Attachment, suicidal behavior, and self-harm in childhood and adolescence: a study of a cohort of Brazilian schoolchildren.

BACKGROUND: Attachment influences the development and the formation of the self and subjectivity and, just as early adverse events, may be related to the occurrence of mental disorders, suicidal behavior, and self-harm throughout life. This study aimed to analyze the effect of mental representation of attachment in children on suicidal behavior and self-harm throughout childhood and adolescence, considering the mediating role of internalizing problems. METHODS: Based on a cohort of 500 students (mean age 8 years, SD 1.2) sampled from public schools in a Brazilian southeastern metropolis, 316 children were followed for eight years in three waves (2006, 2008, 2012). The following data from the research baseline (2005) were used: family drawing, maternal and family variables, and sociodemographic data. The mental representation of attachment (independent variable) was measured by the Family Drawing Global Scale, discriminating between secure attachment and non-secure attachment. Suicidal behavior/self-harm (dependent variable) and internalizing problems were evaluated in three research waves through CBCL and YSR (ASEBA). Descriptive analysis, calculation of frequencies and p-values of the variables of interest, as well as modeling of structural equations, were performed. RESULTS: The prevalence throughout the study was: 17.1% [CI 13.3-20.8] for suicidal ideation and 8.9% [CI 5.6 - 12.2] for self-harm; there was a recurrence at one time in 16.5% [IC 12.6 - 20.3] and in two or more moments in 4.1% [CI 2.0 - 6.3] of the sample. Female gender (p = 0.035), internalizing disorders (p < 0.01), and non-secure attachment (p = 0.035) were associated with the occurrence of suicidal behavior/self-harm. The modeling indicated that 92,2% of the total effect of attachment (p = 0.069) on suicidal behavior/self-harm was due to direct effect, the other 7,8% of the effect being mediated by internalizing problems, adjusted for the confounding variables sex, skin color/race, and social stratum. The total effect showed a positive value, which indicates an increase in suicidal behavior/self-harm when the non-secure attachment is present. The approximate OR of non-secure attachment on the total effect (direct + indirect) was 1.15, indicating that, when adjusting for confounding variables, there was a 15% increase in suicidal behavior/self-injury from non-secure attachment. CONCLUSIONS: The study supports the hypothesis that there is a relationship between disruptive attachment patterns (non-secure attachment) developed during infancy and suicidal and self-harm behavior during childhood and adolescence. These findings validate the concern about the first thousand days of childhood as a critical period for child growth and development, but also for the mental health of children and adolescents.

Representações de mães e crianças sobre o jeito de ser menino ou menina / Representations of mother and children about the way of being boy or girl

O capítulo apresenta três objetivos principais: identificar fatores escolares e comportamentais e vitimização por violência presentes nos meninos e nas meninas, segundo a informação das mães; Investigar a representação que as mães têm do comportamento de seus filhos, a partir da ótica de ser menino e menina, como interagem e lançam expectativas comportamentais sobre ele e ela; Compreender como a mãe é representada por seus filhos, também segundo a perspectiva de gênero da criança. (AU)

Desenho de crianças com sintomas de ansiedade / Children drawnings with anxiety symptoms

Este capítulo tem como objetivo investigar peculiaridades do desenho da família feito por 364 crianças escolares de São Gonçalo, em 2005. Buscamos encontrar diferenças no traçado e no contexto das 63 que apresentam sintomas de transtornos de ansiedade e de outras 301 sem nenhum outro problema emocional ou comportamental, como sintomas de depressão, agressividade, hiperatividade, desatenção e problemas no pensamento de depressão, agressividade, hiperatividade, desatenção e problemas no pensamento e no contato social. (AU)

Crianças com sintomas de depressão: sinais no desenho / Children with depression sympthoms: signs on the drawing

Neste capítulo, nosso objetivo é conhecer as peculiaridades gerais e mais específicas do desenho de crianças com sintomas de depressão. Pretendemos também discutir aspectos familiares, individuais e contextuais relacionados à depressão infantil. Para ilustrar alguns resultados, utilizamos falas das mães entrevistadas na abordagem qualitativa. Aqui o enfoque de análise do desenho busca menos os aspectos projetivos e mais a análise empírica dos achados. Estudamos também alguns casos em maior profundidade, visando minimizar as interpretações isoladas de significados. Uma substancial análise projetiva exigiria lançar mãos de outros recursos não utilizados aqui, principalmente um contato mais próximo e aprofundado com a criança e sua família. (AU)

Expressões do comportamento agressivo e da violação de regras no desenho da família / Expressions of aggressive behavior and the rules violation of family drawning

Este capítulo tem como objetivo investigar peculiaridades de traçado e contexto do desenho de 68 crianças com problemas de comportamento externalizantes, caracterizados por atitudes agressivas e violação de regras sociais. Ao longo do capítulo, comparamos essas crianças com outras 301 sem nenhum outro transtorno emocional ou comportamental como depressão, ansiedade, hiperatividade, desatenção ou problemas no pensamento e no contato social, visando facilitar a visualização de diferenças possivelmente existentes. (AU)

Violência Física Perpetrada por Ciúmes no Namoro de Adolescentes: Um recorte de Gênero em Dez Capitais Brasileiras / Physical Violence Perpetrated by Jealousy in Adolescent Dating: A Gender Approach in Ten Brazilian Capitals

RESUMO A violência entre namorados adolescentes vem ganhando visibilidade no âmbito científico, configurando-se como problema de saúde pública. Este estudo quanti-qualitativo investiga como questões de gênero permeiam a violência física perpetrada no namoro entre adolescentes. Realizou-se inquérito epidemiológico com 3.205 adolescentes (idades de 15 a 19 anos), estudantes do 2º ano do Ensino Médio de escolas públicas e privadas de 10 capitais brasileiras. Entrevistas grupais e individuais foram também realizadas com 519 participantes. Humilhações e agressões entre namorados foram consideradas graves, entretanto, infidelidade e ciúme destacaram-se como disruptores de conflitos e brigas, refletindo normas de gênero tradicionais legitimadoras da violência. Destaca-se a necessidade de ações voltadas à desconstrução de estereótipos de gênero e à problematização da banalização da violência entre adolescentes.

ABSTRACT Adolescent dating violence has been gaining visibility in the scientific realm over the past three decades, being considered as a public health issue. This quantitative and qualitative study investigates gender influences in physical dating violence among Brazilian adolescents. A survey was conducted with 3,205 adolescents (15-19 years old) from 2nd year of high school of public and private schools in 10 Brazilian cities. Group and individual interviews were also conducted with 519 participants. Although humiliations e aggression between lovers were considered serious by most teenagers, infidelity and jealousy stood out as disruptors of conflicts and fights, reflecting traditional gender norms that legitimize violence. Programs aimed at deconstructing gender stereotypes and questioning the banalization of violence among adolescents are needed.

[Adolescence, sexual behavior and risk factors to health]. / Adolescência, comportamento sexual e fatores de risco à saúde.

OBJECTIVE: To analyze the relationships between sexual behavior and risk factors to physical and mental health in adolescents. METHODS: Study of 3,195 pupils aged 15 to 19 in secondary education, in public and private schools in 10 state capitals in Brazil between 2007 and 2008. Multi-stage (schools and pupils) cluster sampling was used in each city and public and private educational network. All of the students selected completed a questionnaire on the following items: socioeconomic and demographic data; sexual behavior; having sex with those of the same sex, the opposite sex, or both; alcohol and cannabis use; using condoms; traumatic sexual experiences as a child or adolescent; suicidal thoughts. The analysis included describing frequencies, Chi-square test, analysis of multiple and cluster correspondence. Responses to an open ended question in which the adolescent expressed general comments about themselves and their lives were qualitatively analyzed using content analysis. RESULTS: Around 3.0% of adolescents reported homosexual or bisexual behavior, with no difference according to sex, age, skin color, social status family structure or educational network. Adolescents with homosexual/bisexual sexual behavior, compared to their heterosexual peers, reported: (p < 0.05): getting drunk (18.7% and 10.5%, respectively), frequent cannabis use (6.1% and 2.1%, respectively), suicidal thoughts (42.5% and 18.7%, respectively), and having been the victim of sexual violence (11.7% and 1.5%; respectively). Adolescents with homosexual/bisexual sexual behavior reported that they used condoms less frequently (74.2%) than their heterosexual peers (48.6%, p < 0.001). In the correspondence analysis, three groups were found, one composed of adolescents with homosexual/bisexual behavior and experiencing risk factors; suffering sexual violence, never using a condom, suicidal thoughts, frequent cannabis use; another composed of occasional cannabis and condom users, who got drunk frequently, and adolescents with heterosexual behavior and none of the risk factors investigated. More of the risk factors were found in adolescents with homosexual/bisexual behavior compared with those with heterosexual behavior. Adolescents with homosexual/bisexual sexual behavior were more likely to talk about their positive personal experiences and negative relationship experiences that their heterosexual peers, but spoke less about religion. CONCLUSIONS: Not only should this issue be studied in more detail, but preventative actions aimed at adolescents with homosexual/bisexual behavior should be widened.

Adolescência, comportamento sexual e fatores de risco à saúde / Adolescencia, comportamiento sexual y factores de riesgo para la salud / Adolescence, sexual behavior and risk factors to health

OBJETIVO : Analisar a relação entre comportamento sexual e fatores de risco à saúde física ou mental entre adolescentes. MÉTODOS : Estudo realizado com 3.195 escolares de 15 a 19 anos de idade, do segundo ano do ensino médio de escolas públicas e particulares das capitais de 10 estados do Brasil, em 2007-2008. Foi utilizada amostragem por conglomerados com multiestágio de seleção (escolas e alunos) em cada cidade e rede de ensino pública e particular. Foi aplicado questionário a todos os alunos selecionados, com os seguintes itens: dados socioeconômicos e demográficos; comportamento sexual; “transar” com pessoas do mesmo sexo, do sexo oposto ou de ambos os sexos; uso de bebida alcoólica e maconha; usar camisinha ao “transar”; presença de experiências sexuais traumáticas na infância ou adolescência; e ideação suicida. A análise incluiu descrição de frequências, teste de Qui-quadrado, análise de correspondência múltipla e de cluster. Foram analisadas qualitativamente, por análise dos conteúdos manifestos, as respostas a uma questão livre em que o adolescente expressou comentários gerais sobre si e sua vida. RESULTADOS : Cerca de 3,0% dos adolescentes referiu comportamento homossexual ou bissexual, sem diferenciação de sexo, idade, cor da pele, estrato social, estrutura familiar e rede de ensino. Adolescentes com comportamento homo/bissexual comparados aos heterossexuais relataram (p < 0,05): ficar de “porre” (18,7% e 10,5%, respectivamente), uso frequente de maconha (6,1% e 2,1%, respectivamente), ideação suicida (42,5% e 18,7%, respectivamente) e ter sido vítima de violência sexual (11,7% e 1,5%; respectivamente). Adolescentes com comportamento homo/bissexual relataram utilizar menos preservativo ...

OBJETIVO : Analizar la relación entre comportamiento sexual y factores de riesgo para la salud física o mental entre adolescentes. MÉTODOS : Estudio realizado con 3.195 escolares de 15 a 19 años de edad, de segundo año de educación básica de escuelas públicas y particulares de las capitales de 10 estados de Brasil, en 2007-2008. Se utilizó muestreo por conglomerados con multifase de selección (escuelas y alumnos) en cada ciudad y red de educación pública y particular. Se aplicó cuestionario a todos los alumnos seleccionados, con los siguientes itens: sexo, edad, color de piel, estructura familiar, estrato social, red de educación y ciudad de residencia; comportamiento sexual; tener relación sexual con personas del mismo sexo, del sexo opuesto o de ambos sexos; uso de bebida alcohólica y marihuana; usar preservativo al tener sexo; presencia de experiencias sexuales traumáticas cuando era niño o adolescente; e ideas suicidas. El análisis incluyó descripción de frecuencias, prueba de Chi-cuadrado, análisis de correspondencia múltiple y de cluster. Se analizaron cualitativamente las respuestas a una pregunta libre en que el adolescente expresó comentarios generales sobre sí y su vida por medio de análisis de los contenidos manifestados. RESULTADOS : Cerca de 3,0% de los adolescentes manifesto tener pareja o tener sexo con personas del mismo sexo (homosexual) o de ambos sexos (bisexual) sin diferenciación de sexo, edad, color de piel, estrato social, estructura familiar y red de educación. Adolescentes con comportamiento homo/bisexual al compararse con los heterosexuales relataron (p<0,05): embriagarse (18,7% y 10,5%, respectivamente), uso frecuente de marihuana (6,1% y 2,1%, respectivamente), ideas suicidas (42,5% y 18,7%, respectivamente) y haber sido víctima de violencia sexual (11,7% ...

OBJECTIVE : To analyze the relationships between sexual behavior and risk factors to physical and mental health in adolescents. METHODS : Study of 3,195 pupils aged 15 to 19 in secondary education, in public and private schools in 10 state capitals in Brazil between 2007 and 2008. Multi-stage (schools and pupils) cluster sampling was used in each city and public and private educational network. All of the students selected completed a questionnaire on the following items: socioeconomic and demographic data; sexual behavior; having sex with those of the same sex, the opposite sex, or both; alcohol and cannabis use; using condoms; traumatic sexual experiences as a child or adolescent; suicidal thoughts. The analysis included describing frequencies, Chi-square test, analysis of multiple and cluster correspondence. Responses to an open ended question in which the adolescent expressed general comments about themselves and their lives were qualitatively analyzed using content analysis. RESULTS : Around 3.0% of adolescents reported homosexual or bisexual behavior, with no difference according to sex, age, skin color, social status family structure or educational network. Adolescents with homosexual/bisexual sexual behavior, compared to their heterosexual peers, reported: (p < 0.05): getting drunk (18.7% and 10.5%, respectively), frequent cannabis use (6.1% and 2.1%, respectively), suicidal thoughts (42.5% and 18.7%, respectively), and having been the victim of sexual violence (11.7% and 1.5%; respectively). Adolescents with homosexual/bisexual sexual behavior reported that they used condoms less frequently (74.2%) than their heterosexual peers (48.6%, p < 0.001). In the correspondence analysis, three groups were found, one composed of adolescents with homosexual/bisexual behavior and experiencing risk factors; suffering sexual violence, never using a condom, suicidal thoughts, frequent cannabis use; another composed of occasional ...

Violência psicológica e contexto familiar de adolescentes usuários de serviços ambulatoriais em um hospital pediátrico público terciário / Psychological violence and the family context of adolescent users of outpatient services in a public tertiary pediatric hospital

Buscou-se investigar a associação da violência psicológica (VP) na adolescência com fatores sociodemográficos, estrutura/relacionamento familiar e com outras formas de maus-tratos. Aplicou-se em 229 adolescentes (11-18 anos) um questionário, em serviços ambulatoriais de um hospital pediátrico público terciário. Encontrou-se que 26,4% dos entrevistados sofrem VP severa no contexto familiar, sendo que apenas cinco relataram não sofrer qualquer tipo de VP familiar, sugerindo que essa violência é considerada como uma forma corriqueira de relacionamento familiar. Comportamentos de VP familiares mais relatados: ser criticado pelo que faz ou diz, não ser encorajado quando tenta atuar de forma autônoma, ser chamado por nomes desagradáveis e ter adulto dizendo que está errado ao tentar agir. Insatisfação dos responsáveis com o adolescente, a estrutura familiar nuclear, a posição da criança entre os irmãos e o compartilhamento dos mesmos pais pelos irmãos mostraram-se associados à VP que ocorre no contexto familiar. O setor saúde, capacitando-se para detectar os sinais de VP, pode promover o direito à saúde integral de adolescentes, confirmando ser um dos principais setores sociais capazes de atuar preventivamente sobre as formas de violência sofridas e praticadas pelo grupo familiar.

The scope of this research was to investigate the association of psychological violence (PV) during adolescence with social and demographic factors, family structure/relationships and with other forms of maltreatment. A questionnaire was applied to 229 adolescents (11-18 years) in outpatient services in a state-run tertiary pediatric hospital. It was found that 26.4% of respondents suffered severe PV in the family context, and only 5 of the respondents reported they did not suffer any PV in the family context, illustrating how this kind of violence is seen as commonplace in the family relationship. The most common forms of PV behavior were: being criticized for what one does or says; not being encouraged when trying to act autonomously; being called nasty names, and having an adult saying one is wrong when one tries to act. Dissatisfaction of parents with the adolescent, the nuclear family structure, the position of the child among siblings sharing the same parents were associated with PV occurring within the family context. In order to enable it to detect signs of PV, the health sector can promote the right to comprehensive health of adolescents, confirming itself as one of the main social sectors capable of acting preventively on the forms of violence suffered and practiced by the family group.

[Psychological violence and the family context of adolescent users of outpatient services in a public tertiary pediatric hospital]. / Violência psicológica e contexto familiar de adolescentes usuários de serviços ambulatoriais em um hospital pediátrico público terciário.

The scope of this research was to investigate the association of psychological violence (PV) during adolescence with social and demographic factors, family structure/relationships and with other forms of maltreatment. A questionnaire was applied to 229 adolescents (11-18 years) in outpatient services in a state-run tertiary pediatric hospital. It was found that 26.4% of respondents suffered severe PV in the family context, and only 5 of the respondents reported they did not suffer any PV in the family context, illustrating how this kind of violence is seen as commonplace in the family relationship. The most common forms of PV behavior were: being criticized for what one does or says; not being encouraged when trying to act autonomously; being called nasty names, and having an adult saying one is wrong when one tries to act. Dissatisfaction of parents with the adolescent, the nuclear family structure, the position of the child among siblings sharing the same parents were associated with PV occurring within the family context. In order to enable it to detect signs of PV, the health sector can promote the right to comprehensive health of adolescents, confirming itself as one of the main social sectors capable of acting preventively on the forms of violence suffered and practiced by the family group.

Association between family environment and attention deficit hyperactivity disorder in children--mothers' and teachers' views.

BACKGROUND: To ascertain whether factors of the family environment and gestational period are associated with the appearance of ADHD in children, as reported by various different informants (mothers and teachers). METHODS: This paper presents results from the dataset of a longitudinal study to evaluate behavioral problems among schoolchildren in São Gonçalo, Rio de Janeiro State, in 2005 and 2006. The cross-section considered for this paper comprises records of exposure factors and ADHD. In all, 370 schoolchildren of the public school system were assessed by 3-stage cluster sampling. The Child Behavior Checklist (CBCL) and the Teacher Report Form (TRF) were used to measure outcomes. The exposure factors examined were: profile of child and mother, variables relating to the family environment, and perinatal considerations. The questions were answered by mothers and teachers. A hierarchical logistic regression model was used. RESULTS: Precariously functioning families, lack of social support for mothers, adverse life events and discord during pregnancy were the factors associated with mother-reported ADHD. When ADHD was reported by teachers, the variables selected were: Intelligence quotient (IQ) and sex, with children with low IQ scores and boys more likely to display the disorder. CONCLUSIONS: Assessment of ADHD by teachers or mothers reveals specific characteristics that reflect how each of these informants understands the children. This highlights the importance of using informants from different environments in diagnosing the disorder.

Sofrimento psíquico e trabalho docente – implicações na detecção de problemas de comportamento em alunos / Psychological distress and teaching – implications for the detection of problem behavior in students

O presente artigo investiga a opinião de professores do ensino fundamental -com e sem sofrimento psíquico - sobre os problemas de comportamento dos alunos e sobre a forma de lidar com esses problemas. Em 2006, 139 professores responderam um questionário autoaplicado a fim de avaliar algumas características do trabalho e a presença de sofrimento psíquico através da escala Self Reported Questionnaire (SRQ-20). Neste mesmo ano, estes profissionais avaliaram a presença de problemas de comportamento em 358 alunos, através da escala Teacher´s Report Form (TRF). Em 2009, 10 Professoras da mesma amostra foram entrevistadas para compreender melhor sobre sua saúde mental e seu trabalho com os alunos. Resultados evidenciam diferenças significativas entre professores com e sem sofrimento psíquico no que tange à forma de avaliar e lidar com os problemas de comportamento dos alunos. A presença de sofrimento psíquico contribui para uma visão mais negativa do trabalho docente. (AU)

This article aims to investigate the opinion of elementary school teachers -with and without psychological distress - on the behavior´s problems of the students and how to deal with these problems. In 2006, 139 teachers answered a questionnaire in order to evaluate some professional characteristics and the presence of psychological distress (Self ReportedQuestionnaire, SRQ-20). These professionals have also evaluated the presence of behavior problems in 358 students, through the scale Teacher's Report Form (TRF). In 2009, 10 teachers from the same sample were interviewed (5 teachers with signs of distress and 5 with no such signs). The results show significant differences between the two groups in regard to how to assess and deal with the problems of student behavior. Furthermore, it appears that the presence of psychological distress contributes to a more negative view of teaching. (AU)

Sofrimento psíquico e trabalho docente – implicações na detecção de problemas de comportamento em alunos / Psychological distress and teaching – implications for the detection of problem behavior in students

O presente artigo investiga a opinião de professores do ensino fundamental -com e sem sofrimento psíquico - sobre os problemas de comportamento dosalunos e sobre a forma de lidar com esses problemas. Em 2006, 139 professores responderam um questionário autoaplicado a fim de avaliar algumas características do trabalho e a presença de sofrimento psíquico através da escala Self Reported Questionnaire (SRQ-20). Neste mesmo ano, estes profissionais avaliaram a presença de problemas de comportamento em 358 alunos, através da escala Teacher´s Report Form (TRF). Em 2009, 10 Professoras da mesma amostra foram entrevistadas para compreender melhor sobre sua saúde mental e seu trabalho com os alunos. Resultados evidenciam diferenças significativas entre professores com e sem sofrimento psíquico no que tange à forma de avaliar e lidar com os problemas de comportamento dos alunos. A presença de sofrimento psíquico contribui para uma visão mais negativa do trabalho docente...

This article aims to investigate the opinion of elementary school teachers -with and without psychological distress - on the behavior´s problems of thestudents and how to deal with these problems. In 2006, 139 teachers answered a questionnaire in order to evaluate some professional characteristics and the presence of psychological distress (Self ReportedQuestionnaire, SRQ-20). These professionals have also evaluated thepresence of behavior problems in 358 students, through the scale Teacher'sReport Form (TRF). In 2009, 10 teachers from the same sample wereinterviewed (5 teachers with signs of distress and 5 with no such signs). Theresults show significant differences between the two groups in regard to how to assess and deal with the problems of student behavior. Furthermore, it appears that the presence of psychological distress contributes to a more negative view of teaching...

Violência comunitária e transtorno de estresse pós-traumático em crianças e adolescentes / Community violence and posttraumatic stress disorder in children and adolescents

O presente estudo tem como objetivo analisar a associação entre exposição à violência comunitária e o Transtorno de Estresse Pós-Traumático (TEPT) segundo gênero e faixa etária entre crianças e adolescentes de escolas públicas de São Gonçalo/RJ. Participaram da análise deste artigo 399 crianças e adolescentes (idade média de 10,6 anos, DP=1,0). A prevalência total de sintomas de TEPT nas crianças e adolescentes é de 9,5%, sendo maior nas meninas (12,6%) do que nos meninos (6,5%). No modelo multivariado, destaca-se que as crianças menores de 10 anos têm duas vezes mais chances de desenvolverem sintomas deste transtorno que as mais velhas e que quanto maior a exposição à violência comunitária maiores as chances de surgimento de sintomas de TEPT.(AU)

This study aims to analyze the association between exposure to community violence and Posttraumatic Stress Disorder (PTSD) by gender and age among children and adolescents of public schools in São Gonçalo-RJ. Three hundred and ninety-nine children and adolescents participated in this analysis (mean age 10.6 years; SD = 1.0). The prevalence of PTSD symptoms in children and adolescents is 9.5%, being higher among girls (12.6%) than among boys (6.5%). In the multivariate model, it is emphasized that children under 10 years old are twice as likely to develop symptoms of this disorder, than older ones; and the higher exposure to community violence, the emergence of PTSD symptoms is more likely.(AU)

Violência comunitária e transtorno de estresse pós-traumático em crianças e adolescentes / Community violence and posttraumatic stress disorder in children and adolescents

O presente estudo tem como objetivo analisar a associação entre exposição à violência comunitária e o Transtorno de Estresse Pós-Traumático (TEPT) segundo gênero e faixa etária entre crianças e adolescentes de escolas públicas de São Gonçalo/RJ. Participaram da análise deste artigo 399 crianças e adolescentes (idade média de 10,6 anos, DP=1,0). A prevalência total de sintomas de TEPT nas crianças e adolescentes é de 9,5%, sendo maior nas meninas (12,6%) do que nos meninos (6,5%). No modelo multivariado, destaca-se que as crianças menores de 10 anos têm duas vezes mais chances de desenvolverem sintomas deste transtorno que as mais velhas e que quanto maior a exposição à violência comunitária maiores as chances de surgimento de sintomas de TEPT...

This study aims to analyze the association between exposure to community violence and Posttraumatic Stress Disorder (PTSD) by gender and age among children and adolescents of public schools in São Gonçalo-RJ. Three hundred and ninety-nine children and adolescents participated in this analysis (mean age 10.6 years; SD = 1.0). The prevalence of PTSD symptoms in children and adolescents is 9.5%, being higher among girls (12.6%) than among boys (6.5%). In the multivariate model, it is emphasized that children under 10 years old are twice as likely to develop symptoms of this disorder, than older ones; and the higher exposure to community violence, the emergence of PTSD symptoms is more likely...

[Reports of domestic, sexual and other forms of violence against children in Brazil]. / Notificações de violência doméstica, sexual e outras violências contra crianças no Brasil.

The scope of this article is to outline the scenario of domestic, sexual and other forms of violence against children (0-9 years old) in Brazil for the year 2010. It is based on data from reports of domestic, sexual and other forms of violence registered with SINAN - Information System for Notifiable Diseases (Continuous VIVA). Absolute and relative numbers are presented, derived from reported violence, discriminating between children under 1 year of age and those between 1-9 years old, due to the specificities that exist in these age groups. Throughout the country, the number of reports among those under 10 years of age is low (17.1%). Differences were found for the distribution of reports in the different Brazilian States. Few municipalities and few services reported violence to SINAN-Net in 2010 in the country. Some differences were found between children under 1 year of age and those between 1 and 9 years of age, as for instance the relationship between the profile of the violence, the victim and the perpetrator, and the handling of the case. The quality of the reported information is discussed showing the high level of unreported data in some spaces of the reporting form. Lack of information may prejudice comprehension of the phenomenon, interfering with the planning, organization and operation actions of the health services in the country.

Notificações de violência doméstica, sexual e outras violências contra crianças no Brasil / Reports of domestic, sexual and other forms of violence against children in Brazil

O artigo tem como objetivo apresentar o quadro de violência doméstica, sexual e outras violências perpetradas contra crianças (0-9 anos) no Brasil no ano de 2010, baseando-se nas notificações de violência doméstica, sexual e outras violências registradas no SINAN - Sistema de Informação de Agravos de Notificação (VIVA Contínuo). São apresentados os números absolutos e relativos derivados das notificações sobre violências, discriminando-se entre crianças menores de 1 ano e aquelas entre 1-9 anos, devido às especificidades existentes nessas faixas etárias. Em todo o país, o número de notificações entre menores de 10 anos é baixo (16,9%). Foram constatadas diferenças quanto à distribuição das notificações por unidade da federação. Observou-se que poucos municípios notificaram violências ao SINAN-Net no ano de 2010 no país. Algumas diferenças foram encontradas entre notificações em menores de 1 ano de idade e notificações de crianças entre 1-9 anos de idade, como por exemplo em relação ao perfil da violência, da vítima e do agressor, e o encaminhamento do caso. A qualidade da informação das notificações é discutida mostrando nível elevado de ausência de registros em alguns campos da ficha. Falhas na informação podem prejudicar o conhecimento mais detalhado do fenômeno, interferindo nas ações de planejamento, organização e operacionalização dos serviços de saúde no país.

The scope of this article is to outline the scenario of domestic, sexual and other forms of violence against children (0-9 years old) in Brazil for the year 2010. It is based on data from reports of domestic, sexual and other forms of violence registered with SINAN - Information System for Notifiable Diseases (Continuous VIVA). Absolute and relative numbers are presented, derived from reported violence, discriminating between children under 1 year of age and those between 1-9 years old, due to the specificities that exist in these age groups. Throughout the country, the number of reports among those under 10 years of age is low (17.1%). Differences were found for the distribution of reports in the different Brazilian States. Few municipalities and few services reported violence to SINAN-Net in 2010 in the country. Some differences were found between children under 1 year of age and those between 1 and 9 years of age, as for instance the relationship between the profile of the violence, the victim and the perpetrator, and the handling of the case. The quality of the reported information is discussed showing the high level of unreported data in some spaces of the reporting form. Lack of information may prejudice comprehension of the phenomenon, interfering with the planning, organization and operation actions of the health services in the country.

[Suicide mortality in people aged 60 and over in Brazilian municipalities between 1996 and 2007]. / Mortalidade por suicídio em pessoas com 60 anos ou mais nos municípios brasileiros no período de 1996 a 2007.

The scope of this article was to assess the nationwide scale of suicides among the elderly. An overview of suicides in Brazilian municipalities was conducted to identify municipalities with the highest incidence of suicide. Data from the Mortality Information System (SIM/MS) were used for the period from 1996 to 2007, using the events with codes X60 through X84 and Y87.0 of the 10th review of the International Classification of Diseases (CID-10). The rates were standardized according to the criteria of the WHO. It was discovered that 3,039 Brazilian municipalities have records of suicide cases of people aged 60 and more in at least one of the triennia analyzed (54.6% of all the municipalities). A total of 29.3% of those municipalities were in the Southern Region, 29.6% in the Southeast and 27.5% in the Northeast. The State of Rio Grande do Sul has the highest percentage of municipalities with suicide cases in the four triennia (27.3%), followed by the States of São Paulo (17.4%) and Santa Catarina (9.1%). Between the first and the final triennium, it was observed that there was a reduction in 32 of the 51 municipalities with higher rates. The mean ratio of male/female deaths was 2.8 male deaths for every female death. The main method used is hanging, strangulation and suffocation among both men (58.2%) and women (49.8%).

[Suicide mortality temporal trends in people aged 60 years or more in the Brazilian states: 1980 to 2009]. / Evolução temporal da mortalidade por suicídio em pessoas com 60 anos ou mais nos estados brasileiros, 1980 a 2009.

The scope of this paper is to determine the temporal evolution of mortality by suicide in people aged 60 or more per State in Brazil between 1980 and 2009. Historical mortality by suicide data (ICD-9 codes E950 to E959 and ICD-10 codes X60 to X84 and Y87.0) were obtained from the Mortality Information System (SIM / MS). Data regarding population counts were obtained from the Brazilian Institute of Geography and Statistics. In the assessment of temporal trends the Poisson regression model was used, in which the dependent variable was the number of deaths and the centralized calendar year was the explanatory variable. Statistically significant trends were considered those whose p-value was d" 0.05. The results revealed the presence of a statistically significant increasing trend in four states and a decrease in two (general population; 60 years or more). In the male population there was an increase in five states and a reduction in two. The female rate showed an increase in one state and a decrease in three. There was an increasing trend in Piauí, Ceará and Rio Grande do Norte and a reduction in Amazonas, Roraima, and São Paulo for people aged between 60 and 69. Increasing rates were observed in the population aged 70-79 in Piauí and decreasing trends in Roraima.

[Factors associated with suicide mortality among the elderly in Brazilian municipalities between 2005 and 2007]. / Fatores associados com a mortalidade por suicídio de idosos nos municípios brasileiros no período de 2005-2007.

This scope of this paper was to conduct an ecological analysis of suicide mortality of people aged 60 years or more in Brazilian municipalities between 2005 and 2007, by investigating factors associated with the event. Data on suicide deaths were extracted from the Mortality Information System, codes X60 to X86 and Y87.0 (ICD-10). Poisson, negative binomial and zero-inflated negative binomial (ZINB) regression models were adjusted. The latter exhibited the best results when comparing models. The proportion of non-whites (negative association), the rate of hospitalization for mood disorders (positive association) and sex ratio (negative association) were identified as factors associated with suicide.