"It's a Lot of Closets to Come Out of in This Life": Experiences of Brazilian Gay Men Living with Human Immunodeficiency Virus at the Time of Diagnosis and Its Biopsychosocial Impacts.

We investigated the experiences of Brazilian gay men with HIV, focusing on the moment of diagnosis and its potential biopsychosocial impacts. This clinical-qualitative study involved 15 participants interviewed online and synchronously by a clinical psychologist in 2021. Thematic analysis was employed to analyze the data. Interpretations were grounded in Minority Stress Theory. Four thematic axes emerged, including "Diagnostic Revelation", "Social and Internalized Stigma", "Biopsychosocial Effects of Living with HIV", and "Gratitude for Treatment Advances and the Brazilian Health System". The diagnosis was often experienced as traumatic, exacerbated by the absence of empathy and emotional support from healthcare providers. Participants commonly reported guilt, fear upon learning of their HIV status, social isolation, loneliness, lack of social support, and damage to affective-sexual relationships. Many also noted a decline in mental health, even those without HIV-related medical complications. Despite over 40 years since the HIV epidemic began, the prevalence of homophobia and serophobia among gay men remains widespread, including within the multidisciplinary teams of specialized services. This indicates that the stigma associated with homosexuality and HIV persists, despite significant biomedical progress in the diagnosis and treatment of the infection, particularly in Brazil.

Association between Sleep Problems and Psychopathologies among Preschoolers: A Brazilian Cross-Sectional Study.

Objective To evaluate the relationship between sleep problems and psychopathologies in Brazilian preschool children. Materials and Methods The present is a cross-sectional study with162 children: 81 with sleep problems referred for treatment (mean age: 3.67 years), matched by gender/age with 81 participants without sleep problems. Sleep problems were identified through a clinical interview with a specialist. Psychopathologies were evaluated using the Child Behavior Checklist for Ages 1.5-5 (CBCL/1.5-5). Results Having sleep problems was a predictor of all forms of psychopathologies on the CBCL scales, except for the withdrawn scale. Aggressive behavior, depression/anxiety, affective problems, and oppositional defiant disorder were associated with presence of sleep problems. Conclusion Given the probable bidirectionality of the association between sleep problems and psychopathologies in children, it is suggested that regular assessments of both phenomena should be performed in children referred for treatment of sleep problems and mental health problems in general.

Association between religiosity/spirituality and substance use among homeless individuals.

BACKGROUND: Alcohol and illicit drug use are prevalent among homeless people. Religiosity and spirituality (RS) have been widely associated with lower consumption of substances. However, evidence of this relationship among homeless people is still scarce. AIMS: To evaluate the associations between RS and alcohol and illicit drug consumption among homeless people in a large Brazilian urban center. METHOD: This cross-sectional study was carried out in São Paulo city, Brazil. Aspects such as spirituality (FACIT-Sp12), religiosity (DUREL), spiritual-religious coping (Brief-RCOPE), and self-report questions concerning the current substance use (alcohol and illicit substances) were evaluated. Adjusted logistic regression models were used to assess the impact of RS beliefs on alcohol and illicit drug consumption. RESULTS: A total of 456 homeless people were included, of an average age of 44.5 (SD = 12.6) years. More than half of the participants consumed alcohol (55.7%) weekly and 34.2% used illicit drugs weekly. Adjusted logistic regression models identified that aspects of RS were associated with lower likelihood factors for alcohol and illicit drug use; conversely, negative spiritual religious coping (SRC) strategies were associated with a higher likelihood to use both. CONCLUSION: The prevalence of alcohol and illicit drug use among participants was high. RS and positive SRC were important protective factors for lower consumption of these substances. Conversely, negative SRC strategies were associated with risk factors.

Fears in preschoolers: translation, reliability, and validity of the Fear Survey Schedule for Infant-Preschoolers (FSSIP) - Brazilian version.

OBJECTIVE: To translate the Fear Survey Schedule for Infants-Preschoolers (FSSIP) into Brazilian Portuguese and to examine its reliability and validity for assessing fears among Brazilian preschoolers. METHODS: Two independent bilingual professionals conducted translation and back-translation of the original survey. The translated version was used to assess 152 preschool children divided in two groups: Clinical - 71 children referred for treatment for nighttime fear, and Control - 81 children enrolled at kindergarten who had not been referred for any mental health service in the previous 6 months. All parents filled out the FSSIP, the Child Behavior Checklist (CBCL/1.5-5), and a sociodemographic questionnaire. RESULTS: Cronbach's alpha coefficients were 0.949 (95% CI: 0.94-0.96) for the entire sample; 0.948 (95% CI: 0.93-0.96) for the Clinical Group, and 0.95 (95% CI: 0.93-0.96) for the Control Group. The mean score for fears was higher in the clinical group (60.19 vs. 51.53, t = -2.056; p = 0.042), indicating acceptable discriminate validity. We also found positive, moderate, and statistically significant correlations between FSSIP and most CBCL scores, indicating good convergent validity. CONCLUSION: The Brazilian Portuguese version of the FSSIP showed good psychometric properties, and hence may be used in research and clinical settings to evaluate fears in preschoolers.

Adolescentes alvos de bullying e adversidade familiar: estudo caso-controle / Teenagers targets of bullying and family adversity: case-control study

Ser vítima de bullying na infância e adolescência é fator de risco para surgimento de transtornos mentais. As variáveis adversas do ambiente familiar contribuem para envolvimento em situações de bullying. Objetivou-se comparar o nível de adversidade familiar de adolescentes alvo de bullying (n = 21) e não-vítimas (n = 21), pareados por idade, sexo e sala de aula. Adolescentes alvo de bullying foram identificados pela Lista de Características dos Amigos de Sala de Aula e pela Escala de Violência Escolar. O nível de adversidade familiar foi avaliado pelo Índice de Adversidade Familiar de Rutter. Verificou-se maior adversidade familiar no grupo composto por alvos de bullying (p > 0,05). A frequência de discórdia conjugal foi mais elevada em famílias de alunos alvos de bullying (Z = -2,01, p = 0,04). Reitera-se a necessidade de desenvolvimento/implementação de programas voltados para diminuir fatores de risco e promover fatores de proteção junto às famílias.

Being a victim of bullying in childhood and adolescence is a risk factor for the emergence of mental disorders. Adverse family environment variables contribute to involvement in bullying situations. This study aimed to compare the level of family adversity of adolescents who were bullied (n = 21) and non-victims (n = 21), matched for age, sex and classroom. Adolescents bullied were identified by Lista de Características dos Amigos de Sala de Aula and Escala de Violência Escolar. The level of family adversity was assessed using the Rutter Family Adversity Index. There was greater family adversity in the group composed of bullied teenagers (p > 0.05). The frequency of marital discord was higher in families of students who were bullied (Z = -2.01, p = 0.04). The data reiterate the need to develop and implement programs aimed at reducing risk factors and promoting protective factors with families.

Fears in preschoolers: translation, reliability, and validity of the Fear Survey Schedule for Infant-Preschoolers (FSSIP) - Brazilian version

Abstract Objective To translate the Fear Survey Schedule for Infants-Preschoolers (FSSIP) into Brazilian Portuguese and to examine its reliability and validity for assessing fears among Brazilian preschoolers. Methods Two independent bilingual professionals conducted translation and back-translation of the original survey. The translated version was used to assess 152 preschool children divided in two groups: Clinical - 71 children referred for treatment for nighttime fear, and Control - 81 children enrolled at kindergarten who had not been referred for any mental health service in the previous 6 months. All parents filled out the FSSIP, the Child Behavior Checklist (CBCL/1.5-5), and a sociodemographic questionnaire. Results Cronbach's alpha coefficients were 0.949 (95% CI: 0.94-0.96) for the entire sample; 0.948 (95% CI: 0.93-0.96) for the Clinical Group, and 0.95 (95% CI: 0.93-0.96) for the Control Group. The mean score for fears was higher in the clinical group (60.19 vs. 51.53, t = -2.056; p = 0.042), indicating acceptable discriminate validity. We also found positive, moderate, and statistically significant correlations between FSSIP and most CBCL scores, indicating good convergent validity. Conclusion The Brazilian Portuguese version of the FSSIP showed good psychometric properties, and hence may be used in research and clinical settings to evaluate fears in preschoolers.

Adolescentes alvos de bullying e adversidade familiar: estudo caso-controle / Teenagens targets of bullying and family adversity: case-control study

Ser vítima de bullying na infância e adolescência é fator de risco para surgimento de transtornos mentais. As variáveis adversas do ambiente familiar contribuem para envolvimento em situações de bullying. Objetivou-se comparar o nível de adversidade familiar de adolescentes alvo de bullying (n = 21) e não-vítimas (n = 21), pareados por idade, sexo e sala de aula. Adolescentes alvo de bullying foram identificados pela Lista de Características dos Amigos de Sala de Aula e pela Escala de Violência Escolar. O nível de adversidade familiar foi avaliado pelo Índice de Adversidade Familiar de Rutter. Verificou-se maior adversidade familiar no grupo composto por alvos de bullying (p > 0,05). A frequência de discórdia conjugal foi mais elevada em famílias de alunos alvos de bullying (Z = -2,01, p = 0,04). Reitera-se a necessidade de desenvolvimento/implementação de programas voltados para diminuir fatores de risco e promover fatores de proteção junto às famílias.

Being a victim of bullying in childhood and adolescence is a risk factor for the emergence of mental disorders. Adverse family environment variables contribute to involvement in bullying situations. This study aimed to compare the level of family adversity of adolescents who were bullied (n = 21) and non-victims (n = 21), matched for age, sex and classroom. Adolescents bullied were identified by Lista de Características dos Amigos de Sala de Aula and Escala de Violência Escolar. The level of family adversity was assessed using the Rutter Family Adversity Index. There was greater family adversity in the group composed of bullied teenagers (p > 0.05). The frequency of marital discord was higher in families of students who were bullied (Z = -2.01, p = 0.04). The data reiterate the need to develop and implement programs aimed at reducing risk factors and promoting protective factors with families.

Impacto da pandemia por COVID-19 em pacientes com transtornos alimentares: considerações para profissionais de saúde mental / Impact of COVID-19 pandemic on patients with eating disorders: considerations for mental health professionals

Apresenta-se um manuscrito no formato de carta ao editor, em que são abordados os impactos da pandemia por COVID-19 na saúde mental de pessoas com transtornos alimentares. São discutidos os impactos mais prováveis, em termos de agravamento dos sintomas nos quadros de Anorexia Nervosa, Bulimia Nervosa e no Transtorno de Compulsão Alimentar. Por fim, são apresentadas considerações para o manejo clínico dos pacientes com a finalidade de mitigar os impactos da pandemia no comportamento alimentar.(AU)

A manuscript in the form of a letter to the editor is presented, in which the impacts of COVID-19 pandemic on the mental health of people with eating disorders are addressed. The most likely impacts are discussed, in terms of worsening of symptoms in Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorder. Finally, considerations are presented for the clinical approach of patients in order to mitigate the impacts of pandemics on eating behavior.(AU)

Se presenta un manuscrito en forma de una carta al editor, en el que se abordan los impactos de la pandemia de COVID-19 sobre la salud mental de las personas con transtornos alimentarios. Se discuten los impactos más probables, en términos de empeoramiento de los síntomas en la Anorexia Nervosa, la Bulimia Nerviosa y en el Transtorno de la Compulsión Alimentaria. Finalmente, se presentan consideraciones para el manejo clínico de los pacientes a fin de mitigar los impactos de la pandemia en el comportamiento alimentario.(AU)

Biblioterapia para medos noturnos em crianças: um estudo de caso / Bibliotherapy for nighttime fears in children: a case study / Biblioterapia para miedos nocturnos en niños: un estudio de caso

Medos noturnos na infância estão associados a ansiedade, problemas de sono e problemas de comportamento diurnos. O objetivo deste artigo é apresentar um estudo de caso de uma intervenção comportamental breve para o medo noturno severo e comportamento de dormir com os pais em uma menina de oito anos de idade. O tratamento consistiu em uma sessão em que os pais foram orientados a ler o livro Dormindo com Rafi: Boa Noite Filhote para sua criança por um período de quatro semanas e a encorajá-la a conduzir uma série de rotinas pré-sono e dormir sozinha. Medo noturno, padrões de sono e problemas de comportamento foram avaliados com medidas de relato parental. A menina também foi questionada para reportar seus medos noturnos por meio de uma escala visual analógica. Verificou-se aumento no número de noites em que a criança dormiu em sua própria cama e redução dos medos noturnos. Os efeitos positivos no pós-tratamento foram mantidos no seguimento de três meses. O presente estudo fornece suporte inicial para o uso desta breve intervenção, que empregou princípios comportamentais básicos, como modelação, modelagem e dessensibilização sistemática no tratamento de medos noturnos em crianças.(AU)

Nighttime fears in childhood are associated with anxiety, sleeping problems, and daytime behavioral problems. This article presents a case study of a brief intervention for severe nighttime fears and co-sleeping problems in an eight-year-old girl. The treatment consisted of instructing the parents to read the book Dormindo com Rafi: Boa Noite Filhote (Sleeping with Rafi: Good Night, Darling) to their daughter for a four-week period, besides encouraging her to adopt a bedtime routine and to sleep on her own. Nighttime fear, sleep patterns, and behavioral problems were assessed with parent-report measures, and the girl was asked to track her nighttime fears using a visual analogue scale. The results showed an increase in the number of nights the child slept in her own bed and a reduction of nighttime fears, which were maintained at the 3-month follow-up. This study provides initial support for the use of this brief intervention that enlisted basic behavioral principles such as shaping, modeling, systematic desensitization, and reinforcement in the treatment of nighttime fears in children.(AU)

Los miedos nocturnos en la infancia están asociados a la ansiedad, a los problemas de sueño y a los problemas de comportamiento diurno. El objetivo de este artículo es presentar un estudio de caso de una intervención conductual breve para el miedo nocturno severo y comportamiento de dormir con los padres de una niña de 8 años de edad. El tratamiento consistió en una sesión en la que se orientó a los padres a leer el libro Dormindo com Rafi, Boa Noite, Filhote! ("Durmiendo con Rafi: buenas noches, mi hijo") para su hija, por un período de cuatro semanas, y la alentasen a conducir una serie de rutinas de presueño y a dormir sola. El miedo nocturno, los patrones de sueño y los problemas de comportamiento fueron evaluados con medidas de relato parental. Los miedos nocturnos de la niña también se evaluaron por una escala visual analógica. Se verificó un incremento de la cantidad de veces en que la niña durmió por las noches en su propia cama y una reducción de sus miedos nocturnos. Los efectos positivos en el postratamiento se mantuvieron tras tres meses. Este estudio proporciona soporte inicial para el uso de esta breve intervención que empleó principios comportamentales básicos, como modelado, desensibilización sistemática y refuerzo en el tratamiento de miedos nocturnos en niños.(AU)

Psychologists training on autism: a cross-sectional study with undergraduate students / Formação do psicólogo sobre autismo: estudo transversal com estudantes de graduação / Formación del psicólogo en autismo: estudio transversal con estudiantes de licenciatura

OBJECTIVES: describing the level of knowledge about Autism Spectrum Disorder (ASD) among Psychology students, comparing the same knowledge among freshmen students and seniors; verifying if students that have gone through undergraduate research (UR) activities had greater knowledge about this. 295 students from two São Paulo's private universities that answered a self-administered structured survey form containing 16 questions about epidemiology, symptomatology, interventions and services for ASD. This study showed an insufficient level about this kind of knowledge - TEA (< 50%), but revealed progress during its course, in a general inquiry among the investigated areas. Students who did UR on mental health performed better than others. CONCLUSIONS: the students revealed signs of improvement in their knowledge during the course, but insufficiently, pointing a need for review/reformulation in the Psychology curricula. It is still necessary that further work to assess the quality of formation of these future professionals.

OBJETIVOS: descrever o nível de conhecimento sobre Transtorno do Espectro Autista-TEA entre estudantes de Psicologia; comparar o nível de conhecimento entre alunos do primeiro e último ano; verificar se alunos que haviam realizado atividades de iniciação científica (IC) possuíam maior conhecimento sobre TEA. Participaram do estudo 295 alunos de duas universidades particulares da cidade de São Paulo que responderam de forma autoaplicável a um questionário estruturado com 16 perguntas sobre epidemiologia, sintomatologia, intervenções e serviços para TEA. O estudo indicou nível insatisfatório no conhecimento sobre TEA (<50%), mas revelou progresso no decorrer do curso, tanto no cômputo geral quanto nas áreas investigadas. Estudantes que realizaram IC em saúde mental apresentaram melhor desempenho. CONCLUSÕES: estudantes apresentaram evolução em seus conhecimentos no decorrer do curso, mas de forma insuficiente, indicando necessidade de revisão/reformulação dos currículos de Psicologia. Ainda é necessário que futuros trabalhos avaliem a qualidade de formação desses futuros profissionais.

OBJETIVOS: describir el nivel de conocimientos sobre Trastorno del Espectro del Autismo (TEA) entre estudiantes de Psicologia; comparar el nivel de conocimientos entre alumnos del primer y último ano; verificar si los alumnos que realizaron actividades de (IC) tenian mayor conocimiento sobre TEA. 295 alumnos de graduación de dos universidades privadas de la ciudad São Paulo respondieron a un cuestionario estructurado con 16 preguntas sobre epidemiologia, sintomatologia, intervenciones y servicios para TEA. El estudio indicó nivel insatisfactorio de conocimiento sobre TEA (< 50%), pero reveló progreso en el transcurso del curso, tanto para los cálculos generales como en las cuatro áreas investigadas. Estudiantes que realizaron IC en salud mental mostraron mejor desempeno. CONCLUSIONES: estudiantes presentaron evolución en sus conocimientos a lo largo del curso, pero de forma insuficiente, indicando necesidad de revisión/reformulación de los currículos de Psicologia. Continua siendo necesario que futuros trabajos evaluen la calidad de formación de esos futuros profesionales.

Evidence-based psychotherapy for treatment of anorexia nervosa in children and adolescents: systematic review

Abstract Background: Efficacy studies on the treatment of anorexia nervosa (AN) in childhood and adolescence are scarce and systematic reviews are almost non-existent. Objective: Systematic review of the literature regarding the modalities of psychological intervention based on evidence used in the treatment of AN in childhood and adolescence. Methods: The research was carried out in the databases: PubMed, PsycINFO and Cochrane, using the combined keywords: anorexia nervosa and evidence-based therapy. Articles published between 1990 and 2015 were assessed. Results: Of the 139 eligible articles, 14 were selected, of which 10 (71.4%) were conducted in the United States and England. The sample ranged from 9 to 167 participants. Randomized Clinical Trial represented the most frequent design (n = 9; 63.4%), with more than half of the interventions structured in 20 or more sessions (n = 9, 64.3%). Nine types of treatments were tested, with the most tested being Family-Based Treatment (FBT) (n = 7; 50%). Interventions involving the family seem to be more effective, however, the rates for complete remission are modest. Discussion: Although evidence of efficacy was verified in the treatments analyzed, the limited number of studies, the various methodological limitations and the methodological heterogeneity between studies make the findings inconclusive.

Indicadores de atraso no desenvolvimento em crianças de creche advindas de famílias de baixa renda / Developmental delays among children from day care center of socially disadvantaged families / Indicadores de retraso del desarrollo en niños de guarderías provenientes de famílias de baja renta

Avaliações periódicas precoces de indicadores de desenvolvimento são importantes para a elaboração de programas preventivos. O objetivo deste estudo foi identificar atrasos em indicadores globais de desenvolvimento em 100 crianças (idades entre 16-24 meses, média de 21,84 meses, DP+1,94), matriculadas em creches de um município do Estado de São Paulo. O instrumento de coleta de dados foi o Teste de Triagem de Desenvolvimento de Denver II (Denver II). Na amostra estudada, o domínio de maior prejuízo foi o da linguagem, seguido pelo domínio de cuidado pessoal-social. Os resultados do estudo apontam para a necessidade de incluir na avaliação do desenvolvimento infantil fatores familiares e educacionais comumente associados a atrasos de desenvolvimento. (AU)

Periodic early assessments of child development are important to elaborate prevention programs. The goal of this study was to identify global developmental delays in 100 children (aged 16-24 months, mean age 21.84 months, SD±1.94) who attended day care centers in a town in the São Paulo State. The used instrument was the Denver Developmental Screening Test II (Denver II). In the current sample, greatest deficits were observed in the speech/language domain, followed by the social-emotional development domain. The study results indicate the need of including familial/educational factors into child development's assessments, which are commonly associated with developmental delays. (AU)

Evaluaciones periódicas tempranas de indicadores de desarrollo son importantes para la creación de programas de prevención. El objetivo de este estudio fue identificar retrasos en indicadores globales de desarrollo en 100 niños (de 16 a 24 meses, promedio 21,84 meses, SD±1,94), asistidos en guarderías en una ciudad de São Paulo. El instrumento de recolección de datos fue el teste de Evaluación del desarrollo Denver II (Denver II). En esta muestra, la mayor pérdida fue el dominio de la lengua, seguida del dominio de la atención personal-social. Los resultados del estudio apuntan para la necesidad de incluir en la evaluación del desarrollo infantil factores ambientales familiares y educacionales comunmente asociados a atrasos del desarrollo. (AU)

Age and gender changes in children and adolescent patients of a Brazilian eating disorder program

ABSTRACT Background International studies have demonstrated an increase in the prevalence of boys and a decrease of patients’ age at the beginning of outpatient treatment for eating disorders (ED). Objective To evaluate if these changes are also present in the Brazilian population participating in the PROTAD, a Brazilian ED program, and to discuss its clinical implication for treatment. Methods Cross-sectional study. We evaluated 150 medical records of patients under 18 years diagnosed with ED (DSM IV-TR). Patients were divided into two groups: G1 (2001-2007) (n = 77) and G2 (2008-2014) (n = 73). The girl/boy proportion and the mean age of patients were compared. Results In G1, six boys (7.8%) were admitted (girl/boy proportion: 11.8:1), while in G2, 16 (22%) boys were admitted (girl/boy proportion: 3.5:1) (p < 0.05). The mean age in G1 was 15.6 years (SD = 1.7; 95%CI: 15.2-15.9), whereas the mean age in G2 was 14.9 years (SD = 1.9; 95%CI: 14.4-15.3) (p > 0.05). Discussion The increase in the number of boys treated for EDs reported in international studies was also found at the PROTAD. Contrary to what has been reported in international studies, the mean age of patients at the PROTAD did not decrease significantly. Gender and sexual orientation issues, clinical presentation, prior overweight history and culture/media impact on boys should be addressed by the healthcare team to increase the therapeutic efficacy.

Efeitos do tratamento com alarme para enurese no autoconceito de crianças / Effects of alarm treatment for enuresis on children's self-concept / Efectos del tratamiento con alarma para enuresis en el autoconcepto de niños

O objetivo do estudo foi avaliar a eficácia do tratamento comportamental para enurese com uso de alarme, realizado à distância, e avaliar efeitos da intervenção no autoconceito dos participantes. Trata-se de um ensaio clínico com delineamento quase-experimental de grupos. Trinta e uma crianças com enurese primária monossintomática participaram (M(idade)=8,3; DP=1,3), 15 meninos (48,3%). Para avaliar a enurese, foi utilizado o Formulário de Avaliação da Enurese; para o autoconceito, a Escala de Autoconceito Infantojuvenil; para instruções sobre o tratamento, o Guia de Pais. A taxa de sucesso no tratamento foi de 71%. Houve diferença estatisticamente detectável na variação do autoconceito pessoal pré e pós-intervenção (M=4,8; DP=1,9; vs M=6,1; DP=1,9; p=0,01), independentemente do desfecho, e diferenças no autoconceito social entre as médias de crianças que tiveram sucesso no tratamento (M=9,8; DP=1,9 vs M=0,5; DP=1,5; p=0,03). A proposta de tratamento da enurese apresentada é viável e eficaz e impactou positivamente o autoconceito das crianças avaliadas. (AU)

The objective of the study was to evaluate the efficacy of enuresis alarm therapy, performed at a distance, and to evaluate the effects of the intervention on the participants' self-concept. This is a clinical trial with a quasi-experimental group design. Thirty-one children with mono-symptomatic primary enuresis participated (M(age)=8.3, SD=1.3), 15 boys (48.3%). Assessments were made using the Enuresis Evaluation Form; Child-Juvenile Self-Concept Scale; and the Parents' Guide, for treatment instructions. Treatment success rate was 71%. There was a statistically significant difference in the variation of the personal self-concept before and after intervention (M=4.8, SD=1.9; vs M=6.1, SD=1.9; p=0.01), regardless of the outcome (M=9.8, SD=1.9 vs M=0.5, SD=1.5; p=0.03), and differences in the social self-concept among the means of children who had successful treatment (M=9.8, SD=1.9 vs M=0.5, DP=1.5; p=0.03). The proposed enuresis treatment is feasible and effective, and positively impacted the self-concept of the children evaluated. (AU)

El objetivo del estudio fue evaluar la eficacia del tratamiento comportamental para Enuresis, con uso de alarma, realizado a distancia, y evaluar también los efectos de la intervención en el autoconcepto de los participantes.Se trata de un ensayo clínico con delineamiento casi experimental de grupos. Participaron 31 niños con enuresis primaria monosintomático (M(edad)=8,3; DP=1,3), 15 varones (48,3%). Para evaluar la enuresis fue utilizado el Formulario de Evaluación de Enuresis, para el autoconcepto; Escala de Autoconcepto Infanto Juvenil, para instrucciones sobre el tratamiento; Guía de Padres. La tasa de éxito del tratamiento fue de 71%. Hubo diferencia estadísticamente detectable en la variación del autoconcepto personal antes y después de la intervención (M=4,8; DP=1,9; vs M=6,1; DP=1,9; p=0,01) independiente de los resultados, y diferencias en el autoconcepto social entre el promedio de los niños que tuvieron un tratamiento exitoso (M=9,8; DP=1,9 vs M=0,5; DP=1,5; p=0,03). La propuesta del tratamiento de enuresis presentada es viable y eficaz e impactó positivamente en el autoconcepto de los niños evaluados. (AU)

Bullying and behavior problems reported by victims and teachers: Brazilian findings / Bullying e problemas de comportamento referidos pelas vítimas e professores: Resultados brasileiros / Bullying y problemas de comportamiento reportados por las víctimas y maestros: Resultados de Brasil

This study aimed to evaluate the occurrence of bullying in a Brazilian public school and to compare the behavior problems reported by the victims to the informed by their teachers. The School Violence Scale was used to identify bullied students. For behavioral problems, Youth Self Report and Teacher Report Form were used. From 154 adolescents assessed, 30 (19.4%) were identified as targets of bullying, (M age=12.4 yr., SD=.7), 24 males (80%). From those, 16 (53.3%) reached clinical levels on internalizing problems, 11(36.6%) on externalizing and 13 (43.3%) on total problems. This subsample reported more internalizing problems (F=13.40, p<.001) and less externalizing problems (F=6.63, p<.01) compared to the rated by teachers. The high frequencies of victims of bullying as well as the high scores of internalizing and externalizing problems in this subsample point to the urgency of preventing bullying and treating the victims.

Este estudo teve como objetivo avaliar a ocorrência de bullying em uma escola pública brasileira e comparar os problemas de comportamento relatados por vítimas ao informado por seus professores. A Escala de Violência Escolar foi utilizada para identificar os alunos vitimas de bullying. Para avaliar problemas comportamentais foram utilizados o Youth Self Report e o Teacher Report Form. Dos 154 adolescentes avaliados, 30 (19,4%) foram identificadas como alvos de bullying, (M idade=12,4 anos, DP=0,7), sendo 24 meninos (80%). Desses, 16 (53,3%) atingiram níveis clínicos de problemas internalizantes, 11(36,6%) de externalizantes e 13 (43,3%) de problemas totais. Esta sub-amostra relatou mais problemas de internalização (F=13,40, p<0,001) e menos problemas de externalização (F=6,63, p<0,01) em comparação ao reportado pelos professores. A alta frequência de vítimas de bullying e os elevados escores de problemas internalizantes e externalizantes nessa sub-amostra apontam para a urgência de prevenir o bullying e tratar as vítimas.

Este estudio tuvo como objetivo evaluar la incidencia de bullying en una escuela pública brasileña y comparar los problemas de comportamiento reportados por las víctimas a lo informado por sus profesores. Para identificar estudiantes víctimas de bullying se utilizó la Escala de Violencia en la Escuela. Para los problemas de comportamiento, se utilizaron Youth Self Report y Teacher Report Form. De 154 adolescentes evaluados, 30(19,4%) fueron identificados como víctimas de bullying (M edad=12,4 años, SD=0,7), 24 chicos (80%). De esos, 16(53,3%) alcanzaron niveles clínicos en problemas de internalización, 11(36,6 %) de externalización y 13(43,3%) de total de problemas. Esta submuestra informó más problemas de internalización (F=13,40, p<0,001) y menos problemas de externalización (F=6,63, p< 0,01) en comparación con los profesores. La alta frecuencia de víctimas de bullying, así como las altas puntuaciones de internalización y externalización en esta submuestra señala la urgencia de la prevención bullying y el del tratamiento de las víctimas.

Análise da evolução dos critérios diagnósticos da anorexia nervosa / Analysis of the evolution of the diagnostic criteria for anorexia nervosa / Análisis de la evolución de los criterios diagnósticos para la anorexia nerviosa

Desde a inclusão da anorexia nervosa (AN) na terceira edição do Manual Diagnóstico e Estatístico de Transtornos Mentais (DSM), os critérios diagnósticos do transtorno têm sido atualizados. O objetivo deste trabalho foi apresentar a evolução destes critérios e discutir sobre suas principais alterações. Trata-se de um estudo teórico. Foram consultadas as versões III, IV, IV-TR e V do DSM e realizada pesquisa nas bases de dados PubMed, Scielo e Scopus, com as seguintes palavras-chave em combinação: "anorexia", "DSM" e "diagnostic criteria". Verificaram-se alterações nos critérios relacionados à necessidade de amenorreia, de índice de massa corporal mínimo e foram acrescentadas informações sobre o nível de gravidade e de remissão do transtorno, além de mais detalhes sobre subtipos de AN. Revisões periódicas do DSM, a partir de contribuições de clínicos e de pesquisadores garantem avaliações mais precisas e o delineamento de intervenções mais efetivas no tratamento e na prevenção de transtornos alimentares.

Since the inclusion of anorexia nervosa (AN) in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), the diagnostic criteria of the disorder have been updated. The aim of this study was to present the evolution of these criteria and discuss the major changes. This is a theoretical study. The III, IV, IV-TR and V versions of DSM were consulted. The authors also consulted PubMed, SciELO and Scopus databases, using the following keywords in combination: anorexia, DSM, and diagnostic criteria. There have been changes in the criteria related to the need for amenorrea and minimum body mass index, and information was added on the level of severity and remission of the disorder, as well as subtype details. Periodic reviews of the DSM, based on clinical researcher's contributions, provide more accurate assessments and the design of more effective interventions in the treatment and prevention of eating disorders.

Desde la inclusión de la anorexia nerviosa (AN) en la tercera edición del Manual Diagnóstico y Estadístico de los Trastornos Mentales (DSM), sus criterios diagnósticos se han actualizado. El objetivo de este estudio fue presentar la evolución de estos criterios y discutir sus principales cambios. Este es un estudio teórico. Las Versiones III, IV, IV-TR y V del DSM fueron consultados y se buscó en la bases de datos PubMed, SciELO y Scopus, con las palabras clave en combinación: "anorexia", "DSM" y "criterios diagnósticos". Se han producido cambios en los criterios de necesidad de amenorrea, índice mínimo de masa corporal y se añade información sobre el nivel de severidad y remisión de la enfermedad, así como más detalles acerca de sus subtipos. Revisiones periódicas del DSM, a partir de contribuciones de clínicos y pesquisadores proporcionan mejor evaluación y intervenciones más eficaces en el tratamiento y prevención de los trastornos alimentarios.

Análise da evolução dos critérios diagnósticos da anorexia nervosa / Analysis of the evolution of the diagnostic criteria for anorexia nervosa / Análisis de la evolución de los criterios diagnósticos para la anorexia nerviosa

Desde a inclusão da anorexia nervosa (AN) na terceira edição do Manual Diagnóstico e Estatístico de Transtornos Mentais (DSM), os critérios diagnósticos do transtorno têm sido atualizados. O objetivo deste trabalho foi apresentar a evolução destes critérios e discutir sobre suas principais alterações. Trata-se de um estudo teórico. Foram consultadas as versões III, IV, IV-TR e V do DSM e realizada pesquisa nas bases de dados PubMed, Scielo e Scopus, com as seguintes palavras-chave em combinação: “anorexia”, “DSM” e “diagnostic criteria”. Verificaram-se alterações nos critérios relacionados à necessidade de amenorreia, de índice de massa corporal mínimo e foram acrescentadas informações sobre o nível de gravidade e de remissão do transtorno, além de mais detalhes sobre subtipos de AN. Revisões periódicas do DSM, a partir de contribuições de clínicos e de pesquisadores garantem avaliações mais precisas e o delineamento de intervenções mais efetivas no tratamento e na prevenção de transtornos alimentares.

Since the inclusion of anorexia nervosa (AN) in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), the diagnostic criteria of the disorder have been updated. The aim of this study was to present the evolution of these criteria and discuss the major changes. This is a theoretical study. The III, IV, IV-TR and V versions of DSM were consulted. The authors also consulted PubMed, SciELO and Scopus databases, using the following keywords in combination: anorexia, DSM, and diagnostic criteria. There have been changes in the criteria related to the need for amenorrea and minimum body mass index, and information was added on the level of severity and remission of the disorder, as well as subtype details. Periodic reviews of the DSM, based on clinical researcher’s contributions, provide more accurate assessments and the design of more effective interventions in the treatment and prevention of eating disorders.

Desde la inclusión de la anorexia nerviosa (AN) en la tercera edición del Manual Diagnóstico y Estadístico de los Trastornos Mentales (DSM), sus criterios diagnósticos se han actualizado. El objetivo de este estudio fue presentar la evolución de estos criterios y discutir sus principales cambios. Este es un estudio teórico. Las Versiones III, IV, IV-TR y V del DSM fueron consultados y se buscó en la bases de datos PubMed, SciELO y Scopus, con las palabras clave en combinación: “anorexia”, “DSM” y “criterios diagnósticos”. Se han producido cambios en los criterios de necesidad de amenorrea, índice mínimo de masa corporal y se añade información sobre el nivel de severidad y remisión de la enfermedad, así como más detalles acerca de sus subtipos. Revisiones periódicas del DSM, a partir de contribuciones de clínicos y pesquisadores proporcionan mejor evaluación y intervenciones más eficaces en el tratamiento y prevención de los trastornos alimentarios.

Psicocardiologia: análise de aspectos relacionados à prevenção e ao tratamento de doenças cardiovasculares / Psychocardiology: analysis of issues related to the prevention and treatment of cardiovascular diseases

Doenças Cardiovasculares (DCV) são atualmente a causa mais frequente de mortalidade no mundo, produzindo um sério impacto funcional e emocional na vida de pacientes e familiares. Configuram-se, assim, como um problema complexo e um desafio para a saúde pública. Diante da importância desta questão, diversas áreas do conhecimento se mobilizam para buscar alternativas de prevenção e desenvolver estratégias de tratamento mais eficazes. O objetivo do artigo é apresentar dados epidemiológicos sobre DCV, indicar fatores de risco e de proteção, descrever a Psicocardiologia, área recente e interdisciplinar entre a Psicologia e a Medicina e, por fim, apontar possibilidades de atuação de terapeutas comportamentais nesse contexto clínicos comportamentais podem contribuir na identificação de classes de comportamentos associados às DCV, manipular as variáveis antecendentes à sua emissão e as consequencias que selecionam e mantêm essa condição. Neste contexto, o paciente deve aprender a discriminar os determinantes de seus comportamentos para alterá-los. (AU)

Cardiovascular diseases (CVD) are currently the most frequent cause of mortality worldwide, producing serious functional and emotional impairment in patients and their families’ lives. Thus, this condicion is considered complex problem and a challenge to the public health system. Given the importance of this issue, several areas of knowledge are mobilized in order to develop prevention strategies and more effective treatment. The aim of the paper is to present epidemiological data on CVD , indicate risk and protective factors, describe Psychocardiology, a recent and interdisciplinary area between psychology and medicine, and finally, point treatment possibilities of behavioral therapists in this context. Behavioral clinicians can contribute to the identification of classes of behaviors associated with CVD, manipulate the antecedents variables for their issuance and the consequences that select and maintain this condition. In this context,the patient may learn to discriminate the determinants of his behavior in order to change them. (AU)