Development of a smartphone screening test for preclinical Alzheimer's disease and validation across the dementia continuum.

BACKGROUND: Dementia prevalence is predicted to triple to 152 million globally by 2050. Alzheimer's disease (AD) constitutes 70% of cases. There is an urgent need to identify individuals with preclinical AD, a 10-20-year period of progressive brain pathology without noticeable cognitive symptoms, for targeted risk reduction. Current tests of AD pathology are either too invasive, specialised or expensive for population-level assessments. Cognitive tests are normal in preclinical AD. Emerging evidence demonstrates that movement analysis is sensitive to AD across the disease continuum, including preclinical AD. Our new smartphone test, TapTalk, combines analysis of hand and speech-like movements to detect AD risk. This study aims to [1] determine which combinations of hand-speech movement data most accurately predict preclinical AD [2], determine usability, reliability, and validity of TapTalk in cognitively asymptomatic older adults and [3], prospectively validate TapTalk in older adults who have cognitive symptoms against cognitive tests and clinical diagnoses of Mild Cognitive Impairment and AD dementia. METHODS: Aim 1 will be addressed in a cross-sectional study of at least 500 cognitively asymptomatic older adults who will complete computerised tests comprising measures of hand motor control (finger tapping) and oro-motor control (syllabic diadochokinesis). So far, 1382 adults, mean (SD) age 66.20 (7.65) years, range 50-92 (72.07% female) have been recruited. Motor measures will be compared to a blood-based AD biomarker, phosphorylated tau 181 to develop an algorithm that classifies preclinical AD risk. Aim 2 comprises three sub-studies in cognitively asymptomatic adults: (i) a cross-sectional study of 30-40 adults to determine the validity of data collection from different types of smartphones, (ii) a prospective cohort study of 50-100 adults ≥ 50 years old to determine usability and test-retest reliability, and (iii) a prospective cohort study of ~1,000 adults ≥ 50 years old to validate against cognitive measures. Aim 3 will be addressed in a cross-sectional study of ~200 participants with cognitive symptoms to validate TapTalk against Montreal Cognitive Assessment and interdisciplinary consensus diagnosis. DISCUSSION: This study will establish the precision of TapTalk to identify preclinical AD and estimate risk of cognitive decline. If accurate, this innovative smartphone app will enable low-cost, accessible screening of individuals for AD risk. This will have wide applications in public health initiatives and clinical trials. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT06114914, 29 October 2023. Retrospectively registered.

Experimental laboratory models as tools for understanding modifiable dementia risk.

Experimental laboratory research has an important role to play in dementia prevention. Mechanisms underlying modifiable risk factors for dementia are promising targets for dementia prevention but are difficult to investigate in human populations due to technological constraints and confounds. Therefore, controlled laboratory experiments in models such as transgenic rodents, invertebrates and in vitro cultured cells are increasingly used to investigate dementia risk factors and test strategies which target them to prevent dementia. This review provides an overview of experimental research into 15 established and putative modifiable dementia risk factors: less early-life education, hearing loss, depression, social isolation, life stress, hypertension, obesity, diabetes, physical inactivity, heavy alcohol use, smoking, air pollution, anesthetic exposure, traumatic brain injury, and disordered sleep. It explores how experimental models have been, and can be, used to address questions about modifiable dementia risk and prevention that cannot readily be addressed in human studies. HIGHLIGHTS: Modifiable dementia risk factors are promising targets for dementia prevention. Interrogation of mechanisms underlying dementia risk is difficult in human populations. Studies using diverse experimental models are revealing modifiable dementia risk mechanisms. We review experimental research into 15 modifiable dementia risk factors. Laboratory science can contribute uniquely to dementia prevention.

Alterations to metabolic hormones in amyotrophic lateral sclerosis and frontotemporal dementia postmortem human tissue.

Metabolic changes are observed in patients with both amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD). Although regulation of metabolic processes in the CNS is predominantly carried out within the hypothalamus, extra-hypothalamic CNS areas contain metabolic hormone receptors, including those for leptin (LEPR), insulin (INSR), and neuropeptide Y (NPY), indicating that they may play a role in biological processes underlying pathogenic disease processes. The status of these hormones within regions vulnerable in ALS/FTD is not well described. This study sought to determine whether the expression of these hormones and their receptors is altered in pathology-rich regions in cases of human FTD (superior frontal gyrus and insular cortex) and ALS (primary motor cortex and lumbar spinal cord) with TDP-43 pathology compared to matched healthy controls. LEPR mRNA was increased within the superior frontal gyrus of FTD cases and within primary motor cortex and lumbar spinal cord of ALS cases; INSR mRNA was increased in superior frontal gyrus and insular cortex of FTD cases. NPY protein was decreased in primary motor cortex and lumbar spinal cord of ALS cases. Our results demonstrate that metabolic hormones undergo complex alterations in ALS and FTD and suggest that these hormones could play critical roles in the pathogenesis of these diseases.

Isolation and Identification of the High-Affinity DNA Aptamer Target to the Brain-Derived Neurotrophic Factor (BDNF).

Aptamers are functional oligonucleotide ligands used for the molecular recognition of various targets. The natural characteristics of aptamers make them an excellent alternative to antibodies in diagnostics, therapeutics, and biosensing. DNA aptamers are mainly single-stranded oligonucleotides (ssDNA) that possess a definite binding to targets. However, the application of aptamers to the fields of brain health and neurodegenerative diseases has been limited to date. Herein, a DNA aptamer against the brain-derived neurotrophic factor (BDNF) protein was obtained by in vitro selection. BDNF is a potential biomarker of brain health and neurodegenerative diseases and has functions in the synaptic plasticity and survival of neurons. We identified eight aptamers that have binding affinity for BDNF from a 50-nucleotide library. Among these aptamers, NV_B12 showed the highest sensitivity and selectivity for detecting BDNF. In an aptamer-linked immobilized sorbent assay (ALISA), the NV_B12 aptamer strongly bound to BDNF protein, in a dose-dependent manner. The dissociation constant (Kd) for NV_B12 was 0.5 nM (95% CI: 0.4-0.6 nM). These findings suggest that BDNF-specific aptamers could be used as an alternative to antibodies in diagnostic and detection assays for BDNF.

Modifiable dementia risk factors and AT(N) biomarkers: findings from the EPAD cohort.

Introduction: Modifiable risk factors account for a substantial proportion of Alzheimer's disease (AD) cases and we currently have a discrete AT(N) biomarker profile for AD biomarkers: amyloid (A), p-tau (T), and neurodegeneration (N). Here, we investigated how modifiable risk factors relate to the three hallmark AT(N) biomarkers of AD. Methods: Participants from the European Prevention of Alzheimer's Dementia (EPAD) study underwent clinical assessments, brain magnetic resonance imaging, and cerebrospinal fluid collection and analysis. Generalized additive models (GAMs) with penalized regression splines were modeled in the AD Workbench on the NTKApp. Results: A total of 1,434 participants were included (56% women, 39% APOE ε4+) with an average age of 65.5 (± 7.2) years. We found that modifiable risk factors of less education (t = 3.9, p < 0.001), less exercise (t = 2.1, p = 0.034), traumatic brain injury (t = -2.1, p = 0.036), and higher body mass index (t = -4.5, p < 0.001) were all significantly associated with higher AD biomarker burden. Discussion: This cross-sectional study provides further support for modifiable risk factors displaying neuroprotective associations with the characteristic AT(N) biomarkers of AD.

Brief webcam test of hand movements predicts episodic memory, executive function, and working memory in a community sample of cognitively asymptomatic older adults.

INTRODUCTION: Low-cost simple tests for preclinical Alzheimer's disease are a research priority. We evaluated whether remote unsupervised webcam recordings of finger-tapping were associated with cognitive performance in older adults. METHODS: A total of 404 cognitively-asymptomatic participants (64.6 [6.77] years; 70.8% female) completed 10-second finger-tapping tests (Tasmanian [TAS] Test) and cognitive tests (Cambridge Neuropsychological Test Automated Battery [CANTAB]) online at home. Regression models including hand movement features were compared with null models (comprising age, sex, and education level); change in Akaike Information Criterion greater than 2 (ΔAIC > 2) denoted statistical difference. RESULTS: Hand movement features improved prediction of episodic memory, executive function, and working memory scores (ΔAIC > 2). Dominant hand features outperformed nondominant hand features for episodic memory (ΔAIC = 2.5), executive function (ΔAIC = 4.8), and working memory (ΔAIC = 2.2). DISCUSSION: This brief webcam test improved prediction of cognitive performance compared to age, sex, and education. Finger-tapping holds potential as a remote language-agnostic screening tool to stratify community cohorts at risk for cognitive decline.

HDAC6 inhibition as a mechanism to prevent neurodegeneration in the mSOD1G93A mouse model of ALS.

The loss of upper and lower motor neurons, and their axons is central to the loss of motor function and death in amyotrophic lateral sclerosis (ALS). Due to the diverse range of genetic and environmental factors that contribute to the pathogenesis of ALS, there have been difficulties in developing effective therapies for ALS. One emerging dichotomy is that protection of the neuronal cell soma does not prevent axonal vulnerability and degeneration, suggesting the need for targeted therapeutics to prevent axon degeneration. Post-translational modifications of protein acetylation can alter the function, stability and half-life of individual proteins, and can be enzymatically modified by histone acetyltransferases (HATs) and histone deacetyltransferases (HDACs), which add, or remove acetyl groups, respectively. Maintenance of post-translational microtubule acetylation has been suggested as a mechanism to stabilize axons, prevent axonal loss and neurodegeneration in ALS. This study used an orally dosed potent HDAC6 inhibitor, ACY-738, prevent deacetylation and stabilize microtubules in the mSOD1G93A mouse model of ALS. Co-treatment with riluzole was performed to determine any effects or drug interactions and potentially enhance preclinical research translation. This study shows ACY-738 treatment increased acetylation of microtubules in the spinal cord of mSOD1G93A mice, reduced lower motor neuron degeneration in female mice, ameliorated reduction in peripheral nerve axon puncta size, but did not prevent overt motor function decline. The current study also shows peripheral nerve axon puncta size to be partially restored after treatment with riluzole and highlights the importance of co-treatment to measure the potential effects of therapeutics in ALS.

Validation of an original Behavioral Changes Scale on the Use of Digital Technologies During Social Distancing

Abstract Introduction The social distancing (SD) adopted during the coronavirus disease 2019 (COVID-19) pandemic has transformed the internet from a convenience into a necessity. The behavioral changes caused by isolation range from adaptation of consumption, work, and teaching routines to altered leisure options to occupy idle time at home. Such transformations can be positive, expanding use of digital technologies (DT), but they can also have serious future physical and emotional consequences if there conscious use of technological devices is lacking. Objectives The study aimed to validate the Behavioral Changes Scale on the Use of Digital Technologies During Social Distancing (BCSDTSD), an instrument for assessing behavioral changes related to use of DT during SD. Method Validation of the BCSDTSD in five phases: 1. construction of an initial scale with 10 questions; 2. evaluation of the questions by a panel of experts; 3. application to 1,012 volunteers via the internet; 4. statistical analysis of the results; and 5. preparation of the validated final version of the BCSDTSD. Data were analyzed using the dplyr, psy , and paran packages and the REdaS statistical program. Three statistical criteria were used in the factor analysis (FA). Results FA confirmed that all 10 questions in the questionnaire should be maintained, confirming its robust construction, and Cronbach's alpha demonstrated its internal consistency with a value of 0.725, which is satisfactory for first-application questionnaires. Conclusion The BCSDTSD instrument was validated for assessment of behavioral changes related to the use of DT during SD.

Validation of a scale to evaluate the abusive use of technologies (Computer, cell phone, tablet, among others)

BACKGROUND INFORMATION: Daily, prolonged interactivity of individuals with technologies (computer, cell phone, tablet, among others) impacts life and significantly changes habits, behaviors, personal and social relationships. Technologies lead to a multitude of advantages, but attention is required concerning possible damages. OBJECTIVE: Validation of a scale to evaluate the abuse use of technologies (TAUS). METHOD: TAUS validation was carried out in 5 phases: (1) initial scale construction with 20 questions, (2) expert evaluation, (3) application to 200 volunteers, (4) statistical analysis and results, (5) preparation of the final version of the validated TAUS. We used the R statistical program and the "dplyr" package version 3.4.2 to present descriptive statistics, to test hypotheses of means differences and for factorial analysis. Factor analysis was used for the orthogonal model. The method used was Principal Components based on Spearman's correlation matrix. RESULTS: The results provided a final, validated version of a TAUS suitable for clinical and research contexts. The last step of the study was to calculate Cronbach's alpha, in order to measure the internal consistency of the scale. The value found was 0.910, which is considered good. CONCLUSIONS: This Technology Abuse Scale may contribute to future studies, to the conscious use of technologies, to a reduction of physical and emotional damage and to an improvement of the subjects' quality of life.

Validation of a scale to evaluate Digital Dependence of Employees

BACKGROUND: The evolution of technologies and mobility, new digital resources have emerged transforming human behavior. These include the abusive use of digital devices, leading to various dependences regarding the way people use technology. Collective environments also begin to exhibit symptoms of such dependences. OBJECTIVE: Validate a Digital Dependence of Employees Scale (DDES), applied to personnel not holding leadership positions in organizations. METHOD: Data were collected via Internet. The sample totaled 301 volunteers from a state-owned company, of which 294 were statistically validated. Participants were asked to answer 20 questions prepared by experts. After the collection procedure, a database was created for statistical analysis. RESULTS: Statistical analysis procedure including factorial analysis was conducted, which confirmed data adequacy. Three statistical criteria were used: Bartlett Sphericity test, Kaiser-Meyer-Olkin Criterion and Factorial analysis, including Screeplot; the latter determined adequate commonalities, indicating the cancellation of only 1 out of the 20 original scale questions. The internal consistency of the scale measured through the Cronbach Alpha Coefficient showed a positive result of 0.764. Thus, scale validation objectives were achieved. CONCLUSION: The DDES scale was considered validated to be applied to employees in organizational environments. The limitations found to apply the scale did not compromise its results.

Validation of a scale to assess Facebook dependence

BACKGROUND INFORMATION: Facebook is a social network that has become part of the everyday life of contemporary humanity and is notably the most accessed digital tool, worldwide; through it, one can simultaneously relate to millions of people, as a source of information, communication or entertainment. OBJECTIVE: To produce and validate a scale to evaluate Facebook dependence (FDS). METHOD: Validation was performed in 5 phases: 1- initial scale construction with 20 questions, 2- expert evaluation, 3- application in 200 volunteers, 4- statistical analysis and results, and 5- elaboration of the final 18-question validated version of FDS. RESULTS: We obtained a descriptive statistical analysis, a clear-cut separation of dependents vs. non-dependents and a successful factorial analysis. These results provided a validated version of FDS. CONCLUSIONS: We were able to construct the validated final version of FDS with 18 questions appropriate to the clinical contexts and to be used in conducting research on Facebook dependence. This scale will contribute to future research related to this specific digital dependence, hopefully reducing harmful effects and improving quality of life.

Validation of the Cell Phone Dependence Scale

BACKGROUND INFORMATION: The boundary between cellphone use and abuse is quite tenuous. Research is required to evaluate the use of this device interacting in the everyday life of users, whether to speak or to perform tasks. OBJECTIVE: To construct a novel and specific scale to evaluate cellphone dependence checking its psychometric properties for clarity, accuracy and reliability. METHODS: Validation of a Cellphone Dependence Scale (CPDS) was performed in 5 phases: 1- initial scale construction with 20 questions, 2- expert evaluation, 3- application to 200 volunteers, 4- statistical analysis and results, and 5- elaboration of the final version of the CPDS. RESULTS: We used the R statistical program Version 3.4.2 and the "dplyr" package to present the descriptive statistics, the hypotheses tests of differences of means and the factorial analysis. The results provided a validated and accepted final version for CPDS. The last step of the study was to calculate Cronbach's alpha, in order to measure the internal consistency of the questionnaire. The value found was 0.897, which is considered very good. CONCLUSIONS: This project resulted in the construction of the final CPDS version suitable for the clinical context and to be used in the conduct of research on cellphone dependence. CPDS may contribute to future studies, conscious use of cellphones, harm reduction, and improved quality of life vis-à-vis the cellphone.

Validation of the scale for assessing depression and its relation to technology dependence

ABSTRACT BACKGROUND: The daily coexistence with the technologies (computer, mobile phone, tablet, among others), begins to produce significant changes in human behavior. We have observed that there is an association between dependence on technologies and major depressive disorder, as well as with other mental disorders. OBJECTIVE: To validate a scale for assessing depression and its relation to dependence on everyday technologies. METHODS: Validation of a Technology Dependent Depression Scale (TDDS) was performed in 5 phases: (1) initial scale construction with 20 questions; (2) expert evaluation; (3) application to 100 volunteers, (4) statistical analysis and results, (5) preparation of the final version of the validated TDDS. RESULTS: We used the R statistical program, version 3.4.2 and the "dplyr" package to present descriptive statistics, hypotheses tests of mean differences and factorial analysis. The results provided a validated and approved final version for TDDS. CONCLUSIONS: We constructed the final version of the validated TDDS, which is adequate for clinical contexts and to be used in future research. All the psychometric properties were checked for accuracy, reliability, presentation, clarity, pertinence and comprehension of the instrument conferring validity to the end-product.

Validation of the scale to evaluate physical damages related to the Abusive Use of Technology in daily life (PDAUTS)

BACKGROUND INFORMATION: New computer technologies, namely smart cellphones and tablets, among others, interacting along the daily life of individuals may contribute toward the rise of problems: depression, stress and physical damage (undue postures, upper and lower extremity disorders, vision problems, obesity), all of them related to excessive time spent on technological equipment; together with inadequate furniture, quality of life can be seriously affected. OBJECTIVE: To validate a scale to evaluate physical damage related to the Abusive Use of Technology (PDAUTS) in daily life. METHODS: Validation of the PDAUTS was performed through 5 phases: (1) initial scale construction with 20 questions; (2) expert evaluation of questions; (3) application to 200 volunteers; (4) statistical analysis of the results; (5) preparation of the final validated version, retaining the 20 questions. RESULTS: We used the R statistical program, version 3.4.2 and the "dplyr" package to present the descriptive statistics, the hypothesis tests of mean differences and the factor analysis. The results provided a validated final version for PDAUTS. The last step of the study was to calculate Cronbach's alpha parameter, in order to measure the internal consistency of the scale. The value found was 0.897, which in is considered very good. CONCLUSION: The validated PDAUTS allowed us to evaluate physical damage in each subject and design adequate training and treatment programs, reducing overall impairments and contributing to the improvement in quality of life.

Treatment outcomes in patients with Internet Addiction and anxiety / Resultado de tratamento de pacientes com dependência de internet e ansiedade

OBJECTIVE: To investigate the effectiveness of a treatment for Internet addiction and anxiety disorders, using cognitive behavioral therapy combined with medication, and to analyze the relationship between anxiety and Internet addiction. METHOD: An open clinical trial included 84 patients (42 in the "comorbidities" group; 42 in the "no comorbidities" group) seeking treatment for anxiety symptoms and/or Internet Addiction. The subjects responded to The Mini International Neuropsychiatric Interview 5.0; the Hamilton Anxiety Scale (HAM-A), the Hamilton Depression Scale (HDRS), Clinical Global Impressions Severity and Improvement (CGI-S and CGI-I) and the Young Internet Addiction Scale (IAT). Patients who had only Internet addiction received psychoeducation on conscious internet use and bibliotherapy; they were defined as the group without comorbidities; patients diagnosed with Internet addiction and anxiety disorder (the group with comorbidities) were forwarded for pharmacotherapy and psychotherapy. RESULTS: Both Internet Addiction and anxiety decreased after treatment; the average of Hamilton Anxiety Scale of the "comorbidities" group at the beginning was 33.9 ± 7.6, suggesting severe anxiety, and at the end of treatment it was 15.0 ± 5.1, suggesting mild anxiety and a significant improvement. The average Internet Addiction score at the beginning was 67.8 ± 9.0; at the end of the psychotherapy an average score of 37.7 ± 11.4 was registered, indicating a notable and highly significant improvement. CONCLUSIONS: The relationship between anxiety and Internet Addiction existed and was strong. Treatment significantly improved both.

OBJETIVO: Investigar a eficácia de tratamento para dependência de internet e transtornos de ansiedade, utilizando terapia cognitivo comportamental combinada com medicação, e analisar a relação entre ansiedade e dependência de internet. MÉTODO: Ensaio clínico aberto realizado no Laboratório de Pânico e Respiração no Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro (IPUB/UFRJ) com 84 pacientes (42 do grupo com comorbidades e 42 do grupo sem comorbidades) que procuravam tratamento para transtornos de ansiedade e/ou dependência de internet. Os sujeitos responderam ao MINI Entrevista Neuropsiquiátrica Internacional 5.0; a Escala Hamilton de Ansiedade (HAM-A), a Escala Hamilton de Depressão (HDRS), a Escala Clínica de Impressão Global de Severidade e de Melhora (CGI-S e CGI-I) e a Escala de Dependência de Internet de Young (IAT). Os pacientes com apenas dependência de internet receberam psicoeducação sobre o uso consciente da internet e biblioterapia, e foram considerados o grupo sem comorbidades, enquanto que, os pacientes com transtornos de ansiedade e dependência de internet foram encaminhados para o tratamento medicamentoso e psicoterapia. RESULTADOS: Tanto a dependência de internet quanto a ansiedade diminuíram após o tratamento, a média da HAM-A no grupo com comorbidades no início foi de 33,9 ± 7,6, sugerindo ansiedade grave e ao final do tratamento foi de 15 ± 5,1, sugerindo uma significativa melhora. A media de dependência de internet obtida na IAT no início do tratamento foi de 67.8 ± 9.0 e ao final da psicoterapia a maioria dos participantes apresentou média de 37.7 ± 11.4 indicando uma melhora notável. CONCLUSÃO: A relação entre ansiedade e dependência de internet existe e é forte.

Social networking, a new online addiction: a review of Facebook and other addiction disorders / Rede social ou novo vício on-line: uma revisão sobre o transtorno de dependência de Facebook

INTRODUCTION: Facebook is the world's most widely accessed social network, where millions of people intercommunicate. Behavioral and psychological changes relate to abusive and uncontrolled use creating severe impacts on users' life. METHOD: A critical revision was performed through MedLine, Lilacs, SciELO and Cochrane databases using the terms: "Facebook Addiction," "Social Network Sites," "Facebook Abuse." The search covered the past 5 years up to January 2015. Articles that examine dependence on Facebook in the general population were included; we analyzed how this concept evolved over the last five years, and hope to contribute to the better understanding of the issue and its impacts. RESULTS: Although controversial, published reports correlate Facebook addiction to mechanisms of reward and gratification. Some users developed an abusive relationship stimulated by the false feeling of satisfaction or as a way to feel better or more self-assured (increased level of excitement or escape). Studies from several countries indicate different prevalence, probably due to lack of consensus, and the use of different denominations, giving rise to the adoption of different diagnostic criteria. CONCLUSION: Social Networks are modern communication tools; however, not only benefits, but also subsequent damage caused by its abusive use must be monitored. Many users with abusive usage and dependence recognize significant losses in their personal, professional, academic, social and family lives. Further investigation is needed to determine if abusive Facebook usage is a new psychiatric classification or merely the substrate of other disorders.

INTRODUÇÃO: O Facebook é a rede social mais amplamente acessada do mundo, onde milhões de pessoas se comunicam entre si. As alterações comportamentais e psicológicos relacionadas com seu uso abusivo e excessivo estão criando sérios impactos sobre a vida dos usuários. MÉTODO: Uma revisão sistemática foi feita através das bases de dados Medline, Lilacs, SciELO e Cochrane usando os termos: "Facebook Addiction," "Social Network Sites," "Facebook Abuse.". A pesquisa abrangeu os últimos 5 anos até janeiro de 2015. Os artigos que examinam a dependência do Facebook na população em geral foram incluídos; analisamos como esse conceito evoluiu ao longo dos últimos cinco anos, e espera-se contribuir para o melhor entendimento da questão e seus impactos. RESULTADOS: Apesar de controversos, relatórios publicados correlacionam a dependência de Facebook a mecanismos de recompensa e gratificação. Alguns usuários desenvolveram um relacionamento abusivo estimulados pela falsa sensação de satisfação ou como uma maneira de se sentir melhor ou mais auto-confiante (aumento do nível de excitação ou fuga). Estudos de vários países indicam prevalência diferente, provavelmente devido à falta de consenso e ao uso de diferentes denominações, dando origem à adopção de critérios de diagnóstico diferentes. CONCLUSÃO: As redes sociais são ferramentas de comunicação modernas; existem inúmeros benefícios, mas também deve ser monitorado os danos subseqüentes causados por seu uso abusivo. Muitos usuários com o uso abusivo ou dependente declaram perdas significativas em suas vidas pessoais, profissionais, acadêmicos, sociais e familiares. É necessária uma investigação mais profunda para determinar se o uso abusivo do Facebook é uma nova classificação psiquiátrica ou meramente o substrato de outros transtornos.

Terapia cognitivo-comportamental e coaching cognitivo-comportamental: como as duas práticas se integram e se diferenciam / Cognitive-behavioural therapy and cognitive-behavioural coaching: differences and similarities between the two approaches

O coaching cognitivo-comportamental (CCC) é um processo estruturado de estabelecimento e alcance de metas que se fundamenta sobre o princípio cognitivo-comportamental, que pressupõe que não são os eventos em si que deflagram respostas emocionais e comportamentais, mas a interpretação que os indivíduos apresentam sobre eles. Nesse sentido, o CCC é um processo de identificação e desbloqueio de padrões cognitivos que dificultam a realização e o alcance de objetivos vinculado a planos de ação para a mudança comportamental, tendo sido descrito como método eficaz para o alcance de resultados na vida profissional e pessoal. No entanto, a interface dessa prática com a terapia cognitivo-comportamental (TCC) tem sido pouco investigada no Brasil. Assim, este artigo tem como objetivo discutir algumas das principais semelhanças e diferenças entre essas duas práticas. Pretende-se, com essa discussão, contribuir para o fortalecimento da prática profissional fundamentada sobre a abordagem cognitivo-comportamental para além do contexto clínico no nosso país, tendo em vista que o CCC visa atuar com clientes que não preencham critérios diagnósticos para transtornos mentais ou que simplesmente almejam alcançar uma experiência de viver mais plena e dotada de significado(AU)

Cognitive-behavioral coaching (CBC) is a structured process of goal establishment and attainment that is grounded on the cognitive-behavioral principle that emotional and behavioral responses are not triggered by events per se but by the individual's interpretation of them. In this respect, the CBC is a process of identifying and unblocking cognitive patterns that difficult goal achievement, tagged to action plans targeting behavioral change. CBC has been described as an effective method for achieving results in both professional and personal dimensions of life. However, the interface of this practice with CBT has been little investigated in Brazil. Thus, the present article aims at attempting to bridge this gap by presenting and discussing some of the main similarities and differences between these two practices. It is intended that this discussion will contribute towards the strengthening of cognitive-behavioral-grounded practices beyond the clinical context in our country, with patients who do not fulfill diagnostic criteria for mental disorders or with those who simply aim at developing a more purposeful experience of living(AU)

Subtipo respiratório versus não respiratório no transtorno de pânico com agorafobia: avaliação com terapia cognitivo-comportamental / Respiratory versus non respiratory subtypes of panic disorder with agoraphobia: cognitive behavioral therapy assessment

OBJETIVO: verificar a resposta dos pacientes com transtorno de pânico com agorafobia à modelo proposto de terapia cognitivo-comportamental (TCC) nos dois subtipos respiratórios de transtorno de pânico: o subtipo respiratório (SR) e subtipo não respiratório (SNR) Amostra randomizada por sorteio com 50 pacientes diagnosticados segundo o Manual Diagnóstico e Estatístico dos Transtornos Mentais. A medicação: antidepressivos tricíclicos ou inibidores seletivos de recaptação da serotonina. Setenta e sete ponto seis porcento da amostra de pacientes de ambos os grupos apresentaram o SR e 22,4 % o SNR. Os pacientes do SR, responderam satisfatoriamente ao tratamento com técnicas da TCC, reduzindo ansiedade, sintomas respiratórios e os ataques de pânico. Os pacientes do SR melhoraram, segundo a escala de avaliação global do funcionamento, de 55,8 para 70,9 em comparação com o SNR.(AU)

The objective of the present study was to verify the response of patients with panic disorder (agoraphobia) to existing cognitive-behavior therapy models (CBT) of two respiratory subtypes of panic disorder (PD): respiratory subtype (RS) and non respiratory subtype (NRS). We randomly selected a sample of 50 patients diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders. The medication used was tricycle or selective serotonin reuptake inhibitor antidepressants. Seventy-seven point six percent of the patients from both groups showed RS and 22.4% the NRS. The RS patients responded satisfactorily to the treatment with techniques of CBT decreasing anxiety, breathing symptoms and panic attacks. According to the global functioning assessment scale, RS patients improved from 55.8 to 70.9 in comparison with NRS ones.(AU)

Subtipo respiratório versus não respiratório no transtorno de pânico com agorafobia: avaliação com terapia cognitivo-comportamental / Respiratory versus non respiratory subtypes of panic disorder with agoraphobia: cognitive behavioral therapy assessment

OBJETIVO: verificar a resposta dos pacientes com transtorno de pânico com agorafobia à modelo proposto de terapia cognitivo-comportamental (TCC) nos dois subtipos respiratórios de transtorno de pânico: o subtipo respiratório (SR) e subtipo não respiratório (SNR) Amostra randomizada por sorteio com 50 pacientes diagnosticados segundo o Manual Diagnóstico e Estatístico dos Transtornos Mentais. A medicação: antidepressivos tricíclicos ou inibidores seletivos de recaptação da serotonina. Setenta e sete ponto seis porcento da amostra de pacientes de ambos os grupos apresentaram o SR e 22,4 % o SNR. Os pacientes do SR, responderam satisfatoriamente ao tratamento com técnicas da TCC, reduzindo ansiedade, sintomas respiratórios e os ataques de pânico. Os pacientes do SR melhoraram, segundo a escala de avaliação global do funcionamento, de 55,8 para 70,9 em comparação com o SNR.

The objective of the present study was to verify the response of patients with panic disorder (agoraphobia) to existing cognitive-behavior therapy models (CBT) of two respiratory subtypes of panic disorder (PD): respiratory subtype (RS) and non respiratory subtype (NRS). We randomly selected a sample of 50 patients diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders. The medication used was tricycle or selective serotonin reuptake inhibitor antidepressants. Seventy-seven point six percent of the patients from both groups showed RS and 22.4% the NRS. The RS patients responded satisfactorily to the treatment with techniques of CBT decreasing anxiety, breathing symptoms and panic attacks. According to the global functioning assessment scale, RS patients improved from 55.8 to 70.9 in comparison with NRS ones.

Cardio-respiratory symptoms in panic disorder: a contribution from cognitive-behaviour therapy / Sintomas cardiorrespiratórios no transtorno de pânico: uma contribuição da terapia cognitivo-comportamental

Objective: To compare patients with panic disorder with agoraphobia treated with cognitive-behavioural therapy (CBT) associated with the medication with patients treated only with medication and verify the behaviour of the cardio-respiratory symptoms of both groups. Methods: Randomized sample in the Psychiatry Institute of the Federal University of Rio de Janeiro, divided in two groups of 25 participants each. Group 1 undertook 10 weekly sessions of CBT with one hour of duration each together with medication. Group 2, Control, were administered medication that only consisted of tricyclic anti-depressants and selective inhibitors of the re-uptake of serotonin. Evaluation instruments were applied at the beginning and to the end of the interventions. Results: According to the applied scales, group 1 showed statistically more significant results than group 2, with: reduction of panic attacks, cardio-respiratory symptoms, anticipatory anxiety, agoraphobia avoidance and fear of bodily sensations. Conclusion: Exposures (in vivo and interoceptive), especially for induction symptom exercises and relaxation, were considered essential to prepare patients with panic disorder to handle future cardio-respiratory symptoms and panic attacks with agoraphobia.

Objetivo: Comparar pacientes com transtorno de pânico com agorafobia, tratados com terapia cognitivo-comportamental (TCC) e medicação, com pacientes com o mesmo diagnóstico, tratados apenas com medicação, e verificar o comportamento dos sintomas cardiorrespiratórios em ambos os grupos. Métodos: Amostra randomizada com 50 voluntários diagnosticados no Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro, dividida em dois grupos de 25 pacientes: o grupo 1 realizou 10 sessões semanais e individuais de TCC com uma hora de duração combinada com medicação. O grupo 2, controle, foi tratado apenas com medicação. A medicação para ambos os grupos consistiu de antidepressivos tricíclicos e inibidores seletivos de recaptação da serotonina. Instrumentos de avaliação foram aplicados no início e ao final das intervenções. Resultados: De acordo com as escalas aplicadas, o grupo 1 apresentou resultados estatisticamente mais significativos do que o grupo 2, com redução dos ataques de pânico, dos sintomas cardiorrespiratórios, ansiedade antecipatória, esquiva agorafobia e medo das sensações corporais. Conclusão: As exposições (in vivo e interoceptivas) e os exercícios de indução dos sintomas e de relaxamento foram considerados essenciais para os pacientes aprenderem a lidar com o transtorno de pânico, com os ataques e com as possíveis situações agorafóbicas futuras.