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.

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.

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.

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.

Decision-making styles during stressful scenarios: The role of anxiety in COVID-19 pandemic.

Introduction: Decision-making is not purely rational but highlighted by the influence of intuitive and emotional processes. Recently, researchers have focused more attention on understanding which environmental and personal features influence decision-making processes, and how. Objective and methods: On this study, we investigate whether Trait Anxiety moderates the impact of Post-Traumatic Stress (PTS) symptoms reported during COVID-19 pandemic on decision-making styles. Results: The study included 1,358 Brazilian participants (80% women) aged between 20 and 74 (M = 41.11; SD = 11.23) who responded to an online survey between May and August of the year 2021 of COVID-19 pandemic to The State-Trait Anxiety Inventory, The Decisions Styles Scale, The Impact of Event Scale - Revised and questions related to COVID-19. Through moderation analysis, we observed that experiencing PTS is associated with a higher tendency to biased/heuristic decision-making processes. Discussion: Trait Anxiety seems to influence how people respond to PTS symptoms on decision-making related processes. Subjects with higher Trait Anxiety reported lower tendency to appeal to rationality, especially under higher reported levels of PTS. Meanwhile, lower Trait Anxiety subjects exhibited more reason-based decision-making under higher rates of PTS. This work contributes to a deeper understanding of the interplay among environmental and individual differences on decision-making styles and helps to identify factors of vulnerability for poorer cognitive functioning on stressful scenarios.

Brazilian Psychiatric Association guidelines for the treatment of generalized anxiety disorder (GAD). Pharmacological and Psychotherapy approach. Perspectives.

OBJECTIVE: To combine elements of a systematic review and critical review to produce best evidence synthesis for the treatament of GAD. METHOD: There was included systematic reviews, metanalysis, and randomized controlled trials. Descriptor used was "generalized anxiety disorder", resulting in 4860 articles and 7 other studies, of which 59 were selected. RESULTS: Antidepressants and benzodiazepines are indicated, as well as pregabalin. From, atypical antipsychotics quetiapine has been studied. Cognitive behavior therapy (third wave of behavioral and cognitive therapies) as well as individual CBT proven to be effective. CONCLUSION: There is extensive literature on many effective treatments for GAD. The present work summarizes the therapeutic possibilities, emphasizing those available in the Brazil. Further studies are still needed to compare other available medications, to assess psychotherapies in more depth, new treatments and specially to assess the ideal time for maintaining therapy.

Relative age effect in Olympic Taekwondo athletes.

Relative age effects refer to the effects of age differences among individuals who have been grouped together for a performance activity. This study aimed to investigate the relative age effect on Olympic Taekwondo athletes, in several Olympic Games, and in both sexes. The study sample consisted of 291 athletes who had competed in Atlanta, Sydney, and Beijing Olympic Games. The relative age effect was examined for the general distribution of athletes by quartile, for each of the individuals, and for male and female athletes. There were no discernable effects of relative age on Olympic Taekwondo athletes.

The Tower of London Test: different scoring criteria for diagnosing Alzheimer's disease and mild cognitive impairment.

The Tower of London (TOL) is used for evaluating planning skills, which is a component of the executive functions. Different versions and scoring criteria were developed for this task, and some of them present with different psychometrical properties. This study aimed to evaluate two specific scoring methods of the TOL in diagnosing Mild Cognitive Impairment and probable Alzheimer's disease. The TOL total scores from 60 patients of each diagnosis were compared with the performance of 60 healthy-aged controls using receiver operating characteristics analysis and multinomial logistic regression. Krikorian method better diagnosed Alzheimer's disease, while Portellas's was better at discriminating healthy controls from Mild Cognitive Impairment, but were not efficient at comparing this last group with Alzheimer's patients. Regression analysis indicates that in addition to screening tests, TOL improves the classification of the three groups. The results suggest the two scoring methods used for this task may be useful for different diagnostic purposes.

Association between motor competence and executive functions in children.

Previous studies investigating the relationship between executive functions (EFs) and motor competence (MC) in typically developing children have produced inconsistent findings regarding the association's strength and nature. Thus, the present study aimed to explore the relationship between EFs and MC in typically developing children aged 6-11 years old. Additionally, we aimed to explore the relationship between EFs and MC in younger (6-8 years old) and older (9-11 years old) typically developing children. In total, 152 children of both sexes performed the Flanker/Reverse Flanker test, Tower of London, Raven's Colored Matrices, Körperkoordinations Test Für Kinder, and Test of Gross Motor Development. Using the global score of MC and EFs and controlling for age, our results showed a significant and medium correlation between MC and EFs (r = 0.380, p < .001). Moreover, the correlation in younger children (r = 0.470), as well as in older (r = 0.272) children were significant. The regression analysis also showed that MC predicts EFs performance in all participants, in younger children, and older children, although with less explained variance for older children. In short, our study suggests that it is needed to promote the development of MC and EFs in children, especially the younger ones.

Psychometric properties of the Brief Symptom Inventory support the hypothesis of a general psychopathological factor.

INTRODUCTION: The existence of a general factor related to psychiatric symptoms is supported by studies using a variety of methods in both clinical and non-clinical samples. OBJECTIVES: This study aims to evaluate the replicability of the internal structure of the Brief Symptom Inventory in a large Brazilian sample. METHODS: Participants were 6,427 Brazilian subjects (81% female). Mean age was 42.1 years (standard deviation [SD] = 13.6, Min = 13, Max = 80). All participants completed the online version of the Brief Symptom Inventory. This scale presents a general score (GSI) and nine specific clusters of symptoms (depression, anxiety, phobic anxiety, interpersonal sensibility, psychoticism, paranoid ideation, obsessive-compulsive behavior, hostility, and somatization symptoms). RESULTS: Confirmatory factor analysis was performed to assess the factor structure of the BSI. The results showed that the best-fitting model was a bifactor solution and the general factor was the main dimension explaining most of the reliable variability in the data. CONCLUSION: The findings suggest that the BSI's internal structure was replicated in a non-clinical sample and that the general factor is the most reliable score. However, it is necessary to better understand the meaning of the general factor scores in a non-clinical sample to increase interpretability of scores.

Well-being at work, productivity, and coping with stress during the COVID-19 pandemic.

This study aims to analyze the mechanisms through which the coronavirus disease (COVID-19) pandemic impacts on well-being at work and on productivity. The secondary objective is to identify stress management strategies for the work environment during the pandemic. This is an integrative review. Phase 1 consisted of searches of open access electronic databases (MEDLINE, SciELO, Bireme, and LILACS) for papers published in 2020 addressing mental health, work, and pandemics. Phase 2 consisted of selecting literature recommended by specialists in occupational psychiatry and positive psychology. These materials were read and critically analyzed. Forty references were included in the literature review. The articles reviewed were classified into the following categories: articles concerning work relationships in Brazil; articles describing the impact of pandemics on mental health and work; articles focusing on the work of health professionals during pandemics; articles about well-being at work; and papers proposing strategies to improve well-being and productivity and to promote mental health. The COVID-19 pandemic can have a significant impact on workers' mental health and productivity. Most professionals face a need to adapt to changes, which can decrease their feeling of well-being. Consequently, strategies to promote well-being and mental health in the work environment should be a priority. Work routines were modified after the COVID-19 pandemic set in and assessing these changes is essential to maintain workers' mental health. By so doing, it is possible to promote general well-being and post-traumatic recovery and reduce stress levels.

Longitudinal invariance and validity of the Impact of Event Scale-Revised under COVID-19 pandemic in a Brazilian sample.

Although the Impact Event Scale-Revised is widely used, its factor structure is still controversial. In addition, its longitudinal measurement invariance (LMI) remains uninvestigated. In this sense, we carried out three studies to investigate its psychometric properties. In Study 1, we evaluated the factorial structure of the scale comparing the different models existing in the literature in Brazilian samples who responded to the instrument during the COVID-19 pandemic. In Study 2, we provide support for a five-factor model throughout convergent validity with psychological distress and sleep problems, and criterion validity between people with diagnostic of mental disorders. Finally, we evaluated the LMI over a 6-month interval. The results indicated that the five-factor model has excellent goodness of fit and holds strict longitudinal invariance. Additionally, internal consistency and stability coefficients indicate that the scale is appropriate to measure posttraumatic stress symptomatology) in nonclinical samples across multiple assessments. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Gender invariance and psychometric properties of a Brazilian version of the Emotion Regulation Questionnaire (ERQ).

INTRODUCTION: Emotion regulation refers to use of strategies to change or suppress a response to an affective experience and is an important component of an individual's subjective wellbeing. Difficulties properly regulating emotions are related to psychopathological processes. OBJECTIVE: This study assessed the factor structure of the Brazilian version of the Emotion Regulation Questionnaire (ERQ); the invariance of its psychometric parameters as a function of gender; and its convergent validity with other scales measuring affective processes. METHOD: A total of 813 adults (73.7% women), aged between 18 and 64 years and with a high educational level used an electronic platform to complete the ERQ, the Positive and Negative Affect Schedule (PANAS), the Affect Scale (AS), and the Difficulties in Emotion Regulation Scale (DERS). Factor structure, reliability, and validity of the adapted version of the ERQ were investigated. RESULTS: Multi-group confirmatory factor analysis (MGCFA) revealed adequate goodness of fit for the ERQ's two-factor model (cognitive reappraisal and emotional suppression), providing evidence of invariance of its psychometric parameters as a function of gender. Correlations between the ERQ's factors and measures of affect and emotional dysregulation presented positive indicators, with significant associations between emotion regulation and affective experiences depending on gender. CONCLUSION: The ERQ presents good psychometric indicators for use with the Brazilian population.

Common Venues in Romantic Relationships of Adults With Symptoms of Autism and Attention Deficit/Hyperactivity Disorder.

Introduction: Autism Spectrum Disorder (ASD) and Attention Deficit/Hyperactivity Disorder (ADHD) figures among the most common neurodevelopmental disorders. Despite having opposite stereotypes, both ADHD and ASD compromise, though in different ways, skills such as social interactions, communication skills, and social thinking, which may underlie difficulties in romantic relationships. Methods: We evaluated 306 adults about their romantic relationships and the intensity of their love. Participants were from one of four groups:, individuals with ASD-only traits, a group with symptoms of ADHD-only, participants with neither ADHD nor ASD symptoms (control) or from a fourth group of individuals with both ADHD and ASD traits. Results: The ASD traits group had fewer married people and more people who have never been married, while the rate of divorce was higher in the ADHD traits group. Regarding the intensity of love, the mean scores of the ADHD and the ADHD+ASD traits groups were higher in the Passionate Love Scale than the mean score of the control group. Passionate love in the ASD group was no different from the other groups. Small positive correlations were found between passionate love and ADHD and ASD behavioral problems. Conclusion: Marital status was distinct depending on symptoms of a neurodevelopmental disorder in adulthood. Also, ADHD and ASD symptoms were associated with greater passionate love. Therefore, ADHD and ASD behavioral dimensions may impact long-term and short-term experiences of a person's relationship with a significant other in distinct ways. Understanding how people with neurodevelopmental disorders experience love might help us to better clarify the mechanisms associated with their relationship patterns.