Clinical validity and intrarater and test-retest reliability of the Structured Clinical Interview for DSM-5 - Clinician Version (SCID-5-CV).

AIM: The Structured Clinical Interview for the DSM is one of the most used diagnostic instruments in clinical research worldwide. The current Clinician Version of the instrument (SCID-5-CV) has not yet been assessed in respect to its psychometric qualities. We aimed to assess the clinical validity and different reliability indicators (interrater test-retest, joint interview, face-to-face vs telephone application) of the SCID-5-CV in a large sample of 180 non-prototypical and psychiatric patients based on interviews conducted by raters with different levels of clinical experience. METHODS: The SCID-5-CV was administered face-to-face and by telephone by 12 psychiatrists/psychologists who took turns as raters and observers. Clinical diagnoses were established according to DSM-5 criteria and the longitudinal, expert, all data (LEAD) procedure. We calculated the percentage of agreement, diagnostic sensitivity and specificity, and the level of agreement (kappa) for diagnostic categories and specific diagnoses. RESULTS: The percentage of positive agreement between the interview and clinical diagnoses ranged between 73% and 97% and the diagnostic sensitivity/specificity were >0.70. In the joint interview, the levels of positive agreement were high (>75%) and kappa levels were >0.70 for most diagnoses. The values were less expressive, but still adequate, for interrater test-retest interviews. CONCLUSION: The SCID-5-CV presented excellent reliability and high specificity as assessed with different methods. The clinical validity of the instrument was also confirmed, which supports its use in daily clinical practice. We highlight the adequacy of the instrument to be used via telephone and the need for careful use by professionals with little experience in psychiatric clinical practice.

Risk factors for mental health problems in school-age children from a community sample.

The epidemiological dimension of mental health problems in childhood and its impact warrant new studies. Knowledge about the predictors of mental health in children is scant in developing countries. The present study estimated the prevalence of psychiatric disorders in Brazilian school-age children based on a community sample from primary health care services, with the aim of verifying the predictive value of biological, social, and familial risk factors in children's mental health. The study was performed with 120 children of both genders identified through their mothers. The children's mental health was evaluated by sociodemographic factors and a diagnostic interview conducted with parents. Biological, social, and familial risk factors were evaluated by the Supplemental Questionnaire and Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, 4th edition. Of the 120 children, 45.8 % were diagnosed with at least one mental health disorder. Children with diagnoses of depressive disorder and generalized anxiety disorder presented evidence of greater exposure to risk factors compared with children without these psychiatric diagnoses. Children with more risk factors throughout their lifetime had greater comorbidities compared with children with a lower number of risk factors. The identification of groups exposed to interconnected risk factors represents a priority when planning mental health practices. The strong role of chronic familial risk factors needs to be emphasized because they are a possible target for the prevention of depressive and anxiety disorders.

Adaptation and initial psychometric study of the self-report version of Liebowitz Social Anxiety Scale (LSAS-SR).

OBJECTIVE: The objectives of the present study were to adapt the Liebowitz Social Anxiety Scale from the clinician administered to the self-report version (LSAS-SR) and to perform the initial psychometric studies concerning internal consistency and item analysis. METHODS: The phase of adaptation was performed by two specialists in the Mental Health area and the face validity was tested by a group of 30 university students. As part of the psychometric study of the LSAS-SR, the internal consistency was assessed and the items were analyzed by applying the scale to 682 university students. RESULTS: The LSAS-SR proved to be easy to understand by the group studied, with no need to make any changes in the instructions for application. The scale showed adequate internal consistency (α = 0.96) as well as an acceptable correlation between items and total score (0.38-0.72). CONCLUSIONS: The initial psychometric studies of the LSAS-SR presented adequate indicators, stimulating the continuation of studies involving the validation and reliability of the scale not only when applied to a sample of the general population, but also when applied to clinical groups.

Progression of the COVID-19 pandemic, Brazilian healthcare workers' emotional burden and the effects on professional fulfillment at the end of the third wave: a longitudinal study.

Introduction: Even though the long-term effects of the COVID-19 pandemic on healthcare workers' mental health remain unknown, such effects might negatively impact health services and patient safety, especially in countries like Brazil, where there is little investment in public health policies. Objectives: To assess how the mental health indicators of Brazilian healthcare workers progressed between the beginning and 2 years after the pandemic (at the end of the third wave when there was a significant decrease in the number of new cases and deaths). Methods: The sample comprised healthcare workers whose mental health indicators have been monitored since the beginning of the pandemic in Brazil. The potential participants were addressed via social media and contacted through class councils and health institutions across Brazil. A total of 165 participants answered instruments at the baseline and 2 years after the pandemic. Data were collected online using the Redcap platform and addressed symptoms of anxiety, depression, post-traumatic stress, insomnia, and burnout (emotional exhaustion, depersonalization, and professional fulfillment). Results: Brazilian healthcare workers faced three periods of intensified incidence of new cases and deaths due to COVID-19 for 2 years. Approximately one-third of the sample still experiences high levels of anxiety, depression, and post-traumatic stress. Insomnia indicators remained the most prevalent compared to the baseline assessment, while post-traumatic stress symptoms (p = 0.04) and professional fulfillment (p = 0.005) decreased. Conclusion: The lack of positive changes in mental health indicators coupled with decreased professional fulfillment over time highlights the pandemic's chronic effects and the need for organizations to monitor these workers' mental health, especially in developing countries like Brazil, where there is a high demand for health services and public policies are poorly structured and unstable.

Mental health trajectories of Brazilian health workers during two waves of the COVID-19 pandemic (2020-2021).

This study aimed to: (a) monitor the progression of symptoms of mental health burden among frontline workers caring for COVID-19 patients in Brazil during the two waves of the pandemic, considering the number of new cases and deaths, and; (b) to verify the different mental health outcomes and potential associations with current burnout symptoms. A non-probabilistic sample of health professionals was assessed as the pandemic progressed in Brazil (May/2020 August/2021). Standardized instruments focusing on anxiety, depression, insomnia, post-traumatic stress, and burnout symptoms were applied online. The results indicate a decrease in anxiety levels, what was related to when the number of new cases declined (end 1th-wave); symptoms returned to higher levels later. Emotional exhaustion increased when there was a higher incidence of cases, returning to the baseline levels at the end of the second wave. Depersonalization symptoms increased in this phase, characterized by a further decrease in new cases, while professional accomplishment decreased during the follow-up. The highest number of new cases was associated with a higher frequency of anxiety (OR = 1.467;95%CI = 1.109-1.941; p = 0.007) and professional accomplishment (OR = 1.490;95%CI = 1.098-2.023; p = 0.011). The subjects with trajectory of resilience against anxiety presented the lowest level of emotional exhaustion and depersonalization (p < 0.05). The conclusion is that the pressure experienced by healthcare professionals throughout the pandemic caused different impacts on their mental health, emphasizing the dynamic nature of this condition and the need for constant monitoring and care. This finding directly affects mental health prevention and intervention measures, which remain a priority and require continuous reinforcement, especially among the most vulnerable groups.

Workplace Protections and Burnout Among Brazilian Frontline Health Care Professionals During the COVID-19 Pandemic.

Health care workers from low- and middle-income countries have been playing a critical role in overcoming the challenges related to the COVID-19 pandemic; yet little is known about the relationship between workplace protections and wellbeing of Brazilian health care workers during the pandemic. This study aimed to evaluate whether Brazilian health care workers were satisfied with their workplace measures to protect their physical and mental health during the pandemic, and to assess the associations of such levels of satisfaction with indicators of burnout. Licensed Brazilian health care professionals were recruited via popular media between 5/19/2020 and 8/23/2020 to complete an online survey including questions about their demographic/professional characteristics, satisfaction with their workplace protective measures during the pandemic, and validated questionnaires assessing neuroticism, resilient coping, and symptoms of burnout. Most participants reported being dissatisfied with their workplace measures to protect their physical (516, 56.3%) and mental health (756, 82.5%). In multivariable analysis adjusted for personal and environmental factors, dissatisfaction with workplace physical health protections was significantly associated with higher levels of emotional exhaustion (B = 1.08, 95% CI = 0.47-1.69) and depersonalization (B = 0.61, 95% CI = 0.10-1.12), and dissatisfaction with workplace mental health protections significantly associated with higher levels emotional exhaustion (B = 1.17, 95% CI = 0.40-1.95). Efforts to improve both physical and mental health protective measures are critical to guarantee that health care workers continue to provide care at their maximum capacity.

Maintained anxiolytic effects of cannabidiol after treatment discontinuation in healthcare workers during the COVID-19 pandemic.

Objective: To assess whether the effects of oral administration of 300 mg of Cannabidiol (CBD) for 28 days on mental health are maintained for a period after the medication discontinuation. Methods: This is a 3-month follow-up observational and clinical trial study. The data were obtained from two studies performed simultaneously by the same team in the same period and region with Brazilian frontline healthcare workers during the COVID-19 pandemic. Scales to assess emotional symptoms were applied weekly, in the first month, and at weeks eight and 12. Results: The primary outcome was that, compared to the control group, a significant reduction in General Anxiety Disorder-7 Questionnaire (GAD-7) from baseline values was observed in the CBD group on weeks two, four, and eight (Within-Subjects Contrasts, time-group interactions: F1-125 = 7.67; p = 0.006; ηp 2 = 0.06; F1-125 = 6.58; p = 0.01; ηp 2 = 0.05; F1-125 = 4.28; p = 0.04; ηp 2 = 0.03, respectively) after the end of the treatment. Conclusions: The anxiolytic effects of CBD in frontline health care professionals during the COVID-19 pandemic were maintained up to 1 month after the treatment discontinuation, suggesting a persistent decrease in anxiety in this group in the real world. Future double-blind placebo-controlled clinical trials are needed to confirm the present findings and weigh the benefits of CBD therapy against potential undesired or adverse effects.

Cannabidiol for COVID-19 Patients with Mild to Moderate Symptoms (CANDIDATE Study): A Randomized, Double-Blind, Placebo-Controlled Clinical Trial.

Importance: Owing to its anti-inflammatory properties and antiviral "in vitro" effect against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), cannabidiol (CBD) has been proposed as a potential treatment for coronavirus disease 2019 (COVID-19). Objective: To investigate the safety and efficacy of CBD for treating patients with mild to moderate COVID-19. Design: Randomized, parallel-group, double-blind, placebo-controlled clinical trial conducted between July 7 and October 16, 2020, in two sites in Brazil. Setting: Patients were recruited in an emergency room. Participants: Block randomized patients (1:1 allocation ratio-by a researcher not directly involved in data collection) with mild and moderate COVID-19 living in Ribeirão Preto, Brazil, seeking medical consultation, and those who voluntarily agreed to participate in the study. Interventions: Patients received 300 mg of CBD or placebo added to standard symptomatic care during 14 days. Main Outcome and Measure: The primary outcome was reduction or prevention of the deterioration in clinical status from mild/moderate to severe/critical measured with the COVID-19 Scale or the natural course of the resolution of typical clinical symptoms. Primary study outcome was assessed on days 14, 21, and 28 after enrollment. Results: A total of 321 patients were recruited and assessed for eligibility, and 105 were randomly allocated either in CBD (n=49) or in placebo (n=42) group. Ninety-one participants were included in the analysis of efficacy. There were no baseline between-group differences regarding disease severity (χ2=0.025, p=0.988) and median time to symptom resolution (12 days [95% confidence interval, CI, 6.5-17.5] in the CBD group, 9 days [95% CI, 4.8-13.2] in the placebo group [χ2=1.6, p=0.205 by log-rank test]). By day 28, 83.3% in the CBD group and 90.2% in the placebo group had resolved symptoms. There were no between-group differences on secondary measures. CBD was well tolerated, producing mostly mild and transient side effects (e.g., somnolence, fatigue, changes in appetite, lethargy, nausea, diarrhea, and fever), with no significant differences between CBD and placebo treatment groups. Conclusions and Relevance: Daily administration of 300 mg CBD for 14 days failed to alter the clinical evolution of COVID-19. Further trials should explore the therapeutic effect of CBD in patients with severe COVID-19, possibly trying higher doses than the used in our study. Trial Registration: ClinicalTrials.gov identifier NCT04467918 (date of registration: July 13, 2020).

Further psychometric study of the Beck Anxiety Inventory including factorial analysis and social anxiety disorder screening.

OBJECTIVE: To analyze the psychometric properties of the Brazilian Portuguese version of the Beck Anxiety Inventory (BAI) in terms of its internal consistency, scores distribution, concurrent and discriminant validity, and factorial analysis in a sample of university students and social anxiety disorder (SAD) cases and non-cases. METHODS: A sample of Brazilian university students from the general population (N = 2314) and a sample of university students identified as cases (N = 88) and non-cases (N = 90) of SAD were assessed, using as a parameter the Structured Clinical Interview for the DSM-IV. The different instruments were completed individually in the presence of an experienced rater. RESULTS: The BAI showed adequate internal consistency (0.88-0.92) and discriminant validity, with 0.74 sensitivity and 0.71 specificity for a cut-off score of 10. The factorial analysis suggested a three-factor solution to be the most adequate. CONCLUSIONS: The version of the BAI studied is quite adequate to be used in the context of Brazilian university students, identifying the presence of anxiety indicators. However, its usefulness to screen for SAD seems limited.

Risk and Protective Factors for the Mental Health of Brazilian Healthcare Workers in the Frontline of COVID-19 Pandemic.

The objective was to compare the mental health indicators of health workers providing care to individuals with COVID-19 in Brazil, considering sociodemographic and occupational variables and the risk perception of contamination by the Sars-CoV-2 of workers from different professions, identifying risk and protective factors. A sample of 916 health workers was assessed: physicians, nursing workers, and workers from other professions (psychologists, physical therapists, nutritionists, speech therapists, occupational therapists, dentists, pharmacists, and social workers). REDCAP software was used to collect data online, using standardized instruments to assess anxiety, depression, posttraumatic stress, and insomnia, and one questionnaire addressed risk and protective variables. Statistical techniques for comparing groups were used along with logistic regression analysis. The results revealed that all the groups presented indicators of significant mental health problems (>36%), especially the nursing group. A larger percentage of participants, regardless of the profession, presented a high rate of insomnia disorders, while posttraumatic stress was the least expressive. Occupational variables stand out as risk factors for mental health, with specificities among the different groups. A protective factor for all the groups was having positive professional prospects. The protective factors for the physicians group included support provided by co-workers, being older and a man, while being satisfied with physical protective measures implemented by the employing institution was a protective factor for the groups composed of nursing workers and other professionals. These findings are relevant for devising mental health care strategies.

Efficacy and Safety of Cannabidiol Plus Standard Care vs Standard Care Alone for the Treatment of Emotional Exhaustion and Burnout Among Frontline Health Care Workers During the COVID-19 Pandemic: A Randomized Clinical Trial.

Importance: Frontline health care professionals who work with patients with COVID-19 have an increased incidence of burnout symptoms. Cannabidiol (CBD) has anxiolytic and antidepressant properties and may be capable of reducing emotional exhaustion and burnout symptoms. Objective: To investigate the safety and efficacy of CBD therapy for the reduction of emotional exhaustion and burnout symptoms among frontline health care professionals working with patients with COVID-19. Design, Setting, and Participants: This prospective open-label single-site randomized clinical trial used a 1:1 block randomization design to examine emotional exhaustion and burnout symptoms among frontline health care professionals (physicians, nurses, and physical therapists) working with patients with COVID-19 at the Ribeirão Preto Medical School University Hospital in São Paulo, Brazil. Participants were enrolled between June 12 and November 12, 2020. A total of 214 health care professionals were recruited and assessed for eligibility, and 120 participants were randomized in a 1:1 ratio by a researcher who was not directly involved with data collection. Interventions: Cannabidiol, 300 mg (150 mg twice per day), plus standard care or standard care alone for 28 days. Main Outcomes and Measures: The primary outcome was emotional exhaustion and burnout symptoms, which were assessed for 28 days using the emotional exhaustion subscale of the Brazilian version of the Maslach Burnout Inventory-Human Services Survey for Medical Personnel. Results: A total of 120 participants were randomized to receive either CBD, 300 mg, plus standard care (treatment arm; n = 61) or standard care alone (control arm; n = 59) for 28 days. Of those, 118 participants (59 participants in each arm; 79 women [66.9%]; mean age, 33.6 years [95% CI, 32.3-34.9 years]) received the intervention and were included in the efficacy analysis. In the treatment arm, scores on the emotional exhaustion subscale of the Maslach Burnout Inventory significantly decreased at day 14 (mean difference, 4.14 points; 95% CI, 1.47-6.80 points; partial eta squared [ηp2] = 0.08), day 21 (mean difference, 4.34 points; 95% CI, 0.94-7.73 points; ηp2 = 0.05), and day 28 (mean difference, 4.01 points; 95% CI, 0.43-7.59 points; ηp2 = 0.04). However, 5 participants, all of whom were in the treatment group, experienced serious adverse events: 4 cases of elevated liver enzymes (1 critical and 3 mild, with the mild elevations reported at the final 28-day assessment) and 1 case of severe pharmacodermia. In 2 of those cases (1 with critical elevation of liver enzymes and 1 with severe pharmacodermia), CBD therapy was discontinued, and the participants had a full recovery. Conclusions and Relevance: In this study, CBD therapy reduced symptoms of burnout and emotional exhaustion among health care professionals working with patients during the COVID-19 pandemic. However, it is necessary to balance the benefits of CBD therapy with potential undesired or adverse effects. Future double-blind placebo-controlled clinical trials are needed to confirm the present findings. Trial Registration: ClinicalTrials.gov Identifier: NCT04504877.

Evaluation of the psychometric properties of the Social Phobia Inventory in university students.

OBJECTIVE: The aim of the study was to study the psychometric properties of the Social Phobia Inventory (SPIN) in its version for the context of Brazilian adults. METHODS: A sample of Brazilian university students from the general population (n = 2314) and a sample of university students identified as cases (n = 88) and noncases (n = 90) of social phobia were assessed, using as a parameter the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. The different instruments were applied individually in the presence of a rater. RESULTS: The SPIN showed adequate internal consistency (.63-.90) and concurrent validity with different instruments of auto- and hetero-evaluation of social phobia. Discriminative validity showed 0.84 to 0.86 sensitivity and 0.84 to 0.87 specificity for cutoff notes between 19 and 21. Factorial analysis showed the presence of a variable number of factors as a function of the different samples. CONCLUSIONS: The version of the SPIN studied is quite adequate for use in the context of Brazilian university students, favoring the screening of social phobia. However, further studies using more diverse samples are needed.

The fast alcohol screening test (FAST) is as good as the AUDIT to screen alcohol use disorders.

This study was aimed at assessing the psychometric qualities of the fast alcohol screening test (FAST), and at comparing these qualities to those of the alcohol use disorders identification test (AUDIT) in three samples of Brazilian adults: (i) subjects attended at an emergency department (530); (ii) patients from a psychosocial care center (40); and (iii) university students (429). The structured clinical interview for diagnosis (SCID)-IV was used as gold standard. The FAST demonstrated high test-retest and interrater reliability coefficients, as well as high predictive and concurrent validity values. The results attest the validity and reliability of the Brazilian version of the FAST for the screening of indicators of alcohol abuse and dependence.

Behavioral problems and their relationship to maternal depression, marital relationships, social skills and parenting.

Behavioral problems have been associated with multiple variables; however, studies simultaneously investigating parenting practices, marital relationships in bi-parental families, maternal depression, and child behavior remain a gap in the literature. The objective was to verify associations between positive and negative parenting practices, marital relationships, social skills, and behavioral problems among children from bi-parental families with and those without maternal depression; to identify the predictive effect of positive and negative parenting practices, marital relationships, children's social skills, and maternal depression, for internalizing, externalizing behavior problems and internalizing and externalizing comorbidities. A case-control study with a cross-sectional design was adopted to ensure the groups were homogeneous in regard to the children's, mothers', and families' sociodemographic characteristics. A total of 35 mothers currently with depression and 35 without depression indicators participated in the study, while the children were 25 preschoolers and 23 school-aged children. The mothers responded to instruments addressing depression, child behavior, parenting practices, and marital relationships. The results reveal maternal depression associated with marital relationships, positive parenting, and context variables. Maternal depression and marital relationship were found to influence externalizing problems; maternal depression, child-rearing practices, marital relationships, and the children's behavioral repertoires influence internalizing and externalizing comorbidities; and none of the independent variables influenced the occurrence of internalizing problems.

Cross- cultural validation of the Brazilian Portuguese version of the Social Phobia Inventory (SPIN): study of the items and internal consistency.

OBJECTIVE: The objective of the present study was to carry out the cross- cultural validation for Brazilian Portuguese of the Social Phobia Inventory, an instrument for the evaluation of fear, avoidance and physiological symptoms associated with social anxiety disorder. METHOD: The process of translation and adaptation involved four bilingual professionals, appreciation and approval of the back- translation by the authors of the original scale, a pilot study with 30 Brazilian university students, and appreciation by raters who confirmed the face validity of the Portuguese version, which was named ' Inventário de Fobia Social' . As part of the psychometric study of the Social Phobia Inventory, analysis of the items and evaluation of the internal consistency of the instrument were performed in a study conducted on 2314 university students. RESULTS: The results demonstrated that item 11, related to the fear of public speaking, was the most frequently scored item. The correlation of the items with the total score was quite adequate, ranging from 0.44 to 0.71, as was the internal consistency, which ranged from 0.71 to 0.90. DISCUSSION/CONCLUSION: The authors conclude that the Brazilian Portuguese version of the Social Phobia Inventory proved to be adequate regarding the psychometric properties initially studied, with qualities quite close to those of the original study. Studies that will evaluate the remaining indicators of validity of the Social Phobia Inventory in clinical and non-clinical samples are considered to be opportune and necessary.

Construction and validation of the Brazilian Questionário de Respostas Socialmente Habilidosas Segundo Relato de Professores (QRSH-PR).

Behavioral problems in preschool children are one of the most frequent motives for seeking psychological care by parents and caregivers. Instruments are considered necessary, created from a Social Skills Training theoretical-practical perspective, which may systematically assist the identification of social skills and behavioral deficits, helping professionals in the prevention and/or reduction of behavioral problems. The purpose of this study was to test the psychometric validity and reliability of an instrument for evaluation of Socially Skilled Responses, from a teacher's perspective (QRSH-PR). For this purpose, 260 preschool children were evaluated, differentiated in subgroups without and without behavioral difficulties, based on the Child Behavior Scale (Escala de Comportamento Infantil/ECI-Professor). Studies were conducted for construct, discrimination, concurrent and predictive validity. The Cronbach Alpha was calculated to evaluate internal consistency. The obtained results pointed to positive indicators in reference to construct, discrimination, and predictive validity, and even for good internal consistency, indicating that the items consistently measure the construct of social skills, and differentiated children with and without behavioral problems. The questionnaire is considered to be gauged for evaluation of socially skilled responses from preschool children, and applicable in educational and clinical environments.

Psychometric properties and diagnostic utility of a Brazilian version of the PCL-5 (complete and abbreviated versions).

Background: With the release of the fifth edition of the Diagnostic and Statistical Manual for Mental Disorders (DSM-5), the Posttraumatic Stress Disorder Checklist (PCL) has been updated to meet the revisions of the diagnostic criteria for Posttraumatic Stress Disorder (PTSD). However, the diagnostic utility and reliability of a Brazilian version of the new Posttraumatic Stress Disorder Checklist (PCL-5) have not been investigated yet. Objective: To investigate the internal consistency, test-retest reliability, and diagnostic utility of the complete version (21-item) and two abbreviated (8-item and 4-item) versions of the Brazilian PCL-5. Methods: A total of 85 individuals with a history of exposure to at least one traumatic event underwent a diagnostic interview using the Structured Clinical Interview for DSM-5 (SCID-5-CV) and completed the Brazilian version of the PCL-5. Moreover, participants were invited to complete the checklist for a second time 10-30 days after the first assessment. Results: Both the complete and abbreviated versions of the Brazilian PCL-5 showed good internal consistency (complete PCL-5, α = .96; 8-item, α = .93; 4-item, α = .85) and test-retest reliability (complete PCL-5, ICC .87 [95% CI, 0.65-0.95]; 8-item, ICC .84 [95% CI, 0.60-0.94]; 4-item, ICC .84 [95% CI, 0.58-0.94]). Diagnostic utility analyses using the Structured Clinical Interview for DSM-5 (SCID-5-CV) revealed that a cutoff point of 36 presented the higher overall efficiency for predicting a PTSD diagnosis Overall Efficiency (OE, .80) and corresponded to Youden's index J (.65). For the 8-item version, a cutoff point of 13 corresponded to Youden's index J (.61), while scores of 21 or more were associated with the highest OE (.78). For the 4-item PCL-5, scores > 7 presented the highest OE (.77) and corresponded to Youden's index J (.59). Conclusions: Overall, the findings provide relevant evidence regarding the high reliability and diagnostic utility of this Brazilian version of the PCL-5.

Antecedentes: con la publicación de la quinta edición del Manual de Diagnóstico y Estadístico para los Trastornos Mentales (DSM-5), el Cuestionario para el Trastorno de Estrés Postraumático (PCL) se ha actualizado para cumplir con las revisiones de los criterios de diagnósticos del trastorno de estrés postraumático (TEPT). Sin embargo, la utilidad diagnóstica y la confiabilidad de una versión brasileña del nuevo cuestionario de trastorno de estrés postraumático (PCL-5) aún no se ha investigado.Objetivo: investigar la consistencia interna, la confiabilidad test-retest y la utilidad diagnóstica de la versión completa (21 ítems) y dos versiones abreviadas (8 y 4 ítems) del PCL-5 brasileño.Métodos: Un total de 85 individuos con antecedentes de exposición, al menos, a un evento traumático se sometieron a una entrevista diagnóstica utilizando la entrevista clínica estructurada para el DSM-5 (SCID-5-CV) y completaron la versión brasileña del PCL-5. Además, los participantes fueron invitados a completar el cuestionario por segunda vez entre 10 y 30 días después de la primera evaluación.Resultados: Tanto la versión completa como las abreviadas de la PCL-5 brasileña mostraron una buena consistencia interna (PCL-5 completa, α = .96; 8 ítem, α = .93; 4-item, α = .85) y confiabilidad test-retest (PCL-5 completa, ICC .87 [IC 95%, .65 - .95]; 8 ítems, ICC .84 [IC 95%, 0.60 - 0.94]; 4 ítems, ICC .84 [IC 95%, 0.58] - 0,94]). Los análisis de utilidad diagnóstica que utilizaron el SCID-5-CV revelaron que un punto de corte de 36 presentó la mayor eficiencia general para predecir un diagnóstico de TEPT (OE, .80) y correspondió al índice J de Youden (.65). Para la versión de 8 ítems, un punto de corte de 13 correspondió al índice J de Youden (.61), mientras que las puntuaciones de 21 o más se asociaron con el OE más alto (.78). Para el PCL-5 de 4 ítems, los puntajes> 7 presentaron el OE más alto (.77) y correspondieron al índice J de Youden (.59).Conclusiones: En conjunto, los hallazgos proporcionan evidencia relevante con respecto a la alta confiabilidad y utilidad diagnóstica de esta versión brasileña del PCL-5.

Personality Inventory for DSM-5 (PID-5): cross-cultural adaptation and content validity in the Brazilian context.

OBJECTIVE: To describe the process of cross-cultural adaptation of the Personality Inventory for DSM-5 (PID-5) to the Brazilian context. METHODS: Cross-cultural adaptation involved the steps of independent translation of the instrument, synthesis version, and back-translation. Analysis of content validity was conducted by a multidisciplinary expert committee and consisted of quantitative assessment of agreement indicators. The test was then applied to a target population. RESULTS: All the steps required for a cross-cultural adaptation were followed and satisfactory agreement values (≥ 4.75) were reached for most of the structures assessed. Most of the changes suggested by the experts were followed; these changes consisted primarily of adjustments to verb tense and agreement and the inclusion of letters and words to allow gender inflection. In the pre-test, no suggestions were made and the instrument was considered comprehensible. CONCLUSION: The Brazilian version of the PID-5 was found to be adequate to the Brazilian context from semantic, idiomatic, cultural, and conceptual perspectives. The Brazilian version assessed here can be freely used, was approved by the publishers who hold the copyright on the instrument, and is considered the official version of the instrument. New studies are underway to determine the validity and reliability of the PID-5.

Associations between Sociodemographic and Behavioral Variables and Educational Practices on Mother-Child Dyads

The association between the sociodemographic variables of children with behavior problems and mothers with maternal depression is widely acknowledged in the literature. However, there is a lack of studies addressing the association of these variables with maternal parenting practices in typical samples, i.e., children without behavior problems and mothers without current depression indicators. The aim of this study was to identify associations between the sociodemographic variables of children and mothers with the mothers' parenting practices and children's behavioral indicators (resources and problems) in a sample of children without behavior problems and mothers without current depression indicators. This quantitative, cross-sectional, descriptive, and correlational study addressed 46 biological mothers (married or in a stable relationship) and their children. A sociodemographic questionnaire and validated instruments addressing child behavior, maternal mental health, and parenting practices were applied. Findings showed that the mothers did not present mental health problems (e.g., behavior problems or maternal depression), but a) they presented deficits of positive practices and an excess of negative practices, and the children displayed deficits in social skills and behavior problems; b) there was an association between positive practices and the children's social skills and between negative practices and children's behavior problems; c) the frequency of positive and negative practices was equivalent among boys and girls, and d) boys more frequently presented behavior problems while school-aged children more frequently presented social skills deficits. The results indicate that even non-clinical samples may present harmful parenting practices, excess negative practices, and deficits in positive practices. Hence, there is a need for timely interventions to prevent behavior problems among children and maternal depression arising from conflicting interactions in the parenthood sphere.

Las asociaciones de variables sociodemográficas de madres con depresión materna y de sus hijos con problemas comportamentales son ampliamente reconocidas en la literatura. Por otro lado, en muestras típicas existe un vacío de estudios que traten de las asociaciones de esas variables con las prácticas parentales maternas; o sea, en niños de corta edad sin problemas comportamentales y en madres sin indicadores de depresión actual. Considerando lo anterior, el objetivo de este estudio fue verificar las asociaciones entre las variables sociodemográficas de hijos y de las prácticas parentales de sus madres con los indicadores comportamentales de recursos y problemas de los hijos. Se utilizó una muestra de hijos sin problemas comporta-mentales y de madres sin indicadores de depresión actual. Se trata de un estudio cuantitativo, transversal, descriptivo y correlacional. Participaron 46 madres biológicas que vivían con su pareja y sus hijos. Las participantes respondieron al cuestionario sobre variables sociodemográficas y a los instrumentos calibrados sobre comportamientos infantiles, salud mental materna y prácticas educativas. Se identificó que: (a) a pesar de no presentar problemas de salud mental (problemas de comportamiento y depresión materna), las madres evidenciaron un déficit de prácticas positivas y un exceso de prácticas negativas; a su vez, los hijos presentaron déficit de habilidades sociales y hubo quejas comportamentales; (b) se encontró asociación entre las prácticas positivas y las habilidades sociales; también se encontró asociación entre las prácticas negativas y las quejas comportamentales; (c) las prácticas positivas y negativas ocurrieron de manera equivalente entre niños y niñas; y (d) los niños tuvieron más quejas comportamentales; además, los hijos, en edad escolar, tuvieron más déficits de habilidades sociales. Los datos indican que inclusive en muestras no clínicas existen variables de riesgo en lo que se refiere a la parentalidad, a excesos de prácticas negativas y a déficits de prácticas positivas. Lo encontrado sugiere la necesidad de intervenir precozmente, para evitar el surgimiento de problemas de comportamiento infantil y también de la depresión materna, cuando esta proviene de interacciones de conflictos en el ambiente de la parentalidad.

Práticas educativas de professores, comportamento e dificuldades de desempenho acadêmico: comparações de grupos / Teachers' practices and students' academic and behavioral difficulties: a comparison of groups / Prácticas educativas de los maestros, comportamiento y dificultades de desempeño escolar: comparaciones de grupos

Constitui-se em lacuna do conhecimento as práticas educativas dos professores frente às crianças que apresentam dificuldades múltiplas ou específicas. Objetivou-se caracterizar e comparar as práticas educativas positivas e negativas de professores para três grupos diferenciados de crianças, considerando-se uma amostra não clínica, sem problemas comportamentais e de desempenho acadêmico (G1) e duas amostras clínicas, uma de crianças com problemas múltiplos, comportamentais e de desempenho acadêmico (G2) e outra de crianças com problemas específicos, comportamentais (G3). Participaram 102 meninos e suas professoras, as quais responderam a instrumentos sobre práticas educativas, habilidades sociais e problemas comportamentais. Verificou-se que, comparativamente, crianças com problemas de desempenho e de comportamento associados apresentaram mais problemas de comportamento, menos habilidades sociais e seus professores relataram mais déficits de práticas educativas positivas e uso mais frequente de práticas negativas. Conclui-se sobre a relevância de estudar riscos combinados e de promover intervenções com professores e crianças

There is a gap in the knowledge concerning the teaching of children with multiple or specific difficulties. The objective was to characterize and compare positive and negative teaching practices among three groups of children: a non-clinical sample, without problem behaviors and typical academic performance (G1), and two clinical samples: a group with multiple behavioral and academic performance problems (G2) and a group with specific problem behaviors (G3). A total of 102 boys and their respective teachers participated in the study. The teachers answered instruments addressing teaching practices, social skills, and problem behaviors. A comparison between the groups showed that children with associated performance and behavioral problems presented more problem behaviors and fewer social skills, while their teachers reported a higher deficit of positive teaching practices and more frequently used negative practices. The results revealed the importance of studying cumulative risks and promoting interventions among teachers and children

Las prácticas educativas de los docentes en relación con los niños que presentan dificultades múltiples o específicas constituyen un vacío de conocimiento. El objetivo fue caracterizar y comparar las prácticas educativas positivas y negativas de los docentes para tres grupos diferentes de niños, considerando una muestra no clínica sin problemas conductuales y de desempeño escolar (G1) y dos muestras clínicas, una de niños con múltiples problemas. rendimiento escolar y conductual (G2) y otro de niños con problemas conductuales específicos (G3). Participaron 102 niños y sus profesores, quienes respondieron a instrumentos sobre prácticas educativas, habilidades sociales y problemas de conducta. Se encontró que, comparativamente, los niños con problemas asociados de desempeño y conducta tenían más problemas de conducta, menos habilidades sociales y sus maestros reportaron más deficiencias en las prácticas educativas positivas y un uso más frecuente de prácticas negativas. Concluye sobre la relevancia de estudiar riesgos combinados y promover intervenciones con docentes y niños