Executive functions and clinical symptoms in children exposed to maltreatment.

There is evidence of an association between childhood maltreatment and lifelong cognitive impairment. Few studies investigate cognitive functioning in maltreated children. The objective of this study was to investigate whether there are differences in executive processing between maltreated and nonmaltreated children. Additionally, clinical symptoms were compared between groups and possible associations between clinical symptoms, and deficits in executive functions were investigated. The sample consisted of 55 children (8-12 years), 30 with a history of maltreatment and 25 with no history of maltreatment. An interview was conducted with the child's legal guardian and instruments were administered: Juvenile Victimization Questionnaire (JVQ), Child Behavior Checklist (CBCL), and Spence Children's Anxiety Scale (SCAS). The following clinical instruments were administered to the children: JVQ, Trauma Symptom Checklist for Children (TSCC), and Children's Depression Inventory (CDI). Children underwent neuropsychological assessment. Data were analyzed by comparing the groups for clinical and cognitive variables. Differences were found between the groups in all executive functions. Most clinical symptomatology scales showed differences between the groups. Few associations were found between clinical and executive impairment profiles. Cognitive stimulation interventions, focused on inhibitory control, should be proposed in combination with psychotherapy.

Validation of the Core Beliefs Inventory (CBI) in Brazilian Portuguese / Validação do Core Beliefs Inventory (CBI) em português do Brasil

Abstract Introduction Experiencing trauma may entail psychopathological consequences, but also changes considered to be positive (i.e., posttraumatic growth). For positive change to occur, an impact on the beliefs of individuals is required, which may be measured through the Core Beliefs Inventory (CBI). The objective of this study was to validate the Brazilian Portuguese version of the CBI. Methods A total of 248 university students (65.7% female) answered the following assessment instruments: sociodemographic data sheet, Posttraumatic Growth Inventory (PTGI), Posttraumatic Symptoms Checklist - Clinician Version (PCL-5) and the CBI. Psychometric properties of the CBI were assessed by conducting an exploratory factor analysis through a principal component analysis with varimax rotation. Internal consistency (Cronbach's α) and convergent validity (Pearson correlation between instruments) were also investigated. Results The total scale showed adequate internal consistency (α = 0.83). A single factor solution explained 42.63% of the variance of the CBI. Significant correlations were found between CBI and PTGI, and between CBI and PCL-5. Conclusion The psychometric properties indicated adequate internal consistency and construct validity of the Brazilian Portuguese version of the CBI.

Resumo Introdução Experimentar um trauma pode levar a consequências psicopatológicas, mas também a alterações consideradas positivas (ou seja, crescimento pós-traumático). Para que mudanças positivas ocorram é necessário um impacto nas crenças dos indivíduos, o que pode ser medido através do Core Beliefs Inventory (CBI). O objetivo deste estudo foi validar a versão em português do Brasil do CBI. Métodos Um total de 248 universitários (65,7% mulheres) responderam aos seguintes instrumentos de avaliação: ficha sociodemográfica, Inventário de Crescimento Pós-Traumático (Posttraumatic Growth Inventory - PTGI), Lista de Verificação de Sintomas Pós-Traumáticos - Versão Clínica (Posttraumatic Symptoms Checklist - Clinician Version - PCL-5) e CBI. As propriedades psicométricas do CBI foram avaliadas a partir de análise fatorial exploratória através de análise de componentes principais com rotação varimax. A consistência interna (α de Cronbach) e a validade convergente (correlação de Pearson entre os instrumentos) também foram investigadas. Resultados A escala total apresentou consistência interna adequada (α = 0,83). Uma solução de fator único explicou 42,63% da variação do CBI. Correlações significativas foram encontradas entre CBI e PTGI e entre CBI e PCL-5. Conclusão As propriedades psicométricas indicaram consistência interna adequada e validade de construto da versão em português do Brasil do CBI.

Translation and cross-cultural adaptation of the International Trauma Questionnaire for use in Brazilian Portuguese.

BACKGROUND: The most recent editions of diagnostic manuals have proposed important modifications in posttraumatic stress disorder (PTSD) criteria. The International Trauma Questionnaire (ITQ) is the gold-standard measurement for assessing PTSD and complex PTSD in accordance with the model of the 11th International Classification of Diseases (ICD-11). OBJECTIVE: The aim of this study was to adapt the ITQ for the Brazilian context. DESIGN AND SETTING: The translation and cross-cultural adaptation of the ITQ for use in Brazilian Portuguese was performed in trauma research facilities in Porto Alegre, Rio de Janeiro and Belo Horizonte, Brazil. METHODS: The adaptation followed five steps: (1) translation; (2) committee synthesis; (3) experts' evaluation through the content validity index (CVI) and assessment of interrater agreement though kappa statistics; (4) comprehension test with clinical and community samples (n = 35); and (5) final back-translation and authors' evaluation. RESULTS: Two independent translations were conducted. While working on a synthesis of these translations, the committee proposed changes in six items to adapt idiomatic expressions or to achieve a more accurate technical fit. Both the expert judges' evaluation (CVI > 0.7; k > 0.55) and the pretest in the target population (mean comprehension > 3) indicated that the adapted items were adequate and comprehensible. The final back-translation was approved by the authors of the original instrument. CONCLUSION: ITQ in its Brazilian Portuguese version achieved satisfactory content validity, thus providing a tool for Brazilian research based on PTSD models of the ICD-11.

Translation and cross-cultural adaptation of the International Trauma Questionnaire for use in Brazilian Portuguese

ABSTRACT BACKGROUND: The most recent editions of diagnostic manuals have proposed important modifications in posttraumatic stress disorder (PTSD) criteria. The International Trauma Questionnaire (ITQ) is the gold-standard measurement for assessing PTSD and complex PTSD in accordance with the model of the 11th International Classification of Diseases (ICD-11). OBJECTIVE: The aim of this study was to adapt the ITQ for the Brazilian context. DESIGN AND SETTING: The translation and cross-cultural adaptation of the ITQ for use in Brazilian Portuguese was performed in trauma research facilities in Porto Alegre, Rio de Janeiro and Belo Horizonte, Brazil. METHODS: The adaptation followed five steps: (1) translation; (2) committee synthesis; (3) experts' evaluation through the content validity index (CVI) and assessment of interrater agreement though kappa statistics; (4) comprehension test with clinical and community samples (n = 35); and (5) final back-translation and authors' evaluation. RESULTS: Two independent translations were conducted. While working on a synthesis of these translations, the committee proposed changes in six items to adapt idiomatic expressions or to achieve a more accurate technical fit. Both the expert judges' evaluation (CVI > 0.7; k > 0.55) and the pretest in the target population (mean comprehension > 3) indicated that the adapted items were adequate and comprehensible. The final back-translation was approved by the authors of the original instrument. CONCLUSION: ITQ in its Brazilian Portuguese version achieved satisfactory content validity, thus providing a tool for Brazilian research based on PTSD models of the ICD-11.

Validation of the Core Beliefs Inventory (CBI) in Brazilian Portuguese.

INTRODUCTION: Experiencing trauma may entail psychopathological consequences, but also changes considered to be positive (i.e., posttraumatic growth). For positive change to occur, an impact on the beliefs of individuals is required, which may be measured through the Core Beliefs Inventory (CBI). The objective of this study was to validate the Brazilian Portuguese version of the CBI. METHODS: A total of 248 university students (65.7% female) answered the following assessment instruments: sociodemographic data sheet, Posttraumatic Growth Inventory (PTGI), Posttraumatic Symptoms Checklist - Clinician Version (PCL-5) and the CBI. Psychometric properties of the CBI were assessed by conducting an exploratory factor analysis through a principal component analysis with varimax rotation. Internal consistency (Cronbach's α) and convergent validity (Pearson correlation between instruments) were also investigated. RESULTS: The total scale showed adequate internal consistency (α = 0.83). A single factor solution explained 42.63% of the variance of the CBI. Significant correlations were found between CBI and PTGI, and between CBI and PCL-5. CONCLUSION: The psychometric properties indicated adequate internal consistency and construct validity of the Brazilian Portuguese version of the CBI.

Psychometric properties of the Posttraumatic Growth Inventory in a sample of Brazilian university students.

OBJECTIVE: To examine psychometric properties of the Brazilian version of the Posttraumatic Growth Inventory (PTGI). METHOD: A total of 300 university students were evaluated though instruments that investigated trauma history, depression and posttraumatic symptoms, and personality traits through the Big Five model. Pearson's correlation was used to assess internal consistency, inter-item reliability and construct validity. Principal component analysis and confirmatory factor analysis were performed to investigate the factor structure of the PTGI. RESULTS: Results confirmed the original five-factor structure. The results showed good internal consistency for the total scale (α = 0.91) and its subscales, ranging from α = 0.85 to α = 0.70. Also, evidence of construct and convergent validity was observed through correlations with posttraumatic and depression symptoms and personality measures. CONCLUSIONS: These preliminary results suggest that the Brazilian PTGI is reliable and showed adequate evidence of validity.

Psychometric properties of the Posttraumatic Growth Inventory in a sample of Brazilian university students / Propriedades psicométricas do Inventário de Crescimento Pós-Traumático em uma amostra de estudantes universitários brasileiros

Abstract Objective: To examine psychometric properties of the Brazilian version of the Posttraumatic Growth Inventory (PTGI). Method: A total of 300 university students were evaluated though instruments that investigated trauma history, depression and posttraumatic symptoms, and personality traits through the Big Five model. Pearson's correlation was used to assess internal consistency, inter-item reliability and construct validity. Principal component analysis and confirmatory factor analysis were performed to investigate the factor structure of the PTGI. Results: Results confirmed the original five-factor structure. The results showed good internal consistency for the total scale (α = 0.91) and its subscales, ranging from α = 0.85 to α = 0.70. Also, evidence of construct and convergent validity was observed through correlations with posttraumatic and depression symptoms and personality measures. Conclusions: These preliminary results suggest that the Brazilian PTGI is reliable and showed adequate evidence of validity.

Resumo Objetivo: O objetivo deste estudo é examinar as propriedades psicométricas da versão brasileira do Inventário de Crescimento Pós-Traumático (Posttraumatic Growth Inventory - PTGI). Método: Foram avaliados 300 estudantes universitários através de instrumentos que investigaram histórico de trauma, sintomas pós-traumáticos e de depressão e traços de personalidade através do modelo Big Five. A correlação de Pearson foi utilizada para investigar consistência interna, confiabilidade entre itens e procedimentos de validade de construto. Análise de componentes principais e análise de fatores confirmatórios foram realizadas para investigar a estrutura fatorial do PTGI. Resultados: Os resultados confirmaram a estrutura original de cinco fatores. Os resultados mostraram boa consistência interna para a escala total (α = 0.91) e suas subescalas, variando de α = 0.85 a α = 0.70. Além disso, evidências de validade de construto e convergente foram observadas através de correlações com sintomas pós-traumáticos e de depressão e medidas de personalidade. Conclusões: Os resultados preliminares sugerem que o PTGI brasileiro é confiável e apresentou evidência de validade adequada.

Posttraumatic growth measures: translation and adaptation of three self-report instruments to Brazilian Portuguese

Abstract Background Posttraumatic growth is one of the most commonly used concepts to evaluate positive changes after trauma. The principal scales used internationally to evaluate this phenomenon have not yet a Brazilian Portuguese version. Objectives This study aimed to translate and adapt to the Brazilian context the Posttraumatic Growth Inventory (PTGI), the Core Beliefs Inventory (CBI), and the Event Related Rumination Inventory (ERRI). Methods The procedures included translation, back translation, expert committee’s evaluation, and pilot testing in the target population. Results All items of all three instruments had a good content validity index after evaluation by four experts and three reformulations. The back translation of the final version also demonstrated that all Brazilian Portuguese versions convey the same meaning as the original English version. The final version was pilot tested with 30 undergraduate students, and all the items were above the cut-off point. Discussion This study was able to produce Brazilian versions of the PTGI, CBI, and ERRI. Further studies are underway to determine the reliability, factorial validity, and convergent validity of the subscales of the instruments.

Event centrality in trauma and PTSD: relations between event relevance and posttraumatic symptoms

Abstract Recent investigations propose that cognitive characteristics of autobiographical memory significantly interact with Posttraumatic Stress Disorder (PTSD). A traumatic event becoming more or less central in a person's identity and life story might influence development of the disorder. Studies show high correlations between event centrality (EC) and PTSD. Participated in this study 68 treatment-seeking individuals referred to a specialized service for suspected trauma-related disorder: 39 matched criteria for PTSD and 29 were exposed to trauma without PTSD. Our aims were to explore how the groups differ regarding EC, depression, anxiety, posttraumatic cognitions, PTSD symptom severity, and peritraumatic dissociative experience; and how distinctively EC interacts with the measures in each group. The PTSD group had higher scores in all variables but dissociation. EC correlated with overall PTSD symptoms only in the PTSD group and with dissociation only in the no-PTSD group. Findings support a model emphasizing the role of memory processes in PTSD. People exposed to trauma who developed PTSD had the memory of the traumatic experience more intensively governing their sense of self and thus eliciting more negative cognitive reactions. As EC facilitates recollection of the traumatic event, it could also mediate a semantization process that reinforces and increases posttraumatic symptoms. (AU)

An update on the efficacy of cognitive-behavioral therapy, cognitive therapy, and exposure therapy for posttraumatic stress disorder.

OBJECTIVE: Even though cognitive-behavioral therapy (CBT) is the current treatment of choice for posttraumatic stress disorder (PTSD), it is still unclear which components of its protocol are more important for clinical improvement. This study aims to replicate a previous review, updating findings on the efficacy of CBT, cognitive therapy (CT), and exposure therapy (ET) for PTSD when compared with other well-established treatments or conditions without active treatment. METHOD: The search was performed in the databases Cochrane, Embase, and Medline. Studies were required to be randomized controlled trials published between 2006 and 2012 comparing CBT, CT, or ET with (1) each other, (2) other active treatments (e.g., EMDR, counseling, supportive therapy), or (3) assessment-only conditions. The main outcome measures were diagnostic and symptomatic remission. RESULTS: The final sample contained 29 articles. CBT, CT, and ET were shown to be efficacious treatments individually when compared to assessment-only conditions, with no difference found between treatments. Comparison with other active treatments favored ET. Both included studies comparing CBT and EMDR favored the latter. CONCLUSIONS: CBT and its components still appear to be equally efficacious in improving PTSD symptoms and diagnosis. Even so, a current tendency of researchers to focus on ET exists. EMDR shows interesting results compared to CBT. Further research should clarify the lasting effects, efficiency, and other comparative benefits of each protocol.