Identifying and validating emotion regulation latent profiles and their relationship with affective variables.

OBJECTIVE: We investigated and validated the presence of emotion regulation profiles in an adult sample. METHOD: In a cross-sectional study, 1165 individuals completed the Emotion Regulation Questionnaire (ERQ), Difficulties in Emotion Regulation Scale (DERS), Positive and Negative Affect Scale (PANAS), and Following Affective States Test (FAST). Sample was divided into three to establish and validate emotion regulation profiles using a latent profile analysis. RESULTS: Sample 1 (n = 375) showed three different profiles: dysregulated, adapted, and unaware regulator. Sample 2 (n = 390) shows a consistent pattern with the same number of profiles that remained stable over time. In Sample 3 (n = 400), we validate and find that cognitive reappraisal and lack of awareness were essential to differentiating profiles. CONCLUSIONS: Three emotional regulation profiles differ due to the levels of positive/negative affect and the propensity to avoid/follow emotions, increasing the understanding of how different regulatory strategies interact and explain different outcomes with mental health.

Cognitive impairment in the HTLV-1 infection: a comparative study associated with functional performance.

Human T cell leukemia virus type-I (HTLV-1) infection courses with a myelopathy, the tropical spastic paraparesis (HAM/TSP). In a case-control study, we compared the neuropsychological profile and functional characteristics in two case HTLV-1-infected groups (asymptomatic and with HAM/TSP) with a control group negative for HTLV-1. Subjects were paired for age, sex, and educational features. The case group differed from control group in neuropsychological measures such as in episodic memory recall, executive functions, and fine motor dexterity measure. Individuals with HAM/TSP have more depressive symptoms and worst performance in activities of daily living (ADL) presenting a less functionality. In multivariate models, the fine motor performance, the executive functioning, the recognition memory, and the depressive symptoms explained part of the variance in functionality. Those findings may contribute to understand of everyday life impairments and limitations of HTLV-1-infected population and to organize the rehabilitation. Once more, based in neuropsychological and functional data, we can reaffirm that HTLV-1 is never a benign condition, but sometimes it is only in a stage coursing with less symptoms.

Adding guidance to deliberate reflection improves medical student's diagnostic accuracy.

CONTEXT: Diagnostic competence in students is a major medical education goal. Adding instructional guidelines to prompt deliberate reflection fosters medical students' diagnostic proficiency. This study investigates the effects of this teaching strategy on diagnostic accuracy in solving clinical cases of different complexity levels by novice and senior students. METHOD: Eighty third-year and 62 sixth-year medical students participated in this three-phase experimental study. First, participants were randomly assigned to one of three experimental conditions (free reflection, cued reflection and worked example) to diagnose 12 clinical text-based cases, following different levels of deliberate reflection. In an immediate test and a delayed test, the participants diagnosed varied sets of 12 cases, six involving the same diseases (four routine and two rare). The main outcomes were the diagnostic accuracy scores achieved for the cases assessed by repeated measures of analysis of variance for each category. RESULTS: There was a significant primary effect of experimental condition (P < .001), year of training (P < .001) and study phase (P < .001) on the diagnostic accuracy achieved. The use of deliberate reflection in addition to instructional guidelines resulted in improved results in the immediate test for all cases evaluated (P < .001), regardless of participants' seniority. In the delayed test, this benefit was maintained for simple cases (P < .001). For complex cases, the benefit was maintained only for senior students (P < .001). The cued reflection and worked example groups did not differ in performance (P > .05), but both groups surpassed the free reflection group (P < .001), regardless of the students' learning stage and case complexity.

Depressive symptoms increase the risk of progression to dementia in subjects with mild cognitive impairment: systematic review and meta-analysis.

OBJECTIVE: There is a long-standing debate in the literature whether depressive symptoms increase the risk of dementia in older with mild cognitive impairment (MCI). We aim to conduct a meta-analysis of studies that evaluated the risk of dementia in subjects with MCI and depressive symptoms compared with subjects with MCI and no depressive symptoms. METHODS: We calculated the relative risk of progression to dementia in subjects with MCI and depressive symptoms compared with subjects with MCI and no depressive symptoms using a generic inverse variance method with random effect models. RESULTS: Eighteen studies were included in the meta-analysis, with a sample size of 10,861 MCI subjects. The pooled relative risk of progressing to dementia was 1.28 CI95% [1.09-1.52] (p = 0.003) in the group of MCI subjects with depressive symptoms compared with the MCI subjects with no depressive symptoms. DISCUSSION: Our results provide additional evidence that depressive symptoms determine an additive risk effect to the progression to dementia in subjects with MCI. The comorbidity between depression and cognitive impairment can be an intervention target for prevention of dementia in MCI subjects. Copyright © 2015 John Wiley & Sons, Ltd.

Association between DCHS2 gene and mild cognitive impairment and Alzheimer's disease in an elderly Brazilian sample.

OBJECTIVES: In 2012, Kamboh and colleagues published a genome-wide association study that identified the DCHS2 gene (rs1466662 T/A) influencing the age at onset of Alzheimer's disease (AD). We aimed to investigate if there is association between the DCHS2 gene and amnestic mild cognitive impairment (aMCI) and AD in a sample of the Brazilian population. METHODS: 143 controls, 79 aMCI and 299 AD patients were selected and submitted to the same protocol of tests. Genotyping was performed using the Real Time PCR RESULTS: Amnestic MCI patients showed a higher prevalence of AA than controls and a lower frequency of TT when compared with controls. We also stratified the sample according to the APOE ε4 status. No difference in DCHS2 genotype or allelic frequency occurred in the APOE ε4 allele carrier subgroup. Amnestic MCI patients showed a higher frequency of AA genotype and a lower frequency of TA and TT when compared with controls in APOE ε4 allele non-carrier subgroup. The allelic distribution followed the same pattern. In AD group, we observed a significant difference with a higher A allelic frequency in AD in this subgroup. A multiple logistic regression demonstrated that in APOE ε4 non-carriers, allele rs1466662 was associated to aMCI group. Different variables were associated with aMCI and AD according to APOE ε4 status in our sample. Low level of education was associated with AD, while diabetes mellitus type 2 was associated with aMCI. Copyright © 2016 John Wiley & Sons, Ltd. CONCLUSIONS: Our findings suggest a possible role for DCHS2 gene in aMCI and AD.

Working Memory and Cognitive Flexibility Mediates Visuoconstructional Abilities in Older Adults with Heterogeneous Cognitive Ability.

Previous studies suggest that executive functions influence the performance on visuoconstructional tasks. This study aims to investigate whether the relationship between planning ability and the copy of complex figures is mediated by distinct components of executive functions (i.e., working memory, inhibitory control and cognitive flexibility). We included a 129 older adults with Alzheimer's disease (n=36, AD), mild cognitive impairment (MCI, n=67), and with no evidence of cognitive impairment (controls, n=26). We evaluated the mediation effect of planning abilities, working memory, cognitive flexibility and inhibitory control on visuoconstructional tasks using a multiple mediation models. We found a significant direct effect of planning on visuoconstructional abilities and a partial mediation effect of working memory and cognitive flexibility on visuoconstructional abilities. The present results indicate that the performance on visuoconstructional task is mediated by multiple interrelated executive functions components, in particular working memory and cognitive flexibility.

THE RELATIVE AGE EFFECT IN COMBAT SPORTS: AN ANALYSIS OF OLYMPIC JUDO ATHLETES, 1964-2012.

This study assessed the relative age effect (RAE) in judo athletes who participated in the Olympic Games from 1964 to 2012. The names and birthdates of the Olympic judo athletes were collected from open-access websites. Data from male (n=1,762) and female (n=665) competitors were analyzed separately. Chi-squared tests were performed to investigate REA in medalists, and by weight categories and sexes. When the analyses used semesters to divide the period when the athletes were born, a RAE was found in male heavyweight athletes and male medallists. Thus, in a selected group of judo athletes who had participated at the highest competitive level, RAEs were present in both athletes who won Olympic medals and heavyweight athletes in the male group.

Genetic variant of AKT1 and AKTIP associated with late-onset depression in a Brazilian population.

OBJECTIVES: Examine the association between polymorphisms in the AKT1 and AKTIP genes and late-onset depression (LOD). Major depressive disorder is one of the most prevalent neuropsychiatric diseases. LOD is a disorder that starts after 65 years old. AKT1 is a downstream enzyme that has been implicated in the pathogenesis of neurotransmitter-related disorders, such as depression. The identification of a novel AKT1-binding protein (AKTIP) was pointed as an important new target. AKTIP binds directly to AKT1, enhancing the phosphorylation of regulatory sites, and this modulation are affected by AKT1 activation. The association of AKT1 and AKTIP polymorphisms with depressive symptoms was not investigated in LOD. DESIGN: Genotype tagSNPs in the AKT1 and AKTIP in LOD patients and controls. SETTINGS: An academic medical center. PARTICIPANTS: Sample composed by 190 outpatients with LOD and 77 healthy individuals. MEASURES: The participants were evaluated using Diagnostic and Statistical Manual IV criteria, MINI-PLUS and the Geriatric Depression Scale. RESULTS: Our findings suggested an association between the tagSNP rs3730358 homozygous A/A (p = 0.006) and LOD. A strong association of allele A and increased association for LOD was demonstrated with tagSNP rs3730358 (p-value = 0.003). LIMITATIONS: Limitation include composition of our control group, where the exclusion criteria generated a kind of super-healthy older group what might have produced a hidden stratification when compared with the LOD. CONCLUSION: This study is the first one to establish the association of the AKT1/AKTIP genes and LOD, and further studies are necessary to clarify the functional role of these proteins.

Corporal artistic training influences attention: a pilot study.

This study assessed the effect of the Body Rhythmics (BRIM) on actors' attentional processes. BRIM is a combination of exercises using numbers and rules that enact musical parameters in the moving body through displacements. Male actors (N = 22) participated in the study: 7 in the BRIM (Study) group and 15 in the Control group (groups were equivalent on mean Raven's IQ). The Continuous Performance Test (CPT-II) was administered before and after an intensive period of BRIM training. There was no significant difference on the CPT-II before training. Group results for before vs after training showed a significant difference for reaction time for the Study group. There was also a trend to increased errors of commission in the Study group after BRIM training.

Model endophenotype for bipolar disorder: Qualitative Analysis, etiological factors, and research areas.

The aim of this study is to present an updated view of the writings on the endophenotype model for bipolar disorder using analytical methodologies. A review and analysis of networks was performed through descriptors and keywords that characterize the composition of the endophenotype model as a model of health. Information was collected from between 1992 and 2014, and the main thematic areas covered in the articles were identified. We discuss the results and question their cohesion, emphasizing the need to strengthen and identify the points of connection between etiological factors and characteristics that make up the model of endophenotypes for bipolar disorder.

Children and adolescents' quality of life in repeated cross-sectional studies during the COVID-19.

During the COVID-19 pandemic, internalizing and externalizing symptoms have impacted the quality of life of children and adolescents. This cross-sectional study evaluated children's quality of life using parental reports, observing associations with mental health problems and sociodemographic variables. Some behavioral measures were linked to lower quality of life, particularly depression symptoms, relationship problems, and inattention. Multiple regression models indicated that reduced children's quality of life (R2 = 36%) was associated with higher levels of internalizing (r = -0.46) and externalizing (r = -0.23) behavioral problems and younger parents (r = -0.08). Children with previous mental disorder diagnoses had lower quality of life than those without (p < 0.001). In summary, children's quality of life during the COVID-19 pandemic was linked to current mental health, parental age, and previous history of mental disorders.

Social support and suicidality during the COVID-19 pandemic among Brazilian healthcare workers: a longitudinal assessment of an online repeated cross-sectional survey.

INTRODUCTION: Healthcare workers (HCWs) are at an increased risk of suicide compared to non-healthcare workers. This study aims to investigate the association between social support and suicidal ideation and behavior (SIB) during the COVID-19 pandemic among Brazilian HCWs. METHODS: This study utilizes data from 10,885 participants who answered the first (time point 1 - between May and June of 2020) and second (time point 2 - between December 2020 and February 2021) assessments of an online repeated cross-sectional survey for evaluating mental health and quality of life of HCWs during the COVID-19 pandemic in Brazil. Logistic regression analysis was conducted to investigate the relationship between social support as the independent variable (time point 1) and SIB as the outcomes (time point 2). RESULTS: Higher social support was associated with a significantly lower chance of reporting SIB in the month prior to follow-up assessment (adjusted odds ratio [AOR]: 0.71, CI 95% 0.66 - 0.76 and AOR 0.61, CI 95% 0.54 - 0.68, respectively). These associations were independent of sex, age, feelings of loneliness, and self-reported psychiatric disorders. CONCLUSION: Social support is associated with a lower chance of suicidality among HCWs, a protective role that is probably more evident for suicidal behavior.

The Stick Design Test on the assessment of older adults with low formal education: evidences of construct, criterion-related and ecological validity.

BACKGROUND: The assessment of visuospatial abilities is usually performed by drawing tasks. In patients with very low formal education, the use of these tasks might be biased by their cultural background. The Stick Design Test was developed for the assessment of this population. We aim to expand the test psychometric properties by assessing its construct, criterion-related and ecological validity in older adults with low formal education. METHOD: Healthy older adults (n = 63) and Alzheimer's disease patients (n = 92) performed the Stick Design Test, Mini-Mental State Examination, Digit Span Forward and the Clock Drawing Test. Their caregivers answered Personal Care and Instrumental Activities of Daily Living). Construct validity was assessed by factor analysis, convergent correlations (with the Clock Drawing Test), and divergent correlations (with Digit Span Forward); criterion-related validity by receiver operating characteristic curve analysis and binary logistic regression; and Ecological validity by correlations with ADL. RESULTS: The test factor structure was composed by one component (R 2 = 64%). Significant correlations with the Clock Drawing Test and Digit Span Forward were found, and the relationship was stronger with the first measure. The test was less associated with formal education than the Clock Drawing Test. It classified about 76% of the participants correctly and had and additive effect with the Mini-Mental State Examination (84% of correct classification). The test also correlated significantly with measures of ADL, suggesting ecological validity. CONCLUSIONS: The Stick Design Test shows evidence of construct, criterion-related and ecological validity. It is an interesting alternative to drawing tasks for the assessment of visuospatial abilities.

Sex differences in dimensions of impulsivity in a non-clinical sample.

Impulsivity has been more closely associated with men than with women because men are more often involved in illegal behaviors. The few studies that have investigated sex differences in impulsivity have used self-report questionnaires and have obtained contradictory results. Two computerized behavioral tests were administered to 125 healthy undergraduate students (75 women, M age 23.8 yr.; 50 men, M age 25.0 yr.). Men exhibited higher scores on motor impulsivity, but there were no significant differences between men and women on attentional and non-planning impulsivity scores. These findings are discussed in terms of the relationship between impulsivity and low- and high-order control.

Executive Functions Contribute to the Differences Between ADHD and Sluggish Cognitive Tempo (SCT) in Adults.

OBJECTIVES: This paper analyses the relationship between sociodemographic variables, executive dysfunctions, Sluggish Cognitive Tempo (SCT) and the mainly dimensions of ADHD: hyperactivity-impulsivity (ADHD-H/I) and inattention (ADHD-IN) in Brazilian adults. METHOD: A cross-sectional, exploratory, and comparative design was used. A total of 446 participants (295 women) aging from 18 to 63 years old (M = 3,499 years, SD = 10.7) were recruited on the internet. Correlations, t independent tests and regressions were conducted. RESULTS: Higher scores in ADHD dimensions were associated to more executive functioning problems and time perception distortions in comparison to those participants without significant ADHD symptoms. However, ADHD-IN dimension as well as SCT were higher associated with these dysfunctions than ADHD-H/I. The regression results showed that ADHD-IN was more related to Self-Management to time while ADHD-H/I to Self-Restraint and SCT to Self-Organization/Problem Solving. CONCLUSION: This paper contributed to the distinction between SCT and ADHD in adults in important psychological dimensions.

Psychometric properties of the Brazilian Portuguese version of the UPPS-P impulsive behavior scale for children and adolescents.

OBJECTIVE: To translate and validate the version for children and adolescents of the UPPS-P scale into Brazilian Portuguese. METHOD: After a five-step translation process, the final draft was submitted to a panel of 12 different specialties experts. Subsequently, the application of the scale was applied concomitantly with the "Swanson, Nolan, and Pelham Scale - Version IV" (SNAP-IV) and the "Child and Adolescent Behavior Inventory" (CABI) scale to analyze the correlation between them. Content Validity Index (CVI) and reliability were estimated by calculating internal consistency and analyzing its test-retest stability. RESULTS: The items whose CVI was lower than 80% underwent a detailed analysis to verify the reason for the bad evaluation. Five items (3, 7, 11, 22 and 35) scored below 80% and were reassessed. There was high internal consistency in all parameters: Lack of premeditation (McDonald's omega = 0.806; Cronbach's alpha = 0.801), Negative Urgency (McDonald's omega = 0.838; Cronbach's alpha = 0.836), Sensation seeking (McDonald's omega = 0.826; Cronbach's alpha = 0.810), Lack of Perseverance (McDonald's omega = 0.800; Cronbach's alpha = 0.799) and Positive Urgency (McDonald's omega = 0.936; Cronbach's alpha = 0.934). A strong correlation was observed between UPPS-P features and impulsivity in behavioral assessments. CONCLUSIONS: The Brazilian Portuguese version of the UPPS-P scale is a good instrument to assess impulsivity in children and adolescents.

Gaming addiction and screen time in a context of increase of internalizing symptoms: Moderation evaluation.

Children and adolescents were largely affected by the psychosocial impact of the 2019-2022 pandemic. During this time, there was an increase in internalizing symptoms, screen and internet use, and internet addiction. However, the interaction of these variables are not fully understood in a stressful time. Here, we have a repeated cross-sectional study aiming to model internalizing symptoms' prediction depending on screen time and game addiction during the COVID-19 pandemic. Parent-reported online data were collected at three timepoints, 6 months apart from each other, from a total of 1211 participants. We found an increase in screen time, game addiction, and internalizing symptoms. Regardless of the time spent in front of screens, higher levels of game addiction were associated with higher levels of internalizing symptoms in children and adolescents. Even if participants demonstrated low screen time, if they were virtually dependent they tended to exhibit higher levels of internalizing symptoms. The same result was found in all three samples. There is a need to investigate the nature of the relationship between internet addiction and internalizing symptoms and the long lasting effects of long hours on the screen.

Cross-cultural adaptation, validity, and reliability of the Child and Adolescent Behavior Inventory (CABI) for use in Brazil.

OBJECTIVE: The Child and Adolescent Behavior Inventory (CABI) is a cost-free 75 question-questionnaire developed by an Italian group to collect information from parents on the behavior of children and adolescents aged 6 to 18 years. It assesses different areas of children's behavior and psychopathology, including internalizing and externalizing symptoms, and can be used to identify children at risk of mental disorders both in clinical and epidemiological settings. In this study, the authors present a Brazilian-Portuguese adaptation of the CABI and its psychometric properties. METHODS: First, the authors conducted a rigorous transcultural adaptation of CABI's questions and instructions for the Brazilian context. In an online sample of 598 parents, the authors found high reliability (internal consistency) for the CABI's main subscales. RESULTS: Validity was supported by exploratory factor analysis (the authors found 6 factors representing several aspects of psychopathology both according to the DSM and HiTop models) and significant differences in most CABI's subscales between children with parent-reported psychopathology and typically developing ones. The present study suggests that the adapted version of CABI is a valid and reliable measure that can be used in Brazil. CONCLUSIONS: The CABI can be useful to the pediatrician to get fast but wide information from parents on the behavioral condition of their children or adolescents, and also to decide whether it is appropriate to consult a mental health professional.

Longitudinal profile of post-traumatic symptoms in HealthCare Workers during COVID-19 pandemic: A latent transition model.

INTRODUCTION: Pandemics have the potential to be considered traumatic event, increasing the risk of developing post-traumatic stress symptoms (PTSS) in HealthCare Workers (HCW). However, few longitudinal studies have evaluated the impact of prolonged exposure to the risk imposed by COVID-19. Our aim was to identify subgroups of HCW with profiles of PTSS, how this profile changed during the pandemic and which variables were related to these changes. METHODS: We evaluated the levels of PTSS and psychological distress in a Brazilian HealthCare Workers' sample (n = 1398) in three waves of assessment: from May to June 2020 (Wave 1), December 2020 to February 2021 (Wave 2) and May to August 2021 (Wave 3), using Latent Profile Analysis (LPA) to identify subgroups with different profiles of symptms, and then, Latent Transition Analysis (LTA) was applied to examine changes in symptom profiles over time, including gender, psychiatric diagnosis history, and pandemic-related fears as covariates. RESULTS: two profiles were identified: high-PTSS profile (Wave 1-23%; Wave 2-64% and Wave 3-73%) and a low-PTSS (Wave 1-77%; Wave 2-36% and Wave 3-27%). Being female, fear of contamination, and fearing financial problems were strong predictors of changes in the profile. In addition, the participants had a high probability of being in the high-PTSS in the long run. CONCLUSION: These results suggests that targeted interventions can mitigate the impact of pandemic. Providing financial support, and psychological support can be beneficial for those with psychiatric diagnoses and experiencing bereavement.

Impacts of mental health in the sleep pattern of healthcare professionals during the COVID-19 pandemic in Brazil.

BACKGROUND: After >2 years of the Coronavirus Disease-19 (COVID-19) pandemic, it is well established how sleep symptoms are rising, especially among healthcare workers (HCW). The aim of this study is to evaluate what features are associated with sleep disturbances in the HCW population. METHODS: Cross-sectional and longitudinal analysis of social and clinical variables associated with sleep problems and insomnia incidence in HCW in a large, national-level cohort. The measurement of sleep problems was assessed by self-report using Jenkins Sleep Scale (JSS). A multivariate analysis was used in the cross-sectional design and generalized linear models were used in the longitudinal design. RESULTS: 10,467 HCW were analyzed in the cross-sectional analysis, 3313 participants were analyzed in the three timepoints of the study. Sex, previously diagnosed mental illness and frontline work with COVID-19 were associated with higher scores in JSS in the univariate analysis. In the multivariate analysis, only previous diagnosis of mental illness was related with sleep difficulties, especially previously diagnosed insomnia. The longitudinal analysis concluded that previous diagnosis of mental illnesses was associated with higher levels of insomnia development (OR = 11.62). The self-reported disorders found to be major risk factors were addiction (OR = 7.69), generalized anxiety disorder (OR = 3.67), social anxiety (OR = 2.21) and bipolar disorder (OR = 2.21). LIMITATIONS: Attrition bias. CONCLUSIONS: Previous diagnosis of mental illness was strongly related to insomnia development in HCW during the COVID-19 pandemic. Strategies that focus on this population are advised.