Rui Coelho
J. Cunha-Vaz
Ana Paula Relvas
Partindo da apresentação de um caso clínico de anorexia nervosa, a autora demonstra alguns contributos da terapia familiar e do modelo sistémico para a compreensão e intervenção neste tipo de patologia psicossomática.
Tatjana Sivik, Natasha Delimar, Rebecca Schoenfeld
The Sivik Psychosomaticism test (SPS) and Test of Operational style (OPER) are reliable and valid instruments for assessing personality characteristics and coping-styles related to the risk for the development of psychosomatic disorders. To further evaluate the construct validity (convergent and divergent), Pearson correlation coefficients between SPS and OPER tests and the Swedish Mood Adjective Checklist (MACL) were calculated. The tests were distributed to 100 patients at a Psychosomatic Clinic and a healthy control.
Significantly negative correlations were found between MACL and SPS scale Emotional Coping Style (all subscales) and SPS total score in both the normal and the patient group as well as several other SPS scales. Positive correlations were found between OPER and MACL variable Extroversion in the patient group.
Gabriele Helga Franke, Joachim Esser, Jens Reimer, Nicole Maehner
To determine differences of vision-targeted quality of life (QOL) under different degrees of visual impairment using the National Eye Institute Visual Function Questionnaire (NEI-VFQ) in a German sample of 241 consecutive patients. Patients with severe visual impairment and partly patients with moderate visual impairment suffered the most from a decrease in vision-targeted QOL. We assume that the NEI-VFQ is a very useful and reliable psychodiagnostic inventory assessing vision-specific QOL and we suggest the use of this instrument in future studies.
Joyce McDougall
The author points out the importance of Psychic reality in breast cancer patients and the fact that psychological support is essential, though many times neglected, to these patients. A case is presented, in which the patient takes a psychoanalytic voyage, revealing her fears, analysing her way to see cancer, death and life.
Ad Vingerhoets, Ivan Nyklicek, Johan Denollet
Attachment theory has become a focus of interest in psychosomatic research in recent years. The theoretical perspective of attachment development covers issues of the developmental predisposition for psychosomatic illness, psychobiological aspects and issues of coping. In detail four issues of psychosomatic research might be addressed from an attachment theoretical perspective: (1) Is the prevalence of insecure attachment models increased in patients with psychosomatic disturbances (developmental aspect)? (2) Does insecure attachment correlate with a higher physiological arousal in reaction to various kinds of stress (psychobiological aspect)? (3) Are associations to be found between insecure attachment and disturbances of affect regulation, which are linked to be aetiology of psychosomatic illness? (4) Are associations to be found between insecure attachment and problems of illness behaviour (aspect of coping)? In the paper presented we focus on two of these issues: we report the empirical evidence suggesting a high proportion of insecure attachment in psychosomatic disorder and discuss the links between insecure attachment, affect regulation and psychosomatic illness.
Carl Eduard Scheidt, Elisabeth Waller
Attachment theory has become a focus of interest in psychosomatic research in recent years. The theoretical perspective of attachment development covers issues of the developmental predisposition for psychosomatic illness, psychobiological aspects and issues of coping. In detail four issues of psychosomatic research might be addressed from an attachment theoretical perspective: (1) Is the prevalence of insecure patterns of attachment increased in patients with psychosomatic disturbances (developmental aspect)? (2) Does insecure attachment correlate with a higher physiological arousal in reaction to various kinds of stress (psychobiological aspect)? (3) Are associations to be found between insecure attachment and disturbances of affect regulation, which are linked to the aetiology of psychosomatic illness behaviour (aspect of coping)? In the paper presented we focus on two of these issues: we report the empirical evidence suggesting a high proportion of insecure attachment in psychosomatic disorder and discuss the links between insecure attachment, affect regulation and psychosomatic illness.
Phil Mollon
Dr. Loftus' work illustrates experimentally some of the conditions in which memory and beliefs about the past can be distorted through misinformation. Clinicians should aim to avoid or minimise the influence of suggestion and to be aware of the inevitable potential for suggestion in any therapeutic endeavour.
The focus of analysis is upon the patient's implicit procedural assumptions about self in relation to intimate others, particularly as these become discernible in relation of the analyst. Where reconstruction of development is considered, this is usually in relation to internal events within the patient's mind.
João Justo
This paper focuses on the psychological interpretation of obstetric pathology. Several investigations have demonstrated the existence of important links between emotional functioning of pregnant women and different pathologies, as well as problems during delivery. The psychological understanding of such phenomena often points to inner conflicts that pregnant women are unable to deal with or to express.
We are raising a continuity hypothesis underlining the observation that women suffering from different obstetric pathologies may be considered as psychologically similar and suffering from a continuum of related emotional factors, having difficulty in expressing their problems. According to this hypothesis, what characterizes the different pathologies is the moment when the emotional burden becomes too heavy and psychological conflicts are expressed by current physiological functioning.
Obstetric problems occur at distinct moments in the course of pregnancy. We can describe the onset and process of the specific obstetric dysfunction each woman suffers. It remains unexplained why some women submerge under pathology at the beginning of pregnancy, some in the middle and, some only near the end of pregnancy. There is a strong probability that the best answer to this question lies in the patient's resources for dealing with the distinct demands of psychological development that parallel pregnancy.
Graça Pereira, Vera Ramalho, Pedro Dias
We are assisting in our days to a postponing of pregnancy to a later period of life. This paper describes an exploratory study on the effects of age on important psychological variables in pregnancy. The sample is composed of two groups of pregnant women: above and below 35 years, and compared how these women differed on maternal adjustment, marital satisfaction and psychological morbidity. Husbands/ partners of these women were also included in the sample and a comparison between the couple was also assessed on the first two variables.
Results showed that younger women were better adjusted and had higher marital satisfaction. No differences were reported in terms of psychological morbidity.
Men reported being better adjusted than their partners on attitudes towards pregnancy. Differences on whether the pregnancy was planned and number of children were also assessed.
Sandra Torres, Marina Prista Guerra
In this article the psychological intervention undertaken with a teenage girl with Anorexia Nervosa diagnosis is described. The intervention was based on the Re-authoring Model by White and Epson and focused the analysis of the "fear of becoming fat" as being the most disturbing one identified by the teenager. Three essential dimensions were emphasized in the therapeutic process of the anorexica: (a) the externalizing language; (b) the discursive context of the problem; and (c) the identification and amplification of moments of active resistance to anorexia nervosa. The continuous and contextual assessment suggests the importance of the construction and projection of alternative narratives, that is, more flexible narratives adapted to new contexts for the resolution of the body related fears and, consequently, for the anorexic’s better functional life.
Silvia Ouakinin, JL Simões da Fonseca
HIV Infection has a wide clinical and prognostic variability, apparently depending on biological, psychological and psychosocial determinants, personal or contextual ones, and therefore can be a privileged field for research of the psychoneuroimmunological interactions. The objective of this study is to evaluate some of the referred interactions, in a sample of 55 HIV1 positive patients and 30 healthy control subjects (N = 85).
Comparison between groups (t test) showed that patients exhibit a statistically significant greater emotional distress than controls, as well as an impairment in their quality of life. In medically stable and unstable patient groups, correlations between different level variables (Pearson correlations) showed psychoimmunological relationships which were apparently more clear in patients who will suffer a slower disease progression. These patients can be distinguished from the others with statistical significance, by levels of anxiety, depression, obsession/compulsion and sleep disturbance, as well as by the immune cell activation marker, CD25. Multiple regression analysis, using immune variables as dependent ones, confirms the importance of dimensions such as hostility, anxiety and stressors in determining immune variability.
In conclusion, we have found suggestive evidence relating the psychological factors and the immune response in HIV Infection.
Ivone Castro-Vale, Liliana de Sousa, Maria Amélia Tavares, Rui Coelho
The present article provides a brief description of the anatomical and chemoarchitectonic organization of the primate amygdala reviewing the functional importance of this structure and analysing how its failure can result in brain disease with special reference to psychiatric disorders.
Rui Coelho