Childhood adverse experiences and clinical manifestations in women with systemic lupus erythematosus.

BACKGROUND: Patients with a history of adverse childhood experiences (ACEs) have a higher incidence of developing autoimmune diseases such as systemic lupus erythematosus. OBJECTIVE: The objective is to associate the ACE with the clinical manifestations of SLE in adult women. METHODS: This is a cross-sectional observational analytical study in a sample of women diagnosed with SLE, whose data were collected through interviews and a review of medical records. The ACE were identified using the Childhood Trauma Questionnaire (CTQ) and were associated with sociodemographic and clinical data, as well as the presence of harm. RESULTS: The sample was composed of 97 women. In this study, significant associations were found between physical abuse and oral ulcers (p = .006) and nephritis (p = .032); between sexual abuse and Sjogren's syndrome (p = .024) and oral ulcers (p = .035); between physical neglect and photosensitivity (p = .024) and oral ulcers (p = .039); and between emotional neglect and diabetes mellitus (p = .033). CONCLUSION: Individuals with a positive history of ACE have significant associations with certain clinical manifestations of SLE and subtypes of ACE, underscoring the importance of preventing childhood trauma to improve adult health. Further studies are needed to elucidate the impact of ACE on adult health.

Personality dimensions, resilience, and depression during COVID-19 pandemic: A one-year longitudinal study.

BACKGROUND: The onset of the COVID-19 pandemic has brought to light a significant surge in depression across diverse populations. While a considerable body of research has linked this upswing to lockdowns and restrictive measures, it is crucial to recognize that lockdowns alone cannot fully elucidate the observed increase in mental health disorders, given the vast array of individual psychological responses. OBJECTIVE: This study aims to test e whether personality dimensions (Extroversion, Neuroticism, and Psychoticism) and resilience play a role in shielding individuals from developing depression during the COVID-19 pandemic, as observed in a sample of Brazilian adults. METHODS: This research employed a one-year longitudinal naturalistic study involving the general population. It utilized a web-based questionnaire administered in three waves during the COVID-19 pandemic: April 2020, September 2020, and May 2021. The research protocol contains the Patient Health Questionnaire-9 - PHQ-9, the Connor-Davidson Resilience Scale - CD-RISC, and the Eysenck Personality Questionnaire Revised-Abbreviated - EPQR-A. RESULTS: Our study encompassed 455 participants, of which 35.6 % met the criteria for depression in the first wave, and this figure decreased to 18.5 % in the second and third waves (p = 0.001). Resilience levels in the non-depressed group (consistently exhibited higher means across all three waves when compared to the depressed group (first wave: x¯= 27.98; second wave: x¯= 37.26; third wave: x¯= 36.67; p = 0.001). Furthermore, resilience exhibited an overall protective effect against depression in all waves (PR = 0.93, p = 0.000). Neuroticism and Psychoticism emerged as predictors of depression across all waves (PR = 1.346; p = 0.0001 and PR = 1.157; p = 0.030), while the Extroversion dimension showed no significant effect. CONCLUSION: The decline in depression rates during the first year of the COVID-19 pandemic was influenced by levels of resilience, which acted as a protective factor against the development of depressive symptoms. Notably, Neuroticism and Psychoticism predicted the risk of developing depressive symptoms. Implications for practical intervention in future crisis scenarios suggest the need for public health policy programs featuring personalized interventions that prioritize enhancing resilience.

Attention Deficits in Healthcare Workers with Non-Clinical Burnout: An Exploratory Investigation.

Burnout syndrome is characterized by exhaustion, cynicism, and reduced effectiveness. Workers with high burnout scores who continue their professional activities are identified as experiencing non-clinical burnout (NCB), which includes early stages where burnout symptoms (BNS) are present but not yet severe enough to necessitate work leave. This study aimed to investigate the impact of BNS on attention performance among healthcare workers (HCWs) at a COVID-19 reference hospital during the pandemic. The Maslach Burnout Inventory (MBI) was applied to assess the three burnout dimensions. The Continuous Visual Attention Test (CVAT) evaluated four different attention subdomains. Participants were divided into two groups based on their scores on the MBI: controls and NCB. Thirteen controls were matched with 13 NCB subjects based on age, sex, and HCW category. This sample (n = 26, 65% male) consisted of 11 physicians and 15 nursing professionals with a mean age of 35.3 years (standard deviation = 5.47). NCB subjects had higher impulsivity than controls. There were not any significant group differences in the other attention subdomains. We found significant correlations between impulsivity and all burnout dimensions: higher absolute scores in BNS are associated with higher impulsivity. We concluded that NCB leads to executive attention deficits.

Analysis of the relationship between perceived stress level and death anxiety in individuals with COPD.

OBJECTIVES: The study aimed to investigate the relationship between perceived stress level and death anxiety in individuals with COPD. METHOD: It was planned with a descriptive and relational screening design. It was carried out with the participation of 132 patients diagnosed with COPD. The study data were collected through Patient Information Form, Perceived Stress Scale, and Death Anxiety Scale. Descriptive statistics and multiple regression analysis were used in data analysis. RESULTS: The COPD patients' total perceived stress scale and perceived insufficient self-efficacy and perceived stress/distress subscale mean scores were found as 32.75 ± 5.32, 15.81 ± 3.60, and 16.93 ± 2.97, respectively. The patients' Anxiety total scale mean score was determined to be 6.96 ± 3.40. A positive and statistically significant relationship was found between COPD patients' Perceived Stress total scale mean score and their Death Anxiety Scale mean score (F = 4.332, p < 0.05). CONCLUSION: Perceived stress level of COPD patients was found to be at a high level, while their death anxiety level was determined as moderate. It was also determined that as perceived stress levels of the patients increased, their death anxiety levels also increased.

Associations between psychological stress, discrimination, and oral health-related quality of life: the buffering effects of social support networks.

Stress and discrimination negatively affect quality of life, but social support may buffer their effects. This study aims: (1) to examine the associations between psychological stress, discrimination, and oral health-related quality of life (OHRQoL); and (2) to assess whether social support, stress and discrimination interact to modify their associations with OHRQoL. We used cross-sectional household-based data from a study including 396 individuals aged 14 years and over from families registered for government social benefits in a city in Southern Brazil. OHRQoL was measured with the Oral Impacts on Daily Performance (OIDP) scale; psychological stress was assessed with the Perceived Stress Scale (PSS); social support was assessed based on the number of close relatives or friends of the participant, and discrimination was assessed with a short version of the Everyday Discrimination Scale. Interactions were estimated using the relative excess of risk due to interaction (RERI). Adjusted effects were calculated with logistic regression. The prevalence of oral impacts among people with higher and lower PSS scores was 81.6% and 65.5%, respectively (p < 0.01). Social support was found to have no interactions with stress levels and discrimination. The association between social discrimination and OHRQoL (OIDP score > 0) was OR = 2.03 (95%CI: 1.23; 3.34) among people with a low level of stress, but was OR = 12.6 (95%CI: 1.31; 120.9) among those with higher levels (p = 0.09, for interaction). Individuals who reported experiencing higher levels of psychological stress and discrimination had worse OHRQoL; a synergistic effect with social support was not clear.

Mutual Aid Groups for Loneliness, Psychosocial Disability, and Continuity of Care.

The objective of the present study was to evaluate the effectiveness of mutual help groups in continuity of care, loneliness and psychosocial disability in a Colombian context. For this, a quasi-experimental design is used, with pre- and post-intervention assessments due to non-randomized participant allocation. The study involved 131 individuals with mental disorders. The Psychosocial Disability Scale, The Alberta Scale of Continuity of Services in Mental Health, the UCLA Scale and the Zarit Caregiver Burden Scale were employed. The intervention was based on the core components of mutual aid groups. Significant differences (p < 0.001) were observed for the study variables, particularly in Loneliness, Continuity of Care, and various domains of psychosocial disability. A large effect size was found for these variables after the intervention. Most variables exhibited a moderate to large effect. This study demonstrates the effectiveness of mutual groups facilitated by mental health personnel at the primary care level.

Correlations between childhood maltreatment, anxiety and depressive symptoms, and risk behaviors in adolescent schoolchildren.

OBJECTIVE: Childhood maltreatment is extremely harmful to health, especially in relation to development of the psychiatric disorders throughout life. The objective of this study was to describe the prevalence and types of maltreatment in a sample of adolescent schoolchildren and to investigate associations between maltreatment types and anxiety and depressive symptoms, sociodemographic variables, and risk behaviors. The study also identified which variables were the greatest predictors of anxiety and depressive symptoms. METHODS: We conducted a cross-sectional study with a sample of 654 school students aged 11 to 17 years. We collected sociodemographic data and administered the Revised Child Anxiety and Depression Scale (RCADS-47) to measure anxiety and depressive symptoms as well as the Childhood Trauma Questionnaire (CTQ) to evaluate maltreatment and adverse experiences such as abuse and negligence during childhood and adolescence. Statistical analyses were conducted to estimate correlations between sociodemographic data, anxiety, depression, and types of maltreatment. A regression analysis was also conducted to identify maltreatment types that predict psychological symptoms. RESULTS: Emotional abuse and emotional neglect were the most prevalent types of maltreatment. Statistically, emotional abuse was the maltreatment type most strongly correlated with depression and anxiety and tended to co-occur with other types of maltreatment. Additionally, emotional and sexual abuse were the greatest predictors of anxiety and depression in adolescents. CONCLUSION: The above results reinforce the findings of previous studies in terms of understanding the effects of maltreatment. They identify emotional abuse as the main predictor of depressive and anxiety symptoms.

Improving Resiliency in U.S. Air Force Healthcare Personnel: A Randomized Preventive Trial.

INTRODUCTION: The effectiveness of the Stress Management and Resilience Training (SMART) with U.S. military personnel has not been reported in the literature. The purpose of this study was to examine the effectiveness of SMART in increasing resilience in Air Force healthcare personnel. MATERIALS AND METHODS: We conducted a pilot, randomized preventive trial with active component Air Force healthcare personnel. SMART was offered via an in-person, 2-h training session delivered through face-to-face or synchronous video teleconference training, or via a self-paced, computer-based training. A baseline survey included demographics questions and the Connor-Davidson-10 Resilience Scale (CD-10), Perceived Stress Scale (PSS), Generalized Anxiety Disorder Scale (GAD-7), and overall quality of life (QOL) measure. Follow-up surveys with the CD-10, PSS, GAD-7, and quality of life were sent to participants at 12, 18, and 24 weeks after completing SMART. RESULTS: Fifty-six service members completed the baseline assessment and were randomized to either the in-person modality (comprised of video teleconference or face-to-face training) or the computer-based training modality, and 49 participants completed SMART. Significant increases in median CD-10 scores were observed among all participants, showing a 4-point (14%), 6-point (21%), and 5-point (17%) increase at week-12, -18, and -24, respectively, from the baseline. A significant overall decrease in median PSS scores from baseline were observed, with 5.5-points (22%), 7.81-points (32%), and 8.5-points (35%) decrease at 12, 18, and 24 weeks post-SMART, respectively. CONCLUSIONS: In this pilot study, SMART demonstrated significant and meaningful improvements in self-reported CD-10 and PSS-14 scores at 12, 18, and 24 weeks post-training completion. A future replication of the study is necessary to evaluate the effectiveness of SMART on a larger scale.

Fourteen-item perceived stress scale assessment using item response theory among pregnant women.

The current study aimed to assess the psychometric properties of the Spanish language version of the 14-item Perceived Stress Scale (PSS-S) in a population of pregnant women who speak Spanish in Peru using item response theory (IRT). Our study consisted of 5,435 pregnant women who participated in the Pregnancy Outcomes Maternal and Infant Study (PrOMIS) cohort in Peru. Exploratory and confirmatory factor analyses were conducted to determine dimensionality of the scale in this population, and item response theory was conducted to determine the applicability of the PSS. The PSS consisted of a 2-factor questionnaire measuring perceived stress and coping capacity accounting for 77% of variability. The IRT analysis showed differences in item difficulty and discrimination. Item difficulty represents the level of the latent construct where 50% of respondents endorse a particular response, and item discrimination determines the rate of change of the probability of endorsing an item for differing ability levels. For the first factor, perceived stress, item 12 was the least difficult and item 2 was the most difficult. For the second factor, coping capacity, item 9 was the least difficult and item 6 was the most difficult. The Spanish version of the 14-item PSS can be a useful assessment tool for perceived stress, but more IRT should be done to delve further into the psychometric properties of the questionnaire to inform clinicians and policy makers more appropriately.

Análise de artigos sobre o teste de apercepção temática (TAT) no Brasil / Analysis of articles on the thematic apperception test (TAT) in Brazil / Análisis de artículos en el test de apercepción temática (TAT) en Brasil

O Teste de Apercepção Temática (TAT) é um instrumento projetivo usado para avaliação da personalidade. Devido ao aumento da utilização do TAT no Brasil em diferentes contextos, percebeu-se a necessidade de realizar uma revisão narrativa. Objetiva-se analisar a produção científica de estudos empíricos em relação aos principais objetivos, características metodológicas e principais resultados. Foram recuperados 18 artigos das bases de dados SciELO, LILACS, PePSIC. Os estudos foram submetidos à análise temática considerando os objetivos principais. Os resultados indicaram uma distribuição desproporcional de publicações nos últimos 15 anos, com maior produção no sudeste do país. Notou-se maioria de estudos qualitativos do tipo exploratório, sendo prevalentes estudos realizados com participantes mulheres, e uso do TAT como instrumento único. Conclui-se a necessidade da realização de estudos empíricos nas diversas regiões do país, com diferentes idades e gêneros para ampliar o escopo do uso do teste.(AU)

The Thematic Apperception Test (TAT) is a projective instrument used to assess individuals' personality. The increase in the use of TAT in Brazil in different contexts entailed the need for a narrative review. This study aimed to analyze the scientific production of empirical studies by evaluating its main objectives, methodological characteristics, and results. In total, 18 articles were retrieved from the SciELO, Lilacs, and PePSIC databases. The studies were subjected to thematic analysis considering their main objectives. Results indicated a disproportionate distribution of publications in the last 15 years, with higher production in the Brazilian southeast. Qualitative exploratory studies predominated, especially those with female participants and TAT as a single instrument. In conclusion, empirical studies must be carried out in different regions of the country with different ages and genders to expand the scope of the use of the test.(AU)

El Test de Apercepción Temática (TAT) es una herramienta proyectiva utilizada en la evaluación de la personalidad. Debido al aumento en el uso de TAT en Brasil en diferentes contextos, surgió la necesidad de realizar una revisión narrativa. El objetivo de este estudio fue analizar la producción científica de los estudios empíricos con relación a los principales objetivos, características metodológicas y principales resultados. Dieciocho artículos fueron recolectados de las bases de datos SciELO, LILACS y PePSIC. Se sometieron los estudios a análisis temático considerando los objetivos principales. Los resultados muestran una distribución desproporcionada de publicaciones en los últimos quince años, con mayor producción en el Sudeste del país. Hubo una mayoría de estudios cualitativos exploratorios, con predominio de estudios realizados con participantes del sexo femenino, y la utilización del TAT como única herramienta. Se concluye que es necesario realizar estudios empíricos en diferentes regiones del país, con diferentes grupos etarios y de género, para ampliar el alcance del uso de la prueba.(AU)

Prevalence of internet addiction and psychological factors in adolescents during the covid-19 pandemic / Prevalência de dependência da internet e fatores psicológicos em adolescentes durante a pandemia de covid-19 / Prevalencia de la adicción a internet y factores psicológicos en adolescentes durante la pandemia de la covid-19

Addictive behaviors related to Internet are becoming more common and this tool has been essential once it enables home office, entertainment, homeschooling, and easy access to information. Despite the easiness brought by technology, the exaggerated use has affected users in different ways, including in the development of psychiatric disorders. This study aimed to assess internet addiction, depression, anxiety, attention-deficit/hyperactivity disorder (ADHD), attention, impulsivity, and stress in 48 adolescents (26 young women and 22 young men), aged from 15 to 18 years, with a mean age of 16.74 (0.61), mostly students of public schools, during COVID-19, to investigate correlations between these variables according to sex and sociodemographic aspects. To assess the factors, the Internet Addiction Test (IAT); the Swanson, Nolan, and Pelham Rating Scale (SNAP-IV) Questionnaire ; the Depression, Anxiety, and Stress scale for brazilian adolescents (EDAE-A); the Barratt Impulsiveness Scale (BIS-11); and a sociodemographic questionnaire were applied. The data collection was performed in schools located in southern Brazil. The results indicated that 12 out of 48 adolescents were considered addicted to the Internet. Moreover, Internet addiction was a predictor of depression in regression analysis (p<0.001). In addition, participants classified as more addicted to the Internet scored lower averages in general attention (p<0.035) and higher averages in behavioral symptoms of inattention and ADHD (p<0.050), stress (p<0.003), anxiety (p<0.016), and depression (p<0.015), with effect sizes ranging from moderate to high. Therefore, the intense internet use by adolescents might cause psychological consequences such as depression in adolescents. Family support and professional intervention might help in the reduction of symptoms and consequences of internet addiction as well as in its prevention.(AU)

A dependência de internet é cada vez mais comum, pois essa ferramenta tem se tornado imprescindível, uma vez que possibilita home office, entretenimento, educação domiciliar e fácil acesso às informações. No entanto, o uso exagerado da tecnologia afeta os usuários de diversas formas, inclusive no desenvolvimento de transtornos psiquiátricos. Este estudo visou avaliar a dependência de internet, depressão, ansiedade, hiperatividade, atenção, impulsividade e estresse em 48 adolescentes (26 meninas e 22 meninos) de 15 a 18 anos, com idade média de 16,74 (0,61), estudantes de escolas públicas do Sul do Brasil durante a covid-19, para investigar correlações entre as variáveis anteriores de acordo com gênero e aspectos sociodemográficos. Para avaliar, aplicou-se o Internet Addiction Test (IAT), um teste de atenção, escala SNAP IV, escala de depressão, ansiedade e estresse para adolescentes (EDAE-A), escala de impulsividade de Barratt e um questionário sociodemográfico. Os resultados indicaram que 12 adolescentes foram considerados viciados em internet, e que a dependência desta foi preditora da depressão na análise de regressão (p < 0,001). Ainda, os participantes classificados como adictos tiveram médias mais baixas em atenção geral (p < 0,035) e mais altas em sintomas comportamentais de desatenção e hiperatividade (p < 0,050), estresse (p < 0,003), ansiedade (p < 0,016) e depressão (p < 0,015), com efeitos que variaram de moderado a alto. Portanto, o uso intenso da internet por adolescentes pode ter consequências psicológicas, como a depressão. Bom apoio familiar e intervenção profissional podem ajudar na redução dos sintomas e consequências, bem como na prevenção da dependência.(AU)

La adicción a Internet es cada vez más habitual, puesto que esta herramienta es esencial para el trabajo remoto, el entretenimiento, la educación domiciliar y el fácil acceso a la información. Sin embargo, su uso exagerado afecta a la vida de las personas de diferentes maneras, incluso en el desarrollo de trastornos psiquiátricos. El objetivo de este estudio fue evaluar la adicción a Internet, depresión, ansiedad, hiperactividad, atención, impulsividad y estrés en 48 adolescentes (26 muchachas y 22 muchachos), de entre 15 y 18 años, con una edad promedio de 16,74 (0,61), en su mayoría estudiantes de escuelas públicas del Sur de Brasil, durante la pandemia de la COVID-19, para investigar las correlaciones entre las variables mencionadas según género y aspectos sociodemográficos. Para evaluar los factores, se aplicaron el Test de Adicción a Internet (TAI), un test de atención, la escala SNAP IV, la Escala de Depresión, Ansiedad y Estrés para adolescentes (EDAE-A), la escala de impulsividad de Barratt y un cuestionario sociodemográfico. Los resultados indicaron que 12 adolescentes fueron considerados adictos a Internet, además, la adicción a Internet fue un predictor de la depresión en el análisis de regresión (p<0,001). Igualmente, los participantes clasificados como más adictos a Internet tuvieron promedios más bajos en atención general (p<0,035), y más altos en síntomas conductuales de falta de atención e hiperactividad (p<0,050), estrés (p<0,003), ansiedad (p<0,016) y depresión (p<0,015), con efectos que varían de moderado a alto. Por lo tanto, el uso intenso podría producir consecuencias psicológicas como la depresión en los adolescentes. Tener un buen apoyo familiar e intervención profesional puede ayudar a reducir los síntomas y las consecuencias de la adicción a Internet, así como prevenirla.(AU)

Práticas de avaliação psicológica em suspeitas de abuso sexual infantil intrafamiliar no contexto do judiciário do estado do Rio de Janeiro / Psychological assessment practices in cases of suspected intrafamilial child sexual abuse in the context of the judiciary power in the state of Rio de Janeiro / Les pratique s de l'évaluation psychologique en cas de suspicion d e violence sexuel intrafamilial chez l' enfant dans le contexte judiciaire de l'état de Rio de Janeiro / Prácticas de evaluación psicológica en presuntas víctimas de abuso sexual infantil intrafamiliar en el Poder Judicial del estado de Río de Janeiro

Resumo: O artigo apresenta os resultados da pesquisa que investigou as práticas em avaliação psicológica realizadas pelos psicólogos forenses do judiciário fluminense nos processos judiciais envolvendo suspeita de abuso sexual infantil intrafamiliar. Foram realizadas entrevistas qualitativas com quatro analistas judiciários do Tribunal de Justiça do Estado do Rio de Janeiro (TJRJ) e duas psicólogas peritas judiciais. A partir da análise de conteúdo de Bardin, emergiram três categorias: avaliação psicológica: percepções e recursos; perícias psicológicas em casos de abuso sexual infantil intrafamiliar; e dificuldades dos psicólogos forenses no contexto do TJRJ. Concluiu-se que as práticas avaliativas são diversas e que há pouca abertura por parte dos psicólogos forenses e da instituição judiciária fluminense para a utilização de instrumentos psicológicos além das entrevistas. O espaçamento temporal entre a ocorrência da violência e a perícia, o alto volume de trabalho e os curtos prazos processuais foram complicadores referidos por todos os participantes.

Abstract: This study investigated the practices in Psychological Assessment carried out by Rio de Janeiro judiciary forensic psychologists in judicial proceedings involving suspected intrafamilial child sexual abuse. For that, six forensic psychologists linked to the Court of Justice of the State of Rio de Janeiro were interviewed. Participants included four judicial analysts occupying positions of psychologists and two psychologists who are judicial experts. Based on Bardin's content analysis, three categories emerged. Psychological Assessment: perceptions and resources; psychological expertise in cases of intrafamilial child sexual abuse and difficulties faced by forensic psychologists in the context of the Court of Justice. We found diverse evaluative practices and scarce spaces for the use of psychological instruments besides interviews. The temporal spacing between the occurrence of violence and expertise, the high volume of work, and the short procedural deadlines configured complicating factors according to all participants.

Résumé : L'article expose les résultats de la recherche qui a enquêté sur les pratiques d'évaluation psychologique réalisées par des psychologues légistes de la justice de Rio de Janeiro dans le cadre de procédures judiciaires impliquant des violences sexuels intrafamiliaux présumés chez des enfants. Des entretiens qualitatifs ont été réalisés avec quatre analystes judiciaires du Tribunal de Justiça do Rio de Janeiro (TJRJ) [Cour d'Appel de l'État de Rio de Janeiro] et deux psychologues judiciaires experts. De l'analyse de contenu de Bardin, trois catégories ont émergé : évaluation psychologique : perceptions et ressources ; expertise psychologique dans les cas de violence sexuel intrafamiliaux chez les enfants ; et difficultés des psychologues judiciaires dans le cadre du TJRJ. Nous concluons que les pratiques évaluatives sont diverses et qu'il y a peu d'ouverture pour l'utilisation d'instruments psychologiques en dehors des entretiens. L'espacement temporel entre la survenance de la violence et l'expertise, le volume de travail important et les courts délais de procédure ont été des facteurs de complication mentionnés par tous les participants.

Resumen: Este artículo expone los resultados de la investigación que tuvo como objetivo conocer las prácticas de evaluación psicológica realizadas por psicólogos forenses del Poder Judicial de Río de Janeiro en procesos judiciales que involucran a presuntas víctimas de abuso sexual infantil intrafamiliar. Se realizaron entrevistas cualitativas a cuatro analistas judiciales del Tribunal de Justicia del Estado de Río de Janeiro (TJRJ) y dos peritos psicólogos judiciales. Del análisis de contenido de Bardin surgieron tres categorías: evaluación psicológica: percepciones y recursos; pericia psicológica en casos de abuso sexual infantil intrafamiliar; y dificultades de los psicólogos forenses en el contexto del TJRJ. Se concluyó que las prácticas evaluativas son diversas y que hay poco espacio para el uso de herramientas psicológicas más allá de las entrevistas. El espaciamiento temporal entre la ocurrencia de la violencia y la pericia, el alto volumen de trabajo y los cortos plazos procesales fueron los factores de complicación mencionados por todos los participantes.

O impacto da ausência do brincar precoce no processo do desenvolvimento psíquico do bebê / Absence of early play and its impact on the psychic development of infants / El impacto de la ausencia del juego precoz en el proceso del desarrollo psíquico del bebé / L'absence de jeux précoces et son impact dans le développement psychique des nourrissons

Resumo A pesquisa teve como objetivo estudar o impacto da ausência do brincar precoce no desenvolvimento psíquico do bebê, quando ele se encontra privado de trocas lúdicas na relação bebê-cuidadora, no contexto das creches. A correlação dos resultados dos instrumentos IRDI, MPPE e AP3 no acompanhamento longitudinal de cinco bebês, dos 8 meses de vida aos 4 anos de idade, apontou que a ausência do brincar precoce resulta no empobrecimento do brincar simbólico e entraves no processo de subjetivação da criança.

Abstract This study investigate the absence of early play, that is, the deprivation of playful exchanges with caregivers in the nursery environment, and its impact on the psychic development of infants. Results from a longitudinal study with five infants, from 8 months to 4 years of age, collected by the IRDI, MPPE and AP3 instruments showed that the absence of early play results in the impoverishment of further symbolic play and in obstacles to the child's subjectivation process.

Resumen La investigación tiene como objetivo estudiar el impacto de la ausencia del juego precoz en el desarrollo psíquico en bebés, cuando estos se encuentran privados de intercambios lúdicos en la relación bebé-cuidador/a. En el ámbito de las guarderías, la correlación de los resultados de los instrumentos IRDI, MPPE y AP3 en el acompañamiento longitudinal de cinco bebés de ocho meses a cuatro años indicó que la ausencia del juego precoz provoca empobrecimiento del juego símbolo e impedimentos en el proceso de subjetividad del niños.

Résumé Cette étude s'intéresse à l'absence de jeux précoces, c'est-à-dire à la privation d'échanges ludiques avec les soignants dans l'espace de la crèche, et à son impact dans le développement psychique des nourrissons. Les résultats d'une étude longitudinale auprès de cinq nourrissons, suivis de 8 mois à 4 ans, recueillis à l'aide des instruments IRDI, MPPE et AP3, ont montré que l'absence de jeux précoces entraîne un appauvrissement des jeux symboliques ultérieurs et des obstacles au processus de subjectivation de l'enfant.

Coeficientes V de Aiken: diferencias en los juicios de validez de contenido / Aiken's V Coefficient: Differences in Content Validity Judgments / Coeficientes Aiken V: Diferenças nos julgamentos de validade do conteúdo

Resumen: Objetivo: Cuando es estudiada la validez de contenido en dos grupos independientes de jueces expertos, se requiere hacer una prueba formal de las diferencias entre sus juicios, dado que es posible obtener distintos juicios de validez de contenido. Pero, generalmente, la investigación de la validez de contenido no examina esta posible fuente de discrepancias. El presente reporte describe la implementación de un método para evaluar la diferencia de coeficientes V de Aiken aplicado al trabajo investigativo en ciencias del deporte. Metodología: El procedimiento aplica una adaptación para construir el intervalo de confianza de la diferencia entre coeficientes V de Aiken y también implementa un estimador estandarizado del tamaño de la distinción entre los coeficientes V, específicamente, la transformación arcoseno de coeficientes V. Resultados: Se desarrollan dos ejemplos, en un marco de análisis secundario de datos, y se demuestra la diferencia entre la conclusión con base impresionista y la conclusión con base empírica y evaluación formal. Se detectaron distinciones estadísticas no observadas previamente. Conclusiones e implicaciones: El método que estima diferencias de coeficientes de validez de contenido V de Aiken para la investigación permite un avance en la metodología que valida instrumentos de medición. Se valora la aplicabilidad de este procedimiento en el contexto de ciencias del deporte y ciencias de la educación, así como en el diseño de la investigación.

Abstract: Objective: When two independent groups of expert judges study content validity, a formal test of the differences between their judgments is required, since different content validity judgments can be obtained. But generally, content validity research does not examine this likely source of discrepancies. This report describes the implementation of a method to evaluate the difference in Aiken's V coefficients applied to research work in sports science. Methodology: The procedure applies an adaptation to construct the confidence interval of the difference between Aiken's V coefficients and also implements a standardized estimator of the size of the difference between the V coefficients, specifically the arcsine transformation of V coefficients. Results: In a secondary data analysis framework, two examples are developed, extracting data from both publications, and the difference between the impressionist-based conclusion and the empirical-based conclusion and formal evaluation is demonstrated. Statistical differences not previously observed were detected. Conclusions and implications: The method to estimate differences in Aiken's content validity coefficients for research allows an advance in the methodology to validate measurement instruments. The applicability of this procedure in the context of sports sciences and education sciences, as well as in the research design involved, is assessed.

Resumo: Objetivo: Quando a validade do conteúdo é estudada em dois grupos independentes de juízes especialistas, é necessário um teste formal das diferenças entre seus julgamentos, uma vez que é possível obter diferentes julgamentos de validade de conteúdo. Mas a pesquisa de validade do conteúdo geralmente não examina esta possível fonte de discrepâncias. Este relatório descreve a implementação de um método para avaliar a diferença dos coeficientes V de Aiken aplicada ao trabalho de investigação das ciências do desporto. Metodologia: O procedimento aplica uma adaptação para construir o intervalo de confiança da diferença entre os coeficientes V de Aiken, e também implementa um estimador estandardizado do tamanho da diferença entre os coeficientes V, especificamente a transformação arco-seno dos coeficientes V. Resultados: Dois exemplos são desenvolvidos em uma estrutura secundária de análise de dados, e a diferença entre a conclusão baseada no impressionismo e a conclusão baseada no empirismo com avaliação formal é demonstrada. Diferenças estatísticas não observadas anteriormente foram detectadas. Conclusões e implicações: O método para estimar as diferenças nos coeficientes de validade do conteúdo V de Aiken para a pesquisa permite um avanço na metodologia de validação dos instrumentos de medição. A aplicabilidade deste procedimento no contexto da ciência do esporte e da ciência educacional, assim como no projeto de pesquisa, é avaliada.

Psychometric properties of the Maslach Burnout Inventory in healthcare professionals, Ancash Region, Peru.

Background: Burnout syndrome (BS) among healthcare professionals in Peru demands immediate attention. Consequently, there is a need for a validated and standardized instrument to measure and address it effectively. This study aimed to determine the psychometric properties of the Maslach Burnout Inventory (MBI) among healthcare professionals in the Ancash region of Peru. Methods: Using an instrumental design, this study included 303 subjects of both sexes (77.56% women), ranging in age from 22 to 68 years (M = 44.46, SD = 12.25), selected via purposive non-probability sampling. Appropriate content validity, internal structure validity, and item internal consistency were achieved through confirmatory factor analysis, and discriminant validity for the three dimensions was obtained. Evidence of convergent validity was found for the Emotional Exhaustion (EE) and Personal Accomplishment (PA) dimensions, with reliability values (ω > .75). Results: The EE and PA dimensions exhibited acceptable levels of reliability (ω and α > .80). However, the Depersonalization (DP) dimension demonstrated significantly lower reliability (α < .60 and ω < .50). Conclusions: A correlated three-factor model was confirmed, with most items presenting satisfactory factor loadings and inter-item correlations. Nonetheless, convergent validity was not confirmed for the DP dimension.

O Procedimento de Desenhos-Estórias com Tema em pesquisas qualitativas sobre imaginários coletivos / El procedimiento de dibujos-relatos con temática en investigacións cualitativas sobre imaginarios colectivos / The Thematic Story-Drawing Procedure in Qualitative Researches about Collective Imaginaries / La procédure de dessins-histoires avec thème dans des recherches qualitatives sur les imaginaires collectifs

O Procedimento de Desenhos-Estórias com Tema é um mediador que vem sendo utilizado em várias pesquisas sobre imaginários coletivos que tomam a psicologia psicanalítica concreta como referencial teórico-metodológico. Assim, justifica-se o objetivo do presente texto de apresentar os fundamentos teórico-metodológicos desse tipo de recurso. Para tanto, o artigo está organizado em três seções. Na primeira, discorre sobre as diversas possibilidades por meio das quais a psicanálise vem sendo vinculada à pesquisa qualitativa, com vistas a situar o trabalho com o Procedimento de Desenhos-Estórias com Tema nesse leque de alternativas. Na segunda, apresenta, detalha e fundamenta o próprio procedimento, dedicando atenção ao processo de definição do tema a ser solicitado. Na terceira, apresenta material de pesquisa para ilustrar as questões que compõem a segunda parte do artigo. Finaliza considerando que o uso do Procedimento de Desenhos-Estórias com Tema, quando fundamentado e articulado com referencial teórico devidamente explicitado, revela-se um mediador dialógico fecundo na produção de material investigativo em pesquisas sobre imaginários coletivos

El Procedimiento de Dibujos-Cuentos con Tema es un mediador que ha sido utilizado en diversas investigaciones sobre imaginarios colectivos que toman la psicología psicoanalítica concreta como marco teórico-metodológico. Así, se justifica el propósito del texto de presentar los fundamentos teórico-metodológicos de este tipo de recurso. El artículo se organiza en tres secciones. En el primero, se discuten las diversas posibilidades a través de las cuales el psicoanálisis se ha vinculado a la investigación cualitativa, con miras a situar el trabajo con el Procedimiento de Dibujos-Cuentos con Tema en este abanico de alternativas. En el segundo, presenta, detalla y justifica el propio procedimiento, prestando atención al proceso de definición del tema a solicitar. En el tercero, presenta material de investigación para ilustrar las preguntas que componen la segunda parte del artículo. Concluye considerando que la utilización del Procedimiento de Dibujos-Cuentos con Tema, cuando fundamentado y articulado con un referencial teórico debidamente explicado, se muestra como un fructífero mediador dialógico en la producción de material investigativo en la investigación de los imaginarios colectivos

The Thematic Story-Drawing Procedure is a mediator that has been used in several researches on collective imagery which take the concrete psychoanalytic psychology as a theoretical-methodological framework. Thus, it is justified the present's paper aim which is to discuss the theoretical and methodological foundations of this type of mediator. The paper is organized in three sections. In the first, it discusses the various possibilities through which psychoanalysis has been linked to qualitative research, situating researches with Thematic Story-Drawing Procedure in these range of possibilities. In the second, it presents, details, and justifies the procedure itself, devoting attention to the process of defining the theme to be requested. In the third, it presents research material to illustrate the questions presented in the second part of the paper.It considers that the use of the Thematic Story-Drawing Procedure, when articulated with a duly explained theoretical framework, proves to be a fruitful dialogic mediator in the production of investigative material in research on collective imaginaries

La Procédure de Dessins-Histoires avecThème est un ressource qui a été utilisé dans plusieurs recherches sur des imaginaires collectives qui prennent la psychologie psychanalytique concrète comme cadre théorique et méthodologique. L'objectifde ce texte se justifie pour présenter les fondements théoriques et méthodologiques de ce type de ressource. À cette fin, l'article est organisé en trois sections. Dans la premier, il aborde des différentes possibilités par lesquelles la psychanalyse est liée à la recherche qualitative, en vue de situer des travails avec la Procédure de Dessins-Histoires avec Thème dans cettes alternatives. Dans la seconde, il présente, détaille et justifie la procédure elle-même, en accordant une attention au processus de définition du thème. Dans la troisième, il présente du matériel de recherche pour illustrer les questions qui composent la deuxième partie de l'article.Il conclut en considérant que l'utilisation de la Procédure de Dessins-Histoires avec Thème, lorsqu'elle est ancrée et articulée avec un cadre théorique dûment expliqué, s'avère être un médiateur dialogique fécond dans la production de matériel d'investigation dans la recherche sur les imaginaires collectifs

Análise da estrutura disponibilizada ao ensino de avaliação psicológica / Analysis of the structure provided for teaching psychological assessment / Análisis de la estructura proporcionada para la enseñanza de la evaluación psicológica

O objetivo do presente estudo foi analisar as condições estruturais disponibilizadas para o ensino das disciplinas de Avaliação Psicológica nos cursos de Psicologia das Instituições de Ensino Superior (IES) do Ceará. Obteve-se autorização de oito instituições para realizar a pesquisa e, tendo como base um roteiro de observação, foram analisados aspectos de material e equipamento, infraestrutura e Serviço de Psicologia. Os principais resultados indicaram que as instituições possuíam uma variedade mínima de 20 testes psicológicos, os alunos assinavam um termo para alugar os testes e as IES desenvolviam atividades para a comunidade. Entretanto, também foi observado a inexistência da testagem informatizada, poucas instituições contavam com testotecas e os funcionários responsáveis pelo serviço e material da avaliação psicológica, em sua maioria, não eram formados em Psicologia. Pode-se concluir que o panorama das instituições cearenses observadas é promissor, mas deve-se continuar em busca de melhorias

The aim of the present study was to analyze the structural conditions made available for the teaching of Psychological Assessment disciplines in the Psychology courses of Higher Education Institutions in Ceará. Authorization was obtained from eight institutions to carry out the research and, based on an observation script, were analyzed aspects of material and equipment, infrastructure and Psychology Service. The main results indicated that the institutions had a minimum range of 20 psychological tests, students signed a term to rent the tests and the institutions developed activities for the community. However, it was also observed that there was no computerized testing, few institutions had "testotecas" and the employees responsible for the service and psychological assessment material were mostly not graduate in Psychology. It can be concluded that the scenario of the institutions in Ceará observed is promising, but one must continue to seek improvements

El objetivo del presente estudio fue analizar las condiciones estructurales disponibles para la enseñanza de asignaturas de Evaluación Psicológica en los cursos de Psicología de las Instituciones de Educación Superior en Ceará. Se obtuvo autorización de ocho instituciones para llevar a cabo la investigación y, en base a un guion de observación, se analizaron aspectos de material y equipo, infraestructura y Servicio de Psicologia. Los principales resultados indicaron que las instituciones tenían un rango mínimo de 20 tests psicológicos, los estudiantes firmaron un plazo para alquilar el tests y las IES desarrollaron actividades para la comunidad. Sin embargo, también se observó que no había tests computarizados, pocas instituciones tenían "testotecas" y los empleados responsables del servicio y el material de evaluación psicológica en su mayoría no estaban graduado en psicología. Se puede concluir que el escenario de las instituciones observadas en Ceará es prometedor, pero hay que seguir buscando mejoras

Escala de potencial criativo no trabalho: análise dos itens via teoria de resposta ao item / Creative Potential at Work Scale: Analysis conducted using Item Response Theory / Escala potencial de trabajo creativo: análisis de ítems a través de la teoría de respuesta a ítems

O presente estudo teve como objetivo realizar a análise dos itens da Escala de potencial criativo no trabalho. A amostra foi composta por 377 participantes, de 18 a 73 anos (M = 33,1; DP = 10,0). Para isso, realizou-se a análise das propriedades psicométricas dos itens, notadamente a estimação da sua dificuldade e medidas de ajuste. Duas análises foram conduzidas. Na primeira, por meio do Modelo de Créditos Parciais, verificou-se os índices de dificuldade dos itens e/ou o nível de habilidade necessária para que o sujeito endosse o conteúdo apresentado no item. Todos os itens que compõem o instrumento apresentaram índices de infit e outfit adequados, com exceção de dois itens. Foi possível, ainda, elaborar o mapa de itens, a fim de identificar aqueles que se mostram mais proeminentes em discriminar indivíduos que apresentam nível de habilidade acima da média. De modo geral, os resultados encontrados nos estudos amparam evidências positivas de validade e precisão da escala. Sugere-se que novos estudos sejam conduzidos com o instrumental, notadamente sua normatização a fim de que o mesmo possa ser disponibilizado, futuramente, para uso profissional

This study aimed to analyze the items of the Scale of creative potential at work. The sample consisted of 377 participants, aged 18 to 73 years (M = 33.1; SD = 10.0). Therefore, the analysis of the psychometric properties of the items was performed, notably the estimation of their difficulty and adjustment measures. Two analyzes were conducted, the first, through the Graduated Response Model, aimed to estimate the difficulty of the items and / or the skill level necessary for the subject to endorse the content presented in the item. All items that make up the instrument presented adequate infit and outfit indices, except for two items. It was also possible to elaborate the item map, to identify those that are more prominent in discriminating individuals with above average skill level. Overall, the results found in the studies support positive evidence of scale validity and accuracy. It is suggested that further studies be conducted with the instrument, notably its standardization so that it can be made available for professional use in the future

El presente estudio tuvo como objetivo llevar a cabo el análisis de los elementos de la Escala de potencial creativo en el trabajo. La muestra consistió en 377 participantes, de 18 a 73 años (M = 33.1; SD = 10.0). Para ello, se realizó el análisis de las propiedades psicométricas de los ítems, en particular la estimación de su dificultad y medidas de ajuste. Se realizaron dos análisis, el primero, utilizando el Modelo de crédito parcial, verificando los índices de dificultad de los ítems y / o el nivel de habilidad necesario para que el sujeto respalde el contenido presentado en el ítem. Todos los artículos que componen el instrumento tenían índices adecuados de infits y outfit, con la excepción de dos artículos. También fue posible elaborar el mapa de elementos, con el fin de identificar aquellos que son más prominentes en discriminar a las personas que tienen un nivel de habilidad superior al promedio. En general, los resultados encontrados en los estudios respaldan la evidencia positiva de la validez y precisión de la escala. Se sugiere que se realicen más estudios con el instrumental, en particular su estandarización para que pueda estar disponible para uso profesional en el futuro

Coparenting Questionnaire (CQ): Adaptation and Validity Evidences for Brazilian Context / Co-parenting Questionnaire (CQ): Adaptação e Evidências de Validade para o Brasil / Cuestionario de Coparentalidad (CQ): Adaptación y Evidencia de Validez para Brasil

Abstract Co-parenting is the reciprocal effort between two caregivers to raise a child and is important in the mental health of families. This study aims to describe the adaptation procedures and initial evidence of validity of the Co-parenting Questionnaire (CQ) for Brazil. The adaptation was carried out according to the stages: translation; synthesis of translated versions; evaluation by experts and target audience; and reverse translation. To assess its factorial structure, confirmatory factor analyzes were performed in multifactorial and bi-factorial models in a sample of 590 mothers/fathers aged 21 to 60 years (M = 36.24; SD = 5.88) residing in 21 states of Brazil. The CQ presented adequate adjustments for a correlated multifactorial solution and for the bifactor model. Complementary indices indicate that its multifactorial structure is the most adequate. Considering that 90% of the participants are women, the results show the CQ is a valid instrument for measuring co-parenting in Brazilian women.

Resumo A coparentalidade é o esforço conjunto entre dois cuidadores para criar uma criança e é importante na saúde mental das famílias. Este estudo teve como objetivo descrever os procedimentos de adaptação e evidências de validade do Coparenting Questionnaire (CQ) para o Brasil. A adaptação foi realizada segundo as etapas: tradução; síntese das versões traduzidas; avaliação por juízes experts e público-alvo; tradução reversa. Para avaliar sua estrutura fatorial, análises fatoriais confirmatórias foram realizadas em modelos multifatoriais e bifatoriais em uma amostra de 590 mães/pais de 21 a 60 anos (M = 36,24; DP = 5,88), residentes em 21 estados do Brasil. O CQ apresentou ajustes adequados para a uma solução multifatorial correlacionada e para o modelo bifactor. Índices complementares indicam que sua estrutura multifatorial é a mais adequada. Considerando que 90% dos participantes são mulheres os resultados mostram o CQ como um instrumento válido para a mensuração da coparentalidade nas mulheres brasileiras.

Resumen La coparentalidad es el esfuerzo conjunto entre dos cuidadores para criar a un niño y es importante la salud mental de las familias. Este artículo busca describir los procedimientos de adaptación y evidencias de validez del Cuestionario de Coparentalidad (CQ) para Brasil. La adaptación se realizó según las etapas: traducción; síntesis de versiones traducidas; evaluación por expertos y público objetivo; y traducción inversa. Para evaluar su estructura factorial, se realizaron análisis factoriales confirmatorios en modelos multifactoriales y bifactoriales en una muestra de 590 madres/padres de 21 a 60 años (M = 36,24; DE = 5,88) residentes en 21 estados brasileros. El CQ presentó ajustes adecuados para una solución multifactorial correlacionada y para el modelo bifactorial. Índices complementarios indican que su estructura multifactorial es la más adecuada. Considerando que el 90% de los participantes son mujeres, los resultados muestran el CQ como válido para medir la coparentalidad en mujeres brasileñas.

O florir da violeta: um estudo de caso em avaliação terapêutica / The flowering of violet: a case study in therapeutic assessment / La flor de la violeta: un estudio de caso en evaluación terapéutica

A Avaliação Terapêutica (AT) é um processo avaliativo e interventivo proposto para ser semiestruturado e colaborativo com o objetivo de promover mudanças positivas no cliente, que é convidado a ter uma participação ativa durante o processo. Na AT, os resultados dos testes psicológicos padronizados ganham destaque como facilitadores do processo de autoconhecimento do cliente. Desse modo, usualmente, integram-se os achados de testes psicológicos de autorrelato com os métodos projetivos para gerar informações que possam ampliar a visão que o cliente tem de si. Neste artigo, buscou-se compreender o potencial de uso dos testes psicológicos e da relação colaborativa a partir de um caso atendido na perspectiva da AT. A participante, Violeta (nome fictício), foi atendida em 10 sessões com duração entre 60 e 115 minutos. Foram utilizados os testes psicológicos Escala de Bem-Estar Psicológico (Ebep), Escala de Vulnerabilidade e Estresse no Trabalho (Event), Bateria Fatorial de Personalidade (BFP), Método de Rorschach e Inventários de Habilidades Sociais 2 (IHS-2). Observou-se que, durante o processo, Violeta ampliou sua autopercepção, o que possibilitou mudanças no modo de agir em seus relacionamentos amorosos e na reflexão sobre como sua postura era vista por si e por seus colegas de trabalho. Acredita-se que a AT cumpriu com o objetivo de estabelecer uma experiência terapêutica que possibilitasse mudanças positivas para a cliente. Este estudo de caso contribuiu para ampliar a compreensão sobre a importância e o uso dos testes psicológicos neste modelo de avaliação psicológica.(AU)

The Therapeutic Assessment (TA) is an evaluative and interventional process proposed to be semi-structured and collaborative with the objective of promoting positive changes in the client, who is invited to have an active participation during the process. At the TA, the results of standardized psychological tests are highlighted as facilitators of the client's self-knowledge process. In this way, the findings of psychological self-report tests are usually integrated with projective methods to generate information that can broaden the client's view of themselves. In this article, understanding the potential use of psychological tests and of the collaborative relationship from a case treated from the TA perspective was sought. The participant, Violet (fictitious name), was assisted in 10 sessions lasting between 60 and 115 minutes. The psychological tests Psychological Well-Being Scale (EBEP), Vulnerability and Stress at Work Scale (EVENT), Personality Factorial Battery (BFP), Rorschach Method and Social Skills Inventories 2 (IHS-2) were used. It was observed that, during the process, Violet increased her self-perception, which allowed changes in her way of acting in her love life and in her reflection on how her posture was seen by herself and herco-workers. It is believed that TA fulfilled the objective of establishing a therapeutic experience that would enable positive changes for the client. This case study contributed to broaden the understanding about the importance and use of psychological testing in this psychological assessment model.(AU)

La Evaluación Terapéutica (ET) es un proceso de evaluación e intervención que se propone ser semiestructurado y colaborativo, con el objetivo de lograr cambios positivos en el cliente, quien es invitado a tener participación activa durante el proceso. En la ET se destacan los resultados de las pruebas psicológicas estandarizadas como facilitadoras del proceso de autoconocimiento del cliente. Los hallazgos de las pruebas psicológicas de autoinforme suelen integrarse con métodos proyectivos para generar información que pueda ampliar la visión que el cliente tiene de sí mismo. En este artículo se buscó comprender el uso potencial de las pruebas psicológicas y de la relación colaborativa a partir de un estudio de caso tratado desde la perspectiva de la ET. Atendieron a la participante Violeta (nombre ficticio), en 10 sesiones que duraron entre 60 y 115 minutos. Se utilizaron las pruebas psicológicas Escala de Bienestar Psicológico (EBEP), Escala de Vulnerabilidad y Estrés en el Trabajo (EVENT), Batería de Factorial de la Personalidad (BFP), Método de Rorschach e Inventario de Habilidades Sociales 2 (IHS-dos). Se observó que, durante el proceso, Violeta amplió su autopercepción, lo que permitió cambios en la forma de actuar en sus relaciones amorosas y en el reflejo de como ella y sus compañeros de trabajo veían su postura. Así, se cree que ET ha cumplido el objetivo de establecer una experiencia terapéutica que permitió cambios positivos a la cliente. Este estudio contribuyó a ampliar la comprensión sobre la importancia y el uso de las pruebas psicológicas en este modelo de evaluación psicológica.(AU)