Translation, cross-cultural adaptation, and validation of the Behavioral Activity Rating Scale (BARS) for the Brazilian population

Abstract Introduction Few instruments are available in Brazil to evaluate psychomotor activity in psychiatric emergency, clinical, and research settings. This study aimed to perform a cross-cultural adaptation of the Behavioral Activity Rating Scale (BARS) into Brazilian Portuguese and assess the adapted scale's psychometric properties. Method An expert consensus committee conducted a translation and back-translation of the original scale, resulting in the BARS-BR. Four pairs of physicians administered the BARS-BR and the Sedation-Agitation Scale (SAS) to patients in a hospital psychiatry emergency room and patients in the hospital's psychiatric wards. The BARS-BR was compared to the SAS to assess concurrent validity and internal consistency was evaluated with the Bland-Altman technique. Results In the emergency room, the correlation coefficients between the first and second assessments were rho = 0.997 and rho = 1.0, respectively. In the hospital wards, the correlation coefficient between the pair of evaluators was rho = 0.951. There were strong correlations between the BARS-BR score of the first examiner and the SAS score of the second examiner (rho = 0.903) and between the SAS score of the first examiner and the BARS-BR score of the second examiner (rho = 0.893). Conclusion The BARS-BR showed good psychometric properties, and we recommend its use because it constitutes an easy method for assessment of changes in psychomotor activity. Further studies are suggested to evaluate adoption and comprehension of the BARS-BR scale by all classes of healthcare professionals.

O Uso de Internet e Redes Sociais e a Relação com Indícios de Ansiedade e Depressão em Estudantes de Medicina / The Use of the Internet and Social Networks and the Relationship with Symptoms of Anxiety and Depression among Medical Students

RESUMO Introdução: A internet é uma ferramenta imprescindível na atualidade, pois possibilita acesso fácil e rápido às informações e a manutenção de laços afetivos por meio das redes sociais. Entretanto, quando se percebe um uso descontrolado e desadaptativo, ocorre a chamada adicção por internet (AI). Estudos prévios investigaram diversas comorbidades associadas a esse transtorno, gerando um importante conhecimento importante para a conduta clínica. Objetivo: Investigar a correlação entre indicadores do uso de internet e redes sociais e a presença de sintomas ansiosos e depressivos. Métodos: Estudo descritivo, transversal, quantitativo, com amostragem por conveniência, realizado com estudantes de Medicina no ano de 2015. Os sintomas ansiosos e depressivos foram analisados por meio do Inventário de Ansiedade de Beck (BAI) e do Inventário de Depressão de Beck (BDI), respectivamente. Além disso, utilizou-se um questionário confeccionado pelos pesquisadores com base no Internet Addiction Test (IAT). Resultados: Dos 169 estudantes que participaram da pesquisa, 98,8% (167) fazem uso diário de internet e/ou redes sociais. Foi avaliada a prevalência de diversos indícios do uso prejudicial da internet, bem como a concepção dos participantes sobre seu uso. Não foi encontrada associação estatística entre o tempo gasto na internet e a presença de sintomas ansiosos e depressivos com os escores BAI e BDI. Contudo, foram percebidas algumas associações estatisticamente significativas com os resultados dos escores BAI e BDI tanto com indicadores da necessidade de verificação da internet quanto com indicativos do uso desadaptativo da internet. Conclusão: O presente estudo ratifica achados prévios na literatura que apontam que a AI não está necessariamente relacionada com o tempo gasto na internet, mas com o padrão desadaptativo do uso. Os resultados aqui encontrados podem servir de base para futuras intervenções em instituições de ensino que busquem minimizar o prejuízo desse transtorno cada vez mais presente.

ABSTRACT Introduction: The internet is now an essential tool, through which people enjoy easy and rapid access to information and can maintain personal relationships through social networks. However, when its use becomes uncontrolled and maladaptive, what can entail is known as Internet Addiction (IA). In previous studies, several comorbidities associated with this disorder have been investigated, generating knowledge that is important for clinical management. Objective: To investigate the correlation between indicators of internet use and social networks with the presence of symptoms of anxiety and depression. Methods: A descriptive, cross-sectional, quantitative study with convenience sampling, carried out with medical students in 2015. The anxiety and depression symptoms were analyzed through the Beck Anxiety Inventory (BAI) and the Beck Depression Inventory (BDI), respectively. In addition, a questionnaire made by the researchers based on the internet Addiction Test (IAT) was used. Results: Out of the 169 students who participated in the research, 98.8% (167) use the internet and/or social networks on a daily basis. The prevalence of various indications of the harmful use of the internet was evaluated, as well as the participants' conception of its use. No statistical association was found between the time spent on the internet and the presence of symptoms of anxiety and depression, according to the BAI and BDI scores. However, some statistically significant associations were observed between the results obtained from the BAI and BDI and indicators of the need for internet verification as well as signs of maladaptive use of the internet. Conclusion: The present study ratifies the previous findings in the literature by pointing out that IA is not necessarily related to the time spent on the internet, but rather to a maladaptive pattern of use. The results found here may serve as basis for future interventions in educational institutions that seek to minimize the damage of this disorder, which has become increasingly present.