Mariana Fortunata Donadon

Recognition of facial expressions by alcoholic patients: a systematic literature review

Background Alcohol abuse and dependence can cause a wide variety of cognitive, psychomotor, and visual-spatial deficits. It is questionable whether this condition is associated with impairments in the recognition of affective and/or emotional information. Such impairments may promote deficits in social cognition and, consequently, in the adaptation and interaction of alcohol abusers with their social environment. The aim of this systematic review was to systematize the literature on alcoholics’ recognition of basic facial expressions in terms of the following outcome variables: accuracy, emotional intensity, and latency time. Methods A systematic literature search in the PsycINFO, PubMed, and SciELO electronic databases, with no restrictions regarding publication year, was employed as the study methodology. Results The findings of some studies indicate that alcoholics have greater impairment in facial expression recognition tasks, while others could not differentiate the clinical group from controls. However, there was a trend toward greater deficits in alcoholics. Alcoholics displayed less accuracy in recognition of sadness and disgust and required greater emotional intensity to judge facial expressions corresponding to fear and anger. Conclusion The current study was only able to identify trends in the chosen outcome variables. Future studies that aim to provide more precise evidence for the potential influence of alcohol on social cognition are needed.

Psychometrics Properties of Early Trauma Inventory Self Report – Short Form (ETISR-SR) for the Brazilian Context

This study aims to translate and validate Early Trauma Inventory Self Report -Short Form (ETISR-SF) to Brazilian Portuguese. 253 adult subjects answered the ETISR-SF, Beck Anxiety Inventory (BAI), Fagerström Test for Nicotine Dependence (FTND), Patient Health Questionnaire (PHQ-9) and Fast Alcohol Screening Test (FAST). The instrument showed good internal consistency (0.83). Correlations with the PHQ-9 and BAI were moderate (r=0.26-0.47) and showed the expected associations with psychiatric constructs. No associations were found for FTND and FAST. Confirmatory Factor Analysis revealed that a correlated four-factor model as well as a second order model subsuming four lower order components presented the best model fit. Test-retest reliability was also excellent (ICC=0.78-0.90). ETISR-SF is suitable for assessing traumatic experiences in a Brazilian community sample. Given the importance of trauma as a public health problem, tools such as ETISR-SF may help clinicians/ researchers to better evaluate and measure such events and further advance clinical care of trauma victims.

The Associations Between Oxytocin and Trauma in Humans: A Systematic Review

Studies have shown that traumatic experiences may affect hormonal systems mediated by the hypothalamic-pituitary-adrenal (HPA) axis and the oxytocinergic system. This effect is the result of long-term impairments in hypothalamic structures and negative feedback mechanisms within the HPA axis, structures that mediate the response to stress. This deregulation reduces the production and release of cortisol and oxytocin (OXT), which may alter stress responses and lead to increased vulnerability to impairments from stressful experiences. The presence of gene polymorphisms might also have an impact on the vulnerability to psychopathology. We made a systematic review of articles dealing with the relationship between OXT and traumatic emotional experiences in humans. Thirty-five studies were reviewed and significant associations between experiences of emotional trauma (ET) and OXT were found. The main results showed that the presence of ET and post-traumatic stress disorder (PTSD) is strongly associated with reductions in endogenous OXT, and also that the acute effects of OXT administrations in individuals with ET tend to be anxiolytic only in less severe forms. In victims of recent traumatic experiences (RTE), OXT increased the re-experience of traumas and restored the function of different neural networks associated with fear control/extinction in PTSD patients. The results available also suggest that gene receptor polymorphisms may have a protective function in different outcomes after the experience of traumatic events. We conclude that the relationship between ET and OXT is multifaceted, complex, and mediated by contextual and individual factors. Directions for future studies are suggested considering the gaps in the available literature.

Chronic pelvic pain, psychiatric disorders and early emotional traumas: Results of a cross sectional case-control study

AIM To compare the prevalence of psychiatric disorders and early emotional traumas between women with chronic pelvic pain (CPP) and healthy women. METHODS One hundred women in reproductive age, 50 of them had CPP (according to the criteria set by the International Association for Study of Pain), and 50 were considered healthy after the gynecological evaluation. The eligibility criteria were defined as follows: chronic or persistent pain perceived in the pelvis-related structures (digestive, urinary, genital, myofascial or neurological systems). Only women in reproductive age with acyclic pain for 6 mo, or more, were included in the present study. Menopause was the exclusion criterion. The participants were grouped according to age, school level and socio-economic status and were individually assessed through DSM-IV Structured Clinical Interview (SCID-I) and Early Trauma Inventory Self-report - short form (ETISR-SF Brazilian version). Descriptive statistics, group comparison tests and multivariate logistics regression were used in the data analysis. RESULTS The early emotional traumas are highly prevalent, but their prevalence did not differ between the two groups. The current Major Depressive Disorder was more prevalent in women with CPP. The CPP was associated with endometriosis in 48% of the women. There was no difference in the prevalence of disorders when endometriosis was taken into account (endometriosis vs other diseases: P > 0.29). The current Major Depressive Disorder and the Bipolar Disorder had greater occurrence likelihood in the group of women with CPP (ODDS = 5.25 and 9.0). CONCLUSION The data reinforce the link between mood disorders and CPP. The preview evidences about the association between CPP and early traumas tended not to be significant after a stronger methodological control was implemented.

Current alcohol dependence and emotional facial expression recognition: a cross-sectional study

Abstract Background: Several studies have demonstrated that chronic and excessive alcohol use causes social cognition deficits. Objectives : Thus, the aim of the current study is to assess the associations between emotional facial expression recognition and current alcohol dependence. Methods : The sample consisted of two groups: one was composed by current alcohol dependent individuals (AG = 110); and a control group, composed of healthy individuals (CG = 110) assessed by the Structured Clinical Interview DSM-IV. The instrument to assess the recognition of facial expressions of emotion was a dynamic task at computer. Results : The AG showed low accuracy in recognizing emotions as a whole and especially fear and disgust. In addition, the group needed greater emotional intensity to recognize joy, fear, disgust and surprise. It also showed increased reaction time for all emotions (p < 0.01). The logistic regression showed the response time for surprise (ODDS = 1.01) and the ability to recognize emotions such as fear (ODDS = 0.68) and disgust (ODDS = 0.70) was significantly associated with alcohol dependence.

Occurrence and predictive factors of psychiatric comorbidity in individuals with alcohol use disorders

Alcoholism is a disorder caused by an excessive and maladaptive pattern of alcohol consumption. A series of impairments can arise from such consumption, including psychiatric comorbidities. The objective of this study was to evaluate the rate of occurrence of anxiety and depression comorbidities in alcoholics and to investigate the associations of such comorbidities with the dose of ingested alcohol, period of alcohol use, personality traits and the presence of early emotional trauma. The sample consisted of 110 alcoholics, evaluated by the Structured Clinical Interview for DSM-IV (SCID-IV – clinical version) and recruited at the Hepatopathy Outpatient Service of a University Hospital. Data collection was individual and took place through the application of self-evaluation instruments. Statistical analysis was performed using parametric statistics with a significance level of p≤0.05. The main results showed that 46.3% of alcoholics had psychiatric comorbidities with mood disorders and/or anxiety. In addition, according to the logistic regression model, the increase in the doses of alcohol ingested and the presence of early emotional traumas were risk factors for the development of such comorbidities in alcoholics: (ODDS=1.18; p=0.005) and (ODDS=1.17; p=0.001), respectively. These data indicate the need for early intervention with regard to the primary care of both alcoholics who suffered early trauma and alcoholics who ingest large amounts of alcohol daily to decrease the risk of psychiatric comorbidities in this high-risk group.

Early emotional trauma in alcohol-dependent men: prevalence, associations and predictive value

Background Several studies have indicated that early emotional traumas (EET) are highly prevalent in alcohol-dependent individuals, and that these traumas work as risk factors for the development of this disorder. Objective The aim of the current study is to evaluate the EET associations and predictive value regarding active alcohol dependence among male individuals from a developing country. Methods The sample consisted of two groups. The first was composed by adult male individuals diagnosed as alcohol dependents (AG, N = 110), and the second with no alcohol abuse and/or dependence diagnosis (CG, N = 110). Both groups were evaluated using Structured Clinical Interview based on the Diagnostic and Statistical Manual of Mental Disorders; Early Emotional Trauma Inventory; and a sociodemographic questionnaire. Results All trauma subtypes (general, physical, emotional and sexual) were more prevalent among AG than CG. However, only traumas categorized as general and emotional worked as risk factor for alcoholism development and they increased the chances to develop this disorder by 1.45 and 1.23 times, respectively. Discussion EETs are important factors that should be taken into account in interventions that aim to prevent, minimize and/or treat this clinical condition and its impact and/or severity, especially in countries such as Brazil.

Habilidades sociais e depressão: um relato de caso

Based on the literature, depressed individuals have few resources or social skills to successfully deal with stressful and/or vulnerability situations, which can contribute to trigger or maintain depressive symptoms. Thus, the aim here is to describe social skills training (SST) interventions applied to a female patient in individual care, using cognitive behavioral approach (CBT), with symptoms of mild depression. This case report describes the care of a 26 year-old patient that underwent 42 sessions of psychotherapy in individual mode. In the diagnostic assessment, we used the DSM-5 and the Beck inventories. The treatment plan involved cognitive behavioral techniques, such as psychoeducation, cognitive restructuring, and social skills training. As a result, it was observed a decrease in depressive mood and improvement in the repertoire of social skills. These factors combined contributed to a better biopsychosocial functioning of the patient and an increase in self-esteem, pointing to the positive impact of SSI in the treatment with CBT of patients with depression.

Habilidades sociais e depressão: a case report

Based on the literature, depressed individuals have few resources or social skills to successfully deal with stressful and/or vulnerability situations, which can contribute to trigger or maintain depressive symptoms. Thus, the aim here is to describe social skills training (SST) interventions applied to a female patient in individual care, using cognitive behavioral approach (CBT), with symptoms of mild depression. This case report describes the care of a 26 year-old patient that underwent 42 sessions of psychotherapy in individual mode. In the diagnostic assessment, we used the DSM-5 and the Beck inventories. The treatment plan involved cognitive behavioral techniques, such as psychoeducation, cognitive restructuring, and social skills training. As a result, it was observed a decrease in depressive mood and improvement in the repertoire of social skills. These factors combined contributed to a better biopsychosocial functioning of the patient and an increase in self-esteem, pointing to the positive impact of SSI in the treatment with CBT of patients with depression.

Social skills and depression: a case report

Based on the literature, depressed individuals have few resources or social skills to successfully deal with stressful and/or vulnerability situations, which can contribute to trigger or maintain depressive symptoms. Thus, the aim here is to describe social skills training (SST) interventions applied to a female patient in individual care, using cognitive behavioral approach (CBT), with symptoms of mild depression. This case report describes the care of a 26 year-old patient that underwent 42 sessions of psychotherapy in individual mode. In the diagnostic assessment, we used the DSM-5 and the Beck inventories. The treatment plan involved cognitive behavioral techniques, such as psychoeducation, cognitive restructuring, and social skills training. As a result, it was observed a decrease in depressive mood and improvement in the repertoire of social skills. These factors combined contributed to a better biopsychosocial functioning of the patient and an increase in self-esteem, pointing to the positive impact of SSI in the treatment with CBT of patients with depression.