Triagem e tratamento somático do transtorno de estresse pós-traumático em população adulta exposta a experiências traumáticas
Posttraumatic Stress Disorder (PTSD) is characterized by the development of psychological, physiological and behavioral clinical symptoms after exposure to one or more traumatic events that may vary between different individuals, presenting different combinations of symptomatic patterns included...
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Transtorno de estresse pós-traumático Saúde mental Assalto Somatic Experiencing® Hormônios esteroides Afeto Validação questionário DSM-IV DSM-5 |
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Transtorno de estresse pós-traumático Saúde mental Assalto Somatic Experiencing® Hormônios esteroides Afeto Validação questionário DSM-IV DSM-5 Almeida, Ana Kelly de Triagem e tratamento somático do transtorno de estresse pós-traumático em população adulta exposta a experiências traumáticas |
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Posttraumatic Stress Disorder (PTSD) is characterized by the development of psychological,
physiological and behavioral clinical symptoms after exposure to one or more traumatic events
that may vary between different individuals, presenting different combinations of symptomatic
patterns included in the diagnostic criteria for the disease in the Diagnostic and Statistical
Manual of Mental Disorders (DSM-IV). Physiological stress is the way in which the body
responds to traumatic events, which have become increasingly common with the increasing
violence in urban centers, being demonstrated by the frequent occurrence of robberies or
assaults followed by death, leading to the onset of PTSD and worsens the impact on mental
health. Currently, evidence from studies on the neurobiology of PTSD has demonstrated neural
systems particularly involved in its pathophysiology and different types of treatment
approaches. For example, somatic approaches and therapeutic methods, including the SE™
method - Somatic Experiencing® (Somatic Experience), focused on improving the symptoms
of chronic stress and post-traumatic stress. In this context, the objectives of this study involve
3 aspects related to PTSD: 1) Investigate the state of the art in the use of somatic therapies,
particularly the SETM method, applied to the treatment of PTSD; (2) Evaluate the effect of SETM
in men victims of assault in the city of Natal, medicated and non-medicated, with clinical
diagnosis of PTSD; (3) Validate a questionnaire for screening PTSD based on the Diagnostic
and Statistical Manual of Mental Disorders (DSM-5). In the first study, a literature review on
somatic approaches was carried out, demonstrating that techniques and methods such as Yoga,
Mindfulness, Brainspotting and SETM presented positive results in reducing PTSD symptoms
with individual, group and couple visits. However, despite the efficacy of these treatments, there
was a low academic production, particularly from SETM, with research only in international
settings and mostly developed with male individuals. In the second study, a sample composed
of 23 participants was used, six of whom were using (GM group) and 17 were not using
medication (GS group) for PTSD, to investigate the effectiveness of the treatment using the
SETM method. The results showed a significant decrease in PTSD symptoms on the
psychometric scales, with a significant increase in the scores of positive affect and perception
of well-being, the latter scale evaluated in the 3-month follow-up after therapy. The method
proved to be effective for both GM and GS, with mild and moderate degrees of PTSD being the
most benefited. There were no significant differences when considering the classification of
PTSD in acute and chronic. Both groups showed discreet responses in relation to cortisol. On
the other hand, DHEA showed a significant decrease, suggesting a neuroprotective role, in
addition to being positively associated with CRP before treatment, when both biological
markers were high. It can be suggested that the effectiveness of SETM was significant since both
medicated and non-medicated patients benefited equally. Therefore, the use of SETM proved to
be a complementary treatment that can be better used by professionals who work with PTSD.
Study 3 aimed to validate an instrument based on DSM-5 for screening and checking PTSD
symptoms. The proposed scale was constructed with 41 items and answered by 408 participants
(254 women and 154 men), resulting in four empirical factors, grouping items of different
symptomatic criteria of PTSD. Exploratory factor analysis, covering the analysis of factor loads,
indicated a one-dimensional construct on the scale. The four factors (Hyperstimulation,
Difficulties in cognition and mood, Intrusion and Avoidance) presented values of internal
consistency calculated by the Cronbach's Alpha test equal to 0.94, 0.83, 0.94 and 0.70,
respectively. The means obtained from the four factors of the groups of subjects diagnosed (n
= 152) and not diagnosed with PTSD (n = 249) was significantly different (p = 0.000). Thus, it
was possible to demonstrate a strongly significant correlation between the factors and the score
of the Event Impact Scale. This study adds important results in a relatively new and emerging
field of research, currently more based on structural and functional neuroimaging studies and
on neurobiological models of trauma and PTSD based on neural networks. |
| author2 |
Sousa, Maria Bernardete Cordeiro de |
| author_facet |
Sousa, Maria Bernardete Cordeiro de Almeida, Ana Kelly de |
| format |
doctoralThesis |
| author |
Almeida, Ana Kelly de |
| author_sort |
Almeida, Ana Kelly de |
| title |
Triagem e tratamento somático do transtorno de estresse pós-traumático em população adulta exposta a experiências traumáticas |
| title_short |
Triagem e tratamento somático do transtorno de estresse pós-traumático em população adulta exposta a experiências traumáticas |
| title_full |
Triagem e tratamento somático do transtorno de estresse pós-traumático em população adulta exposta a experiências traumáticas |
| title_fullStr |
Triagem e tratamento somático do transtorno de estresse pós-traumático em população adulta exposta a experiências traumáticas |
| title_full_unstemmed |
Triagem e tratamento somático do transtorno de estresse pós-traumático em população adulta exposta a experiências traumáticas |
| title_sort |
triagem e tratamento somático do transtorno de estresse pós-traumático em população adulta exposta a experiências traumáticas |
| publisher |
Universidade Federal do Rio Grande do Norte |
| publishDate |
2020 |
| url |
https://repositorio.ufrn.br/jspui/handle/123456789/30133 |
| work_keys_str_mv |
AT almeidaanakellyde triagemetratamentosomaticodotranstornodeestressepostraumaticoempopulacaoadultaexpostaaexperienciastraumaticas |
| _version_ |
1773967479589044224 |
| spelling |
ri-123456789-301332020-09-27T07:55:56Z Triagem e tratamento somático do transtorno de estresse pós-traumático em população adulta exposta a experiências traumáticas Almeida, Ana Kelly de Sousa, Maria Bernardete Cordeiro de Rodrigues Netto, Liana Fuzikawa, Cíntia Satiko Nunes, Emerson Arcoverde Galdino, Melyssa Kellyane Cavalcanti Borba, Paula Adriana Transtorno de estresse pós-traumático Saúde mental Assalto Somatic Experiencing® Hormônios esteroides Afeto Validação questionário DSM-IV DSM-5 Posttraumatic Stress Disorder (PTSD) is characterized by the development of psychological, physiological and behavioral clinical symptoms after exposure to one or more traumatic events that may vary between different individuals, presenting different combinations of symptomatic patterns included in the diagnostic criteria for the disease in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Physiological stress is the way in which the body responds to traumatic events, which have become increasingly common with the increasing violence in urban centers, being demonstrated by the frequent occurrence of robberies or assaults followed by death, leading to the onset of PTSD and worsens the impact on mental health. Currently, evidence from studies on the neurobiology of PTSD has demonstrated neural systems particularly involved in its pathophysiology and different types of treatment approaches. For example, somatic approaches and therapeutic methods, including the SE™ method - Somatic Experiencing® (Somatic Experience), focused on improving the symptoms of chronic stress and post-traumatic stress. In this context, the objectives of this study involve 3 aspects related to PTSD: 1) Investigate the state of the art in the use of somatic therapies, particularly the SETM method, applied to the treatment of PTSD; (2) Evaluate the effect of SETM in men victims of assault in the city of Natal, medicated and non-medicated, with clinical diagnosis of PTSD; (3) Validate a questionnaire for screening PTSD based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). In the first study, a literature review on somatic approaches was carried out, demonstrating that techniques and methods such as Yoga, Mindfulness, Brainspotting and SETM presented positive results in reducing PTSD symptoms with individual, group and couple visits. However, despite the efficacy of these treatments, there was a low academic production, particularly from SETM, with research only in international settings and mostly developed with male individuals. In the second study, a sample composed of 23 participants was used, six of whom were using (GM group) and 17 were not using medication (GS group) for PTSD, to investigate the effectiveness of the treatment using the SETM method. The results showed a significant decrease in PTSD symptoms on the psychometric scales, with a significant increase in the scores of positive affect and perception of well-being, the latter scale evaluated in the 3-month follow-up after therapy. The method proved to be effective for both GM and GS, with mild and moderate degrees of PTSD being the most benefited. There were no significant differences when considering the classification of PTSD in acute and chronic. Both groups showed discreet responses in relation to cortisol. On the other hand, DHEA showed a significant decrease, suggesting a neuroprotective role, in addition to being positively associated with CRP before treatment, when both biological markers were high. It can be suggested that the effectiveness of SETM was significant since both medicated and non-medicated patients benefited equally. Therefore, the use of SETM proved to be a complementary treatment that can be better used by professionals who work with PTSD. Study 3 aimed to validate an instrument based on DSM-5 for screening and checking PTSD symptoms. The proposed scale was constructed with 41 items and answered by 408 participants (254 women and 154 men), resulting in four empirical factors, grouping items of different symptomatic criteria of PTSD. Exploratory factor analysis, covering the analysis of factor loads, indicated a one-dimensional construct on the scale. The four factors (Hyperstimulation, Difficulties in cognition and mood, Intrusion and Avoidance) presented values of internal consistency calculated by the Cronbach's Alpha test equal to 0.94, 0.83, 0.94 and 0.70, respectively. The means obtained from the four factors of the groups of subjects diagnosed (n = 152) and not diagnosed with PTSD (n = 249) was significantly different (p = 0.000). Thus, it was possible to demonstrate a strongly significant correlation between the factors and the score of the Event Impact Scale. This study adds important results in a relatively new and emerging field of research, currently more based on structural and functional neuroimaging studies and on neurobiological models of trauma and PTSD based on neural networks. Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES O Transtorno de Estresse Pós-Traumático (TEPT) se caracteriza essencialmente pelo desenvolvimento de sintomas clínicos de natureza psicológica, fisiológica e comportamental após a exposição a um ou mais eventos traumáticos que podem variar entre os diferentes indivíduos, apresentando diferentes combinações de padrões sintomáticos incluídos nos critérios diagnósticos da doença no Manual Diagnóstico e Estatístico dos Transtornos Mentais (DSM-IV). O estresse fisiológico é a forma pela qual o organismo responde aos eventos traumáticos, os quais têm se tornado cada vez mais comuns com a crescente violência dos centros urbanos, sendo demonstrado pela frequente ocorrência de assaltos ou roubos seguidos de morte, levando ao desencadeamento do TEPT, com agravo no impacto na saúde mental. Atualmente, evidências a partir de estudos sobre a neurobiologia do TEPT demonstraram sistemas neurais particularmente envolvidos na sua fisiopatologia e diferentes tipos de abordagens para tratamento. Como por exemplo, abordagens e métodos terapêuticos de natureza somática, entre elas o método SE™ – Somatic Experiencing® (Experiência Somática), centradas na melhora dos sintomas de estresse crônico e estresse pós-traumático. Nesse contexto, os objetivos deste estudo envolvem 3 aspectos relacionados ao TEPT: (1) Investigar o estado da arte no uso de terapias somáticas, particularmente do método da SETM, aplicadas ao tratamento do TEPT; (2) Avaliar o efeito do SETM em homens vítimas de assalto na cidade de Natal, medicados e não medicados, com diagnóstico clínico de TEPT; (3) Validar um questionário para triagem de TEPT construído com base no Manual Diagnóstico e Estatístico dos Transtornos Mentais (DSM-5). No primeiro estudo foi realizada uma revisão de literatura sobre abordagens somáticas demonstrando que técnicas e métodos como Ioga, Mindfulness, Brainspotting e SETM apresentaram resultados positivos na redução dos sintomas do TEPT com atendimentos individuais, em grupo e de casais. No entanto, apesar da eficácia desses tratamentos, constatou-se uma baixa produção acadêmica, particularmente da SETM, com pesquisas apenas em cenários internacionais e na sua maioria desenvolvidas com indivíduos do sexo masculino. No segundo estudo foi utilizada uma amostra composta por 23 participantes, sendo que seis faziam uso (grupo GM) e 17 não faziam de medicação (grupo GS) para o TEPT, para investigar a eficácia do tratamento usando o método SETM. Os resultados evidenciaram uma diminuição significativa dos sintomas do TEPT nas escalas psicométricas, sendo observado também aumento significativo nos escores de afeto positivo e percepção do bem estar e, esta última avaliada 3 meses após a terapia. O método se mostrou eficaz tanto para o GM quanto para o GS, sendo que os graus leve e moderado do TEPT foram os mais beneficiados. Não houve diferenças significativas quando foi considerada a classificação do TEPT em agudo e crônico. Ambos os grupos apresentaram respostas discretas em relação ao cortisol. Por outro lado, o DHEA apresentou uma diminuição significativa, sugerindo um papel neuroprotetor, além de associar-se positivamente com a PCR antes do tratamento, onde ambos marcadores encontravam-se aumentados. Pode ser sugerido que a eficácia do SETM foi significativa uma vez que tanto pacientes medicados como não medicados se beneficiaram igualmente. Logo, o uso do SETM mostrou-se como tratamento complementar que pode ser melhor utilizado por profissionais que trabalham com o TEPT. O estudo 3 teve como objetivo validar um instrumento baseado no DSM-5 para triagem e verificação de sintomas do TEPT. A escala proposta, foi construída com 41 itens e respondida por 408 participantes (254 mulheres e 154 homens), resultando em quatro fatores empíricos, agrupando itens de diferentes critérios sintomáticos do TEPT. A análise fatorial exploratória, abrangendo a análise das cargas fatoriais, indicou um construto unidimensional na escala. Os quatro fatores (Hiperestimulação, Dificuldades de cognição e humor, Intrusão e Evitação) apresentaram valores de consistência interna calculadas pelo teste Alfa de Cronbach iguais a 0,94, 0,83, 0,94 e 0,70, respectivamente. As médias obtidas a partir dos quatro fatores dos grupos de sujeitos diagnosticados (n = 152) e não diagnosticados com TEPT (n = 249) foi significativamente diferente (p= 0,000). Nesse sentido, foi possível demonstrar uma correlação fortemente significativa entre os fatores e a pontuação da Escala de Impacto de Evento. Esse estudo acrescenta resultados dentro de um campo de pesquisa relativamente novo e emergente a partir de um cenário onde predominam estudos estruturais e funcionais de neuroimagem, bem como de modelos neurobiológicos do trauma e do TEPT com base em redes neurais. 2020-09-21T18:08:36Z 2020-09-21T18:08:36Z 2020-06-02 doctoralThesis ALMEIDA, Ana Kelly de. Triagem e tratamento somático do transtorno de estresse pós-traumático em população adulta exposta a experiências traumáticas. 2020. 183f. Tese (Doutorado em Psicobiologia) - Centro de Biociências, Universidade Federal do Rio Grande do Norte, Natal, 2020. https://repositorio.ufrn.br/jspui/handle/123456789/30133 pt_BR Acesso Aberto application/pdf Universidade Federal do Rio Grande do Norte Brasil UFRN PROGRAMA DE PÓS-GRADUAÇÃO EM PSICOBIOLOGIA |