Negligência na infância em usuárias de crack: estudo longitudinal sobre a gravidade da abstinência e sintomas depressivos durante a desintoxicação

• Autor(a) principal: Francke, Ingrid D'Avila
• Data de Publicação: 2012
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da PUC_RS
• Texto Completo: http://tede2.pucrs.br/tede2/handle/tede/779
• topic: PSICOLOGIA; PSICOLOGIA COGNITIVA; DEPENDÊNCIA QUÍMICA; CRIANÇAS - MAUS TRATOS; DEPRESSÃO; DESINTOXICAÇÃO; CNPQ::CIENCIAS HUMANAS::PSICOLOGIA

Addiction to crack cocaine has been a constant subject of discussion in public policy as well as scientific and clinical settings. Although the spread of crack is a serious public health problem, there is a paucity of scientific data on the impact caused by exposure to the substance and the vulnerability factors that interfere in the course of this exposure. This reinforces the need for more investment in theoretical and empirical research on the subject. This dissertation is one of the first to result from "The Cohort Study on Vulnerability Factors Associated with Craving in Women Crack Cocaine Addiction: Impact of Childhood Neglect on Cognition, Behavior and neuroendocrine response." This work was divided into two sections: theoretical and empirical. Because of the need to organize and expand the understanding of a comprehensive model of the motivational factors that culminate in addiction, the first section of this paper is a review on the subject. The theoretical article "Stress and Motivated Behavior: Impulse and Compulsion in Addiction" combines a theoretical overview to describe the associations between the dysregulation of motivated behavior and the neurobiological changes resulting from drug abuse. It also discusses the influence of early stress on neurodevelopmental disorders and changes in volition (compulsive and impulsive behaviors). Furthermore, this section addresses the behavioral concept of the reward system and the anti-reward system, as well as their neurobiological basis in the context of addiction. The theoretical study focused on literature that contributes to the understanding of addiction as a dysregulation of the innate motivational system essential to survival. The second section of this study provides the empirical article "Childhood Neglect: Impact on the Severity of Abstinence and Depressive Symptoms in Women Dependent on Crack Cocaine." This study was conducted on the first 96 subjects drawn from the cohort study; 16 subjects were removed from the analysis because they fulfilled the exclusion criteria. The sample was monitored during the period of detoxification in a specialized hospital unit. The purpose of the research was to investigate the role of physical neglect (PN) as a vulnerability factor with respect to symptoms that arise during the period of detoxification. These measures, the severity of withdrawal symptoms and depressed mood are considered as the most likely to contribute to a potential relapse. Thus, the empirical study has shown that women with PN (n=38) had more severe withdrawn syndrome, exacerbated symptoms of depressed mood and lower remission of symptoms during the entire period of hospitalization when compared with women without PN (n=42). Finally, this dissertation intends to contribute data, theoretical and empirical, about the impact of childhood neglect on the system that regulates motivated behaviors, and the repercussions of this "scar" on the exacerbation of depressive symptoms and perceived craving during the period of crack detoxification.