assoun, Didier Anzieu, Juan-David Nasio e Maria Helena Fernandes. Nossa pesquisa está vinculada ao Projeto de Pesquisa sobre O Social e as Psicopatologias do corpo, desenvolvido na Linha de Pesquisa Psicopathologia Fundamental e Psicanálise do Programa de Pós-graduação em Psicologia Clínica da Universidade Católica de Pernambuco, que se propõe a analisar o circuito pulsional nas psicopatologias do corpo, configuradas no contexto social contemporâneoFibromyalgia may be considered to be a rheumatic syndrome characterized by chronic pain, fatigue, sleep disorders, depression and painful, anatomically defined sites. Although the etiology and etiological factors are controversial, this syndrome affects preferentially women between 30 and 60 years old. The purpose for this study was to analyze the symptoms of the fibromyalgia and their correlation with the psychosomatic body unit, from an interdisciplinary point of view. It was a psychoanalytical study in which we have analyzed field diary and life history of three female patients from the Physical Therapy Clinic of the Military Police of Pernambuco Hospital. The Freudian literature helped us to distinguish our own psychoanalytic study line. In addition, we have used literary works from other contemporary authors, such as Paul-Laurent Assoun, Didier Anzieu, Juan-David Nasio and Maria Helena Fernandes. This study is part of the research called The Social and the Body Psychopathology, in which the goal is to analyze the circuit of the drive in the psycho diseases of the body related to a social-contemporary context; and it is linked to the Fundamental Psychopathological and Psychoanalysis Research Group of the Psychological Post-Graduation Program of the Catholic University of Pernambuco
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Siddons, Heather Michelle. "Anxiety in young children : direct and indirect connections with asthma, protective parenting and parental adjustment." Monash University, Dept. of Psychological Medicine, 2004. http://arrow.monash.edu.au/hdl/1959.1/5194.
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Battiss, Benita. "A component-analysis of psycho-physiological management of migraine and tension headache." Thesis, 2012. http://hdl.handle.net/10210/5792.
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M.A.In all communities studied, most people suffer from headaches sometime in their life (Blau, 1991; Selby, 1983). A small portion of this group suffer from both migraine and tension-type headache on a regular basis. Currently the main treatment modality for headache is pharmacological in nature. This type of treatment is limited in as far as it does not address the concomitant psychological variables that often accompany chronic headaches. Furthermore, it seems that most psychophysiological therapies were developed in the USA and Canada over the last 30 years, but thus far research has not been done within the South African context. The aim of this study was to determine the effectiveness of an individualized psychophysiological treatment program for individuals suffering from migraine and tension-type headache. A change in headache activity and mood states such as anxiety and depression was envisaged. Seven subjects suffering from both migraine and tension-type headache were selected to participate in the study. The A-B-A single-subject design was employed allowing three weeks before and after the intervention for baseline recordings. The intervention consisted of seven sessions of cognitive coping training and electromyographic biofeedback. All subjects kept daily records of their headache activity over the eleven week period. They completed the Psychological Assessment of Headache Questionnaire, levels of depression and anxiety were assessed by the Beck Depression Inventory and the State-Trait Anxiety Inventory which were administered three weeks prior to and after the intervention. Results indicated that subjects who exhibited a decrease in headache frequency and intensity and an increase in the number of headache-free days per week, were those who were not habituated to analgesic medication. Subjects who reported no differences at all with regard to headache activity were those who suffered from chronic daily headache. Those subjects were older and consumed analgesic and other medications daily. These findings support those found in literature (Blanchard & Andrasik, 1988). All but one subject reported lower scores at post-assessment on indicators of depression and state-anxiety. Even though there were no significant improvements regarding headache activity, for certain subjects. The overall aim of the study, namely to evaluate the effectiveness of individualized treatment strategies, were addressed and contribute to future intervention studies.
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Francis-Jones, Nicholas Ian. "The role of cognitive processes in recurrent headache." Phd thesis, 1989. http://hdl.handle.net/1885/141657.
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Eyjolfsdottir, Gyda 1970. "Psychosocial aspects and functional analysis of symptom-giving pelvic girdle relaxation in Icelandic women." 2004. http://hdl.handle.net/2152/12710.
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Rawsthorne, Julie Karen. "Chronic headache : an ecosystemic exploration." Diss., 1998. http://hdl.handle.net/10500/17602.
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Chronic headache may be the most frequently reported
somatic symptom, yet it puzzles health experts and poses a
considerable treatment challenge. It was suggested that this
is because conventional views of headache, adhering to a
Newtonian-Cartesian epistemology, focus almost exclusively on
intrapsychic factors ignoring the wider social context in which
the problem is embedded. An overview of the existing body of
knowledge on the most widely researched headache conditions was
presented, and it was argued that a conceptual shift is
required to achieve a more comprehensive understanding of the
problem.
This study was conducted within an holistic, ecosystemic
epistemology. A qualitative approach employing a case study
method was adopted to provide rich descriptions of the contexts
in which two chronic headache sufferers' symptoms were
embedded. The case study presentations also illustrated the
attempts that were made to intervene into the headache contexts
from a second-order cybernetics stance.Psychology
M.A. (Clinical Psychology)
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Capello, Jeremy 1970. "An evaluation of the Doctor Interactive Group Medical Appointment : assessing changes in health behaviors attributed to an integrated healthcare model." 2008. http://hdl.handle.net/2152/17781.
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This dissertation investigated the effect of a Doctor Interactive Group Medical Appointment (DIGMA), a unique multidisciplinary medical treatment modality, upon the health behavior of hypertensive patients at the Veterans Health Administration Outpatient Clinic (VA-OPC) in Austin, Texas. Health behavior modification, differences in stress perceptions, blood pressure changes due to the intervention and differences in coping strategies were assessed. Integrated healthcare utilizes a multidisciplinary approach in considering physiological and psychological aspects of health, promoting patients to act on their own behalf in managing health. Increased healthcare costs, decreased patient satisfaction of care received and practitioner satisfaction in care provided currently afflict primary healthcare. Earlier, a “drop-in” shared medical appointment aimed to improve continuity of care, and increase patient and physician satisfaction by allowing patients better access to physicians without taxing more resources. Contrasting the “drop-in” model, this study examined the efficacy of a multi-session DIGMA. Functioning as an adjunct to hypertensive management, participants attended 5 sessions, including one introduction meeting, three consecutive weekly group sessions and an individual telephone session occurring one week following the intervention. The study utilized a pretest/posttest design, with participants acting as their own controls. Self-report measures and blood pressure readings were administered prior to the onset, and again at termination of the DIGMA program. Analyses of variance and hierarchical regression models helped reveal any significant changes in health behaviors, perceptions of stress, and coping styles related to hypertension among 58 participants occurring over time for 7 distinct cohorts participating in the DIGMA. Findings revealed significant differences in both systolic and diastolic blood pressure readings between pre and post intervention. Significant changes in health promoting behaviors among participants who successfully completed all components of the program were also detected. In addition, adaptive coping strategies were found to significantly impact components of health behaviors. Qualitative information supports the quantitative data in determining whether the agent of change is the group process itself, the information imparted in the group, or some other variable. Findings reveal the dynamic of the group, as well as the modality in which information was conveyed positively influenced health behavior changes. Results, implications, and limitations of the study as well as future directions are discussed.text
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OPRI, Roberta. "Non-celiac Gluten Sensitivity in children with headache: a focus on clinical and immunological aspects." Doctoral thesis, 2016. http://hdl.handle.net/11562/937038.
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INTRODUZIONELe cefalee sono frequenti in età pediatrica. Identificare cause potenzialmente trattabili è obiettivo primario. La cefalea è frequente nelle patologie glutine-correlate, in particolare in Sensibilità al glutine non celiaca (NCGS). La prevalenza di NCGS nei bambini cefalalgici ed i meccanismi etio-patogenetici della cefalea in NCGS non sono chiariti.SCOPI DELLO STUDIOObiettivi dello studio: 1) indagare prevalenza e quadro clinico di NCGS in bambini che presentano anticorpi anti-gliadina nativa (AGA); 2) valutare il profilo di espressione genica in cellule mononucleate del sangue periferico (PBMCs) in pazienti con NCGS; 3) misurare nel siero mediatori solubili identificati mediante gene expression profiling ed anticorpi anti-Tranglutaminasi 6 (TG6), markers di patologie neurologiche glutine-dipendenti.PAZIENTI E METODISono stati considerati soggetti di età <18 anni valutati per cefalea nel periodo 1/03/13 – 31/07/15 presso la Neuropsichiatria Infantile (A..O.U.I. Verona). Criteri di inclusione: 1) cefalea primaria (criteri ICHD III-beta); 2) accettare valutazione di profilo biochimico completo, IgA totali, AGA IgG ed IgA, anticorpi anti-tranglutaminasi 2 IgA (TGA), IgE specifiche per grano, glutine, gliadina. Criteri di esclusione: cefalea secondaria, nevralgia cranica; trattamenti introdotti o modificati negli ultimi 2 mesi; deficit di IgA; soggetti positivi per TGA o IgE specifiche per grano, glutine, gliadina; enteropatia alla biopsia duodenale. Come da protocollo diagnostico per sospetta NCGS, i soggetti AGA-positivi hanno seguito dieta priva di glutine (DPG) per 3 mesi, con successiva reintroduzione (gluten challenge). I soggetti AGA-negativi hanno proseguito la dieta abituale. Per i pazienti NCGS è stata effettuato gene expression profiling in PBMCs. In relazione ai dati di espressione genica, sono stati scelti per dosaggio sierico di CTLA-4 solubile (sCTLA-4) e gp130 solubile (sgp130). E’ stato inoltre effettuato il dosaggio sierico di CD25 solubile (sCD25), marker di attivazione T-linfocitaria, e di anticorpi TG6. RISULTATISono stati reclutati 17 pazienti con emicrania o cefalea muscolo-tensiva: 11 soggetti AGA-positivi (età media 10,6 anni; range d’età 7,9-12,5 anni), 6 soggetti AGA-negativi (età media 11,6 anni; range d’età 9,1-13,8 anni). Nessuno dei soggetti AGA-positivi aveva enteropatia. Sei pazienti AGA-positivi su 11 (55%) hanno ricevuto la diagnosi di NCGS. Sintomi gastrointestinali erano più frequenti in questi pazienti (50% dei soggetti). Le caratteristiche della cefalea ed i sintomi extra-intestinali non sono risultati di supporto per identificare i soggetti NCGS. Tre oggetti, tutti AGA-positivi, presentavano anticorpi anti-TG6; i soggetti con livelli elevati di anticorpi TG6 non hanno avuto miglioramento clinico in DPG per 3 mesi.Il profilo di espressione genica in PBMCs ha documentato up-regolazione di geni correlati ad attivazione di linfociti T e B, geni correlati a linfociti Th17 e geni con signature “Interferone tipo I”.In dieta a normale contenuto di glutine i livelli sierici di sCTLA-4 sono risultati più elevati nei soggetti AGA-positivi. In corso di dieta aglutinata si è osservata riduzione dei livelli di sCTLA4 in tutti i soggetti AGA-positivi, anche se la diagnosi di NCGS non è stata confermata in alcuni. I livelli sierici di sgp130 e sCD25 sono risultati simili nei 3 gruppi di pazienti. CONCLUSIONIUn sottogruppo di pazienti pediatrici con cefalea ha NCGS. I dati di analisi di espressione genica sono suggestivi di una condizione immuno-mediata con signature “Interferone di tipo I”, tipica di malattie autoimmuni. Elevati livelli sierici di sCTLA-4 in soggetti AGA-positivi potrebbero costituire indizio di sensibilizzazione al glutine e coinvolgimento della risposta immunitaria adattativa.Il riscontro di anticorpi anti-TG6 nel siero di pazienti AGA-positivi con cefalea potrebbe essere predittivo di un’insoddisfacente risposta clinica alla dieta aglutinata perseguita per soli 3 mesi.Headaches are frequent in childhood. The identification of any underlying treatable causes is a primary endpoint. Headache is frequent in patients with gluten-related disorders, particularly Non-celiac Gluten Sensitivity (NCGS). Prevalence of NCGS in children with headache and etio-pathogenetic bases for headache in NCGS are unclear.AIMS OF THE STUDYThe study aimed: 1) to explore the prevalence and the clinical picture of NCGS in children with headache and native anti-gliadin antibodies (AGA); 2) to analyze gene expression profiles in peripheral blood mononuclear cells (PBMCs) from children with headache and NCGS; 3) the measurement of soluble mediators in sera of patients identified by means of gene expression profiling, and to determine serum levels of Tranglutaminase 6 (TG6) antibodies, markers of neurological gluten-related disorders.PATIENTS AND METHODSPatients aged <18 years evaluated for headache at the Child Neuropsychiatry Unit, University Hospital of Verona, Italy, in the period 1/03/13 – 31/07/15 were considered for recruitment. Inclusion criteria: 1) primary headache (ICHD III-beta criteria); 2) to accept determination of total IgA, AGA IgG and IgA, anti-tranglutaminase 2 IgA antibodies (TGA), specific IgE to wheat, gluten, gliadin on serum samples. Exclusion criteria: secondary headache, cranial nerve neuralgia; ongoing treatments introduced or modified less than 2 months before; total or partial IgA deficiency; to have tested positive for TGA or IgE to wheat, gluten, gliadin; enteropathy at duodenal biopsy in AGA-positive patients. According to the diagnostic algorithm for NCGS, AGA-positive patients underwent a 3 months – period on gluten-free diet (GFD) followed by reintroduction of dietary gluten for 3 months (gluten challenge). AGA-negative patients continued on their normal diet. The headache clinical course was evaluated by means of standardized scales and questionnaires.PBMCs were collected from NCGS patients in active phase of the disease for gene expression profiling and consequently soluble CTLA-4 (sCTLA-4) and soluble gp130 (sgp130) were chosen to be determined in sera. Soluble CD25 (sCD25), a biomarker for T lymphocyte activation, and TG6 IgA and IgG were also measured in sera. RESULTSSeventeen patients were recruited with migraine or tension-type headache: 11 subjects (mean age, 10.6 years; age range, 7.9-12.5 years) tested positive for AGA, 6 children (mean age, 11.6 years; age range, 9.1-13.8 years) were AGA-negative. None of AGA-positive subjects had enteropathy. Six out 11 AGA-positive patients (55%) received the diagnosis of NCGS. No headache features resulted to be typical of NCGS patients. Gastrointestinal symptoms occurred more frequently in NCGS patients (50%). Extra-intestinal symptoms could not distinguish NCGS patients among other patients.Three patients out 11 (27%) tested positive for TG6 antibodies; all also tested as AGA-positive. Patients with high levels of TG6 antibodies did not show improvement on GFD for 3 months.The gene expression profiling of PBMCs documented up-regulation genes related to T- and B-lymphocyte activation, Th17 cell subset and type I Interferon signature.Levels of sCTLA-4 were higher in AGA-positive patients and markedly reduced on GFD, despite NCGS was not confirmed in some patients. Serum levels of sgp130 and sCD25 were similar in all groups. CONCLUSIONSA subgroup of children with headache has Non-celiac Gluten Sensitivity. Experimental data in NCGS patients suggest the existence of an activated immune response with a type-1 Interferon signature, which is typical of autoimmune diseases. High levels of serum sCTLA-4 in AGA-positive patients may be a clue for gluten sensitization and involvement of adaptive immunity.TG6 antibodies in sera may predict a poor clinical response to GFD upon 3 months – period.
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Adams, Robert John Trenaman. "Health-related quality of life, and psychosocial aspects, of asthma." Thesis, 1998. http://hdl.handle.net/2440/38444.
Full textAbstract:
Bibliography: leaves 363-416.v, 416 leaves
A longitudinal observational study of hospital asthma patients, recruited from two different settings, has been conducted. The results show that failing to look at the patient in the context of their whole life and considering the socio-economic, psychological and attitudes and beliefs of patients, the current reductions in reductions in asthma morbidity and mortality may not continue.
Thesis (M.D.) -- University of Adelaide, Dept. of Medicine, 1999
47
Adams, Robert John. "Health-related quality of life and psychological aspects of asthma / Robert John Trenaman." 1998. http://hdl.handle.net/2440/38444.
Full textAbstract:
Bibliography: leaves 363-416.v, 416 leaves ;
Title page, contents and abstract only. The complete thesis in print form is available from the University Library.
A longitudinal observational study of hospital asthma patients, recruited from two different settings, has been conducted. The results show that failing to look at the patient in the context of their whole life and considering the socio-economic, psychological and attitudes and beliefs of patients, the current reductions in reductions in asthma morbidity and mortality may not continue.
Thesis (M.D.)--University of Adelaide, Dept. of Medicine, 1999
48
Roldan, Fernando Hector. "Type A behaviour and the perception and report of visceral sensations." Phd thesis, 1989. http://hdl.handle.net/1885/142463.
Full text
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Segev, Uri. "Type A behavior pattern and dependency in the adjustment of post-myocardial infarction patients." Thesis, 1986. http://hdl.handle.net/10413/7719.
Full textAbstract:
The World Health Organization (1969) has declared that heart
disease is the largest plague that ever faced humanity. Myocardial
Infarction (MD, in addition to causing more deaths than all other
diseases of the heart combined, is responsible for changes, and in
many cases deterioration, in the quality of life of survivors. Intervention
programs tend to focus on preventing re-occurrence of MI. At
the same time there is an urgent need for sophisticated rehabilitation
programs that aim to improve quality of life after MI. It is speculated
here that identification of the personality factors that relate to
the different adjustment patterms of different subgroups of post-MI
patients will assist in the design of an efficient rehabilitation
program. Accordingly, the present study focuses on the inquiry of the
psychological mechanisms that mediate between the Type A behavior pattern
(TABP) and adjustment style. An integrated crisis and developmental
theory based on psychoanalytical, attachment and social learning
theories is proposed. The Thesis put forward is that TABP is not a
homogeneous pattern and that interpersonal dependency is an underlying
personality factor that subdivides Type A patients to subgroups with
different developmental and adjustment patterns. It is claimed here
that dependent Type A patients have a dependent-independent developmental
psychodynamic conflict, and that for them, TABP is an adopted
defense mechanism. They are expected to have more adjustment difficulties
to the specific characteristics of the post-MI crisis than inde pendent Type A patients for whom TABP is a socially learned developmental
process in an urban Western environment. Type B patients, who
also lack the psychodynamic conflict, are expected to adjust as a
group better than dependent Type A patients.
Seventy-nine white urban South African males aged 30-60
years, after clinical MI, were tested. A combination of qualitative
and quantitative methods of assessment was used in order to test the
relationships between personality factors and adjustment, which was
defined by multi-dimensional criteria (32 indices of adjustment) that
related to various aspects of life in the post-MI period.
The results confirmed the heterogeneity of TABP, dependent
Type A patients adjusted less well than independent Type A patients to
16 out of 32 indices of adjustment. As expected for the same 16 indices,
the behavior of Type B patients was better adjusted than dependent
Type A patients. The outcomes of the adjustment of post-MI
patients to all 32 indices is discussed. On the basis of the study's
results and the crisis and developmental theory set out here, a differential
rehabilitation program is proposed that relates to the different
needs of the subgroups of post-MI patients.Thesis (Ph.D.)-University of Natal, Durban, 1986.
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Graham, Neil M. H. (Neil Murray Hamilton). "Psychosocial risk factors for hypertension in Australian adults." 1990. http://web4.library.adelaide.edu.au/theses/09MPM/09mpmg741.pdf.
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