ABSTRACT
ABSTRACT Objective: The aim of this study was to compare the social cognition profiles of male adults with ASD (n = 15), SCHZ (n = 16) and controls (n = 20). Change the second sentence of the abstract. Methods: A cross-sectional assessment of social cognition domains with emotional face perception with eye tracking was performed, and two IQ measures (Verbal IQ and Performance IQ) (Wechsler Adult Intelligence Scale), and the DSM-IV Structured Clinical Interview were applied. Results: There were no significant differences in terms of average performance in social cognition tests or eye tracking tasks between the ASD and SCHZ groups. However, both had lower performances in most cases when compared to the control group. In the social cognition tasks, individuals in the control group performed better than both clinical groups. Conclusion: Although differences were identified between individuals with ASD and SCHZ, it was not possible to determine patterns or to differentiate the clinical groups.
RESUMO Objetivo: O objetivo deste estudo foi comparar os perfis de cognição social de adultos do sexo masculino com TEA (n = 15), SCHZ (n = 16) e controles (n = 20). Métodos: Foram aplicadas uma avaliação transversal dos domínios de cognição social com percepção emocional com rastreamento ocular, duas medidas de QI (QI verbal e QI de desempenho) (Escala de Inteligência Adulta de Wechsler) e a Entrevista Clínica Estruturada DSM-IV. Resultados: Não houve diferenças significativas em termos de desempenho médio em testes de cognição social ou tarefas de rastreamento ocular entre os grupos ASD e SCHZ. No entanto, ambos tiveram desempenhos mais baixos na maioria dos casos, quando comparados ao grupo controle. Nas tarefas de cognição social, os indivíduos do grupo controle tiveram melhor desempenho do que ambos os grupos clínicos. Conclusão: Embora tenham sido identificadas diferenças entre indivíduos com TEA e SCHZ, não foi possível determinar padrões ou diferenciar os grupos clínicos.
ABSTRACT
The study reports the development and investigation of the psychometric properties of the Difficulties in Executive Functions, Regulation and Delay Aversion Inventory - Version for children and adolescents (IFERA-I). Items were developed to assess working memory, flexibility, inhibition, delay aversion and state regulation. All of these are constructs related to the complex cognitive heterogeneity of the Attention deficit and hyperactivity disorder. Evidence of content validity was gathered through verification by experts, and items with 100% agreement among evaluators were considered adequate. Parents (N=211) and teachers (N=189) of children (6 to 14 years of age) responded to the IFERA-I, Childhood Executive Functioning Inventory (CHEXI) and Swanson, Nolan and Pelham Questionnaire (SNAP-IV). Convergence patterns between the CHEXI and SNAP-IV were observed. Confirmatory Factor Analysis revealed an acceptable five-factor model for parental responses, with good levels of reliability. No model was corroborated for the teachers' responses. The results provide some evidence that the IFERA-I is a reliable and valid measure of different cognitive dimensions. They also suggest directions for future research and improvement of the measure. (AU)
O estudo relata o desenvolvimento e investigação das propriedades psicométricas do Inventário de Dificuldades em Funções Executivas, Regulação e Aversão ao Adiamento - Versão para crianças e adolescentes (IFERA-I). Foram desenvolvidos itens para avaliação de memória de trabalho, flexibilidade, inibição, aversão ao adiamento e regulação do estado, construtos relacionados à complexa heterogeneidade cognitiva observada no Transtorno de Déficit de Atenção e Hiperatividade/impulsividade. Evidências de validade de conteúdo foram reunidas através da verificação por especialistas, sendo considerados adequados itens com 100% de concordância entre avaliadores. Pais (N=211) e professores (N=189) de crianças (6 a 14 anos) responderam ao IFERA-I, Inventário de Funcionamento Executivo Infantil (CHEXI) e Swanson, Nolan e Pelham Questionnaire (SNAP-IV). Padrões de convergência com CHEXI e SNAP-IV foram observados. Análise fatorial confirmatoria revelou um modelo aceitável de cinco fatores para respostas dos pais, com bons índices de confiabilidade. Nenhum modelo foi corroborado para respostas dos professores. Os resultados fornecem algumas evidências de que o IFERA-I é uma medida confiável e válida de diferentes dimensões cognitivas. Ao mesmo tempo, também sugerem direções para futuras pesquisas e aprimoramento da medida. (AU)
El estudio relata el desarrollo e investigación de las propiedades psicométricas del Inventario de Dificultades en las Funciones Ejecutivas, Regulación y Aversión al Aplazamiento - Versión para niños y adolescentes (IFERA-I). Se desarrollaron ítems para evaluar memoria de trabajo, flexibilidad, inhibición, aversión al aplazamiento y regulación del estado, constructos relacionados con la compleja heterogeneidad cognitiva observada en el Trastorno por Déficit de Atención con Hiperactividad/Impulsividad. Evidencias de validez de contenido se recopilaron mediante la verificación por parte de expertos, y los ítems se consideraron adecuados con un 100% de acuerdo entre los evaluadores. Padres (N=211) y maestros (N=189) de niños (6 a 14 años) respondieron a IFERA-I, Inventario de Funcionamiento Ejecutivo de la Infancia (CHEXI) y Swanson, Nolan y Pelham Questionnaire (SNAP-IV). Se observaron patrones de convergencia con CHEXI y SNAP-IV. Análisis factorial confirmatorio reveló un modelo aceptable de cinco factores para las respuestas de los padres, con buenos niveles de confiabilidad. No se corroboró ningún modelo para las respuestas de los profesores. Los resultados proporcionan algunas evidencias de que el IFERA-I es una medida confiable y válida de diferentes dimensiones cognitivas. Al mismo tiempo, también sugieren direcciones para la investigación futura y la mejora de la medida. (AU)
Subject(s)
Humans , Male , Female , Child , Adolescent , Attention Deficit Disorder with Hyperactivity/psychology , Executive Function , Neuropsychological Tests , Psychometrics , Students/psychology , Reproducibility of Results , Factor Analysis, Statistical , Education, Primary and Secondary , Correlation of DataSubject(s)
Schizophrenia , Humans , Latin America/epidemiology , Social Class , Socioeconomic Factors , CognitionABSTRACT
BACKGROUND: Cognition heavily relies on social determinants and genetic background. Latin America comprises approximately 8% of the global population and faces unique challenges, many derived from specific demographic and socioeconomic variables, such as violence and inequality. While such factors have been described to influence mental health outcomes, no large-scale studies with Latin American population have been carried out. Therefore, we aim to describe the cognitive performance of a representative sample of Latin American individuals with schizophrenia and its relationship to clinical factors. Additionally, we aim to investigate how socioeconomic status (SES) relates to cognitive performance in patients and controls. METHODS: We included 1175 participants from five Latin American countries (Argentina, Brazil, Chile, Colombia, and Mexico): 864 individuals with schizophrenia and 311 unaffected subjects. All participants were part of projects that included cognitive evaluation with MATRICS Consensus Cognitive Battery and clinical assessments. RESULTS: Patients showed worse cognitive performance than controls across all domains. Age and diagnosis were independent predictors, indicating similar trajectories of cognitive aging for both patients and controls. The SES factors of education, parental education, and income were more related to cognition in patients than in controls. Cognition was also influenced by symptomatology. CONCLUSIONS: Patients did not show evidence of accelerated cognitive aging; however, they were most impacted by a lower SES suggestive of deprived environment than controls. These findings highlight the vulnerability of cognitive capacity in individuals with psychosis in face of demographic and socioeconomic factors in low- and middle-income countries.
Subject(s)
Schizophrenia , Humans , Latin America/epidemiology , Schizophrenia/epidemiology , Schizophrenia/diagnosis , Social Class , Socioeconomic Factors , CognitionABSTRACT
BACKGROUND: Cognitive deficits are implicated in theoretical explanatory models for binge eating disorder (BED). Furthermore, evidence suggest that alterations in executive function may underlie symptoms in BED. The current systematic review and meta-analysis provides an update on executive functioning in individuals with BED. METHODS: Literature searches (up to November 2019) were conducted in electronic databases combining binge eating or BED with executive functions. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines was used. Studies of any design comparing adults with BED with those without BED in executive function domains were selected. Methodological quality of studies was based on the Newcastle-Ottawa scale. RESULTS: Of 1,983 citations identified, 28 case-control studies met inclusion criteria for this review. Six meta-analyses that examined four domains (decision-making, cognitive flexibility, inhibitory control, and working memory) were conducted. The only meta-analysis to show a significant difference in executive functioning between BED and obese controls was working memory (SMD = 0.32, 95% IC: -0.60, -0.03; p = 0.028), with an effect size of small magnitude. Qualitative inspection of the literature indicated mixed findings for control inhibition, decision making and cognitive flexibility in individuals with BED compared to controls (obese or normal weight). In addition, people with BED showed poorer problem solving performance, but similar planning abilities to obese controls. CONCLUSIONS: Individuals with BED were found to show worse performance on working memory tasks compared to obese individuals without the disorder. The findings did not provide definitive evidence of alterations in other aspects of executive functioning. Interest in executive functioning in people with BED is increasing but is limited by insufficient data from small studies with varied methodology. Future studies should focus on using similar tests and outcome measures, in order to enable more pertinent comparisons across studies.
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We investigated the role of DGCR2, a corticogenesis-related gene, on schizophrenia (SZ) and its subphenotypes, including brain morphology. A total of 221 SZ patients, 263 controls and 70 antipsychotic-naïve first episode of psychosis (FEP) were genotyped for 17 DGCR2 polymorphisms. While no association between DGCR2 polymorphisms and SZ was found, the missense variant rs2072123 was associated to left rostral anterior cingulate thickness, showing that DGCR2 seems not to be associated directly with the SZ but might be influencing the brain morphology. We also showed a DGCR2 downregulation in SZ patients when compared to controls and FEP.
Subject(s)
Gyrus Cinguli/pathology , Platelet Glycoprotein GPIb-IX Complex/genetics , Schizophrenia/genetics , Schizophrenia/pathology , Adult , Female , Genotype , Humans , Male , Mutation, Missense , Psychotic Disorders/genetics , Psychotic Disorders/pathologyABSTRACT
Objective: In schizophrenia, scores reflecting deficits in different cognitive processes are strongly correlated, making it difficult to establish a solid relationship between different cognitive mechanisms and other features of this disorder. The objective of this study was to explore whether three frequently postulated executive functions (updating, shifting, and inhibition) could be compared between groups and considered independently in terms of their respective roles in functional outcome. Methods: This study relied on confirmatory factor analysis of schizophrenia patients (n=141) and healthy controls (n=119). The main analyses examined the degree to which three executive functions (updating, set-shifting, and inhibition) could be separated in schizophrenia and compared this model among groups. Structural equation modeling analysis was also performed to examine the extent to which executive function components contribute to functional outcome in schizophrenia. Results: Multiple-group confirmatory factor analysis with unconstrained model parameters indicated that the full three-factor model may fit the data in both groups (χ2 = 61.48, degrees of freedom = 34, p < 0.001, comparative fit index = 0.95; standardized root mean square residual = 0.037; root mean square error of approximation = 0.04; Akaike's information criteria = 169.49; normed fit index = 0.90), although there was also a good data fit for the patient group with a two-factor model. In the patient group, structural equation modeling suggested that shifting and (principally) updating were associated with the general measure of functional outcome (regression path coefficients: 0.34, p < 0.005; 0.39, p < 0.005, respectively), although when combined the mechanisms fail to contribute. Conclusion: This data suggests that the factor structure may be similar but not identical between groups, and both updating and shifting may play an important role in functional outcome in schizophrenia.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Aged , Aged, 80 and over , Young Adult , Schizophrenia/physiopathology , Executive Function/physiology , Inhibition, Psychological , Memory Disorders/physiopathology , Case-Control Studies , Educational Status , Middle Aged , Neuropsychological TestsABSTRACT
OBJECTIVE: In schizophrenia, scores reflecting deficits in different cognitive processes are strongly correlated, making it difficult to establish a solid relationship between different cognitive mechanisms and other features of this disorder. The objective of this study was to explore whether three frequently postulated executive functions (updating, shifting, and inhibition) could be compared between groups and considered independently in terms of their respective roles in functional outcome. METHODS: This study relied on confirmatory factor analysis of schizophrenia patients (n=141) and healthy controls (n=119). The main analyses examined the degree to which three executive functions (updating, set-shifting, and inhibition) could be separated in schizophrenia and compared this model among groups. Structural equation modeling analysis was also performed to examine the extent to which executive function components contribute to functional outcome in schizophrenia. RESULTS: Multiple-group confirmatory factor analysis with unconstrained model parameters indicated that the full three-factor model may fit the data in both groups (χ2 = 61.48, degrees of freedom = 34, p < 0.001, comparative fit index = 0.95; standardized root mean square residual = 0.037; root mean square error of approximation = 0.04; Akaike's information criteria = 169.49; normed fit index = 0.90), although there was also a good data fit for the patient group with a two-factor model. In the patient group, structural equation modeling suggested that shifting and (principally) updating were associated with the general measure of functional outcome (regression path coefficients: 0.34, p < 0.005; 0.39, p < 0.005, respectively), although when combined the mechanisms fail to contribute. CONCLUSION: This data suggests that the factor structure may be similar but not identical between groups, and both updating and shifting may play an important role in functional outcome in schizophrenia.
Subject(s)
Executive Function/physiology , Inhibition, Psychological , Memory Disorders/physiopathology , Schizophrenia/physiopathology , Adolescent , Adult , Aged , Aged, 80 and over , Case-Control Studies , Educational Status , Female , Humans , Male , Middle Aged , Neuropsychological Tests , Young AdultABSTRACT
Objective: Cognitive impairment is a core feature of schizophrenia, related to dopaminergic dysfunction in the prefrontal cortex (PFC). It is hypothesized that functional single nucleotide polymorphism (SNP) rs4680 of the catechol-O-methyltransferase (COMT) gene could mediate the relationship between cognition and dopamine activity in the PFC. Other COMT SNPs could also play a role. Methods: We evaluated the role of three COMT SNPs (rs737865, rs165599, and rs4680) in schizophrenia and their impact on three working memory tasks. For genetic association analyses, 212 individuals with schizophrenia and 257 healthy controls (HCs) were selected. The Visual Working Memory (VWM) Task, Keep Track Task, and Letter Memory Task were administered to 133 schizophrenics and 93 HCs. Results: We found a significant association of rs737865, with the GG genotype exerting a protective effect and the GA haplotype (rs4680/rs165599) exerting a risk effect for schizophrenia. COMT rs4680 AA carriers and rs737865 AA carriers scored lowest on the Keep Track Task. When the genotype*group interaction effect was evaluated, rs165599 exerted opposite effects for VWM and Keep Track task performance in patients and controls, with AA carriers scoring lowest on both tests among controls, but highest among patients. Conclusion: These data support the hypothesis that COMT polymorphisms may be associated with schizophrenia and modulate cognition in patients and controls.
Subject(s)
Humans , Male , Female , Adult , Schizophrenia/genetics , Catechol O-Methyltransferase/genetics , Prefrontal Cortex/metabolism , Memory, Short-Term/physiology , Phenotype , Schizophrenia/physiopathology , Schizophrenia/metabolism , Haplotypes , Catechol O-Methyltransferase/metabolism , Case-Control Studies , Genetic Predisposition to Disease , Polymorphism, Single Nucleotide/genetics , Gene Frequency , Genotype , Neuropsychological TestsABSTRACT
O objetivo do estudo foi traduzir, adaptar e investigar propriedades psicométricas da Childhood Executive Functioning Inventory (CHEXI) em uma amostra de crianças brasileiras. Após tradução, adaptação transcultural, retrotradução e equivalência semântica, realizada por juízes da área, a versão brasileira da CHEXI foi respondida por pais e professores de 408 crianças, idades entre 4 e 7 anos, também avaliadas com a Escala de Maturidade Mental Colúmbia e SNAP-IV. Elevados índices de consistência interna foram encontrados. A análise fatorial exploratória gerou dois fatores para a versão brasileira: um fator mais geral de funções executivas e um específico de inibição. As pontuações nas subescalas de planejamento, regulação e, marginalmente, memória de trabalho da CHEXI explicaram de modo significativo o indicador de desatenção da SNAP-IV, enquanto a pontuação na subescala de inibição explicou o indicador de hiperatividade/impulsividade. Os resultados fornecem bons parâmetros psicométricos para a CHEXI, além de contribuir para a realização de estudos com funções executivas e indicadores de TDAH no país.
The aim of the study was to translate, adapt and investigate psychometric properties of Childhood Executive Functioning Inventory (CHEXI) for a sample of Brazilian children. After translation, cultural adaptation, back-translation and semantic equivalence performed by area judges, the Brazilian version of CHEXI was answered by parents and teachers of 408 children aged between 4 and 7 years, also evaluated with the Columbia Mental Maturity Scale and SNAP-IV. High internal consistency indices were found. Exploratory factor analysis yielded two factors for the Brazilian version: a more general factor of executive functions and one specific factor of inhibition. The scores on the subscales of planning, regulation and marginally working memory in CHEXI explained significantly the inattention indicator of SNAP-IV, while the score on the inhibition subscale explained the indicator of hyperactivity/impulsivity. The results provide good psychometric parameters for CHEXI, besides contributing to the studies with Executive functions and ADHD signs in Brazil.
El objetivo del estudio fue traducir, adaptar e investigar las propiedades psicométricas del Childhood Executive Functioning Inventory (CHEXI) en una muestra de niños brasileños. Después de la traducción, adaptación transcultural, retro-traducción y equivalencia semántica realizada por jueces del área, la versión brasileña de la CHEXI fue respondida por padres y maestros de 408 niños de edad comprendida entre 4 y 7 años, también evaluados con la Escala de Madurez Mental Columbia y SNAP-IV. Se encontraron altos índices de consistencia interna. El análisis factorial exploratorio generó dos factores para la versión brasileña: un factor más general de las funciones ejecutivas y un factor específico de inhibición. Las puntuaciones en las subescalas de planificación, regulación y marginalmente memoria de trabajo de la CHEXI explicaron significativamente el indicador de falta de atención de la SNAP-IV, mientras que la puntuación en la sub-escala de inhibición explicó el indicador de hiperactividad / impulsividad. Los resultados proporcionaron buenos parámetros psicométricos para la CHEXI, además de contribuir para la realización de estudios con funciones ejecutivas e indicadores de TDAH en el país.
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Attention Deficit Disorder with Hyperactivity/psychology , Executive Function , Translations , Reproducibility of Results , Factor Analysis, Statistical , NeuropsychologyABSTRACT
O objetivo do estudo foi traduzir, adaptar e investigar propriedades psicométricas da Childhood Executive Functioning Inventory (CHEXI) em uma amostra de crianças brasileiras. Após tradução, adaptação transcultural, retrotradução e equivalência semântica, realizada por juízes da área, a versão brasileira da CHEXI foi respondida por pais e professores de 408 crianças, idades entre 4 e 7 anos, também avaliadas com a Escala de Maturidade Mental Colúmbia e SNAP-IV. Elevados índices de consistência interna foram encontrados. A análise fatorial exploratória gerou dois fatores para a versão brasileira: um fator mais geral de funções executivas e um específico de inibição. As pontuações nas subescalas de planejamento, regulação e, marginalmente, memória de trabalho da CHEXI explicaram de modo significativo o indicador de desatenção da SNAP-IV, enquanto a pontuação na subescala de inibição explicou o indicador de hiperatividade/impulsividade. Os resultados fornecem bons parâmetros psicométricos para a CHEXI, além de contribuir para a realização de estudos com funções executivas e indicadores de TDAH no país.
The aim of the study was to translate, adapt and investigate psychometric properties of Childhood Executive Functioning Inventory (CHEXI) for a sample of Brazilian children. After translation, cultural adaptation, back-translation and semantic equivalence performed by area judges, the Brazilian version of CHEXI was answered by parents and teachers of 408 children aged between 4 and 7 years, also evaluated with the Columbia Mental Maturity Scale and SNAP-IV. High internal consistency indices were found. Exploratory factor analysis yielded two factors for the Brazilian version: a more general factor of executive functions and one specific factor of inhibition. The scores on the subscales of planning, regulation and marginally working memory in CHEXI explained significantly the inattention indicator of SNAP-IV, while the score on the inhibition subscale explained the indicator of hyperactivity/impulsivity. The results provide good psychometric parameters for CHEXI, besides contributing to the studies with Executive functions and ADHD signs in Brazil.
El objetivo del estudio fue traducir, adaptar e investigar las propiedades psicométricas del Childhood Executive Functioning Inventory (CHEXI) en una muestra de niños brasileños. Después de la traducción, adaptación transcultural, retro-traducción y equivalencia semántica realizada por jueces del área, la versión brasileña de la CHEXI fue respondida por padres y maestros de 408 niños de edad comprendida entre 4 y 7 años, también evaluados con la Escala de Madurez Mental Columbia y SNAP-IV. Se encontraron altos índices de consistencia interna. El análisis factorial exploratorio generó dos factores para la versión brasileña: un factor más general de las funciones ejecutivas y un factor específico de inhibición. Las puntuaciones en las subescalas de planificación, regulación y marginalmente memoria de trabajo de la CHEXI explicaron significativamente el indicador de falta de atención de la SNAP-IV, mientras que la puntuación en la sub-escala de inhibición explicó el indicador de hiperactividad / impulsividad. Los resultados proporcionaron buenos parámetros psicométricos para la CHEXI, además de contribuir para la realización de estudios con funciones ejecutivas e indicadores de TDAH en el país.
Subject(s)
Humans , Male , Female , Child, Preschool , Child , Executive Function , Attention Deficit Disorder with Hyperactivity/psychology , Reproducibility of Results , Translations , Reproducibility of Results , Factor Analysis, Statistical , NeuropsychologyABSTRACT
OBJECTIVE: Cognitive impairment is a core feature of schizophrenia, related to dopaminergic dysfunction in the prefrontal cortex (PFC). It is hypothesized that functional single nucleotide polymorphism (SNP) rs4680 of the catechol-O-methyltransferase (COMT) gene could mediate the relationship between cognition and dopamine activity in the PFC. Other COMT SNPs could also play a role. METHODS: We evaluated the role of three COMT SNPs (rs737865, rs165599, and rs4680) in schizophrenia and their impact on three working memory tasks. For genetic association analyses, 212 individuals with schizophrenia and 257 healthy controls (HCs) were selected. The Visual Working Memory (VWM) Task, Keep Track Task, and Letter Memory Task were administered to 133 schizophrenics and 93 HCs. RESULTS: We found a significant association of rs737865, with the GG genotype exerting a protective effect and the GA haplotype (rs4680/rs165599) exerting a risk effect for schizophrenia. COMT rs4680 AA carriers and rs737865 AA carriers scored lowest on the Keep Track Task. When the genotype*group interaction effect was evaluated, rs165599 exerted opposite effects for VWM and Keep Track task performance in patients and controls, with AA carriers scoring lowest on both tests among controls, but highest among patients. CONCLUSION: These data support the hypothesis that COMT polymorphisms may be associated with schizophrenia and modulate cognition in patients and controls.
Subject(s)
Catechol O-Methyltransferase/genetics , Memory, Short-Term/physiology , Prefrontal Cortex/metabolism , Schizophrenia/genetics , Adult , Case-Control Studies , Catechol O-Methyltransferase/metabolism , Female , Gene Frequency , Genetic Predisposition to Disease , Genotype , Haplotypes , Humans , Male , Neuropsychological Tests , Phenotype , Polymorphism, Single Nucleotide/genetics , Schizophrenia/metabolism , Schizophrenia/physiopathologyABSTRACT
RESUMO Objetivo Adaptar para o Brasil e investigar a confiabilidade e validade da Recovery Assessment Scale (RAS) em pessoas com esquizofrenia. Métodos Etapa 1 – foi realizada tradução profissional para o português, adaptação e retrotradução da RAS. Etapa 2 – estudo-piloto em um grupo de 12 pessoas com esquizofrenia para garantir compreensão dos itens da escala. Etapa 3 – As pessoas com esquizofrenia (N = 104) foram submetidas à versão brasileira da RAS e a instrumentos de funcionalidade, qualidade de vida e sintomas para busca de evidências de validade. Resultados Os resultados revelaram bons índices de consistência interna e de precisão teste e reteste dos instrumentos. Foram estabelecidas evidências de validade convergente entre a RAS e medidas de qualidade de vida (r = 0,58; p < 0,001), funcionamento ocupacional (r = 0,40; p < 0,001), habilidades de vida independente (r = 0,24; p < 0,02), gravidade (CGI, r = -0,31; p < 0,003) sintomas da esquizofrenia: PANSS total (r = -0,21; p < 0,05), PANSS negativa (r = -0,28; p < 0.007), PANSS positiva (r = -0.08; p = 0,437)] e depressão [Calgary (r = -0,27; p < 0,01)]. A análise fatorial exploratória revelou seis fatores, sendo quatro destes similares a estudos prévios. Conclusão A partir deste estudo, considerou-se que a palavra “superação” reflete melhor o conceito de “recovery”. A versão brasileira da escala RAS é um instrumento válido e reprodutível para aferir a capacidade de “superação” das pessoas com esquizofrenia.
ABSTRACT Objective To adapt and investigate the validity reliability study of the Brazilian version of the Recovery Assessment Scale-RAS in people with schizophrenia. Methods Stage 1 – professional translation to Portuguese, adaptation, and back-translation of the RAS; Stage 2 – RAS was presented to 12 outpatients with schizophrenia to evaluate if they would be able to understand and respond to the instrument; Stage 3 – patients with schizophrenia (n = 104) were assessed with the Brazilian version of the RAS, functional outcomes measures, quality of life and symptoms scales. Results Results showed good internal consistency and retest reliability, and convergent validity between the RAS and quality of life measures (r = 0.58; p < 0.001), occupational functioning (r = 0.40; p < 0.001), independent living skills (r = 0.24; p < 0,02), functionality (CGI, r = -0.31; p < 0.003) and symptoms of schizophrenia, including PANSS total score total (r = -0.21; p < 0.05), PANSS negative (r = -0.28; p < 0.007), PANSS positive (r = -0.08; p = 0.48), and Calgary Depression Scale (r = -0.27; p < 0.01)]. Exploratory factor analysis yielded six factors, four of these very similar to previous studies. Conclusion This study suggests that the word “superação” (“overcome”) better reflects the concept of “recovery” in Brazilian Portuguese. The Brazilian version of RAS is a valid and reliable instrument to evaluate the process of recovery in people with schizophrenia.
ABSTRACT
OBJECTIVE: Translate, adapt, and validate the MATRICS Consensus Cognitive Battery (MCCB) in Brazil. METHOD: The present study followed three steps: 1) translation to Portuguese, cultural adaptation, and back translation to English; 2) completion of a pilot study (N=30) conducted with the purpose of assessing whether the general comprehension of the items was clear and all participants adequately responded to the battery; 3) completion of a Reliability and Validation Study of the Brazilian version of the MCCB with 99 individuals with schizophrenia and 99 healthy subjects. All participants were administered the Structured Clinical Interview for DSM-IV (Diagnostic and Statistical Manual of Mental Disorders) and patients were also rated on the Global Assessment of Functioning (GAF) Scale and the Positive and Negative Symptoms Scale (PANSS). RESULTS: The results showed adequate to high levels of baseline and 4-week retest reliability, except the MSCEIT-ME; adequate internal consistency for the MSCEIT-ME for the total sample and patients group, and moderate Alpha for the health control sample; as well as evidence of convergent validity and sensitivity to differentiate performance between the groups. All the 10 MCCB measures showed the lowest learning effects. CONCLUSION: Overall the Brazilian version of the MCCB showed similar results to the original North American version. Our findings provides reassurance that the MCCB is a reliable and valid measure of cognition across different countries and cultures, which is especially important to the ongoing work in attempting to discover cognition-enhancing drugs and the effects of cognitive interventions for the treatment of schizophrenia.
Subject(s)
Cognition Disorders/diagnosis , Cognition Disorders/etiology , Neuropsychological Tests/standards , Psychometrics/standards , Schizophrenia/complications , Translating , Adult , Brazil , Consensus , Female , Humans , Male , Middle Aged , Neuropsychological Tests/statistics & numerical data , Psychiatric Status Rating Scales , Psychometrics/methods , Schizophrenic PsychologyABSTRACT
Objective: To investigate if verbal fluency impairment in schizophrenia reflects executive function deficits or results from degraded semantic store or inefficient search and retrieval strategies. Method: Two groups were compared: 141 individuals with schizophrenia and 119 healthy age and education-matched controls. Both groups performed semantic and phonetic verbal fluency tasks. Performance was evaluated using three scores, based on 1) number of words generated; 2) number of clustered/related words; and 3) switching score. A fourth performance score based on the number of clusters was also measured. Results: SZ individuals produced fewer words than controls. After controlling for the total number of words produced, a difference was observed between the groups in the number of cluster-related words generated in the semantic task. In both groups, the number of words generated in the semantic task was higher than that generated in the phonemic task, although a significant group vs. fluency type interaction showed that subjects with schizophrenia had disproportionate semantic fluency impairment. Working memory was positively associated with increased production of words within clusters and inversely correlated with switching. Conclusion: Semantic fluency impairment may be attributed to an inability (resulting from reduced cognitive control) to distinguish target signal from competing noise and to maintain cues for production of memory probes.
Subject(s)
Humans , Male , Female , Adult , Young Adult , Schizophrenia/complications , Semantics , Executive Function/physiology , Language Disorders/etiology , Verbal Behavior/physiology , Phonetics , Case-Control Studies , Language Disorders/diagnosis , Memory, Short-Term , Middle Aged , Neuropsychological TestsABSTRACT
OBJECTIVE: To investigate if verbal fluency impairment in schizophrenia reflects executive function deficits or results from degraded semantic store or inefficient search and retrieval strategies. METHOD: Two groups were compared: 141 individuals with schizophrenia and 119 healthy age and education-matched controls. Both groups performed semantic and phonetic verbal fluency tasks. Performance was evaluated using three scores, based on 1) number of words generated; 2) number of clustered/related words; and 3) switching score. A fourth performance score based on the number of clusters was also measured. RESULTS: SZ individuals produced fewer words than controls. After controlling for the total number of words produced, a difference was observed between the groups in the number of cluster-related words generated in the semantic task. In both groups, the number of words generated in the semantic task was higher than that generated in the phonemic task, although a significant group vs. fluency type interaction showed that subjects with schizophrenia had disproportionate semantic fluency impairment. Working memory was positively associated with increased production of words within clusters and inversely correlated with switching. CONCLUSION: Semantic fluency impairment may be attributed to an inability (resulting from reduced cognitive control) to distinguish target signal from competing noise and to maintain cues for production of memory probes.
Subject(s)
Executive Function/physiology , Language Disorders/etiology , Schizophrenia/complications , Semantics , Adult , Case-Control Studies , Female , Humans , Language Disorders/diagnosis , Male , Memory, Short-Term , Middle Aged , Neuropsychological Tests , Phonetics , Verbal Behavior/physiology , Young AdultABSTRACT
BACKGROUND: Although cognitive deficits have consistently been characterized as core features of schizophrenia, they have not been incorporated into definitions of remission. Furthermore, just a few studies have examined the relationship between cognitive deficits and symptomatic remission. The main aim of the present study is to evaluate the executive functioning of nonremitted schizophrenia patients. METHODS: 72 remitted and 42 nonremitted schizophrenia patients, and 119 healthy controls were examined. Subjects were tested with a comprehensive battery of cognitive tests, including a measure to assess the general components of executive functioning and individual tasks to tap the three specific executive dimensions assessed in the present study, namely updating, shifting and inhibition. RESULTS: Schizophrenia subjects performed poorly on general executive functioning and shifting tasks in comparison to healthy controls. Remitted subjects performed better than nonremitted on inhibition and updating tasks. Whereas being a male and showing decreases in updating increase the chances of being in the nonremitted schizophrenia subjects group, increases in shifting and updating enhance the odds of being in the healthy control group. CONCLUSION: The present findings suggest that executive function deficits are present in chronic schizophrenic patients. In addition, specific executive processes might be associated to symptom remission. Future studies examining prospectively first-episode, drug naive patients diagnosed with schizophrenia may be especially elucidative.
ABSTRACT
Objective This study describes the development of two updating measures of working memory (WM): Letter Updating Test (LUT) and Word Updating Test (WUT). Methods In stage 1, items were created and the instruments were assessed by experts and laymen. In stage 2, tests were given to 15 patients with schizophrenia and 15 paired controls. All were able to understand and respond to the instruments. In stage 3, 141 patients with schizophrenia and 119 healthy controls aged 18 to 60 took part; they were assessed on WM, processing speed (PS) and functional outcome. Results The results showed adequate rates of internal consistency for both measures developed, for both the total sample and each group separately, as well as evidence of convergent validity, discriminant validity and sensitivity to differentiate performance among the groups. Principal component analysis yielded two components, one for updating tests and other for PS measures, indicating factorial validity. Positive and significant, yet low, correlations were found with functionality measures. Conclusion These results provide adequate psychometric parameters for the measures developed, applicable to cognitive research settings in schizophrenia.
Objetivo O estudo descreve o desenvolvimento de duas medidas de atualização da memória de trabalho (MT): Teste de Atualização de Letras (TAL) e Teste de Atualização de Palavras (TAP). Métodos Na etapa 1 foram criados itens e os instrumentos foram analisados por experts e leigos. Na etapa 2, os testes foram aplicados em 15 pacientes com esquizofrenia e 15 controles pareados. Todos foram capazes de compreender e responder aos instrumentos. Na etapa 3, participaram 141 pacientes com esquizofrenia e 119 controles saudáveis com idades entre 18 e 60 anos, avaliados em MT, velocidade de processamento (VP) e funcionalidade. Resultados Os resultados revelaram bons índices de consistência interna para ambas as medidas desenvolvidas, tanto para a amostra total como para cada grupo separadamente, bem como evidências de validade convergente com medidas de MT, validade discriminante com medidas de VP e sensibilidade para discriminar o desempenho entre os grupos. Análise de componentes principais revelou que os testes de atualização apresentaram altas cargas e um fator separado das medidas de VP. Relações positivas, significativas, porém baixas, foram encontradas com medidas de funcionalidade. Conclusão Esses resultados fornecem bons parâmetros psicométricos para as medidas desenvolvidas, aplicáveis em contextos de pesquisa cognitiva da esquizofrenia.
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BACKGROUND: Binge eating disorder is a new category in DSM-5 and highly associated with higher body mass index. The neural mechanisms that underlie binge eating are of great interest in order to improve treatment interventions. Brain mechanisms underlying drug and food craving are suggested to be similar: for example, both are reported to be associated with increased neural activity in the orbitofrontal and anterior cingulate cortex, and a diminished regulatory influence from lateral prefrontal circuits. Several studies have begun to assess the potential benefits of brain stimulation in reducing craving and addictive behaviors. Data from a study of a one-off session of transcranial magnetic stimulation in healthy women identified as strong cravers and of individuals with bulimic-type eating disorders, reported a reduction in food craving and binge eating episodes. This provides support for a more extensive investigation of the potential therapeutic benefits of transcranial magnetic stimulation. Lastly, brain imaging studies and a dimensional approach, will improve understanding of the neural correlates of the disorders and of the mode of action of transcranial magnetic stimulation. METHODS/DESIGN: Sixty eligible obese females, with binge eating disorder, will be randomly allocated to receive 20 sessions of transcranial magnetic stimulation intervention (n = 30) or the sham transcranial magnetic stimulation intervention (n = 30) scattered 3 days/week. Thirty eligible controls will complete the baseline assessment. The primary outcome (number of binge eating episodes) will be assed at each treatment sessions, and 8 weeks after intervention completion (follow-up). It is hypothesized that mean weekly binge-eating episodes will be reduced in the intervention group, compared to the sham group, and that the effect will be maintained at follow-up. DISCUSSION: Despite the severity associated with Binge Eating Disorder, there are limited treatment options. This study is an important step in the development of more effective treatments. Importantly, the study is the first to investigating binge eating disorder using a dimensional approach, by looking at the different aspects of the disorder, such as behavioral factors, biological factors, brain circuits and chemistry. TRIAL REGISTRATION: Clinical Trials NCT02180984 . Registered in July 2014.
Subject(s)
Binge-Eating Disorder/complications , Binge-Eating Disorder/therapy , Obesity/complications , Transcranial Magnetic Stimulation , Adult , Binge-Eating Disorder/blood , Clinical Protocols , Craving , Double-Blind Method , Estrogens/blood , Female , Functional Neuroimaging , Ghrelin/blood , Humans , Hydrocortisone/blood , Inflammation Mediators/blood , Leptin/blood , Middle Aged , Neuropsychological Tests , Obesity/blood , Obesity/therapy , Treatment OutcomeABSTRACT
Objectives: The Positive and Negative Syndrome Scale (PANSS) was developed to assess the symptoms of schizophrenia dimensionally. Although it is widely used in clinical trials in Brazil, it is not fully validated. The aim of this study is to assess the factor structure of the Brazilian PANSS and generate validation data for its current version. Methods: A total of 292 patients diagnosed with schizophrenia were enrolled. Results: Principal component analysis suggested a forced five-factor final model that accounted for 58.44% of the total variance, composed of negative, disorganization/cognition, excitement, positive, and depression/anxiety. Conclusion: The Brazilian PANSS has a similar factor structure and internal consistency compared to its other country versions.
