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1.
BMC Psychol ; 12(1): 267, 2024 May 13.
Artigo em Inglês | MEDLINE | ID: mdl-38741197

RESUMO

BACKGROUND: The aim of this research was to analyze whether the personality factors included in the Big Five model differentially predict the self-regulation and affective states of university students and health. METHODS: A total of 637 students completed validated self-report questionnaires. Using an ex post facto design, we conducted linear regression and structural prediction analyses. RESULTS: The findings showed that model factors were differential predictors of both self-regulation and affective states. Self-regulation and affective states, in turn, jointly predict emotional performance while learning and even student health. These results allow us to understand, through a holistic predictive model, the differential predictive relationships of all the factors: conscientiousness and extraversion were predictors regulating positive emotionality and health; the openness to experience factor was non-regulating; nonregulating; and agreeableness and neuroticism were dysregulating, hence precursors of negative emotionality and poorer student health. CONCLUSIONS: These results are important because they allow us to infer implications for guidance and psychological health at university.


Assuntos
Adaptação Psicológica , Emoções , Comportamentos Relacionados com a Saúde , Personalidade , Autocontrole , Estudantes , Humanos , Estudantes/psicologia , Estudantes/estatística & dados numéricos , Feminino , Masculino , Universidades , Adulto Jovem , Autocontrole/psicologia , Adulto , Adolescente , Inquéritos e Questionários , Sucesso Acadêmico
2.
Front Public Health ; 12: 1304310, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38450140

RESUMO

Introduction: Workplace Mental health promotion in healthcare sector, is a global priority due to the stress associated with caregiving environments and the increase of mental health problems among health professionals and students. The role of emotional intelligence (EI) and sense of coherence (SOC) have been identified as critical health protectors. However, the relationship between them as well as the underlying mechanisms of these relationships on health benefits in this population is still unclear. Aim: To synthetize the existing literature on the relationship between emotional intelligence and sense of coherence, as well as their mutual impact on healthcare workers' and student's well-being. Method: A scoping review was conducted following the Joanna Briggs Institute guidelines. A systematic search was conducted in PsyCINFO, CINHAL, SCOPUS and PUBMED databases, using key-terms such as students, health professionals, emotional intelligence, and sense of coherence. Results: A total of 11 articles were included, with a range of years from 2014 to 2022. Evidence was found to support the positive relationship between sense of coherence and emotional intelligence. The use of EI as a training pathway to improve SOC and health promoting behaviors is suggested. The benefits of intervening on these factors contribute to improved health professionals' and students' general well-being and motivation for a better performance, either in their studies or clinical work. Conclusion: The positive relationship between emotional intelligence and a sense of coherence has direct and indirect benefits on students' and healthcare professionals' well-being. Future studies should address longitudinal and experimental analysis to confirm these findings.


Assuntos
Inteligência Emocional , Senso de Coerência , Humanos , Atenção à Saúde , Saúde , Pessoal de Saúde , Promoção da Saúde , Estudantes
4.
Front Psychol ; 14: 1079950, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36968699

RESUMO

Research in psychology related to the conceptualization of empathy has been on the rise in the last decades. However, we argue that there is still space for further research to help capture the important notion of empathy and its theoretical and conceptual depth. Following a critical review of the current state of the research that conceptualizes and measures empathy, we focus on works that highlight the importance of a shared vision and its relevance in psychology and neuroscience. Considering the state of the art of current neuroscientific and psychological approaches to empathy, we argue for the relevance of shared intention and shared vision in empathy-related actions. Upon review of different models that emphasize a shared vision for informing research on empathy, we suggest that a newly developed theory of self, human growth and action-the so-called Inter-Processual Self theory (IPS)-can significantly and novelly inform the theorization on empathy beyond what the literature has stated to date. Then, we show how an understanding of integrity as a relational act that requires empathy is an essential mechanism for current key research on empathy and its related concepts and models. Ultimately, we aim to present IPS as a distinctive proposal to expand upon the conceptualization of empathy.

5.
Front Aging Neurosci ; 14: 936661, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36275008

RESUMO

The ability to appropriately perceive distances in activities of daily living, such as driving, is necessary when performing complex maneuvers. With aging, certain driving behaviors and cognitive functions change; however, it remains unknown if egocentric distance perception (EDP) performance is altered and whether its neural activity also changes as we grow older. To that end, 19 young and 17 older healthy adults drove in a driving simulator and performed an functional magnetic resonance imaging (fMRI) experiment where we presented adults with an EDP task. We discovered that (a) EDP task performance was similar between groups, with higher response times in older adults; (b) older adults showed higher prefrontal and parietal activation; and (c) higher functional connectivity within frontal and parietal-occipital-cerebellar networks; and (d) an association between EDP performance and hard braking behaviors in the driving simulator was found. In conclusion, EDP functioning remains largely intact with aging, possibly due to an extended and effective rearrangement in functional brain resources, and may play a role in braking behaviors while driving.

6.
Front Psychol ; 13: 856558, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35664176

RESUMO

The aim of this research was to delimit the predictive and mediational model of resilience between character strengths to predict flourishing, in a sample of undergraduate students. After signing their informed consent, 642 university students completed three validated scales (i.e., character strengths, resilience, and flourishing). Using an ex post facto design, regression, structural modeling, and mediation analyses were carried out, in order to construct a multi-causal predictive model. Results indicated a consistent predictive direct effect of character strengths on resilience and flourishing and of resilience on flourishing. As hypothesized, resilience also showed a mediating effect on the relationship between character strengths and flourishing. Additionally, results also revealed that the reactive and proactive factors of resilience were explained by different character strengths (e.g., emotional strength/cognitive, interpersonal strengths), reinforcing the idea that the two directions are complementary and necessary. Finally, several implications were established for the practice of positive psychology.

7.
Brain Imaging Behav ; 16(3): 1349-1361, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35020124

RESUMO

Recent imaging studies with the stop-signal task in healthy individuals indicate that the subthalamic nucleus, the pre-supplementary motor area and the inferior frontal gyrus are key components of the right hemisphere "inhibitory network". Limited information is available regarding neural substrates of inhibitory processing in patients with asymmetric Parkinson's disease. The aim of the current fMRI study was to identify the neural changes underlying deficient inhibitory processing on the stop-signal task in patients with predominantly left-sided Parkinson's disease. Fourteen patients and 23 healthy controls performed a stop-signal task with the left and right hands. Behaviorally, patients showed delayed response inhibition with either hand compared to controls. We found small imaging differences for the right hand, however for the more affected left hand when behavior was successfully inhibited we found reduced activation of the inferior frontal gyrus bilaterally and the insula. Using the stop-signal delay as regressor, contralateral underactivation in the right dorsolateral prefrontal cortex, inferior frontal and anterior putamen were found in patients. This finding indicates dysfunction of the right inhibitory network in left-sided Parkinson's disease. Functional connectivity analysis of the left subthalamic nucleus showed a significant increase of connectivity with bilateral insula. In contrast, the right subthalamic nucleus showed increased connectivity with visuomotor and sensorimotor regions of the cerebellum. We conclude that altered inhibitory control in left-sided Parkinson's disease is associated with reduced activation in regions dedicated to inhibition in healthy controls, which requires engagement of additional regions, not observed in controls, to successfully stop ongoing actions.


Assuntos
Doença de Parkinson , Núcleo Subtalâmico , Humanos , Inibição Psicológica , Imageamento por Ressonância Magnética , Doença de Parkinson/diagnóstico por imagem , Córtex Pré-Frontal , Núcleo Subtalâmico/diagnóstico por imagem
8.
BMJ Open ; 11(12): e048469, 2021 12 15.
Artigo em Inglês | MEDLINE | ID: mdl-34911708

RESUMO

OBJECTIVES: To examine the mediation role of self-care between stress and psychological well-being in the general population of four countries and to assess the impact of sociodemographic variables on this relationship. DESIGN: Cross-sectional, online survey. PARTICIPANTS: A stratified sample of confined general population (N=1082) from four Ibero-American countries-Chile (n=261), Colombia (n=268), Ecuador (n=282) and Spain (n=271)-balanced by age and gender. PRIMARY OUTCOMES MEASURES: Sociodemographic information (age, gender, country, education and income level), information related to COVID-19 lockdown (number of days in quarantine, number of people with whom the individuals live, absence/presence of adults and minors in charge and attitude towards the search of information related to COVID-19), Perceived Stress Scale-10, Ryff's Psychological Well-Being Scale-29 and Self-Care Activities Screening Scale-14. RESULTS: Self-care partially mediates the relationship between stress and well-being during COVID-19 confinement in the general population in the total sample (F (3,1078)=370.01, p<0.001, R2=0.507) and in each country. On the other hand, among the evaluated sociodemographic variables, only age affects this relationship. CONCLUSION: The results have broad implications for public health, highlighting the importance of promoting people's active role in their own care and health behaviour to improve psychological well-being if stress management and social determinants of health are jointly addressed first. The present study provides the first transnational evidence from the earlier stages of the COVID-19 lockdown, showing that the higher perception of stress, the less self-care activities are adopted, and in turn the lower the beneficial effects on well-being.


Assuntos
COVID-19 , Autocuidado , Controle de Doenças Transmissíveis , Comparação Transcultural , Estudos Transversais , Humanos , SARS-CoV-2
9.
Artigo em Inglês | MEDLINE | ID: mdl-33668717

RESUMO

The aim of the present cross-sectional study was to analyze the differential impact of the first COVID-19 lockdown (3 April 2020) on stress, health practices, and self-care activities across different Hispanic countries, age range, and gender groups. One thousand and eighty-two participants from Spain, Chile, Colombia, and Ecuador took part in this study. Irrespective of the country, and controlling for income level, young people, especially females, suffered a greater level of stress, perceived the situation as more severe, showed less adherence to health guidelines, and reported lower levels of health consciousness, in comparison to their male peers and older groups. However, in the case of self-care, it seems that older and female groups are generally more involved in self-care activities and adopt more healthy daily routines. These results are mostly similar between Colombia, Ecuador, and Spain. However, Chile showed some different tendencies, as males reported higher levels of healthy daily routines and better adherence to health guidelines compared to females and people over the age of 60. Differences between countries, genders, and age ranges should be considered in order to improve health recommendations and adherence to guidelines. Moreover, developing community action and intersectoral strategies with a gender-based approach could help to reduce health inequalities and increase the success of people's adherence to health guidelines and self-care-promoting interventions. Future studies should be addressed to explore the possible causations of such differences in more cultural-distant samples and at later stages of the current outbreak.


Assuntos
COVID-19/psicologia , Comportamentos Relacionados com a Saúde , Autocuidado , Estresse Psicológico/epidemiologia , Chile/epidemiologia , Colômbia/epidemiologia , Controle de Doenças Transmissíveis , Estudos Transversais , Equador/epidemiologia , Feminino , Humanos , Masculino , Espanha/epidemiologia
10.
Health Qual Life Outcomes ; 19(1): 1, 2021 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-33388064

RESUMO

BACKGROUND: In a context where there is no treatment for the current COVID-19 virus, the combination of self-care behaviours together with confinement, are strategies to decrease the risk of contagion and remain healthy. However, there are no self-care measures to screen self-care activities in general population and which, could be briefly in a lockdown situation. This research aims to build and validate a psychometric tool to screen self-care activities in general population. METHODS: Firstly, an exploratory factor analysis was performed in a sample of 226 participants to discover the underlying factorial structure and to reduce the number of items in the original tool into a significant pool of items related to self-care. Later a confirmatory factor analyses were performed in a new sample of 261 participants to test for the fit and goodness of factor solutions. Internal validity, reliability, and convergent validity between its score with perceived stress and psychological well-being measures were examined on this sample. RESULTS: The exploratory analyses suggested a four-factor solution, corresponding to health consciousness, nutrition and physical activity, sleep, and intra-personal and inter-personal coping skills (14 items). Then, the four-factor structure was confirmed as the best model fit for self-care activities. The tool demonstrated good reliability, predictive validity of individuals' perception of coping with COVID-19 lockdown, and convergent validity with well-being and perceived stress. CONCLUSIONS: This screening tool could be helpful to address future evaluations and interventions to promote healthy behaviours. Likewise, this tool can be targeted to specific population self-care's needs during a scalable situation.


Assuntos
Adaptação Psicológica , COVID-19/psicologia , Qualidade de Vida/psicologia , Autocuidado/psicologia , Inquéritos e Questionários/normas , Adulto , Análise Fatorial , Feminino , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria , Reprodutibilidade dos Testes , Autocuidado/normas
11.
Front Psychol ; 12: 686928, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-35153881

RESUMO

Rather than occurring abstractly (autonomously), ethical growth occurs in interpersonal relationships (IRs). It requires optimally functioning cognitive processes [attention, working memory (WM), episodic/autobiographical memory (AM), inhibition, flexibility, among others], emotional processes (physical contact, motivation, and empathy), processes surrounding ethical, intimacy, and identity issues, and other psychological processes (self-knowledge, integration, and the capacity for agency). Without intending to be reductionist, we believe that these aspects are essential for optimally engaging in IRs and for the personal constitution. While they are all integrated into our daily life, in research and academic work, it is hard to see how they are integrated. Thus, we need better theoretical frameworks for studying them. That study and integration thereof are undertaken differently depending on different views of what it means to live as a human being. We rely on neuroscientific data to support the chosen theory to offer knowledge to understand human beings and interpersonal relational growth. We should of course note that to describe what makes up the uniqueness of being, acting, and growing as a human person involves something much more profound which requires too, a methodology that opens the way for a theory of the person that responds to the concerns of philosophy and philosophical anthropology from many disciplines and methods (Orón Semper, 2015; Polo, 2015), but this is outside the scope of this study. With these in mind, this article aims to introduce a new explanatory framework, called the Interprocessual-self (IPS), for the neuroscientific findings that allow for a holistic consideration of the previously mentioned processes. Contributing to the knowledge of personal growth and avoiding a reductionist view, we first offer a general description of the research that supports the interrelation between personal virtue in IRs and relevant cognitive, emotional, and ethic-moral processes. This reveals how relationships allow people to relate ethically and grow as persons. We include conceptualizations and descriptions of their neural bases. Secondly, with the IPS model, we explore neuroscientific findings regarding self-knowledge, integration, and agency, all psychological processes that stimulate inner exploration of the self concerning the other. We find that these fundamental conditions can be understood from IPS theory. Finally, we explore situations that involve the integration of two levels, namely the interpersonal one and the social contexts of relationships.

12.
Front Aging Neurosci ; 13: 778201, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-35095468

RESUMO

The human brain undergoes structural and functional changes across the lifespan. The study of motor sequence learning in elderly subjects is of particularly interest since previous findings in young adults might not replicate during later stages of adulthood. The present functional magnetic resonance imaging (fMRI) study assessed the performance, brain activity and functional connectivity patterns associated with motor sequence learning in late middle adulthood. For this purpose, a total of 25 subjects were evaluated during early stages of learning [i.e., fast learning (FL)]. A subset of these subjects (n = 11) was evaluated after extensive practice of a motor sequence [i.e., slow learning (SL) phase]. As expected, late middle adults improved motor performance from FL to SL. Learning-related brain activity patterns replicated most of the findings reported previously in young subjects except for the lack of hippocampal activity during FL and the involvement of cerebellum during SL. Regarding functional connectivity, precuneus and sensorimotor lobule VI of the cerebellum showed a central role during improvement of novel motor performance. In the sample of subjects evaluated, connectivity between the posterior putamen and parietal and frontal regions was significantly decreased with aging during SL. This age-related connectivity pattern may reflect losses in network efficiency when approaching late adulthood. Altogether, these results may have important applications, for instance, in motor rehabilitation programs.

13.
Pers Individ Dif ; 177: 110679, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36540668

RESUMO

Background: The relationship between emotional intelligence (EI) and stress has been widely studied, as well as the beneficial role of self-care to maintain health and wellbeing. However, the joint contribution of EI and self-care in predicting stress has not been examined during COVID-19 lockdown. This study aimed to examine the mediating role of self-care in the relationship between EI and stress and the potential moderator role of gender. Methods: A sample of 1082 participants from four Hispanic countries completed measures related to socio-demographic, trait emotional intelligence (Trait Meta-Mood Scale), self-care activities (Self-care Activities Screening Scale) and stress (Perceived Stress Scale). Results: Mediation analyses revealed that self-care increased the explained variance of the prediction of stress by EI dimensions after controlling gender and age. However, gender only moderated the relationship between self-care and stress in the mediation model corresponding to emotional attention. Conclusions: Data supported a general model for the interaction of EI and self-care as contributing factors of stress. Further research is needed to replicate it in more culturally distant samples and to fully explore the potential role of gender differences. Future intervention programs should include a balanced combination of EI and self-care to increase their benefits on people's health.

14.
Hum Mol Genet ; 29(19): 3211-3223, 2020 11 25.
Artigo em Inglês | MEDLINE | ID: mdl-32916704

RESUMO

The morphological changes that occur in the central nervous system of patients with severe acute intermittent porphyria (AIP) have not yet been clearly established. The aim of this work was to analyze brain involvement in patients with severe AIP without epileptic seizures or clinical posterior reversible encephalopathy syndrome, as well as in a mouse model receiving or not liver-directed gene therapy aimed at correcting the metabolic disorder. We conducted neuroradiologic studies in 8 severely affected patients (6 women) and 16 gender- and age-matched controls. Seven patients showed significant enlargement of the cerebral ventricles and decreased brain perfusion was observed during the acute attack in two patients in whom perfusion imaging data were acquired. AIP mice exhibited reduced cerebral blood flow and developed chronic dilatation of the cerebral ventricles even in the presence of slightly increased porphyrin precursors. While repeated phenobarbital-induced attacks exacerbated ventricular dilation in AIP mice, correction of the metabolic defect using liver-directed gene therapy restored brain perfusion and afforded protection against ventricular enlargement. Histological studies revealed no signs of neuronal loss but a denser neurofilament pattern in the periventricular areas, suggesting compression probably caused by imbalance in cerebrospinal fluid dynamics. In conclusion, severely affected AIP patients exhibit cerebral ventricular enlargement. Liver-directed gene therapy protected against the morphological consequences of the disease seen in the brain of AIP mice. The observational study was registered at Clinicaltrial.gov as NCT02076763.


Assuntos
Encéfalo/patologia , Ventrículos Cerebrais/patologia , Modelos Animais de Doenças , Hidroximetilbilano Sintase/genética , Porfiria Aguda Intermitente/fisiopatologia , Adulto , Animais , Encéfalo/metabolismo , Estudos de Casos e Controles , Ventrículos Cerebrais/metabolismo , Ensaios Clínicos Fase I como Assunto , Feminino , Terapia Genética , Humanos , Masculino , Camundongos , Pessoa de Meia-Idade , Porfiria Aguda Intermitente/genética , Porfiria Aguda Intermitente/metabolismo , Estudos Prospectivos
15.
Neuroimage ; 203: 116181, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31521824

RESUMO

When humans make decisions, objective rewards are mainly discounted by delay, risk and effort. Whereas recent research has demonstrated that several brain areas process costs and code subjective value in effort-based decision making, it remains obscure how neural activity patterns change when effort costs are reduced due to the acquisition of healthy habits, such as moving from sedentary to active lifestyles. Here, a sample of sedentary volunteers was behaviorally assessed and fMRI-scanned before and after completing a 3-month fitness plan. The impact of effort cost on decisions, measured as the constant defining a hyperbolic decaying function, was reduced after the plan. A logistic mixed model demonstrated that the explanatory power of effort decreased with time. At a neural level, there was a marginally significant disruption of effort-cost related functional activity in the anterior cingulate after the plan. Functional connectivity between the amygdala and anterior cingulate cortex was strengthened after habit acquisition. In turn, this interaction was stronger in those participants with lower effort discounting. Thus, we show for the first time changes in value-based decision making after moving from a sedentary to an active lifestyle, which points to the relevance of the amygdala-cingulate interplay when the impact of effort on decisions fades away.


Assuntos
Tonsila do Cerebelo/fisiologia , Tomada de Decisões/fisiologia , Exercício Físico/psicologia , Giro do Cíngulo/fisiologia , Adolescente , Adulto , Mapeamento Encefálico , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Vias Neurais/fisiologia , Esforço Físico , Comportamento Sedentário , Adulto Jovem
16.
Cortex ; 113: 96-110, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30634107

RESUMO

According to the theory of value-based decision making, subjects tend to choose the most valuable among a set of options. However, agents may not be consistent when facing the same decision several times. In this paper, Shannon's entropy (H) is employed as a measure of behavioral inconsistency: it is a central measure of information theory that, applied to decision making, allows the estimation of behavioral preferences among a set of options. We scanned (functional magnetic resonance imaging, fMRI) 24 young (18-25 year) subjects (14 female) while performing a decision-making task, where monetary rewards were devalued by physical effort (minutes running in the treadmill) and risk. Twenty different pairs of options were presented nine times each, and H was calculated for each pair and subject. Behavioral analyses showed that subjective value (SV) significantly explained agents' preferences only in pairs with a low inconsistent response. Averaged response time positively correlated with H, confirming entropy as an indicator of choice difficulty. Group analyses on fMRI data revealed a cluster in the paracingulate cortex as the neural correlate of H. Besides, BOLD signal in the posterior cingulate correlated with the SV of the pair only in consistent decisions, confirming that SV loses its explanatory power on highly inconsistent decisions. Finally, the anterior and central cingulate were especially recruited when predicting a secured effortless reward, compared with a secured reward that involved a maximum effort. Our study shows that different regions of the cingulate cortex are involved in choice inconsistency, SV and processing effort costs.


Assuntos
Encéfalo/diagnóstico por imagem , Comportamento de Escolha/fisiologia , Esforço Físico/fisiologia , Adolescente , Adulto , Mapeamento Encefálico , Tomada de Decisões/fisiologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Tempo de Reação/fisiologia , Adulto Jovem
17.
Hum Brain Mapp ; 39(11): 4196-4212, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-29962070

RESUMO

Numerous daily tasks, including car driving, require fine visuospatial tuning. One such visuospatial ability, speed discrimination, declines with aging but its neural underpinnings remain unknown. In this study, we use fMRI to explore the effect of aging during a high speed discrimination task and its neural underpinnings, along with a complete neuropsychological assessment and a simulated driving evaluation in order to examine how they interact with each other through a multivariate regression approach. Beyond confirming that high speed discrimination performance is diminished in the elderly, we found that this deficit might be partly due to a lack of modulation in the activity and connectivity of the default mode network (DMN) in this age group, as well as an over-recruitment of frontoparietal and cerebellar regions, possibly as a compensatory mechanism. In addition, younger adults tended to drive at faster speeds, a behavior that was associated to adequate DMN dynamics and executive functioning, an effect that seems to be lost in the elderly. In summary, these results reveal how age-related declines in fine visuospatial abilities, such as high speed discrimination, were distinctly mediated by DMN functioning, a mechanism also associated to speeding behavior in a driving simulator.


Assuntos
Condução de Veículo , Encéfalo/fisiologia , Discriminação Psicológica/fisiologia , Envelhecimento Saudável/fisiologia , Percepção de Movimento/fisiologia , Adulto , Idoso , Condução de Veículo/psicologia , Encéfalo/diagnóstico por imagem , Mapeamento Encefálico , Simulação por Computador , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Vias Neurais/diagnóstico por imagem , Vias Neurais/fisiologia , Fatores de Tempo
18.
Sci Rep ; 8(1): 7584, 2018 05 15.
Artigo em Inglês | MEDLINE | ID: mdl-29765117

RESUMO

Poisoning, a subtype of physical injury, is an important hazard in children and youth. Individuals with ADHD may be at higher risk of poisoning. Here, we conducted a systematic review and meta-analysis to quantify this risk. Furthermore, since physical injuries, likely share causal mechanisms with those of poisoning, we compared the relative risk of poisoning and injuries pooling studies reporting both. As per our pre-registered protocol (PROSPERO ID CRD42017079911), we searched 114 databases through November 2017. From a pool of 826 potentially relevant references, screened independently by two researchers, nine studies (84,756 individuals with and 1,398,946 without the disorder) were retained. We pooled hazard and odds ratios using Robust Variance Estimation, a meta-analytic method aimed to deal with non-independence of outcomes. We found that ADHD is associated with a significantly higher risk of poisoning (Relative Risk = 3.14, 95% Confidence Interval = 2.23 to 4.42). Results also indicated that the relative risk of poisoning is significantly higher than that of physical injuries when comparing individuals with and without ADHD (Beta coefficient = 0.686, 95% Confidence Interval = 0.166 to 1.206). These findings should inform clinical guidelines and public health programs aimed to reduce physical risks in children/adolescents with ADHD.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Intoxicação/epidemiologia , Ferimentos e Lesões/epidemiologia , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/complicações , Criança , Pré-Escolar , Humanos , Lactente , Masculino , Razão de Chances , Guias de Prática Clínica como Assunto , Medição de Risco
19.
Neurosci Biobehav Rev ; 84: 63-71, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29162520

RESUMO

A systematic review with meta-analyses was performed to: 1) quantify the association between ADHD and risk of unintentional physical injuries in children/adolescents ("risk analysis"); 2) assess the effect of ADHD medications on this risk ("medication analysis"). We searched 114 databases through June 2017. For the risk analysis, studies reporting sex-controlled odds ratios (ORs) or hazard ratios (HRs) estimating the association between ADHD and injuries were combined. Pooled ORs (28 studies, 4,055,620 individuals without and 350,938 with ADHD) and HRs (4 studies, 901,891 individuals without and 20,363 with ADHD) were 1.53 (95% CI=1.40,1.67) and 1.39 (95% CI=1.06,1.83), respectively. For the medication analysis, we meta-analysed studies that avoided the confounding-by-indication bias [four studies with a self-controlled methodology and another comparing risk over time and groups (a "difference in differences" methodology)]. The pooled effect size was 0.879 (95% CI=0.838,0.922) (13,254 individuals with ADHD). ADHD is significantly associated with an increased risk of unintentional injuries and ADHD medications have a protective effect, at least in the short term, as indicated by self-controlled studies.


Assuntos
Acidentes/estatística & dados numéricos , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Substâncias Protetoras/uso terapêutico , Humanos , Razão de Chances , Modelos de Riscos Proporcionais
20.
BMJ Open ; 7(9): e018027, 2017 09 25.
Artigo em Inglês | MEDLINE | ID: mdl-28951416

RESUMO

INTRODUCTION: Attention-deficit hyperactivity disorder (ADHD) has been related to increased rates of unintentional injuries. However, the magnitude of the effect and to which extent variables such as sex, age or comorbidity can influence this relationship is unknown. Additionally, and importantly, it is unclear if, and to which degree, ADHD medications can decrease the number of unintentional injuries. Due to the amount of economic and social resources invested in the treatment of injuries, filling these gaps in the literature is highly relevant from a public health standpoint. Here, we present a protocol for a systematic review and meta-analysis to estimate the relationship between ADHD and unintentional injuries and assess the impact of pharmacological treatment for ADHD METHODS AND ANALYSIS: We will combine results from 114 bibliographic databases for studies relating ADHD and risk of injuries. Bibliographic searches and data extraction will be carried out independently by two researchers. The studies' risk of bias will be assessed using the Newcastle-Ottawa Scale. Articles reporting ORs or HRs of suffering an injury in ADHD compared with controls (or enough data to calculate them) will be combined using Robust Variance Estimation, a method that permits to include multiple non-independent outcomes in the analysis. All analyses will be carried out in Stata. Age, sex and comorbid conduct disorders will be considered as potential causes of variance and their effect analysed through meta-regression and subgroup analysis. Sensitivity analyses will exclude articles with longer follow-ups, non-stringent definitions of ADHD or controls and statistically uncontrolled/controlled outcomes. Studies implementing a self-controlled case series methodology to investigate if ADHD drugs reduce the risk of injuries will be combined with a generalised linear mixed model using the Poisson distribution and a log link function. REGISTRATION DETAILS: PROSPERO-Prospective Register of Systematic Reviews (CRD42017064967).


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Projetos de Pesquisa , Ferimentos e Lesões/epidemiologia , Adolescente , Criança , Comorbidade , Humanos , Metanálise como Assunto , Fatores de Risco , Revisões Sistemáticas como Assunto
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