Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 56
Filtrar
1.
Artigo em Inglês | MEDLINE | ID: mdl-31423596

RESUMO

BACKGROUND: The Extended Strengths and Weaknesses Assessment of Normal Behavior (E-SWAN) reconceptualizes each diagnostic criterion for selected DSM-5 disorders as a behavior, which can range from high (strengths) to low (weaknesses). Initial development focused on Panic Disorder, Social Anxiety, Major Depression, and Disruptive Mood Dysregulation Disorder. METHODS: Data were collected from 523 participants (ages 6-17). Parents completed each of the four E-SWAN scales and traditional unidirectional scales addressing the same disorders. Distributional properties, Item Response Theory Analysis (IRT), and Receiver Operating Characteristic (ROC) curves were used to assess and compare the performance of E-SWAN and traditional scales. RESULTS: In contrast to the traditional scales, which exhibited truncated distributions, all four E-SWAN scales had symmetric distributions. IRT analyses indicate the E-SWAN subscales provided reliable information about respondents throughout the population distribution; traditional scales only provided reliable information about respondents at the high end of the distribution. Predictive value for DSM-5 diagnoses was comparable to prior scales. CONCLUSIONS: E-SWAN bidirectional scales can capture the full spectrum of the population distribution of behavior underlying DSM disorders. The additional information provided can better inform examination of inter-individual variation in population studies, as well as facilitate the identification of factors related to resiliency in clinical samples.

2.
Artigo em Inglês | MEDLINE | ID: mdl-31442562

RESUMO

OBJECTIVE: To investigate the effect of relatively younger age on Attention-deficit/hyperactivity disorder (ADHD) symptoms and diagnosis through three population-based cohorts and a meta-analysis. METHOD: Individuals included in this study were participants of three community-based cohorts in Brazil: the 1993 Pelotas Cohort (N=5,249), the 2004 Pelotas Cohort (N=4,231), and the Brazilian High-Risk Study for Psychiatric disorders (HRC study, N=2,511). We analyzed the effect of relatively younger age on ADHD symptoms and diagnosis. For the meta-analysis, we searched MEDLINE, PsycINFO, and Web of Science from inception through December 25th, 2018. We selected studies that reported measures of association between relative immaturity and an ADHD diagnosis. We followed the Meta-analysis of Observational Studies in Epidemiology guidelines. The protocol for meta-analysis is available on PROSPERO (CRD42018099966). RESULTS: In the meta-analysis, we identified 1,799 potentially eligible records, from which 25 studies including 8,076,570 individuals (164,049 ADHD cases) were analyzed with their effect estimates. The summarized relative risk of an ADHD diagnosis was 1.34 (95% Confidence Interval, 1.26 to 1.43, p <.001) for children born in the first four months of the school year (relatively younger). Heterogeneity was high (I2 = 96.7%). Relative younger age was associated with higher levels of ADHD symptoms in the 1993 Pelotas cohort (p=.003), in the 2004 Pelotas cohort (p=.046) and in the HRC study (p=.010). CONCLUSION: Children and adolescents who are relatively younger compared to their classmates have a higher risk of receiving an ADHD diagnosis. Clinicians should consider the developmental level of young children when evaluating ADHD symptoms.

3.
Schizophr Res ; 205: 23-29, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30879477

RESUMO

OBJECTIVE: To investigate how a set of positive social and personality characteristics called 'positive attributes' affects the emergence and persistence of Psychotic Experiences (PE) in adolescence. METHOD: We used data from a community-based Brazilian High-Risk Cohort (HRC). 2511 6-12 year-old children were evaluated at baseline, and 80.05% completed a 3-year follow-up interview. At baseline, childhood trauma was assessed using parent- and self-report, and positive attributes were assessed by parent-report. Trained psychologists rated self-reported PE at both time points. Linear models evaluated the effect of childhood trauma and positive attributes on PE at follow-up. Mediation models tested i.) the indirect effect of positive attributes on the association between childhood trauma and follow-up PE and, ii.) the indirect effect of childhood trauma and positive attributes on the relationship between PE at baseline and follow-up. RESULTS: Higher levels of baseline PE (B = 0.157, p < .001) and higher childhood trauma (B = 0.110, p < .001) were associated with increased follow-up PE. Higher positive attributes predicted lower PE after 3 years, adjusting for the prevalence of baseline PE and childhood trauma (B = -0.042, p < .022). Positive attributes partially mediated the relationship between childhood trauma and follow-up PE. The indirect pathway of childhood trauma and positive attributes mediated the association between baseline and follow-up PE. CONCLUSIONS: Higher levels of positive social and behavioral traits in childhood may diminish the subsequent emergence of PE. As these attributes can be promoted, our findings suggest that positive attributes may represent a novel target for preventive interventions in children at risk of developing PE.

4.
Atten Defic Hyperact Disord ; 11(1): 47-58, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30927230

RESUMO

Increased reaction time variability (RTV) is one of the most replicable behavioral correlates of attention-deficit/hyperactivity disorder (ADHD). However, this may not be specific to ADHD but a more general marker of psychopathology. Here we compare RT variability in individuals with ADHD and those with other childhood internalizing and externalizing conditions both in terms of standard (i.e., the standard deviation of reaction time) and alternative indices that capture low-frequency oscillatory patterns in RT variations over time thought to mark periodic lapses of attention in ADHD. A total of 667 participants (6-12 years old) were classified into non-overlapping diagnostic groups consisting of children with fear disorders (n = 91), distress disorders (n = 56), ADHD (n = 103), oppositional defiant or conduct disorder (ODD/CD; n = 40) and typically developing controls (TDC; n = 377). We used a simple two-choice reaction time task to measure reaction time. The strength of oscillations in RTs across the session was extracted using spectral analyses. Higher RTV was present in ADHD compared to all other disorder groups, effects that were equally strong across all frequency bands. Interestingly, we found that lower RTV to characterize ODD/CD relative to TDC, a finding that was more pronounced at lower frequencies. In general, our data support RTV as a specific marker of ADHD. RT variation across time in ADHD did not show periodicity in a specific frequency band, not supporting that ADHD RTV is the product of spontaneous periodic lapses of attention. Low-frequency oscillations may be particularly useful to differentiate ODD/CD from TDC.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/fisiopatologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/fisiopatologia , Transtorno da Conduta/fisiopatologia , Modelos Neurológicos , Transtornos Fóbicos/fisiopatologia , Tempo de Reação/fisiologia , Estresse Psicológico/fisiopatologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/diagnóstico , Criança , Comportamento de Escolha/fisiologia , Transtorno da Conduta/diagnóstico , Endofenótipos , Feminino , Humanos , Masculino
5.
Lancet Psychiatry ; 5(10): 782-783, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30274671
6.
J Am Acad Child Adolesc Psychiatry ; 57(8): 610-613.e2, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30071982

RESUMO

Unlike most leading causes of death in the United States, suicide rates have not declined during the past 50 years.1 Among young people the situation is even more dramatic, because suicide rates are rising,2 and suicide is now the second cause of death in 15- to 29-year-olds globally.3 It has been suggested that descriptions of suicide in the media might affect behavior and that the young might be more vulnerable to this effect.4.

7.
Depress Anxiety ; 35(12): 1207-1217, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30004611

RESUMO

BACKGROUND: Although severe irritability is a predictor of future depression according to recent meta-analytic evidence, other mechanisms for this developmental transition remain unclear. In this study, we test whether deficits in emotion recognition may partially explain this specific association in youth with severe irritability, defined as disruptive mood dysregulation disorder (DMDD). METHODS: Participants aged 8-20 years (M = 13.3, SD = 2.8) included youth with DMDD, split by low depressive (DMDD/LD; n = 52) and high depressive (DMDD/HD; n = 25) symptoms, and healthy controls (HC; n = 39). A standardized computer task assessed emotion recognition of faces and voices of adults and children expressing happiness, fear, sadness, and anger. A Group (3) × Emotion (4) × Actor (2) × Modality (2) repeated measures analysis of covariance examined the number of errors and misidentification of emotions. Linear regression was then used to assess whether deficits in emotion recognition were predictive of depressive symptoms at a 1 year follow-up. RESULTS: DMDD/HD youth were more likely to interpret happy stimuli as angry and fearful compared to DMDD/LD (happy as angry: p = 0.018; happy as fearful: p = 0.008) and HC (happy as angry: p = 0.014; happy as fearful: p = 0.024). In youth with DMDD, the misidentification of happy stimuli as fearful was associated with higher depressive symptoms at follow-up (ß = 0.43, p = 0.017), independent of baseline depressive and irritability symptoms. CONCLUSIONS: Deficits in emotion recognition are associated, cross-sectionally and longitudinally, with depressive symptoms in youth with severe irritability. Future studies should examine the neural correlates that contribute to these associations.

8.
J Child Adolesc Psychopharmacol ; 28(9): 620-630, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29969293

RESUMO

BACKGROUND: The objective of this study is to assess group differences in symptom reduction between individuals receiving group cognitive behavioral therapy (G-CBT) and attention bias modification (ABM) compared to their respective control interventions, control therapy (CT), and attention control training (ACT), in a 2 × 2 factorial design. METHODS: A total of 310 treatment-naive children (7-11 years of age) were assessed for eligibility and 79 children with generalized, separation or social anxiety disorder were randomized and received G-CBT (n = 42) or CT (n = 37). Within each psychotherapy group, participants were again randomized to ABM (n = 38) or ACT (n = 41) in a 2 × 2 factorial design resulting in four groups: G-CBT + ABM (n = 21), G-CBT + ACT (n = 21), CT + ABM (n = 17), and CT + ACT (n = 20). Primary outcomes were responder designation as defined by Clinical Global Impression-Improvement (CGI-I) scale (≤2) and change on the Pediatric Anxiety Rating Scale (PARS). RESULTS: There were significant improvements of symptoms in all groups. No differences in response rates or mean differences in PARS scores were found among groups: G-CBT + ABM group (23.8% response; 3.9 points, 95% confidence interval [CI] -0.3 to 8.1), G-CBT + ACT (42.9% response; 5.6 points, 95% CI 2.2-9.0), CT + ABM (47.1% response; 4.8 points 95% CI 1.08-8.57), and CT + ACT (30% response; 0.8 points, 95% CI -3.0 to 4.7). No evidence or synergic or antagonistic effects were found, but the combination of G-CBT and ABM was found to increase dropout rate. CONCLUSIONS: We found no effect of G-CBT or ABM beyond the effects of comparison groups. Results reveal no benefit from combining G-CBT and ABM for anxiety disorders in children and suggest potential deleterious effects of the combination on treatment acceptability.

9.
Am J Psychiatry ; 175(6): 555-563, 2018 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-29495896

RESUMO

OBJECTIVE: Alzheimer's disease is a heritable neurodegenerative disorder in which early-life precursors may manifest in cognition and brain structure. The authors evaluate this possibility by examining, in youths, associations among polygenic risk score for Alzheimer's disease, cognitive abilities, and hippocampal volume. METHOD: Participants were children 6-14 years of age in two Brazilian cities, constituting the discovery (N=364) and replication samples (N=352). As an additional replication, data from a Canadian sample (N=1,029), with distinct tasks, MRI protocol, and genetic risk, were included. Cognitive tests quantified memory and executive function. Reading and writing abilities were assessed by standardized tests. Hippocampal volumes were derived from the Multiple Automatically Generated Templates (MAGeT) multi-atlas segmentation brain algorithm. Genetic risk for Alzheimer's disease was quantified using summary statistics from the International Genomics of Alzheimer's Project. RESULTS: Analyses showed that for the Brazilian discovery sample, each one-unit increase in z-score for Alzheimer's polygenic risk score significantly predicted a 0.185 decrement in z-score for immediate recall and a 0.282 decrement for delayed recall. Findings were similar for the Brazilian replication sample (immediate and delayed recall, ß=-0.259 and ß=-0.232, both significant). Quantile regressions showed lower hippocampal volumes bilaterally for individuals with high polygenic risk scores. Associations fell short of significance for the Canadian sample. CONCLUSIONS: Genetic risk for Alzheimer's disease may affect early-life cognition and hippocampal volumes, as shown in two independent samples. These data support previous evidence that some forms of late-life dementia may represent developmental conditions with roots in childhood. This result may vary depending on a sample's genetic risk and may be specific to some types of memory tasks.

10.
Rev. bras. psiquiatr ; 40(1): 48-55, Jan.-Mar. 2018. tab
Artigo em Inglês | LILACS-Express | ID: biblio-899405

RESUMO

Objectives: Little is known about the prevalence and correlates of deliberate self-harm (DSH) in children from low- and middle-income countries. We investigated the prevalence of DSH and its clinical and maternal psychopathological associations in Brazilian children (n=2,508, ages 6-14y) in a community-based study. Methods: Participants of the High Risk Cohort Study for the Development of Childhood Psychiatric Disorders (HRC) and their mothers were assessed in structured interviews. Current (last month) and lifetime DSH were estimated, including analysis stratified by age groups. Logistic regressions were performed to investigate the role of the children's clinical diagnoses and maternal psychopathology on DSH prevalence estimates, adjusting for potential confounding factors. Results: The prevalence of current DSH was 0.8% (children 0.6%, adolescents 1%) and lifetime DSH was 1.6% (1.8% and 1.5%, respectively). Current and lifetime DSH were more frequent in children with depression, attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD), even in multiple models accounting for demographic variables and co-occurring psychiatric disorders. Maternal anxiety disorder was strongly associated with current and lifetime DSH in offspring; whereas current DSH, specifically in young children, was associated with maternal mood disorder. Conclusion: Diagnoses of depression, ADHD and ODD were consistently associated with DSH, as was having a mother with anxiety disorder.

11.
Artigo em Inglês | MEDLINE | ID: mdl-28868642

RESUMO

To test how reliable the tool recommend by Cochrane Collaboration for assessing risk of bias systematic reviews of randomized clinical trials is in the context of methylphenidate for children and adolescents with attention deficit hyperactivity disorder. Confirmatory factor analysis was used to evaluate a unidimensional model for the 7 indicators, applied to 184 Randomized Clinical Trial (RCTs) within a 2015 Cochrane systematic review titled "Methylphenidate for children and adolescents with attention deficit hyperactivity disorder." A unidimensional model resulted in excellent adequacy indices, but only 2 indicators had very high factor loadings and low measurement errors. In terms of content, the 7 indicators showed poor reliability (ω = 0.642); however, the set of indicators was precise in evaluating studies with a high amount of bias risk. The Cochrane model of risk of bias as it is, exhibited good fit indices but the majority of the items were not reliable to adequately capture risk of bias in the context of clinical trials of methylphenidate for ADHD.

12.
Depress Anxiety ; 35(3): 229-238, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29212134

RESUMO

BACKGROUND: Considerable research links threat-related attention biases to anxiety symptoms in adults, whereas extant findings on threat biases in youth are limited and mixed. Inconsistent findings may arise due to substantial methodological variability and limited sample sizes, emphasizing the need for systematic research on large samples. The aim of this report is to examine the association between threat bias and pediatric anxiety symptoms using standardized measures in a large, international, multi-site youth sample. METHODS: A total of 1,291 children and adolescents from seven research sites worldwide completed standardized attention bias assessment task (dot-probe task) and child anxiety symptoms measure (Screen for Child Anxiety Related Emotional Disorders). Using a dimensional approach to symptomatology, we conducted regression analyses predicting overall, and disorder-specific, anxiety symptoms severity, based on threat bias scores. RESULTS: Threat bias correlated positively with overall anxiety symptoms severity (ß = 0.078, P = .004). Furthermore, threat bias was positively associated specifically with social anxiety (ß = 0.072, P = .008) and school phobia (ß = 0.076, P = .006) symptoms severity, but not with panic, generalized anxiety, or separation anxiety symptoms. These associations were not moderated by age or gender. CONCLUSIONS: These findings indicate associations between threat bias and pediatric anxiety symptoms, and suggest that vigilance to external threats manifests more prominently in symptoms of social anxiety and school phobia, regardless of age and gender. These findings point to the role of attention bias to threat in anxiety, with implications for translational clinical research. The significance of applying standardized methods in multi-site collaborations for overcoming challenges inherent to clinical research is discussed.


Assuntos
Ansiedade/fisiopatologia , Viés de Atenção/fisiologia , Medo/fisiologia , Transtornos Fóbicos/fisiopatologia , Adolescente , Criança , Feminino , Humanos , Masculino
13.
J Child Psychol Psychiatry ; 59(3): 203-212, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28731214

RESUMO

BACKGROUND: Integration of positive psychology into clinical research and treatment has been slow. This integration can be facilitated by the conceptualisation of mental disorders as the high, symptomatic extreme of continuous normal variation. This assumes that there is also a low, positive extreme, which is, however, unchartered territory. This study aims to examine how well current measures capture the low extreme of mental disorder continua, using attention-deficit hyperactivity disorder (ADHD) as an example. METHODS: The ability of three validated scales to capture ADHD as a continuous trait was examined using Item Response Theory in a sample of 9,882 adolescents from the UK population-representative Twins Early Development Study. These scales were: the Strengths and Weakness of ADHD Symptoms and Normal behaviour scale (SWAN), Strength and Difficulties Questionnaire (SDQ - hyperactivity subscale), and Conners' Parent Rating Scale (Conners). RESULTS: Only the SWAN reliably differentiated interindividual differences between participants lying at any level of the continuous ADHD latent trait, including the extreme low, positive end (z-scores from -3 to +3). The SDQ showed low reliability across the ADHD latent trait. In contrast, the Conners performed best at differentiating individuals scoring at or above the mean to the high symptomatic range (z-scores from 0 to +3). The SWAN was the only measure to provide indicators of 'positive mental health', endorsed in the presence of particularly good attentive abilities. CONCLUSIONS: Scales such as the SWAN that reliably capture ADHD as a continuous trait, including the positive end, are important for not missing meaningful variation in population-based studies. Indicators of positive mental health may be helpful in clinical practice, as positive attributes have been shown to directly influence as well as buffer negative effects of psychiatric symptoms.

14.
J Psychiatr Res ; 96: 224-230, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29102817

RESUMO

BACKGROUND: The present study was designed to explore alterations in brain dynamics at rest that are associated with Obsessive Compulsive Symptoms (OCS) in childhood by measuring low frequency fluctuation of spontaneous brain activity in a large school community sample from a developing country. METHOD: Resting state functional magnetic resonance imaging data were collected in a sample of 655 children and adolescents (6-15 years old) from the brazilian 'High Risk Cohort Study for Psychiatric Disorders (HRC)'. OCS were assessed using items from the Compulsion and Obsessions section of the Development and Well-Being Assessment (DAWBA). The correlation between the fractional amplitude of low frequency fluctuations (fALFF) and the number of OCS were explored by using a general linear model, considering fALFF as response variable, OCS score as regressor and age, gender and site as nuisance variables. RESULTS: The number of OCS was positively correlated with the fALFF coefficients at the right sensorimotor cortex (pre-motor, primary motor cortex and post-central gyrus) and negatively correlated with the fALFF coefficients at the insula/superior temporal gyrus of both hemispheres. Our results were specific to OCS and not due to associations with overall psychopathology. CONCLUSIONS: Our results suggest that brain spontaneous activity at rest in the sensorimotor and insular/superior-temporal cortices may be involved in OCS in children. These findings need independent replication and future studies should determine whether brain spontaneous activity changes within these regions might be predictors of risk for obsessive-compulsive disorder latter in life.


Assuntos
Encéfalo/fisiopatologia , Transtorno Obsessivo-Compulsivo/fisiopatologia , Adolescente , Encéfalo/diagnóstico por imagem , Mapeamento Encefálico , Criança , Estudos de Coortes , Feminino , Humanos , Imagem por Ressonância Magnética , Masculino , Transtorno Obsessivo-Compulsivo/diagnóstico por imagem , Escalas de Graduação Psiquiátrica , Descanso
15.
Braz J Psychiatr ; 40(1): 48-55, 2018 Jan-Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28832748

RESUMO

OBJECTIVES: Little is known about the prevalence and correlates of deliberate self-harm (DSH) in children from low- and middle-income countries. We investigated the prevalence of DSH and its clinical and maternal psychopathological associations in Brazilian children (n=2,508, ages 6-14y) in a community-based study. METHODS: Participants of the High Risk Cohort Study for the Development of Childhood Psychiatric Disorders (HRC) and their mothers were assessed in structured interviews. Current (last month) and lifetime DSH were estimated, including analysis stratified by age groups. Logistic regressions were performed to investigate the role of the children's clinical diagnoses and maternal psychopathology on DSH prevalence estimates, adjusting for potential confounding factors. RESULTS: The prevalence of current DSH was 0.8% (children 0.6%, adolescents 1%) and lifetime DSH was 1.6% (1.8% and 1.5%, respectively). Current and lifetime DSH were more frequent in children with depression, attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD), even in multiple models accounting for demographic variables and co-occurring psychiatric disorders. Maternal anxiety disorder was strongly associated with current and lifetime DSH in offspring; whereas current DSH, specifically in young children, was associated with maternal mood disorder. CONCLUSION: Diagnoses of depression, ADHD and ODD were consistently associated with DSH, as was having a mother with anxiety disorder.


Assuntos
Comportamento Autodestrutivo/epidemiologia , Tentativa de Suicídio/estatística & dados numéricos , Adolescente , Transtornos de Ansiedade/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Brasil/epidemiologia , Criança , Estudos de Coortes , Depressão/psicologia , Feminino , Humanos , Masculino , Comportamento Materno , Prevalência , Psicopatologia , Fatores de Risco , Comportamento Autodestrutivo/psicologia , Fatores Socioeconômicos , Tentativa de Suicídio/psicologia
16.
Am J Psychiatry ; 174(11): 1112-1119, 2017 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-28946760

RESUMO

OBJECTIVE: Previous studies have implicated aberrant reward processing in the pathogenesis of adolescent depression. However, no study has used functional connectivity within a distributed reward network, assessed using resting-state functional MRI (fMRI), to predict the onset of depression in adolescents. This study used reward network-based functional connectivity at baseline to predict depressive disorder at follow-up in a community sample of adolescents. METHOD: A total of 637 children 6-12 years old underwent resting-state fMRI. Discovery and replication analyses tested intrinsic functional connectivity (iFC) among nodes of a putative reward network. Logistic regression tested whether striatal node strength, a measure of reward-related iFC, predicted onset of a depressive disorder at 3-year follow-up. Further analyses investigated the specificity of this prediction. RESULTS: Increased left ventral striatum node strength predicted increased risk for future depressive disorder (odds ratio=1.54, 95% CI=1.09-2.18), even after excluding participants who had depressive disorders at baseline (odds ratio=1.52, 95% CI=1.05-2.20). Among 11 reward-network nodes, only the left ventral striatum significantly predicted depression. Striatal node strength did not predict other common adolescent psychopathology, such as anxiety, attention deficit hyperactivity disorder, and substance use. CONCLUSIONS: Aberrant ventral striatum functional connectivity specifically predicts future risk for depressive disorder. This finding further emphasizes the need to understand how brain reward networks contribute to youth depression.


Assuntos
Transtorno Depressivo Maior/diagnóstico por imagem , Estriado Ventral/diagnóstico por imagem , Adolescente , Encéfalo/diagnóstico por imagem , Encéfalo/fisiopatologia , Brasil/epidemiologia , Criança , Estudos de Coortes , Transtorno Depressivo/diagnóstico por imagem , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/fisiopatologia , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/fisiopatologia , Feminino , Seguimentos , Neuroimagem Funcional , Humanos , Processamento de Imagem Assistida por Computador , Estudos Longitudinais , Imagem por Ressonância Magnética , Masculino , Razão de Chances , Recompensa , Medição de Risco , Estriado Ventral/fisiopatologia
17.
Rev. bras. psiquiatr ; 39(2): 118-125, Apr.-June 2017. tab, graf
Artigo em Inglês | LILACS-Express | ID: biblio-844182

RESUMO

Objective: To distinguish normative fears from problematic fears and phobias. Methods: We investigated 2,512 children and adolescents from a large community school-based study, the High Risk Study for Psychiatric Disorders. Parent reports of 18 fears and psychiatric diagnosis were investigated. We used two analytical approaches: confirmatory factor analysis (CFA)/item response theory (IRT) and nonparametric receiver operating characteristic (ROC) curve. Results: According to IRT and ROC analyses, social fears are more likely to indicate problems and phobias than specific fears. Most specific fears were normative when mild; all specific fears indicate problems when pervasive. In addition, the situational fear of toilets and people who look unusual were highly indicative of specific phobia. Among social fears, those not restricted to performance and fear of writing in front of others indicate problems when mild. All social fears indicate problems and are highly indicative of social phobia when pervasive. Conclusion: These preliminary findings provide guidance for clinicians and researchers to determine the boundaries that separate normative fears from problem indicators in children and adolescents, and indicate a differential severity threshold for specific and social fears.

18.
J Atten Disord ; : 1087054717707047, 2017 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-28478691

RESUMO

OBJECTIVE: The aim of this study is to investigate measurement invariance (MI) for an ADHD latent trait across different sociodemographic groups (sex, age, and maternal education), IQs, and co-occurring psychiatric diagnoses. METHOD: Participants were 2,299 children aged 6 to 14 years. ADHD symptoms were assessed by parent report using the Development and Well-Being Assessment (DAWBA). MI was tested through multigroup confirmatory factor analysis and multiple indicators multiple causes models. RESULTS: In a bifactor model including a general ADHD factor and three specific factors (hyperactivity, inattention, and impulsivity), invariance properties were demonstrated and no individual items showed differential functioning. The ADHD general factor was higher in boys and in those with psychiatric disorders. Younger age predicted hyperactivity. Lower IQ and higher level of education of the mother predicted inattention. CONCLUSION: The ADHD trait, as measured by the DAWBA, functions in the same way, and with equivalent scale, revealing true differences in ADHD symptoms based on those.

19.
Eur Child Adolesc Psychiatry ; 26(11): 1377-1386, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28462487

RESUMO

The consolidation of social friendship groups is a vital part of human development. The objective of this study is to understand the direct and indirect influences of three major symptomatic domains-emotional, hyperkinetic, and conduct-on friendship. Specifically, we aim to study if the associations of one domain with friendship may be mediated by co-occurring symptoms from another domain. A total of 2512 subjects aged 6-14 years participated in this study. Friendship was evaluated by the Development and Well-Being Assessment's friendship section. We evaluated two main constructs as outcomes: (1) social isolation and (2) friendship latent construct. Emotional, hyperkinetic, and conduct symptomatic domains were evaluated with the Strengths and Difficulties Questionnaire (SDQ). All SDQ domains were positively associated with social isolation and negatively associated with friendship latent construct in univariate analysis. However, serial mediation models showed that the association between conduct domains with social isolation was mediated by emotion and hyperkinetic domains. Moreover, the associations between emotional and hyperkinetic domains with friendship latent construct in non-isolated children were mediated by the conduct domain. Emotion and hyperkinetic domains were directly and indirectly associated with social isolation, whereas conduct was directly and indirectly associated with overall friendship in non-isolated children. Results suggest that interventions aimed to improve social life in childhood and adolescence may have stronger effects if directed towards the treatment of emotion and hyperkinetic symptoms in socially isolated children and directed towards the treatment of conduct symptoms in children with fragile social connections.


Assuntos
Amigos/psicologia , Negociação/psicologia , Psicopatologia/métodos , Adolescente , Criança , Feminino , Humanos , Masculino
20.
Braz J Psychiatr ; 39(2): 118-125, 2017 Apr-Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28300935

RESUMO

Objective:: To distinguish normative fears from problematic fears and phobias. Methods:: We investigated 2,512 children and adolescents from a large community school-based study, the High Risk Study for Psychiatric Disorders. Parent reports of 18 fears and psychiatric diagnosis were investigated. We used two analytical approaches: confirmatory factor analysis (CFA)/item response theory (IRT) and nonparametric receiver operating characteristic (ROC) curve. Results:: According to IRT and ROC analyses, social fears are more likely to indicate problems and phobias than specific fears. Most specific fears were normative when mild; all specific fears indicate problems when pervasive. In addition, the situational fear of toilets and people who look unusual were highly indicative of specific phobia. Among social fears, those not restricted to performance and fear of writing in front of others indicate problems when mild. All social fears indicate problems and are highly indicative of social phobia when pervasive. Conclusion:: These preliminary findings provide guidance for clinicians and researchers to determine the boundaries that separate normative fears from problem indicators in children and adolescents, and indicate a differential severity threshold for specific and social fears.


Assuntos
Medo/psicologia , Transtornos Fóbicos/diagnóstico , Adolescente , Criança , Análise Fatorial , Feminino , Humanos , Masculino , Transtornos Fóbicos/classificação , Transtornos Fóbicos/etiologia , Escalas de Graduação Psiquiátrica , Psicometria , Curva ROC , Padrões de Referência , Fatores de Risco , Índice de Gravidade de Doença , Meio Social , Inquéritos e Questionários
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA