Translation and adaptation into Brazilian Portuguese of the Family Accommodation Scale for Obsessive-Compulsive Disorder - interviewer-Rated (FAS-IR) / Tradução e adaptação para o português do Brasil da Escala de Acomodação Familiar - Pontuado pelo Entrevistador (FAS-IR)

OBJECTIVE: To describe the process of translation and adaptation into Brazilian Portuguese of the Family Accommodation Scale for Obsessive-Compulsive Disorder - Interviewer-Rated (FAS-IR). METHOD: The process of translation and adaptation of the scale involved four bilingual health professionals. The scale was initially translated into Brazilian Portuguese independently by two professionals. Then, the two versions were compared, resulting in a preliminary Portuguese version that was administered to 15 relatives of patients diagnosed with obsessive-compulsive disorder (OCD) with different education levels, deliberately chosen to collect language adjustment suggestions. Subsequently, the scale was translated back into English independently by two other professionals. After comparing the two back translations, a new English version was generated. This version was reviewed and approved by the authors of the original scale. RESULTS: The Brazilian Portuguese version of the FAS-IR proved to be easily understood and can be used in relatives of OCD patients from different socioeconomic backgrounds. CONCLUSION: Adaptation of the FAS-IR into Brazilian Portuguese will enable health professionals to assess the level of accommodation in relatives of OCD patients and allows the development of future studies aimed at 1) studying the influence of family accommodation on maintaining and possibly facilitating OCD symptoms, and 2) assessing the effect of family accommodation on treatment outcomes in Portuguese-speaking populations.

OBJETIVO: Descrever o processo de tradução e adaptação para o português do Brasil da Family Accommodation Scale for Obsessive-Compulsive Disorder - Interviewer-Rated (FAS-IR). MÉTODO: O processo de tradução e adaptação da escala envolveu quatro profissionais de saúde bilíngues. A escala foi inicialmente traduzida de forma independente para o português do Brasil por dois profissionais. A seguir, as duas versões foram comparadas, resultando em uma versão inicial em português que foi aplicada a 15 familiares de pacientes com transtorno obsessivo-compulsivo (TOC), com diferentes níveis de instrução, deliberadamente escolhidos para coletar as sugestões de ajuste linguístico. Subsequentemente, a escala foi retrotraduzida independentemente por outros dois profissionais da saúde. Depois de comparar as duas retrotraduções, uma nova versão da escala foi gerada em inglês. Essa versão foi revisada e aprovada pelos autores da escala original. RESULTADOS: A versão em português do Brasil da escala FAS-IR mostrou ser facilmente compreendida e pode ser usada em familiares de pacientes com TOC de diferentes níveis socioeconômicos. CONCLUSÃO: A FAS-IR adaptada ao português do Brasil fará com que profissionais de saúde possam avaliar o nível de acomodação em familiares de pacientes com TOC e permitirá a realização de futuros estudos com os objetivos de 1) estudar a influência da acomodação familiar na manutenção e, possivelmente, na facilitação dos sintomas do TOC e 2) examinar o efeito da acomodação familiar sobre os resultados do tratamento em populações de países de língua portuguesa.

Family approaches to treatment for obsessive compulsive disorder

This article reviews the family constellation of patients with obsessive compulsive disorder (OCD), the presence of OCD symptoms among family members, and familial aspects including parental attachment, expressed emotion (EE), and family accommodation. Some evidence supports a negative effect of hostility, emotional over-involvement, and criticism perceived by the patient on behavioral treatment outcome. However, actual criticism observed by the relative during an interview was associated with more benefit from therapy. Family accommodation predicted poorer family functioning and more severe OCD symptoms after behavioral treatment. A review of the limited treatment literature indicates no actual tests of the effects of psycho-educational and supportive treatments, although several reports suggest they are useful for families and patients. Including relatives in treatment has proved beneficial in some studies, especially with children, but not in others. Multiple family groups that focus on behavioral contracting for exposure and stopping rituals may be a promising intervention. Likewise, efforts to reduce family accommodation in the context of behavioral treatment have proved useful. Additional research on the content, process and effects of family interventions for OCD is much needed