Elisa Medici Pizão Yoshida

Avaliação psicológica de obesos grau III antes e depois de Cirurgia Bariátrica

This study evaluates depression, anxiety, psychopathologic symptoms, alexithymia and defensive style of grade III obese patients, before and after bariatric surgery. The study followed a cross-sectional design, with a group of surgical candidates (Gr1, N=32) and one of postoperative patients (Gr2, N=33) between 6 and 33 months after the surgery. Instruments: Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Symptom Assessment Scale (EAS-40), Toronto Alexithymia Scale (TAS-26) and Defensive Style Questionnaire (DSQ-40). The results pointed to low levels of depression, anxiety, psychopathological symptoms and alexithymia in both groups, although those of Gr2 were significantly lower than those of Gr1 (p<0.05). Concerning the defensive style, Gr1 showed more immature defense (p<0. 02) than Gr2.Avalia depressao, ansiedade, sintomas psicopatologicos, alexitimia e estilo defensivo de obesos grau III, antes e depois de cirurgia bariatrica. O estudo seguiu delineamento quase-experimental, de tipo cross-sectional. Contou com grupo pre-cirurgico (Gr1, N=32) e pos-cirurgico (Gr2, N=33), entre seis e 33 meses apos a cirurgia. Instrumentos: Inventario de Depressao de Beck (BDI), Inventario de Ansiedade de Beck (BAI), Escala de Avaliacao de Sintomas (EAS-40), Versao em Portugues da Escala de Alexitimia de Toronto (TAS-26) e Versao em Portugues do Defense Style Questionnaire (DSQ-40). Os dois grupos apresentaram baixos niveis de depressao, ansiedade, sintomas psicopatologicos e alexitimia. No entanto, os niveis do Gr 2 foram significantemente inferiores (p<0,05). Em relacao ao estilo defensivo, o Gr1 apresentou mais defesas imaturas (p<0,02) do que o Gr 2.

Produção científica sobre psicoterapias breves no Brasil e demais países latino-americanos (1990-2000)

Scientific production on brief psychotherapies in Brazil and other Latin-American countries (1990-2000) . The purpose of this study was to outline a profile of the scientific literature concerning brief psychotherapies in Brazil and other countries of Latin America, from 1990 to 2000, based on an electronic databases survey. Data obtained from Lilacs, PsycINFO, Medline, Adolec, Scielo, MedCarib, Brazilian Thesis, PAHO and WHOLIS resulted in 81 abstracts analyzed according to the: production distribution, authorship, affiliation, source, publication year, language, document type, population, theoretic approach and publication type. Results suggested that: 1) the electronic databases are currently important sources for accessing the Brazilian brief psychotherapy production, but not for the other Latin America countries; 2) despite the quantitative difference of both productions, a similar profile may be verified respecting many of the variables under study.

Significância clínica de mudança em processo de psicoterapia psicodinâmica breve

The current investigation is part of a work in progress aimed to analyze the process of change and the outcome of brief psychotherapies in patients of Brazilian communitarian health units. Specifically, the current work aimed to explore a method to determine clinically meaningful change of symptoms evaluated by self-report measures, when normative data are not available. It consists in the specific use of the well-known Jacobson and Truaxs method to determine the clinical significance of a treatment. To calculate the change scores and cutoffs of symptomatic measures, data from a sample of college students were used as representative of a functional population. Changes of one psychotherapeutic process were analyzed. Results suggest that clinical significance of change can be reliably determined by self-report measures. Some limitations of this method are considered.A presente investigacao e parte de um trabalho em andamento cujo objetivo e a analise do processo de mudanca e o resultado de psicoterapias breves em pacientes de clinicas comunitarias brasileiras. Mais especificamente, objetivou-se explorar um metodo para determinar a mudanca clinicamente significante de sintomas avaliados por meio de medidas de auto-relato, quando dados normativos nao estao disponiveis. Constitui um uso especifico do bem conhecido metodo de Jacobson e Truax para estimar a significância clinica de um tratamento. Para calcular os escores de mudanca e os pontos de corte de medidas sintomaticas utilizaram-se dados de amostra de universitarios, como representativa da populacao funcional. Mudancas em um processo psicoterapeutico foram analisadas. Os resultados sugerem que a significância clinica da mudanca pode ser determinada de forma fidedigna por meio de medidas de auto-relato. Alguns limites do metodo foram considerados.

Validade da escala de estágios de mudança

The study, with a clinical sample (N=147), presents the internal consistency, factorial structure, concurrent and predictive validities of the Portuguese version of the Stages of Change Scales-SCS. The psychometric properties of the scales, a 32 item self-report instrument, are compared to those of two studies with the English version. Results point to a factorial structure compatible with that of the original version, which evaluates four stages of change: precontemplation, contemplation, action and maintenance. Adaptations, of at least four items of the precontemplation and contemplation stages, are required to improve the internal consistency coefficients, lower than those of the original studies. The weak association between the SCS and the Escala Diagnostica Adaptativa Operacionalizada-Redefinida - EDAO-R suggests the criterion unsuitability to the concurrent validity. Based on the SCS scores, results do not allow to predict which patients are more suitable to conclude brief psychotherapies. New researches are suggested.

Escala de Avaliação de Sintomas-40 (EAS-40): validade e precisão em amostra não-clínica

La EES-40, una escala de 40 items de tipo de auto-relato, objetiva evaluar sintomas psicopatologicos y fue adaptada del Symptom Checklist-90-R (SCL-90-R) para pacientes ambulatoriales brasilenos de hospitales generales. El objetivo de la investigacion fue estimar la validez de grupos comparados, validez concurrente y precision test-retest de la EES-40 para una poblacion no clinica. La muestra de 113 universitarios (99 M y 14 H) respondio la EES-

Psicoterapias breves psicodinâmicas: características da produção científica nacional e estrangeira (1980/2003)

) y la version brasilena de la Toronto Alexithymia Scale (TAS) (criterio externo). Los resultados sugieren que la EES-40 puede ser util para la evaluacion de sintomas psicologicos de universitarios con buena estabilidad temporal, permitiendo discriminar poblaciones con perfiles diferentes. En relacion a la validez concurrente, las dimensiones de la EES-40 se mostraron correlacionadas de diversas formas con los componentes de la TAS. Nuevas investigaciones deben ser realizadas llevando en cuenta una distribucion mejor de las muestras en relacion al sexo.The EAS-40 is a 40 items, sef-report scale designed to evaluate psychopathological symptoms and it was adapted from the Symptom Checklist–90–R (SCL–90-R) to Brazilian outpatiens of general hospitals.The aim was to estimate the test-retest reliability and the criterion validity of the EAS-40 to a non clinical population. The sample, composed by 113 college students (99 F and 14 M), answered to the EAS-40 and to the Brazilian version of the Toronto Alexithymia Scale (TAS) (external criterion). Results suggested that the EAS-40 can be a useful instrument to evaluate colleges’ psychological symptoms with good temporal stability. It allows discriminating populations with different profiles. As to the concurrent validity, results showed that the EAS-40 dimensions are diversely correlated to the various TAS components. New researches, involving a more balanced sample concerning to participants’ gender must be carried out.

Validade da Versão em Português da Toronto Alexithymia Scale-TAS em Amostra Clínica

It presents a survey of some formal characteristics of the scientific production with the aim of knowing whom, where, and what have been indexed in electronic databases, under the entry: “brief psychodynamic psychotherapy” and “time-limited psychodynamic psychotherapy”. Foreign and national productions were checked and critiques were presented. The sample of 534 abstracts (1980 to 2003), published in Brazil and abroad, indicated that the foreign production was quantitatively superior concerning the number of references, journals and authors. However, the national production compares in some aspects such as: reference average by author, predominance of unique authorship and adoption of integrative psychotherapy, in which influences of other approaches, rather than the psychodynamic, are identified. In the two realities there was a predominance of publications about adult single psychotherapies, in psychiatric journals. It is expected that, with the expansion of psychology database, the last characteristic changes, at least in Brazil.

Intervenção breve em organizações: mudança em coaching de executivos

Psychometric properties of the Portuguese version of the Toronto Alexithymia Scale -TAS were studied in a sample of 294 inpatients with different pathologies, assisted at a general hospital. Results showed good internal consistency (a = 0,72) and test-retest reliability (r= 0,72). For this population the data were best represented by a three-factor structure. The items on the first factor are associated with the ability to identify ones feelings and to distinguish them from bodily sensations. The items on the second subscale relate to a concrete style of thinking. The items on the third subscale pertain to daydreaming and imagination. In conclusion, alexithymia, as measured by the Portuguese version of the TAS, is multidimensional and not well-represented by a global severity score.

Mudança em pacientes de clínica-escola: avaliação de resultados e processos

Executive coaching is a process designed to help professionals to reach organizational goals by learning new competences. Different proposals have been suggested in the literature with none or few empirical evidences of efficiency. This study aimed to evaluate the efficiency of an executive coaching program developed and carried out by first author, and composed by four modules: self-perception; improvements identification; action plan elaboration / execution and follow-up. Participants were ten executives directed by their companies to accomplish a coaching process. Processes were assessed by comparing final to initial psychological measures. Instruments: Escala Diagnostica Adaptativa Operacionalizada (EDAO-R), Escala de Estagios de Mudancas (EEM), Personal Profile Analysis (PPA) e Autoanalise do Desempenho (AAD). Results suggested that the coaching improved the level of adaptive efficacy by the development of specific habilities. The initial stage of change allowed choosing the best cognitive strategy. Limits on the methodological were pointed out.Executive coaching is a process designed to help professionals to reach organizational goals by learning new competences. Different proposals have been suggested in the literature with none or few empirical evidences of efficiency. This study aimed to evaluate the efficiency of an executive coaching program developed and carried out by first author, and composed by four modules: self-perception; improvements identification; action plan elaboration / execution and follow-up. Participants were ten executives directed by their companies to accomplish a coaching process. Processes were assessed by comparing final to initial psychological measures. Instruments: Escala Diagnostica Adaptativa Operacionalizada (EDAO-R), Escala de Estagios de Mudancas (EEM), Personal Profile Analysis (PPA) e Autoanalise do Desempenho (AAD). Results suggested that the coaching improved the level of adaptive efficacy by the development of specific habilities. The initial stage of change allowed choosing the best cognitive strategy. Limits on the methodological were pointed out.

Psicoterapia psicodinâmica breve: estratégia terapêutica e mudança no padrão de relacionamento conflituoso

This study investigated changes in patients cared for in a Training-Clinic and sought to understand the factors influencing the results of psychotherapeutic practices. The sample was composed of nine participants (eight women and one man) aged 33 years old or older, after they had completed psychotherapy treatment. Semi-structured interviews were conduc- ted to evaluate adaptive efficacy, stage of change, and psychopathological symptoms. The Scale for Efficacy of Adaptation (EDAO-R), the Stage of Change Scales (EEM), and the Symptom Assessment Scale 40 (EAS-40) were used. Data suggest that easing symptoms is possible, as is progressing in stage changes; adaptive efficacy, however, is more resistant to change. Positive therapeutic bonds and the willingness of patients to act as agents of their own change may have been relevant in the psychotherapies outcomes, even though these were not directly evaluated. Longitudinal studies are needed to monitor processes from their beginnings.Este artigo objetivou avaliar mudancas em pacientes atendidos em clinica-escola e compreender possiveis fatores que influenciaram os resultados das psicoterapias. A amostra foi composta por nove participantes (oito mulheres e um homem), com idade igual ou superior a 33 anos, em fase de termino de atendimento psicoterapico. Realizou-se entrevista individual semiestruturada para avaliar eficacia adaptativa, estagio de mudanca e sintomas psicopatologicos. Utilizaram-se a Escala Diagnostica Adaptativa Operacionalizada Redefinida (EDAO-R), a Escala de Estagios de Mudanca (EEM) e a Escala de Avaliacao de Sintomas (EAS-40). Os resultados sugerem ser possivel esperar abrandamento dos sintomas psicopatologicos e progresso nos estagios de mudanca. A qualidade da configuracao adaptativa e mais resistente a melhoras. A alianca terapeutica positiva e a disposicao do paciente como agente da propria mudanca podem ter sido relevantes nos resultados das psicoterapias, ainda que nao diretamente avaliados. Sao necessarias pesquisas longitudinais para o acompanhamento dos processos desde o inicio.