Quando o corpo grita o que alma açaima: Fibromialgia e psicossomática: Dois estudos de caso
Bibliographic record
Abstract
O presente trabalho, pretende reflectir sobre o funcionamento psicossomático de pacientes portadores do síndroma de fibromialgia, através da análise de dois casos clínicos e dos dados obtidos na avaliação efectuada a um grupo de oito pacientes, atendidas na Associação Portuguesa de Miastenia Grávis e doenças Neuromusculares. Pretendemos entender se existe relação entre ansiedade e depressão e os sintomas somáticos nestes pacientes e se podemos sugerir que estes apresentam uma personalidade-padrão definidora do seu funcionamento geral. A outra questão que se nos apresentou no decorrer da observação destes pacientes prendeu-se com o desejo de entender se os mesmos apresentavam traços alexitimicos . O método utilizado foi o da observação participante por meio de entrevistas abertas, assim como, da aplicação de testes psicológicos que pudessem complementar os dados. Os instrumentos utilizados foram: o Inventário Multifásico de Personalidade de Minnesota (Mini - Mult); O State-Trait Anxiety Inventory (S.T.A.I.); O Inventário de Depressão de Beck (B.D.I.) e a Escala de Alexitimia de Toronto (T.A.S. – 20). No que concerne os resultados obtidos, verificámos que a maioria dos sujeitos apresenta as seguintes características: sinais de inconformidade, imaturidade, pessimismo, teimosia, apatia, retracção e auto-punição, assim como, egocentrismo, sugestionabilidade e traços narcisicos. Quanto à relação entre ansiedade, depressão e alexitimia neste tipo de afecção, os resultados dos testes demonstraram o seguinte: a maior parte das pacientes observados revela sintomatologia depressiva variável. No que se refere aos dois casos clínicos estudados, ambas as pacientes apresentavam ansiedade/estado/traço baixa ou moderada. Do que pudemos observar ao longo da investigação, não obstante os resultados dos testes, todas elas tinham históricos variáveis de ansiedade ou depressão. Exceptuando dois casos que revelaram dificuldades na expressão emocional, considerámos que as pacientes não apresentavam traços alexitimicos relevantes. ABSTRACT The current study, intends to examine the psychosomatic functioning of fibromialgia syndrome carrying patients, through the analysis of two clinical cases, as well as, through the data gotten in the effectuated evaluation to a group of eight patients, taken care of in the Portuguese Association of Myasthenia Gravis and Neuromuscular Illnesses. We intended to understand the association between anxiety, depression and somatic symptoms in these patients and if we can state that there is a defining personality-standard of its general functioning. We tried to understand, at the same time, if these patients revealed alexithymic symptoms. The subjects’ psychological dimensions were investigated by open interviews, as well as, by several self-report questionnaires including: Minnesota Multiphasic Personality Inventory (Mini-Mult); State-Trait Anxiety Inventory (S.T.A.I.); Beck Depression Inventory (BDI), Toronto Alexithymia Scale – TAS – 20. In what concerns the gotten results, we verified that the majority of the patients present the following characteristics: narcissistic symptoms, denial signals, immaturity, pessimism, stubbornness, apathy, withdrawal and auto-punishment, as well as, egocentrism and suggestibility. In what concerns the relation between anxiety, depression and alexithymia in this type of syndrome, the results of the tests had demonstrated the following: most of the observed patients disclosed unpredictable depressive symptomatology. As for the two studied clinical cases, both the patients presented moderate or low anxiety/state/trace levels. Of what we could observe throughout the inquiry, despite the test results, all the patients exposed unreliable clinical pasts of anxiety or depression. On what concerns the alexithymia, with the exception of two cases that presented difficulties in the emotional expression, we considered that the patients did not revealed alexithymic signals.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".