RESUMO
Working memory (WM) and inhibitory control (IC) play a crucial role in learning during early childhood. The literature suggests a non-linear developmental trajectory of executive functions (EFs) with varied results according to gender, usually attributed to environmental factors. However, there is insufficient and inconclusive data on whether this pattern is reproduced in the Latin American preschool population since most studies have been conducted in English-speaking, European, and Asian environments. Thus, objectively comparing children's executive performance across diverse international geographical contexts becomes challenging. This study aimed to conduct a cross-sectional analysis of the performance in WM and IC of 982 Ecuadorian preschoolers aged between 42 and 65 months (M = 53.71; SD = 5.714) and belonging to medium-high, medium, and low-medium socioeconomic strata. The participants consisted of 496 boys (M = 53.77; SD = 5.598) and 486 girls (M = 53.65; SD = 5.834), representing nine cities in Ecuador. To assess the effect of age and gender on performance in these two domains, the sample was divided into four 6-month age intervals. Two tests were administered to the participants, and a survey was conducted with 799 of their usual caregivers. Viewing the cross-sectional mean scores of the WM and IC tests as a temporal continuum reveals an upward trend in each age interval studied. Girls outperformed boys on the IC test, showing statistically significant differences in the earliest age interval. The gender differences in executive performance reported in the literature emphasize the need to explore the modulating effect of environmental variables on early childhood development. This information could offer valuable insights for adapting and optimizing cognitive and didactic strategies in early childhood tailored to the characteristics and needs of the preschool population.
Assuntos
Desenvolvimento Infantil , Função Executiva , Memória de Curto Prazo , Humanos , Masculino , Feminino , Equador , Pré-Escolar , Estudos Transversais , Memória de Curto Prazo/fisiologia , Função Executiva/fisiologia , Desenvolvimento Infantil/fisiologia , Inibição Psicológica , Fatores Sexuais , Fatores EtáriosRESUMO
At least one in three women experience intimate partner violence (IPV) in their lifetime. The most commonly sustained IPV-related brain injuries include strangulation-related alterations in consciousness (S-AICs) and traumatic brain injuries (TBIs). Moreover, survivors of IPV-related S-AICs and/or TBIs often demonstrate psychological distress such as depression, anxiety, and post-traumatic stress. However, the co-occurrence of S-AICs and TBIs, and whether such TBIs may be moderate to severe, has not been systematically examined, and most data have been collected from women in North America. The purpose of this study was to examine the co-occurrence of IPV-related S-AICs and TBIs across a range of geographical locations and to determine the extent to which these S-AICs are related to psychological distress. Women who had experienced physical IPV (n = 213) were included in this secondary analysis of retrospectively collected data across four countries (Canada, the United States, Spain, and Colombia). The Brain Injury Severity Assessment (BISA) was used to assess IPV-related BI across all sites. Because various questionnaires were employed to assess levels of depression, anxiety, and post-traumatic stress disorder at each site, we created a standardized composite score by converting raw scores into Z-scores for analysis. Mann-Whitney U tests and chi-square tests were conducted to examine differences between women with and without experience of S-AICs and to discover if there was a relationship between the occurrence of S-AICs and TBIs. Analysis of variance and analysis of covariance (to control for the potential confounding effects of age, education, and non IPV-related TBI) were used to compare levels of psychological distress in women who had or had not experienced S-AICs. Approximately, 67% of women sustained at least one IPV-related BI (i.e., TBI and/or S-AIC). In a subsample of women who sustained at least one IPV-related BI, approximately 37% sustained both S-AICs and TBIs, 2% sustained only S-AICs (with no TBIs), and 61% sustained TBIs exclusively (with no S-AICs). Furthermore, women who had sustained S-AICs (with or without a TBI) were more likely to have experienced a moderate-to-severe BI than those who had not sustained an S-AIC (BISA severity subscale: U = 3939, p = 0.006). In addition, women who experienced S-AICs (with or without a TBI) reported higher levels of psychological distress compared with women who never experienced S-AICs, irrespective of whether they occurred once or multiple times. These data underscore the importance of assessing for S-AIC in women who have experienced IPV and when present, to also assess for TBIs and the presence of psychological distress. Unfortunately, there were methodological differences across sites precluding cross-site comparisons. Nonetheless, data were collected across four culturally and geographically diverse countries and, therefore, highlight IPV-related BIs as a global issue that needs to be aggressively studied with policies established and then implemented to address findings.
Assuntos
Lesões Encefálicas Traumáticas , Violência por Parceiro Íntimo , Angústia Psicológica , Humanos , Feminino , Adulto , Lesões Encefálicas Traumáticas/psicologia , Lesões Encefálicas Traumáticas/complicações , Lesões Encefálicas Traumáticas/epidemiologia , Violência por Parceiro Íntimo/psicologia , Pessoa de Meia-Idade , Estados Unidos/epidemiologia , Colômbia/epidemiologia , Canadá/epidemiologia , Espanha/epidemiologia , Transtornos da Consciência/epidemiologia , Transtornos da Consciência/etiologia , Transtornos da Consciência/psicologia , Estudos Retrospectivos , Adulto JovemRESUMO
The number of computerized and reliable performance validity tests are scarce. This study aims to address this issue by validating a free and computerized performance validity test: the Coin in Hand-Extended Version (CIH-EV). The CIH-EV test was administered in four countries (Colombia, Spain, Portugal, and the United States) and performance was compared with other commonly used validated tests. Results showed that the CIH-EV has at least 95% specificity and 62% sensitivity, and performance was highly correlated with scores on the Test of Memory Malingering, Victoria Symptom Validity Test, and Digit Span of the Wechsler Adult Intelligence Scale. There were no significant differences in scores across countries, suggesting that the CIH-EV performs similarly in a variety of cultures. Our findings suggest that the CIH-EV has the potential to serve as a valid validity test either alone or as a supplement to other commonly used validity tests.
Assuntos
Simulação de Doença , Adulto , Colômbia , Humanos , Testes Neuropsicológicos , Portugal , Reprodutibilidade dos Testes , Espanha , Estados UnidosRESUMO
The Personality Assessment Inventory (PAI; Morey, 1991, 2007) is among the most important personality and psychopathology assessment tools. However, its psychometric properties in the Spanish-speaking prison population have not yet been studied. We aimed to explore the factor structure of the Spanish adaptation of the PAI (Ortiz-Tallo et al., 2011) in an Ecuadorian sample of 811 convicted men using exploratory structural equation modeling, with the further objective of confirming its internal consistency. Hoelzle and Meyer (2009) identified three dimensions that are highly congruent across samples: general distress, elevated mood and dominance, and substance abuse and psychopathy. Taking these findings and the internalizing and externalizing dimensions (Ruiz & Edens, 2008) as a theoretical basis, three- and two-factor models were tested for the 22 scales and 11 clinical scales, respectively. We also tested four- and three-factor models that grouped the scales related to substance abuse as an independent factor, leaving intact the distribution presented by the remaining scales in the previous models. Although the original models showed a good fit, the 4- and 3-factor models obtained significantly better fit indexes. With respect to reliability, the Cronbach's alpha coefficients ranged from .49 to .89. This version shows acceptable psychometric properties in correctional settings.
Assuntos
Transtornos Mentais/diagnóstico , Inventário de Personalidade/normas , Prisioneiros , Psicometria/normas , Adulto , Equador , Análise Fatorial , Humanos , Masculino , Reprodutibilidade dos Testes , Transtornos Relacionados ao Uso de Substâncias/diagnósticoRESUMO
Although highly active antiretroviral therapy (HAART) has improved survival rates of HIV patients, HIV-associated neurocognitive disorders (HAND) still exist in a highly prevalent group of persons with this disease. In this study we seek to evaluate the influence of drug use in the neuropsychological performance of seropositive drug users. We carried out an extensive neuropsychological evaluation and compared the performance of seropositive drug users (n = 90) with that of a control group of seronegative drug users (n = 48). The results reveal that methadone maintenance programmes can make the seropositive subject neuropsychologically vulnerable. Likewise, we found that giving up drugs have a protective effect in the presence of neuropsychological alterations associated with HIV. These findings lead us to suggest that seropositivity is not sufficient to explain the neuropsychological alterations of seropositive drug users, noting that these alterations are multifactorial.
Aunque la terapia antirretroviral de gran actividad (TARGA) ha mejorado los índices de supervivencia de los pacientes infectados por el VIH, los trastornos neurocognitivos asociados con el VIH (TNAV) todavía existen en un grupo de personas altamente prevalente a esta enfermedad. En este estudio buscamos evaluar la influencia del consumo de drogas en el rendimiento neuropsicológico de los usuarios de drogas seropositivos. Llevamos a cabo una amplia evaluación neuropsicológica, y el rendimiento de los usuarios de drogas seropositivos (n = 90) se comparó con la de un grupo control de usuarios de drogas seronegativos (n = 48). Los resultados demuestran que los programas de tratamiento de mantenimiento con metadona pueden convertir en vulnerable a nivel neuropsicológico al individuo seropositivo. Asimismo, descubrimos que abandonar las drogas provoca un efecto protector frente a la existencia de alteraciones neuropsicológicas asociadas con el VIH. Estos resultados nos llevan a sugerir que la seropositividad no basta para explicar las alteraciones neuropsicológicas de los usuarios de drogas seropositivos, ya que estas alteraciones al parecer son multifactoriales.
Assuntos
HIV , Usuários de Drogas , Testes Neuropsicológicos , Transtornos Neurocognitivos , Terapia Antirretroviral de Alta Atividade , Reserva Cognitiva , Metadona/administração & dosagemRESUMO
Benzodiazepines and methadone use has been associated with various neuropsychological impairments. However, to the best of our knowledge, no studies have been carried out on the effect of these substances (either separately or combined) on impulsive personality, including studies in prisoners. The aim of this study is to examine the impulsive personality of a sample of 134 male prisoners using the Sensitivity to Punishment and Sensitivity to Reward Questionnaire (Torrubia, Avila, Molto, & Caseras, 2001) and the UPPS-P Scale (Cyders et al., 2007). Some of these were methadone users, methadone and benzodiazepines users, polydrug users in abstinence and non-dependent drug users. The results showed that drug users have greater sensitivity to reward, positive urgency, negative urgency and sensation seeking than non-dependent users. Methadone users showed more sensitivity to punishment and lack of perseverance with respect to other users. No differences were found between methadone+benzodiazepines users and other groups. The secondary aim is to examine which impulsive personality dimensions are related to the two motivational systems proposed by Gray (BIS-BAS) using exploratory factor analysis. Results showed two different components. One component was defined by the subscales sensitivity to reinforcement, positive urgency, negative urgency and sensation seeking. The second component was defined by the subscales sensitivity to punishment, lack of perseverance and lack of premeditation.
El consumo de benzodiacepinas y metadona se ha asociado a diversas alteraciones neuropsicológicas. Sin embargo, no conocemos estudios sobre el efecto de estas sustancias tanto de forma separada como de forma combinada en rasgos de personalidad impulsiva, y en menor medida en población penitenciaria. El objetivo principal de este estudio es examinar la impulsividad rasgo, medida con el Cuestionario de Sensibilidad al Castigo Sensibilidad a la Recompensa (Torrubia, Avila, Moltó y Caseras, 2001), y la escala de Evaluación del Comportamiento Impulsivo UPPS-P (Cyders et al., 2007), en una muestra de 134 varones de un centro penitenciario con consumo de metadona, metadona y benzodiacepinas, abstinentes de consumo, y no dependientes del consumo de sustancias (criterios DSM-IV). Los resultados mostraron que los grupos de consumidores presentan mayor sensibilidad a la recompensa, urgencia positiva, urgencia negativa y búsqueda de sensaciones que los no consumidores; los grupos de consumo de metadona presentan mayor sensibilidad al castigo y falta de perseverancia. El grupo de no consumidores presenta menor falta de perseverancia que el grupo de metadona y el grupo de metadona+benzodiacepinas. No se han encontrado diferencias específicamente del grupo de metadona+benzodiacepinas con el resto de los grupos. Como objetivo secundario, examinar, mediante análisis factorial exploratorio, qué dimensiones de personalidad impulsiva se relacionan con los dos sistemas motivacionales propuestos por Gray (SIC-SAC). Los resultados mostraron un componente definido por las subescalas sensibilidad al refuerzo, urgencia positiva, urgencia negativa y búsqueda de sensaciones, y un segundo definido por las subescalas sensibilidad al castigo, falta de perseverancia y falta de premeditación.
Assuntos
Benzodiazepinas/uso terapêutico , Comportamento Impulsivo/efeitos dos fármacos , Metadona/uso terapêutico , Prisioneiros/psicologia , Adolescente , Adulto , Humanos , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
Los objetivos de este trabajo fueron definir los trastornos psicopatológicos más comunes asociados a la obesidad y a la desnutrición, así como establecer el grupo de referencia normativo al cual pertenece México en la escala Child Behavior Checklist 6-18 (CBCL/6-18). Este fue un estudio transversal de diseño cuasiexperiemental. Se utilizó la información de 125 niños de escuelas públicas de Ciudad Juárez, Chihuahua, México, en estados de desnutrición, obesidad y normopeso, obtenida mediante las 113 preguntas relacionadas con el comportamiento de niños, que contiene el CBCL 6-18. Por medio de análisis de varianzas se estudiaron las posibles diferencias entre los grupos. Encontramos que nuestra muestra mexicana, pertenece al grupo normativo de referencia tres; las diferencias más significativas se encuentran en el grupo de obesos en la escala de problemas internalizados específicamente en ansiedad/depresión, y en el total de problemas.
This paper sought to define the most common psychopathological disorders associated with obese and malnourished children, and establish the normative group to which Mexico belongs in the Child Behavior Checklist 6-18(CBCL/6-18). This was a cross-sectional study of cuasiexperimental design. CBCL/6-18 data from 125 children from public school in Ciudad Juárez, Chihuahua, México were categorized into obese, malnourished and normal nutrition states. The 113 questions related to the behavior of children of the CBCL 6-18 through variance analysis were used to explore the possible differences between groups. Our Mexican children sample belongs to the normative group three. We found that the major differences were in internalized problems, specifically in anxiety/depression, and on Total Problems with the obese group.
Assuntos
Humanos , Masculino , Feminino , Criança , Psicopatologia , Desnutrição , Criança , ObesidadeRESUMO
El virus de la inmunodeficiencia humana (VIH) puede llegar a producir alteraciones cognitivas que interfieren de forma significativa en la vida diaria de las personas que lo padecen. Estos déficits pueden incrementarse cuando existe historia previa de consumo de sustancias psicoactivas. El objetivo de este trabajo es estudiar el perfil neuropsicológico de un grupo de pacientes con VIH e historia previa de consumo de drogas y compararlo con un grupo de pacientes ex drogodependientes seronegativos. Se administró una batería neuropsicológica a una muestra de 28 sujetos españoles, 14 con VIH y 14 seronegativos, donde se evaluaron los 8 dominios cognitivos que suelen estar más afectados en el VIH: atención/memoria de trabajo, velocidad de procesamiento de la información, memoria/aprendizaje, abstracción/función ejecutiva, lenguaje/verbal y habilidades motoras. Los resultados mostraron peor ejecución del grupo con VIH en todos los dominios cognitivos. El menor rendimiento neuropsicológico del grupo con VIH podría deberse presumiblemente a la acción del virus. Independientemente de cuál sea la etiología del deterioro cognitivo, lo importante es detectar los déficits neuropsicológicos de la forma más precoz posible para mejorar la calidad de vida de los pacientes mediante la intervención neuropsicológica.
Human immunodeficiency virus (HIV) can result in cognitive disorders that significantly interfere with the daily activities of HIV patients. These disorders may be worse when there is a history of psychoactive substance use. Our objective is to assess the neuropsychological profile in a group of HIV patients with previous drug use compared to a group of HIV-negative patients with a history of drug use. The study included a total of 28 Spanish adult subjects, of which 14 were HIV-infected and 14 were HIV-negative. The subjects were assessed using a neuropsychological test battery to evaluate the following 8 most commonly affected cognitive domains in people with HIV: attention and working memory, speed of information processing, memory and learning capacity, abstract thinking and executive functions, speech and language skills, and psychomotor skills. The results showed a worse performance in all the cognitive areas among HIV patients as compared to HIV-negative patients. The worse performance of this group could be a result of the viral infection. Regardless of the cognitive impairment a etiology, the key task here is to diagnose neuropsychological deficits as soon as possible in order to improve the quality of life of HIV patients through neuropsychological intervention.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Disfunção Cognitiva , Testes Neuropsicológicos , HIV , Transtornos Relacionados ao Uso de SubstânciasRESUMO
La "Centrality of Event Scale" (CES) es un instrumento utilizado para evaluar la centralidad que tiene una determinada experiencia en la persona. Estudios previos muestran que la centralidad es un constructo altamente relacionado con el estrés post-traumático, la depresión o el duelo complicado. El objetivo de este estudio fue realizar su adaptación al castellano y caracterizar su fiabilidad y validez. Participaron dos muestras compuestas por 208 y 320 estudiantes universitarios que completaron la CES y medidas de depresión (BDI), ansiedad (STAI) y sintomatologia de estrés post-traumático (PSS). Los resultados coinciden con los obtenidos con la versión original de la CES, tanto en consistencia interna (alfa de Cronbach de 0.92 y 0.94, para cada muestra), como en test-retest a los dos meses (r=0.803, p<0.01). El análisis de componentes principales muestra un único factor explicativo que daba cuenta del 45% de la varianza. Finalmente las puntuaciones de la CES muestran relaciones con diversos indices de psicopatologia, siendo además un predictor, junto con las medidas de ansiedad y depresión, del 32% de la sintomatologia de estrés post-traumático. La adaptación al castellano de la escala CES parece ser una medida válida y fiable sobre centralidad del evento.
The "Centrality of Event Scale" (CES) is an instrument used to assess the centrality that a particular event has in the person. Previous studies show that centrality is a construct highly relevant for post-traumatic stress symptomatho-logy, depression and complicated grief. The aim of this study was to adapt into Spanish the CES and obtain evidences of reliability and validity. Two samples consisting of208 and 320 college students participated in the study. They completed the CES and measures of depression (BDI), anxiety (STAI) and symptoms of post-traumatic stress (PSS). The results agree with those obtained by the original version of the CES, showing high internal consistency (Cronbach's alpha of 0.92 and 0.94, for each sample) and acceptable test-retest reliability at two months (r = 0.803, p < 0.01). The principal component analysis shows a single explanatory factor that accounted for 45% of the variance. Finally, CES scores show significative relationships with various indicators of psychopatholo-gy, and is also a predictor, along with measures of anxiety and depression, of the 32% of the symptoms of post-traumatic stress disorder. The Spanish version of the CES seems to be a valid and reliable measure of the centrality of the event.
Assuntos
Transtornos de Estresse Pós-Traumáticos , DepressãoRESUMO
La investigación actual en el campo de la violencia de pareja es escasa en lo que se refiere al papel del procesamiento emocional de los maltratadores. Sin embargo, ningún estudio ha investigado en la misma muestra la capacidad de reconocer las emociones y la influencia de las emociones en los aspectos atencionales. El objetivo de este estudio es investigar en una muestra de maltratadores la capacidad de reconocer las emociones de fotografías estandarizadas y analizar la interferencia de las palabras con contenido emocional en una tarea atencional. La muestra consistió en 90 hombres condenados por violencia de pareja y 77 hombres condenados por otros delitos. Se evaluaron las características sociodemográficas asociadas a nuestra muestra y el procesamiento emocional de las expresiones faciales con la prueba de Ekman y la Tarea Stroop Emocional, diseñada específicamente para evaluar el procesamiento emocional en situaciones de violencia contra la pareja. Los resultados mostraron un mejor reconocimiento emocional de los maltratadores en las emociones faciales de enfado y sorpresa. Para el procesamiento de palabras con contenido emocional, las diferencias no fueron estadísticamente significativas.
Current research in the field of intimate partner violence has been scarce as regards the role of emotional processing in abusers. Nevertheless, no study has investigated the ability to recognize emotions and the influence of emotions on attention-related aspects among the same sample. The aim of this study is to investigate the ability to recognize emotions in standardized photographs, and to analyze the interference that words with emotional content exert on an attention task in a sample of abusers. The sample consisted of 90 men convicted of intimate partner violence and 77 men convicted of other crimes. Demographic characteristics associated to the sample were evaluated, as were emotional processing of facial expressions with the Ekman Test and the Emotional Stroop task, specifically designed to assess emotional processing in situations of intimate partner violence. The results showed better emotional recognition among abusers in the recognition of facial emotions of anger and surprise. As for the processing of words with emotional content, differences were not statistically significant.
Assuntos
Emoções Manifestas , Violência por Parceiro Íntimo , Atenção , Maus-Tratos Conjugais , Teste de Stroop , Reconhecimento FacialRESUMO
It has been shown that supplementation with omega-3 improves cognitive performance, especially in infants and toddlers, but it is unknown whether these results are effective in older malnourished children. The aims of this study, therefore, were to investigate the omega-3 supplementation effects in 8- to 12-year-old children and to know which neuropsychological functions improve after three months of intervention in a sample of Mexican children with mild to moderate malnutrition. This study was a randomized, double-blind, treatment and placebo study of 59 children aged 8-12 years who were individually allocated to 2 groups. The duration of the intervention lasted 3 months. Neuropsychological performance was measured at baseline and at 3 months. Results show that more than 50% of children in the treatment group had greater improvement in 11 of the 18 neuropsychological variables studied. Processing speed, visual-motor coordination, perceptual integration, attention and executive function showed improvement in more than 70% of the omega-3 supplemented children. This trial was registered at clinicaltrials.gov as NCT01199120.
Assuntos
Transtornos da Nutrição Infantil/tratamento farmacológico , Suplementos Nutricionais , Ácidos Docosa-Hexaenoicos/uso terapêutico , Ácido Eicosapentaenoico/uso terapêutico , Função Executiva , Memória , Criança , Transtornos da Nutrição Infantil/psicologia , Método Duplo-Cego , Feminino , Humanos , Masculino , Testes Neuropsicológicos , Resultado do TratamentoRESUMO
Even though theories and research have pointed out the importance of variables such as age, gender, or education on neuropsychological assessment, much less emphasis has been placed on language and culture. With the increasing population of Spanish speakers in North America and the limited amount of clinical and scholarly information currently available, neuropsychological assessment of this group has similarly become of increasing importance. Though several studies have been published over the last two decades, an assumption exists that all Spanish speakers, holding education and age constant, would perform similarly regardless of their origin. To address this assumption, a sample of 126 participants was tested from four different countries (Chile, Dominican Republic, Puerto Rico, and Spain). Participants were compared on the following commonly used neuropsychological tests: Verbal Serial Learning Curve, Rey- Osterrieth Complex Figure Test, Verbal Phonemic Fluency Test, the Stroop Color and Word Test, and the Trail Making Test. Analyses revealed significant differences across the groups in two of the five tests administered. Significant differences were observed in the delayed recall of the Serial Learning Test and in the Verbal Fluency Test. The findings highlight the importance of within-group differences between Spanish speakers.
Assuntos
Comparação Transcultural , Testes de Linguagem/estatística & dados numéricos , Testes Neuropsicológicos/estatística & dados numéricos , Desempenho Psicomotor/fisiologia , Adulto , Chile/etnologia , República Dominicana/etnologia , Feminino , Humanos , Masculino , Porto Rico/etnologia , Espanha/etnologia , Teste de Stroop/estatística & dados numéricos , Teste de Sequência Alfanumérica/estatística & dados numéricos , Adulto JovemRESUMO
The main objective of this study was to analyze emotional response to a set of everyday emotional visual stimuli unrelated to drug use. Two groups of prescribed opiate drug abusers (heroin+methadone vs. methadone-only groups) currently participating in the Andalusian Experimental Prescribed Drug Program (Programa Experimental de Prescripcion de Estupefacientes de Andalucia, PEPSA) were studied, and comparisons made between them, within them for different phases, and between them and a normative group of nonusers. For this purpose we used the I.C.E.R.E., an instrument based on the I.A.P.S. (International Affective Picture System) and on Peter Lang's S.A.M. (Self-Assessment Manikin). The results showed patterns of emotional response in the opiate users, compared to the non-users, characterized by a lower rating of the everyday natural stimuli of a pleasant nature and a greater sensitivity to the stimuli of a neutral and negative nature. These patterns were quite stable even in different clinical situations and stages of development of the P.E.P.S.A.
Assuntos
Afeto , Prescrições de Medicamentos/estatística & dados numéricos , Emoções Manifestas , Dependência de Heroína/epidemiologia , Dependência de Heroína/psicologia , Adulto , Feminino , Heroína/administração & dosagem , Dependência de Heroína/diagnóstico , Humanos , Injeções Intravenosas , Masculino , Entorpecentes/administração & dosagem , Índice de Gravidade de Doença , Abuso de Substâncias por Via Intravenosa/diagnóstico , Abuso de Substâncias por Via Intravenosa/epidemiologia , Abuso de Substâncias por Via Intravenosa/psicologiaRESUMO
Summary Introduction: Systemic lupus erythematosus (SLE), a prototype of the autoimmune diseases, is a multi-systemic disease characterized by an alteration in the immunological response, where the production of antibodies is directed against nuclear antigens, thus affecting many organs and systems. The course of this disease includes a wide range of clinical manifestations, different anatomo-pathological findings, and a series of immunological abnormalities. It is characterized by outbreaks and remissions. SLE can be manifested by general malaise, fever, fatigue, weight loss, skin rashes or joint inflammation, anemia, inflammation of the lymphatic glands, lowering of the defenses against infection, and cardiac, kidney, pulmonary and neurological alterations. In chronic dermatological lupus, only the skin is affected; this condition can present rash erythemas, etc. The recent introduction of new immunological diagnostic methods (antinuclear antibodies, anti-DNA antibodies, complementary fraction, etc.) has made it possible to recognize less severe forms of the disease, as well as its outbreaks and therapeutic guidelines. Different psychological variables have been associated with the exacerbation of the disease; one of the most notable is stress, and many patients with lupus also suffer diverse psychiatric and personality disorders associated with the disease, with a prevalence oscillating between 20% and 60%. Furthermore, these alterations have been associated with a lower quality of life, poorer evolution and psychiatric antecedents. In the specific case of personality alterations, previous research has found the existence of a "triad of personality" characteristics in patients with lupus. Depression, hysteria and hypochondria are the factors making up this triad. However, it has not been shown whether these personality disorders are just another symptom of the disease or a consequence of the emotional disorders produced by it. The purpose of this study was to test the possible existence of personality disorders and their relationship with other affective disorders in SLE. Methods: In order to do this, we studied 30 patients with lupus and evaluated their possible personality disorders with the MMPI and their levels of depression and anxiety with the BDI and STAI, respectively. Then, after analyzing the results obtained on the tests administered, three groups were established: patients with lupus who had no emotional disorders, patients with lupus who presented clinical anxiety, and patients with lupus who presented clinical depression. These categories were represented graphically. In order to test the effects of anxiety and depression in the psychopathological personality profile, 10 between-group univariate variance analyses (ANOVA) were carried out, one for each subscale of the MMPI. The variable "presence or non-presence of emotional disorders" was the two-level factor. Results: In the graphic representation of the personality patterns of the three groups, it can be seen that patients with lupus who did not present emotional disorders (neither depression or anxiety) did not show any alterations in their personality patterns. However, this pattern was altered in those who presented depression or anxiety. Later, the results found show statistically significant differences on the subscales of Hypochondria [F=9.795, df=1, 29, ±0.004)], Psychasthenia [F=15.266, df=1, 29, p±0.001], and Schizophrenia [F=4.97, df=1, 29, p±0.001)] among those patients who presented emotional disorders and those who did not present any emotional disorder, with the latter receiving higher scores. Conclusion: We can state that the development of personality disorders in patients with lupus is associated with emotional alterations, which probably relate more to processes of adaptation to the disease than to the disease itself.
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