Aims: The objective of this paper is to perform a cross-cultural comparison of gambling disorder ... more Aims: The objective of this paper is to perform a cross-cultural comparison of gambling disorder (GD) due to electronic gaming machines (EGM), a form of gambling that may have a high addictive potential. Our goal is to investigate two treatment-seeking samples of adults collected in Brazil and the United States, countries with different socio-cultural backgrounds. This comparison may lead to a better understanding of cultural influences on GD. Methods: The total studied sample involved 733 treatment-seeking subjects: 353 men and 380 women (average age¼45.80, standard deviation 7 10.9). The Brazilian sample had 517 individuals and the American sample 216. Subjects were recruited by analogous strategies. Results: We found that the Brazilian sample was younger, predominantly male, less likely to be Caucasian, more likely to be partnered, tended to have a faster progression from recreational gambling to GD, and were more likely to endorse chasing losses. Conclusion: This study demonstrated that there are significant differences between treatment-seeking samples of adults presenting GD due to EGM in Brazil and in the United States. These findings suggest that cultural aspects may have a relevant role in GD due to EGM.
The aim of this study was to measure happiness in a sample of Brazilian psychiatrists and correla... more The aim of this study was to measure happiness in a sample of Brazilian psychiatrists and correlate it with the defense styles used by them and sociodemographic data. This study was observational, cross-sectional, and analytical. Data were collected through self-administered questionnaires by Brazilian psychiatrists who participated in the XXXII Brazilian Congress of Psychiatry , 2014. In this sample of psychiatrists, happiness levels were high (scoring 5.69 of a total of 7), and mature defense styles prevailed, especially humor and anticipation. In a multivariate analysis, having children, good sleep quality, increased sexual interest, and use of defense styles such as humor, anticipation, and idealization all showed a positive relationship with happiness; on the other hand, using defense style such as acting out or annulment demonstrated a negative relationship with happiness. Despite the well-known professional burden that they bear, Brazilian psychiatrists surveyed presented, in general, high levels of subjective well-being and happiness.
Resumo Contexto: A felicidade é uma emoção básica caracterizada por um estado emocional positivo,... more Resumo Contexto: A felicidade é uma emoção básica caracterizada por um estado emocional positivo, com sentimentos de bem-estar e de prazer, associados à percepção de sucesso e à compreensão coerente e lúcida do mundo. Nos últimos anos, diversos pesquisadores têm se preocupado em desvendar as relações entre felicidade e saúde mental. Objetivo: Revisar criticamente a literatura científica que aborda o tema da felicidade, assim como as suas contribuições para a saúde mental e a psiquiatria. Métodos: Revisão sistemática da literatura por meio do indexador MedLine, utilizando-se dos unitermos: happiness, mental health, well-being, positive psychology, resilience, optimism, gratitude, quality of life, positive emotions, personality. Resultados: Variáveis como origem, saúdes física e mental, religiosidade e determi-nadas características psicológicas se associam positivamente à felicidade. Não há evidências de que idade, gênero, estado civil, poder aquisitivo nem ocorrência de eventos externos (favoráveis ou não) se associem significativamente à felicidade. Conclusão: A felicidade é um fenômeno predominantemente subjetivo, estando subordinada mais a traços psicológicos e socioculturais do que a fatores externamente determinados. A identificação desses fatores é particularmente útil na subpopulação que é mais predisposta a doenças mentais, favorecendo o desenvolvimento de abordagens preventivas, com potencial repercussão nas áreas social e ocupacional. Ferraz, R.B. et al. / Rev. Psiq. Clín 34(5); 234-242, 2007 Abstract Background: Happiness is a basic emotion characterized by a positive emotional state, with feelings of well-being and pleasure, associated with a perception of sucess and a coherent and lucid comprehension of the world. Recently, several researchers have been involved in the elucidation of the relationship between happiness and mental health. Objective: Critically review the scientific literature concerning the topic happiness and its contributions to mental health and to psychiatry. Methods: Systematic review of the literature through the MedLine database, using the uniterms: happiness, mental health, well-being, positive psychology, resilience, optimism, gratitude, quality of life, positive emotions and personality. Results: Variables such as origin, physical and mental health, religiosity and certain psychological characteristics are positively associated with happiness. There is no evidence suggesting that age, gender, marital status, wealthiness or the occurrence of external factors (favorable or not) significantly associate with happiness. Conclusion: Happiness is a predominantly subjective phenomenon, subordinated to psychological and socio-cultural traits much more than to external factors. The identification of these factors is particularly useful when applied to subjects that are more predisposed to mental disorders, favoring the development of prevention approaches, which have potential repercussion in the social and occupational areas.
Background: Body dysmorphic disorder may negatively affect self-perception
of body shape and lead... more Background: Body dysmorphic disorder may negatively affect self-perception of body shape and lead patients to seek cosmetic surgery. This study estimates the level of body dissatisfaction and prevalence of body dysmorphic disorder symptoms in candidates for three plastic surgical procedures. Methods: Three hundred patients of both sexes divided into three groups (abdominoplasty, n = 90; rhinoplasty, n = 151; and rhytidectomy, n = 59) were classified as having (n = 51, n = 79, and n = 25, respectively) or not having (n = 39, n = 72, and n = 34, respectively) body dysmorphic disorder symptoms, based on the Body Dysmorphic Disorder Examination, which was administered preoperatively. Results: Prevalence rates of body dysmorphic disorder symptoms in the abdominoplasty, rhinoplasty, and rhytidectomy groups were 57, 52, and 42 percent, respectively. Significant between-group differences were observed regarding age (p < 0.001), body mass index (p = 0.001), and onset of body dysmorphic disorder symptoms (p < 0.001). Within-group differences in body dysmorphic disorder severity were observed in the abdominoplasty (p < 0.001), rhinoplasty (p < 0.001), and rhytidectomy (p = 0.005) groups. Body dysmorphic disorder severity was significantly associated with degree of body dissatisfaction (mean Body Dysmorphic Disorder Examination total scores; p < 0.001), avoidance behaviors (p < 0.001), sexual abuse (p = 0.026), suicidal ideation (p < 0.001), and suicide attempt (p = 0.012). Conclusions: Abdominoplasty candidates showed the highest prevalence; rhytidectomy candidates exhibited the highest percentage of severe cases, and rhinoplasty candidates had the lowest percentage of severe cases.
Kleptomania is characterized by repetitive stealing and has severe consequences for patients. Sti... more Kleptomania is characterized by repetitive stealing and has severe consequences for patients. Stigma, a lack of standardized therapy and a limited number of assessment tools hinder advances in treatment. This study provides preliminary data on the Portuguese-language version of the Kleptomania Symptom Assessment Scale (P-K-SAS) and preliminary data on an outpatient program. Experts in the field analyzed an initial P-K-SAS version, produced through translation/back-translation, in order to arrive at a final version. Eight patients currently on cognitive-behavioral therapy (CBT) and 10 patients under maintenance CBT were initially assessed, then re-assessed 6months later. The mean P-K-SAS score was higher among patients initiating CBT than among those under maintenance CBT (21.1±8.0 vs. 11.3±7.5; Mann-Whitney U=15.0, P=.024). The final version of the P-K-SAS presented excellent reliability (Cronbach&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s alpha=0.980; inter-item correlation, 0.638-0.907). The P-K-SAS presented solid psychometrics and seems ready for use in assessing the effectiveness of treatments for kleptomania. The findings suggest that kleptomania patients need follow-up treatment that goes beyond the traditional 12-session structure.
Pathological gambling was only recently recognized as a psychiatric disorder (DSM-III, APA, 1980)... more Pathological gambling was only recently recognized as a psychiatric disorder (DSM-III, APA, 1980). Most studies of pathological gambling include only male subjects. Despite the paucity of information, it is likely that at least one-third of pathological gamblers are women. The objective of this article is to review clinical and epidemiological characteristics of female gamblers as compared to their male counterparts. MEDLINE and PsycINFO were searched for investigational studies and reviews of the past 10 years on clinical (sociodemographic, course and progression, psychiatric comorbidities, genetics, and personality) and epidemiological aspects of female gamblers. Other relevant articles were also selected from reference lists. It is concluded that the current literature indicates some common characteristics in female and male gamblers, but it also indicates the possibility that each gender may carry etiopathogenic differences that when better understood should lead to improved treatment and prevention strategies.
This study examined compulsive sexual behavior (CSB) and psychopathology in a treatment-seeking s... more This study examined compulsive sexual behavior (CSB) and psychopathology in a treatment-seeking sample of men in São Paulo, Brazil. Eighty-six men (26% gay, 17% bisexual, 57% heterosexual) who met diagnostic criteria for excessive sexual drive and sexual addiction completed assessments consisting of the Mini International Neuropsychiatric Interview, a structured clinical interview for DSM-IV Axis I Disorders-Clinical Version (segment for Impulse Control Disorder), Sexual Compulsivity Scale (SCS), and questions about problematic CSB. The average SCS score for our sample was above the cut-off score reported in other studies, and 72% of the sample presented at least one Axis I psychiatric diagnosis. There were no differences among gay, bisexual, and heterosexual men on SCS scores and psychiatric conditions, but gay and bisexual men were more likely than heterosexual men to report casual sex and sex with multiple casual partners as problematic behaviors. SCS scores were associated with psychiatric co-morbidities, mood disorder, and suicide risk, but diagnosis of a mood disorder predicted higher SCS scores in a regression analysis. The study provides important data on the mental health needs of men with CSB in São Paulo, Brazil.
Epidemiological, behavioral, and clinical data on sexual compulsivity in Brazil are very limited.... more Epidemiological, behavioral, and clinical data on sexual compulsivity in Brazil are very limited. This study sought to adapt and validate the Sexual Compulsivity Scale (SCS), the 22-item version of the Compulsive Sexual Behavior Inventory (CSBI-22), and the Hypersexual Disorder Screening Inventory (HDSI) for use in Brazil. A total of 153 participants underwent psychiatric assessment and completed self-reported measures. The adaptation process of the instruments from English to Portuguese followed the guidelines of the International Society for Pharmacoeconomics and Outcomes Research. The reliability and validity of the HDSI criteria were evaluated and the construct validity of all measures was examined. For the SCS and HDSI, factor analysis revealed one factor for each measure. For the CSBI-22, four factors were retained although we only calculated the scores of two factors (control and violence). All scores had good internal consistency (alpha &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;.75), presented high temporal stability (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;.76), discriminated between patients and controls, and presented strong (ρ &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; .81) correlations with the Sexual Addiction Screening Test (except for the violence domain = .40) and moderate correlations with the Impulsive Sensation Seeking domain of the Zuckerman Kuhlman Personality Questionnaire (ρ between .43 and .55). The sensitivity of the HDSI was 71.93 % and the specificity was 100 %. All measures showed very good psychometric properties. The SCS, the HDSI, and the control domain of the CSBI-22 seemed to measure theoretically similar constructs, as they were highly correlated…
There is evidence of an association between the practice of intentional unsafe sex among men who ... more There is evidence of an association between the practice of intentional unsafe sex among men who have sex with men (MSM) and sensation seeking and impulsivity. However, other aspects of personality have been less frequently investigated. This study aims to investigate the association between the practice of intentional unsafe sex and personality traits in individuals who sought treatment and met the criteria for compulsive sexual behavior in São Paulo, Brazil. The sample consisted of 69 sexually compulsive MSM. The participants underwent psychiatric evaluation and an interview to define intentional condomless sex and completed self-report instruments. The participants completed the following measures: the Temperament and Character Inventory and the Sexual Compulsivity Scale. Twenty-five participants (36%) reported intentional unsafe sex with casual partners, of whom 84% were gay and 16% bisexual (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05). Fifteen (22%) individuals reported being HIV positive, and 11 (73%) of them practiced intentional unprotected anal intercourse (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05). The mean of sexual compulsivity was associated with men who engaged in intentional unsafe sex (P=0.01). Men who reported intentional unsafe sex scored significantly higher on the novelty seeking temperament dimension (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05) and scored significantly lower on the self-directedness character dimension (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). However, self-directedness predicted intentional unsafe sex in the multiple logistic regression (P=0.001). Sexually compulsive individuals who practiced intentional unsafe sex presented lower self-directedness than the group who did not engage in intentional unsafe sex, which suggests less autonomy regarding life itself. To the best of our knowledge, this is the first study to consider intentional unsafe sex in sexually compulsive men.
There is evidence of an association between the practice of intentional unsafe sex among men who ... more There is evidence of an association between the practice of intentional unsafe sex among men who have sex with men (MSM) and sensation seeking and impulsivity. However, other aspects of personality have been less frequently investigated. This study aims to investigate the association between the practice of intentional unsafe sex and personality traits in individuals who sought treatment and met the criteria for compulsive sexual behavior in São Paulo, Brazil. The sample consisted of 69 sexually compulsive MSM. The participants underwent psychiatric evaluation and an interview to define intentional condomless sex and completed self-report instruments. The participants completed the following measures: the Temperament and Character Inventory and the Sexual Compulsivity Scale. Twenty-five participants (36%) reported intentional unsafe sex with casual partners, of whom 84% were gay and 16% bisexual (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05). Fifteen (22%) individuals reported being HIV positive, and 11 (73%) of them practiced intentional unprotected anal intercourse (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05). The mean of sexual compulsivity was associated with men who engaged in intentional unsafe sex (P=0.01). Men who reported intentional unsafe sex scored significantly higher on the novelty seeking temperament dimension (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05) and scored significantly lower on the self-directedness character dimension (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). However, self-directedness predicted intentional unsafe sex in the multiple logistic regression (P=0.001). Sexually compulsive individuals who practiced intentional unsafe sex presented lower self-directedness than the group who did not engage in intentional unsafe sex, which suggests less autonomy regarding life itself. To the best of our knowledge, this is the first study to consider intentional unsafe sex in sexually compulsive men.
Aims: The objective of this paper is to perform a cross-cultural comparison of gambling disorder ... more Aims: The objective of this paper is to perform a cross-cultural comparison of gambling disorder (GD) due to electronic gaming machines (EGM), a form of gambling that may have a high addictive potential. Our goal is to investigate two treatment-seeking samples of adults collected in Brazil and the United States, countries with different socio-cultural backgrounds. This comparison may lead to a better understanding of cultural influences on GD. Methods: The total studied sample involved 733 treatment-seeking subjects: 353 men and 380 women (average age¼45.80, standard deviation 7 10.9). The Brazilian sample had 517 individuals and the American sample 216. Subjects were recruited by analogous strategies. Results: We found that the Brazilian sample was younger, predominantly male, less likely to be Caucasian, more likely to be partnered, tended to have a faster progression from recreational gambling to GD, and were more likely to endorse chasing losses. Conclusion: This study demonstrated that there are significant differences between treatment-seeking samples of adults presenting GD due to EGM in Brazil and in the United States. These findings suggest that cultural aspects may have a relevant role in GD due to EGM.
The aim of this study was to measure happiness in a sample of Brazilian psychiatrists and correla... more The aim of this study was to measure happiness in a sample of Brazilian psychiatrists and correlate it with the defense styles used by them and sociodemographic data. This study was observational, cross-sectional, and analytical. Data were collected through self-administered questionnaires by Brazilian psychiatrists who participated in the XXXII Brazilian Congress of Psychiatry , 2014. In this sample of psychiatrists, happiness levels were high (scoring 5.69 of a total of 7), and mature defense styles prevailed, especially humor and anticipation. In a multivariate analysis, having children, good sleep quality, increased sexual interest, and use of defense styles such as humor, anticipation, and idealization all showed a positive relationship with happiness; on the other hand, using defense style such as acting out or annulment demonstrated a negative relationship with happiness. Despite the well-known professional burden that they bear, Brazilian psychiatrists surveyed presented, in general, high levels of subjective well-being and happiness.
Resumo Contexto: A felicidade é uma emoção básica caracterizada por um estado emocional positivo,... more Resumo Contexto: A felicidade é uma emoção básica caracterizada por um estado emocional positivo, com sentimentos de bem-estar e de prazer, associados à percepção de sucesso e à compreensão coerente e lúcida do mundo. Nos últimos anos, diversos pesquisadores têm se preocupado em desvendar as relações entre felicidade e saúde mental. Objetivo: Revisar criticamente a literatura científica que aborda o tema da felicidade, assim como as suas contribuições para a saúde mental e a psiquiatria. Métodos: Revisão sistemática da literatura por meio do indexador MedLine, utilizando-se dos unitermos: happiness, mental health, well-being, positive psychology, resilience, optimism, gratitude, quality of life, positive emotions, personality. Resultados: Variáveis como origem, saúdes física e mental, religiosidade e determi-nadas características psicológicas se associam positivamente à felicidade. Não há evidências de que idade, gênero, estado civil, poder aquisitivo nem ocorrência de eventos externos (favoráveis ou não) se associem significativamente à felicidade. Conclusão: A felicidade é um fenômeno predominantemente subjetivo, estando subordinada mais a traços psicológicos e socioculturais do que a fatores externamente determinados. A identificação desses fatores é particularmente útil na subpopulação que é mais predisposta a doenças mentais, favorecendo o desenvolvimento de abordagens preventivas, com potencial repercussão nas áreas social e ocupacional. Ferraz, R.B. et al. / Rev. Psiq. Clín 34(5); 234-242, 2007 Abstract Background: Happiness is a basic emotion characterized by a positive emotional state, with feelings of well-being and pleasure, associated with a perception of sucess and a coherent and lucid comprehension of the world. Recently, several researchers have been involved in the elucidation of the relationship between happiness and mental health. Objective: Critically review the scientific literature concerning the topic happiness and its contributions to mental health and to psychiatry. Methods: Systematic review of the literature through the MedLine database, using the uniterms: happiness, mental health, well-being, positive psychology, resilience, optimism, gratitude, quality of life, positive emotions and personality. Results: Variables such as origin, physical and mental health, religiosity and certain psychological characteristics are positively associated with happiness. There is no evidence suggesting that age, gender, marital status, wealthiness or the occurrence of external factors (favorable or not) significantly associate with happiness. Conclusion: Happiness is a predominantly subjective phenomenon, subordinated to psychological and socio-cultural traits much more than to external factors. The identification of these factors is particularly useful when applied to subjects that are more predisposed to mental disorders, favoring the development of prevention approaches, which have potential repercussion in the social and occupational areas.
Background: Body dysmorphic disorder may negatively affect self-perception
of body shape and lead... more Background: Body dysmorphic disorder may negatively affect self-perception of body shape and lead patients to seek cosmetic surgery. This study estimates the level of body dissatisfaction and prevalence of body dysmorphic disorder symptoms in candidates for three plastic surgical procedures. Methods: Three hundred patients of both sexes divided into three groups (abdominoplasty, n = 90; rhinoplasty, n = 151; and rhytidectomy, n = 59) were classified as having (n = 51, n = 79, and n = 25, respectively) or not having (n = 39, n = 72, and n = 34, respectively) body dysmorphic disorder symptoms, based on the Body Dysmorphic Disorder Examination, which was administered preoperatively. Results: Prevalence rates of body dysmorphic disorder symptoms in the abdominoplasty, rhinoplasty, and rhytidectomy groups were 57, 52, and 42 percent, respectively. Significant between-group differences were observed regarding age (p < 0.001), body mass index (p = 0.001), and onset of body dysmorphic disorder symptoms (p < 0.001). Within-group differences in body dysmorphic disorder severity were observed in the abdominoplasty (p < 0.001), rhinoplasty (p < 0.001), and rhytidectomy (p = 0.005) groups. Body dysmorphic disorder severity was significantly associated with degree of body dissatisfaction (mean Body Dysmorphic Disorder Examination total scores; p < 0.001), avoidance behaviors (p < 0.001), sexual abuse (p = 0.026), suicidal ideation (p < 0.001), and suicide attempt (p = 0.012). Conclusions: Abdominoplasty candidates showed the highest prevalence; rhytidectomy candidates exhibited the highest percentage of severe cases, and rhinoplasty candidates had the lowest percentage of severe cases.
Kleptomania is characterized by repetitive stealing and has severe consequences for patients. Sti... more Kleptomania is characterized by repetitive stealing and has severe consequences for patients. Stigma, a lack of standardized therapy and a limited number of assessment tools hinder advances in treatment. This study provides preliminary data on the Portuguese-language version of the Kleptomania Symptom Assessment Scale (P-K-SAS) and preliminary data on an outpatient program. Experts in the field analyzed an initial P-K-SAS version, produced through translation/back-translation, in order to arrive at a final version. Eight patients currently on cognitive-behavioral therapy (CBT) and 10 patients under maintenance CBT were initially assessed, then re-assessed 6months later. The mean P-K-SAS score was higher among patients initiating CBT than among those under maintenance CBT (21.1±8.0 vs. 11.3±7.5; Mann-Whitney U=15.0, P=.024). The final version of the P-K-SAS presented excellent reliability (Cronbach&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s alpha=0.980; inter-item correlation, 0.638-0.907). The P-K-SAS presented solid psychometrics and seems ready for use in assessing the effectiveness of treatments for kleptomania. The findings suggest that kleptomania patients need follow-up treatment that goes beyond the traditional 12-session structure.
Pathological gambling was only recently recognized as a psychiatric disorder (DSM-III, APA, 1980)... more Pathological gambling was only recently recognized as a psychiatric disorder (DSM-III, APA, 1980). Most studies of pathological gambling include only male subjects. Despite the paucity of information, it is likely that at least one-third of pathological gamblers are women. The objective of this article is to review clinical and epidemiological characteristics of female gamblers as compared to their male counterparts. MEDLINE and PsycINFO were searched for investigational studies and reviews of the past 10 years on clinical (sociodemographic, course and progression, psychiatric comorbidities, genetics, and personality) and epidemiological aspects of female gamblers. Other relevant articles were also selected from reference lists. It is concluded that the current literature indicates some common characteristics in female and male gamblers, but it also indicates the possibility that each gender may carry etiopathogenic differences that when better understood should lead to improved treatment and prevention strategies.
This study examined compulsive sexual behavior (CSB) and psychopathology in a treatment-seeking s... more This study examined compulsive sexual behavior (CSB) and psychopathology in a treatment-seeking sample of men in São Paulo, Brazil. Eighty-six men (26% gay, 17% bisexual, 57% heterosexual) who met diagnostic criteria for excessive sexual drive and sexual addiction completed assessments consisting of the Mini International Neuropsychiatric Interview, a structured clinical interview for DSM-IV Axis I Disorders-Clinical Version (segment for Impulse Control Disorder), Sexual Compulsivity Scale (SCS), and questions about problematic CSB. The average SCS score for our sample was above the cut-off score reported in other studies, and 72% of the sample presented at least one Axis I psychiatric diagnosis. There were no differences among gay, bisexual, and heterosexual men on SCS scores and psychiatric conditions, but gay and bisexual men were more likely than heterosexual men to report casual sex and sex with multiple casual partners as problematic behaviors. SCS scores were associated with psychiatric co-morbidities, mood disorder, and suicide risk, but diagnosis of a mood disorder predicted higher SCS scores in a regression analysis. The study provides important data on the mental health needs of men with CSB in São Paulo, Brazil.
Epidemiological, behavioral, and clinical data on sexual compulsivity in Brazil are very limited.... more Epidemiological, behavioral, and clinical data on sexual compulsivity in Brazil are very limited. This study sought to adapt and validate the Sexual Compulsivity Scale (SCS), the 22-item version of the Compulsive Sexual Behavior Inventory (CSBI-22), and the Hypersexual Disorder Screening Inventory (HDSI) for use in Brazil. A total of 153 participants underwent psychiatric assessment and completed self-reported measures. The adaptation process of the instruments from English to Portuguese followed the guidelines of the International Society for Pharmacoeconomics and Outcomes Research. The reliability and validity of the HDSI criteria were evaluated and the construct validity of all measures was examined. For the SCS and HDSI, factor analysis revealed one factor for each measure. For the CSBI-22, four factors were retained although we only calculated the scores of two factors (control and violence). All scores had good internal consistency (alpha &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;.75), presented high temporal stability (&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;.76), discriminated between patients and controls, and presented strong (ρ &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; .81) correlations with the Sexual Addiction Screening Test (except for the violence domain = .40) and moderate correlations with the Impulsive Sensation Seeking domain of the Zuckerman Kuhlman Personality Questionnaire (ρ between .43 and .55). The sensitivity of the HDSI was 71.93 % and the specificity was 100 %. All measures showed very good psychometric properties. The SCS, the HDSI, and the control domain of the CSBI-22 seemed to measure theoretically similar constructs, as they were highly correlated…
There is evidence of an association between the practice of intentional unsafe sex among men who ... more There is evidence of an association between the practice of intentional unsafe sex among men who have sex with men (MSM) and sensation seeking and impulsivity. However, other aspects of personality have been less frequently investigated. This study aims to investigate the association between the practice of intentional unsafe sex and personality traits in individuals who sought treatment and met the criteria for compulsive sexual behavior in São Paulo, Brazil. The sample consisted of 69 sexually compulsive MSM. The participants underwent psychiatric evaluation and an interview to define intentional condomless sex and completed self-report instruments. The participants completed the following measures: the Temperament and Character Inventory and the Sexual Compulsivity Scale. Twenty-five participants (36%) reported intentional unsafe sex with casual partners, of whom 84% were gay and 16% bisexual (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05). Fifteen (22%) individuals reported being HIV positive, and 11 (73%) of them practiced intentional unprotected anal intercourse (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05). The mean of sexual compulsivity was associated with men who engaged in intentional unsafe sex (P=0.01). Men who reported intentional unsafe sex scored significantly higher on the novelty seeking temperament dimension (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05) and scored significantly lower on the self-directedness character dimension (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). However, self-directedness predicted intentional unsafe sex in the multiple logistic regression (P=0.001). Sexually compulsive individuals who practiced intentional unsafe sex presented lower self-directedness than the group who did not engage in intentional unsafe sex, which suggests less autonomy regarding life itself. To the best of our knowledge, this is the first study to consider intentional unsafe sex in sexually compulsive men.
There is evidence of an association between the practice of intentional unsafe sex among men who ... more There is evidence of an association between the practice of intentional unsafe sex among men who have sex with men (MSM) and sensation seeking and impulsivity. However, other aspects of personality have been less frequently investigated. This study aims to investigate the association between the practice of intentional unsafe sex and personality traits in individuals who sought treatment and met the criteria for compulsive sexual behavior in São Paulo, Brazil. The sample consisted of 69 sexually compulsive MSM. The participants underwent psychiatric evaluation and an interview to define intentional condomless sex and completed self-report instruments. The participants completed the following measures: the Temperament and Character Inventory and the Sexual Compulsivity Scale. Twenty-five participants (36%) reported intentional unsafe sex with casual partners, of whom 84% were gay and 16% bisexual (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05). Fifteen (22%) individuals reported being HIV positive, and 11 (73%) of them practiced intentional unprotected anal intercourse (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05). The mean of sexual compulsivity was associated with men who engaged in intentional unsafe sex (P=0.01). Men who reported intentional unsafe sex scored significantly higher on the novelty seeking temperament dimension (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05) and scored significantly lower on the self-directedness character dimension (P&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). However, self-directedness predicted intentional unsafe sex in the multiple logistic regression (P=0.001). Sexually compulsive individuals who practiced intentional unsafe sex presented lower self-directedness than the group who did not engage in intentional unsafe sex, which suggests less autonomy regarding life itself. To the best of our knowledge, this is the first study to consider intentional unsafe sex in sexually compulsive men.
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of body shape and lead patients to seek cosmetic surgery. This study estimates
the level of body dissatisfaction and prevalence of body dysmorphic disorder
symptoms in candidates for three plastic surgical procedures.
Methods: Three hundred patients of both sexes divided into three groups
(abdominoplasty, n = 90; rhinoplasty, n = 151; and rhytidectomy, n = 59) were
classified as having (n = 51, n = 79, and n = 25, respectively) or not having
(n = 39, n = 72, and n = 34, respectively) body dysmorphic disorder symptoms,
based on the Body Dysmorphic Disorder Examination, which was administered
preoperatively.
Results: Prevalence rates of body dysmorphic disorder symptoms in the
abdominoplasty, rhinoplasty, and rhytidectomy groups were 57, 52, and
42 percent, respectively. Significant between-group differences were observed
regarding age (p < 0.001), body mass index (p = 0.001), and onset of body
dysmorphic disorder symptoms (p < 0.001). Within-group differences in body
dysmorphic disorder severity were observed in the abdominoplasty (p < 0.001),
rhinoplasty (p < 0.001), and rhytidectomy (p = 0.005) groups. Body dysmorphic
disorder severity was significantly associated with degree of body dissatisfaction
(mean Body Dysmorphic Disorder Examination total scores; p < 0.001),
avoidance behaviors (p < 0.001), sexual abuse (p = 0.026), suicidal ideation
(p < 0.001), and suicide attempt (p = 0.012).
Conclusions: Abdominoplasty candidates showed the highest prevalence; rhytidectomy
candidates exhibited the highest percentage of severe cases, and rhinoplasty
candidates had the lowest percentage of severe cases.
of body shape and lead patients to seek cosmetic surgery. This study estimates
the level of body dissatisfaction and prevalence of body dysmorphic disorder
symptoms in candidates for three plastic surgical procedures.
Methods: Three hundred patients of both sexes divided into three groups
(abdominoplasty, n = 90; rhinoplasty, n = 151; and rhytidectomy, n = 59) were
classified as having (n = 51, n = 79, and n = 25, respectively) or not having
(n = 39, n = 72, and n = 34, respectively) body dysmorphic disorder symptoms,
based on the Body Dysmorphic Disorder Examination, which was administered
preoperatively.
Results: Prevalence rates of body dysmorphic disorder symptoms in the
abdominoplasty, rhinoplasty, and rhytidectomy groups were 57, 52, and
42 percent, respectively. Significant between-group differences were observed
regarding age (p < 0.001), body mass index (p = 0.001), and onset of body
dysmorphic disorder symptoms (p < 0.001). Within-group differences in body
dysmorphic disorder severity were observed in the abdominoplasty (p < 0.001),
rhinoplasty (p < 0.001), and rhytidectomy (p = 0.005) groups. Body dysmorphic
disorder severity was significantly associated with degree of body dissatisfaction
(mean Body Dysmorphic Disorder Examination total scores; p < 0.001),
avoidance behaviors (p < 0.001), sexual abuse (p = 0.026), suicidal ideation
(p < 0.001), and suicide attempt (p = 0.012).
Conclusions: Abdominoplasty candidates showed the highest prevalence; rhytidectomy
candidates exhibited the highest percentage of severe cases, and rhinoplasty
candidates had the lowest percentage of severe cases.