Theoretical procedures of the cross-cultural adaptation process of the Child Mania Rating Scale - Parent Version (CMRS-P) for the Brazilian context

Abstract Objectives To describe the theoretical procedures employed in the process of cross-cultural adaptation (CCA) for Brazil of the Child Mania Rating Scale - Parent Version (CMRS-P). Methods Seven steps were carried out: (1) translations and synthesis; (2) Committee of Judges-I; (3) grammatical review; (4) Committee of Judges-II; (5) semantic analysis (pre-test); (6) back-translation; and (7) discussion with the authors of the original instrument. Participants were two professional translators, 14 experts, a grammar proofreader, and 21 parents/guardians, representatives of the target population. The results were analyzed in terms of the percentage of agreement between evaluators and the content validity coefficient (CVC) and by analysis of comments and suggestions. Results Grammatical and cultural adjustments were made, in addition to substitution and/or inclusion of words and examples. Adequacy agreement indexes exceeding 86% were achieved and the CVC result for the total scale was excellent (0.95). The pre-test indicated good acceptance and understanding by participants. Conclusion The proposed version proved to be promising for use in the Brazilian context, although further psychometric studies are still needed to prove the scale's validity and reliability.

Music performance anxiety: perceived causes, coping strategies and clinical profiles of Brazilian musicians / Ansiedade de performance musical: causas percebidas, estratégias de enfrentamento e perfil clínico de músicos brasileiros

Abstract Introduction Music performance anxiety (MPA) is characterized by long-lasting, high intensity apprehension associated with performing music in public. At extreme levels, MPA can impair the career and quality of life. Our goal is to describe the clinical profile, perceived causes and coping strategies associated with MPA. Methods In this cross-sectional study, several self-assessment instruments were administered to a sample of 214 Brazilian musicians (68% male, 53.3% classical/46.7% popular musicians). Data were analyzed using descriptive and parametric statistics, based on the variables of musical training and level of MPA. Results Percentages of indicators of pathology were high (40% high MPA levels, 37% social anxiety, 12.5% depression, 13.5% alcohol abuse), and musicians with high MPA levels were the most affected. A wide variety of situations were associated with MPA, especially those related to the individual (pressure from self/concern about audience). Emotion-focused coping and internal resources were prominent among the resources used for coping with MPA (breathing, increased practice, familiarization with performance venue), although they were not always effective. It was relatively uncommon for musicians to seek specialized resources and treatments. Conclusions The results demonstrate the vulnerability of the targeted professional groups and the need for preventive strategies and behavioral, environmental, educational, and pharmacological interventions to change this scenario.

Resumo Introdução Ansiedade de performance musical (APM) é definida como uma condição de apreensão duradoura e intensa, associada ao desempenho musical em público. Em níveis extremos é prejudicial à carreira e qualidade de vida do músico. Objetiva-se descrever o perfil clínico, as causas percebidas e estratégias de enfrentamento da APM. Métodos Neste estudo transversal, vários instrumentos de autoavaliação foram administrados a 214 músicos brasileiros (68% do sexo masculino, 53,3% clássicos/ 46,7% populares). Os dados foram analisados por estatística descritiva e paramétrica, com base nas variáveis formação musical e nível de APM. Resultados Encontrou-se um percentual elevado de indicadores de psicopatologia (40% altos níveis de APM, 37% ansiedade social, 12,5% depressão, 13,5% abuso de álcool), sendo os músicos com altos níveis de APM aqueles com maior comprometimento. Uma ampla variedade de situações foi associada à APM, com destaque para aquelas relacionadas ao próprio indivíduo (pressão de si próprio/preocupação com a plateia). Entre os recursos utilizados para enfrentamento da APM destacaram-se aqueles focados na regulação emocional e no uso de recursos internos dos músicos (respiração, aumento do treino, familiarização com a prática no local da apresentação), embora nem sempre tenham sido eficazes. Mostrou-se pouco comum a busca por recursos e tratamentos especializados. Conclusões Evidencia-se a condição de vulnerabilidade desse grupo profissional e a necessidade de estratégias preventivas e intervenções comportamentais, ambientais, educativas e farmacológicas que permitam mudanças neste cenário.

Associations between competitive anxiety, athlete characteristics and sport context: evidence from a systematic review and meta-analysis

Abstract Background: There is a vast literature investigating the possible associations between competitive anxiety, athlete variables and sports context. As far as we are concerned, there is no study which has compiled such findings to produce more robust evidence on this topic. Objectives: The aim of the study was to conduct an exploratory systematic review of the literature followed by a meta-analysis in order to investigate possible associations between competitive anxiety, social-demographic characteristics, profile of the athlete and sports context. Methods: Systematic searches of PubMed, PsycInfo, Web of Science, Lilacs and SciELO electronic databases were performed to identify studies published between January 2006 and January 2018, including a manual search in the references of the selected studies. Results: A total of 59 studies were included for qualitative synthesis and 27 for meta-analysis. More robust associations were observed between competitive anxiety and female gender, lower age, and less experience time. Discussion: Knowing the variables which exert influence on competitive anxiety can be relevant to plan specific treatment and intervention programs, enabling the athlete's development beyond technical and physical preparation.

Long-term effects of ayahuasca in patients with recurrent depression: a 5-year qualitative follow-up

Background Ayahuasca is a botanical hallucinogenic preparation traditionally used by indigenous populations of Northwestern Amazonian countries for ritual and therapeutic purposes. It is rich in β-carboline alkaloids and N,N-dimethyltryptamine (DMT). Preclinical, observational, and experimental studies suggest that ayahuasca and its alkaloids have anxiolytic and antidepressive effects. We recently reported in an open-label trial that ayahuasca administration was associated with significant decreases in depression symptoms for 2-3 weeks after the experimental session in 17 patients with treatment-resistant major depressive disorder. Objectives To investigate if the experiment had any long-lasting effects on patients Methods Eight patients were interviewed 4 to 7 years after ayahuasca intake. Results Our results suggest that ayahuasca was well tolerated and that symptom reductions were limited to a few weeks. Importantly, most patients believed that the experience was among the most important of their lives, even 4-7 years later. Discussion To the best of our knowledge, this is the first long-term follow-up of a clinical sample that participated in an ayahuasca trial. Further studies with different and repeated dosing should be designed to further explore the antidepressive and anxiolytic effects of ayahuasca.

Cross-cultural adaptation of the Sport Anxiety Scale-2 (SAS-2) for the Brazilian context / Adaptação transcultural da Sport Anxiety Scale-2 (SAS-2) para o contexto brasileiro

Abstract Objective To present the process of cross-cultural adaptation of the Sport Anxiety Scale-2 (SAS-2) for the Brazilian context. Method The following stages were used: translation into Brazilian Portuguese by independent translators, elaboration of a synthesis version, back-translation, evaluation by experts and pretest with target population. Results All the stages of cross-cultural adaptation were completed, and in the majority of items evaluated, good concordance between experts was obtained (≥ 80%). Suggested adjustments were compiled into the consensus version by the two authors, with the resulting material being considered adequate in the pretest (and thus no further changes were needed). Termed as "Escala de Ansiedade Esportiva-2," the final version was considered by the main author of the original scale as an official version in Brazilian Portuguese. Conclusions In view of the fulfilment of all steps suggested for the cross-cultural adaptation process, the SAS-2 is now available in Brazilian Portuguese to be tested for its psychometric qualities.

Resumo Objetivo Apresentar o processo de adaptação transcultural da Sport Anxiety Scale-2 (SAS-2) para o contexto brasileiro. Método Os seguintes estágios foram utilizados: tradução para o português do Brasil por tradutores independentes, elaboração da versão síntese, retrotradução, avaliação de equivalência por especialistas e pré-teste na população-alvo. Resultados Todos os estágios do processo de adaptação transcultural foram respeitados, e, na maioria das estruturas avaliadas, obteve-se porcentagem de concordância satisfatória entre os especialistas (≥ 80%). Os ajustes sugeridos foram compilados pelas duas autoras na versão de consenso, e o material foi considerado adequado no pré-teste, não havendo necessidade de mais modificações. Nomeada "Escala de Ansiedade Esportiva-2", foi considerada pelo autor principal da escala original como a versão oficial em português do Brasil. Conclusão Mediante cumprimento de todas as etapas sugeridas para o processo de adaptação transcultural, a SAS-2 está disponível em português brasileiro para ser testada quanto às suas qualidades psicométricas.

Current alcohol dependence and emotional facial expression recognition: a cross-sectional study

Abstract Background Several studies have demonstrated that chronic and excessive alcohol use causes social cognition deficits. Objectives Thus, the aim of the current study is to assess the associations between emotional facial expression recognition and current alcohol dependence. Methods The sample consisted of two groups: one was composed by current alcohol dependent individuals (AG = 110); and a control group, composed of healthy individuals (CG = 110) assessed by the Structured Clinical Interview DSM-IV. The instrument to assess the recognition of facial expressions of emotion was a dynamic task at computer. Results The AG showed low accuracy in recognizing emotions as a whole and especially fear and disgust. In addition, the group needed greater emotional intensity to recognize joy, fear, disgust and surprise. It also showed increased reaction time for all emotions (p < 0.01). The logistic regression showed the response time for surprise (ODDS = 1.01) and the ability to recognize emotions such as fear (ODDS = 0.68) and disgust (ODDS = 0.70) was significantly associated with alcohol dependence. Discussion These specific associations are of great value to a more refined understanding of alcoholism, and they concern relapse and treatment.

Interventions for music performance anxiety: results from a systematic literature review

Abstract Background Music performance anxiety (MPA) is characterised by fears related to performing music. It may result in damages to personal life and professional career, so treatment and prevention are very important. Objective To undertake a systematic literature review on the effectiveness/efficacy of MPA interventions and to integrate these findings to those in the literature reviewed previously. Methods We used PubMed, PsycINFO and SciELO databases and keywords music*, performance anxiety, treatment, therapy and intervention and manual research. We selected articles published between October-2002/July-2016. Results Out of 97 articles, 23 were reviewed. Sixteen studies presented inter-group experimental design, and seven presented pre-post experimental design. The intervention modalities reviewed were cognitive behavioural therapy (CBT), virtual reality exposure, biofeedback, yoga, meditation, music therapy and the Alexander technique. Although the interventions presented some indicators of efficacy in the MPA outcomes and improvement in performance quality, important methodological limitations were observed: low number of individuals and non-specific criteria for their inclusion/exclusion. This reinforces previous findings regarding methodological fragilities associated with this context. Discussion CBT is the most frequently studied modality and with the greatest number of effectiveness indicators. The remaining modalities indicate tendencies in positive outcomes that require further and efficient investigation in more rigorous studies with greater methodological control.

Heritability of social anxiety disorder: a systematic review of methodological designs

Abstract Background The investigation of heritability stands out as an important means to establish the weight of genetic and environmental factors in the development of social anxiety disorder. Objective This study aims to make a critical review of methodological designs used in the investigation of the social anxiety disorder (SAD) heritability. Methods We reviewed 31 research articles published until October 2015 and found through the electronic search bases PubMed, Web of Science, and Scopus and manual searches in the reference lists of the selected references. Most of the investigations involved adult samples and twins to assess heritability. Results There was great variability in the screening and diagnostic instruments used in the studies, leading to different outcomes. Structural equation models proved to be the most adequate to assess SAD heritability, allowing better estimates of this aspect of the disorder. SAD heritability rates varied between 13% and 76% in the articles reviewed. Discussion We discuss methodological aspects that may affect the quality and the development of improved studies to investigate SAD heritability such as sample size, quality of screening instruments, and use of diagnostic interviews. More homogeneous investigations involving larger samples and standardized instruments and methods are desirable and opportune.

Early emotional trauma in alcohol-dependent men: prevalence, associations and predictive value

Abstract Background Several studies have indicated that early emotional traumas (EET) are highly prevalent in alcohol-dependent individuals, and that these traumas work as risk factors for the development of this disorder. Objective The aim of the current study is to evaluate the EET associations and predictive value regarding active alcohol dependence among male individuals from a developing country. Methods The sample consisted of two groups. The first was composed by adult male individuals diagnosed as alcohol dependents (AG, N = 110), and the second with no alcohol abuse and/or dependence diagnosis (CG, N = 110). Both groups were evaluated using Structured Clinical Interview based on the Diagnostic and Statistical Manual of Mental Disorders; Early Emotional Trauma Inventory; and a sociodemographic questionnaire. Results All trauma subtypes (general, physical, emotional and sexual) were more prevalent among AG than CG. However, only traumas categorized as general and emotional worked as risk factor for alcoholism development and they increased the chances to develop this disorder by 1.45 and 1.23 times, respectively. Discussion EETs are important factors that should be taken into account in interventions that aim to prevent, minimize and/or treat this clinical condition and its impact and/or severity, especially in countries such as Brazil.

Estrutura fatorial, fidedignidade e parâmetros de itens da versão em português brasileiro do questionário GAD-7 / Factor structure, reliability, and item parameters of the brazilian-portuguese version of the GAD-7 questionnaire / Estructura factorial, confiabilidad, y ítems parámetros de la versión de portugués brasileño del cuestionario GAD-7

This study examined the psychometric properties of the Brazilian-Portuguese version of the Generalized Anxiety Disorder GAD-7 questionnaire in a community sample (n = 206) of Brazilian adults. The sample was 41% female, with a mean age of 21.10 (SD = 4.49),75.6% from colleges/universities. Results of a confirmatory factor analysis provided support to the original unidimensional model of the GAD-7 in the Brazilian context. Analyses of Variance (ANOVA) showed that the GAD-7 scores were significantly different between males and females, with females scoring higher than males. The scale demonstrated good reliability evidence; both Cronbach's alpha coefficient (α = .916) and rho composite reliability coefficient (ρ= .909) were adequate. Item parameter analysis showed items 5 and 7 presented the highest severity thresholds for the generalized anxiety latent trait, whereas item 1 presented the lowest ones. Our findings suggest that the Brazilian-Portuguese version of the GAD-7 is suitable for assessing Generalized Anxiety Disorder symptoms in Brazilian adults in community settings.

Este estudo analisou as propriedades psicométricas da versão em Português Brasileiro do questionário de "Transtorno de Ansiedade Generalizada - GAD-7 em uma amostra de comunidade (n = 206) da população adulta brasileira. A amostra foi composta por de 41% de participantes do sexo feminino, com idade média de 21,10 (DP = 4,49), e 75,6% em instituições de ensino superior. Os resultados da análise fatorial confirmatória forneceram apoio para o modelo unidimensional original do GAD-7 no contexto brasileiro. As análises de variância (ANOVA) mostraram que os escores do GAD-7 foram significativamente diferentes entre homens e mulheres, com as mulheres apresentando maiores escores que os homens. A escala demonstrou uma boa fidedignidade; sendo que tanto o coeficiente de Cronbach alfa (α = 0,916) e rho coeficiente de confiabilidade composta (ρ = 0,909) foram adequados. A análise dos parâmetros dos itens mostrou itens 5 e 7 apresentaram os limiares mais elevados de severidade para o traço-latente de ansiedade generalizada, enquanto que o item 1 apresentou as menores. Nossos resultados sugerem que a versão Português Brasileiro do GAD-7 é adequada para avaliar os sintomas do transtorno de ansiedade generalizada em adultos brasileiros em ambientes comunitários.

Este estudio examinó las propiedades psicométricas de la versión de portugués brasileño del cuestionario de Desorden de Ansiedad Generalizada GAD-7, en una muestra comunitaria (n = 206) de adultos brasileños. La muestra se compone de 41% de mujeres, con una edad media de 21,10 (SD = 4,49), y 75,6% estudiantes universitarios. El análisis factorial confirmatorio proporcionó evidencias que soportan el modelo unidimensional original del GAD-7 en el contexto brasileño. El análisis de variancia (ANOVA) mostró que las puntuaciones fueron significativamente diferentes entre hombres y mujeres, siendo que las mujeres obtuvieron puntuaciones más altas que los hombres. La escala demostró tener una buena confiabilidad; el coeficiente de alpha de Cronbach (α= .916) y el coeficiente rho de fiabilidad (ρ = .909) fueron adecuados. El análisis de datos mostró los ítems 5 y 7 tuvieron los umbrales de gravedad más altos en el trazo de ansiedad generalizada, mientras el ítem 1 tuvo el más bajo. Nuestros hallazgos sugieren que la versión en portugués brasileño de GAD-7 es adecuado para la evaluación de síntomas de trastorno de ansiedad generalizada en adultos brasileños en contextos comunitarios.

Exploratory factor analysis of Kenny Music Performance Anxiety Inventory (K-MPAI) in a Brazilian musician sample

Abstract Background The Kenny Music Performance Anxiety Inventory (K-MPAI) is very significant among the available instruments which measures Musical Performance Anxiety (MPA). Objective The aim of this study is to find evidence of validity of the Kenny Music Performance Anxiety Inventory (K-MPAI), in its translated and adapted Brazilian version, through the study of its factor structure. Methods A convenience sample of 230 amateur musicians completed the K-MPAI. Results The initial factor analysis yielded eight factors, explaining 62.4% of variance. However, due to the factors’ composition and internal consistency values lower than 0.50, the number of factors was later set at three, considering the internal consistency of those, the theoretical propositions and symptomatology aspects that supported the construction of scale. They were named “Worries and insecurity” (α = 0.82), “Depression and hopelessness” (α = 0.77) and “Early parental relationships” (α = 0.57). Discussion/Conclusions These results point to the scale’s construct validity, since they support the theoretical basis used for the development of the K-MPAI and the clinical manifestations of the MPA.

Associations between chronic pelvic pain and psychiatric disorders and symptoms

Background Chronic pelvic pain (CPP) is a complex condition wich is associated with emotional factors, specially depression and anxiety. Objectives To make a systematic review to provide a detailed summary of relevant literature on the association between CPP and different psychiatric disorders/symptoms. Methods A systematic review of articles in the international literature published between 2003 and 2014 was performed in the electronic databases PubMed, PsycINFO, LILACS, and SciELO using the terms (chronic pelvic pain) AND (psychiatry OR psychiatric OR depression OR anxiety OR posttraumatic stress OR somatoform). The searches returned a total of 529 matches that were filtered according to predefined inclusion and exclusion criteria. A total of 18 articles were selected. Results The investigations focused mainly on the assessment of depression and anxiety disorders/symptoms, with rather high rates (17-38.6%). Depression and anxiety symptoms were more prevalent among women with CPP compared to healthy groups. Comparisons between groups with CPP and with specific pathologies that also have pain as a symptom showed that depression indicators are more frequent in CPP. Depressive symptoms tend to be more common in CPP and have no particular association with pain itself, the core feature of CPP. Discussion Other aspects of CPP seem to play a specific role in this association. Anxiety and other psychiatric disorders require further investigation so that their impact on CPP can be better understood.

Percepção do apoio social de famílias que convivem com a depressão materna / Perceived social support of families in the context of maternal depression / Percepción del apoyo social en familias que conviven con la depresión materna

A depressão materna configura-se como uma adversidade à dinâmica familiar e à socialização das crianças, associando-se a outras condições de risco ou proteção. Objetivou-se comparar e correlacionar o apoio social para famílias de crianças com e sem dificuldades de socialização, que convivem com a depressão materna, identificando os recursos de apoio percebidos pelas mães. Foram avaliadas 40 mães com diagnóstico de depressão recorrente, mediante questionário, entrevistas e escalas, e 40 crianças, de ambos os sexos, em idade escolar. As díades foram distribuídas em dois grupos de acordo com avaliações específicas: G1 - 25 crianças com dificuldades de socialização - e G2 - 15 crianças sem dificuldades. Os serviços religiosos e de saúde foram os principais recursos utilizados pelos grupos. Verificou-se na comparação entre os grupos que as famílias de G1 contam com menor apoio de relações sociais, evidenciando a relevância do apoio como fator protetivo à socialização de escolares...

Maternal depression appears as an adversity to family dynamics and socialization of children, associating with other conditions of risk or protection. The objective was to compare and correlate the social support for families of children with and without difficulties socializing, in the context of maternal depression, identifying resources to support perceived by mothers. Were evaluated 40 mothers diagnosed with recurrent depression by questionnaire, interviews and scales, and 40 children of both sexes in school age. The dyads were divided into two groups according to specific assessments: G1 - 25 children with socialization difficulties - and G2 - 15 children without difficulties. Religious services and health were the main resources used by the groups. It was found when comparing the groups G1 families have less support of social relations, highlighting the importance of social support as protective factor in the socialization of children...

La depresión materna constituye una adversidad en la dinámica familiar y en la socialización de los niños y se puede asociar a otras condiciones de riesgo o de protección. El objetivo del estudio fue comparar y correlacionar el apoyo social a las familias de niños con y sin dificultades de socialización, que conviven con la depresión materna, identificando los recursos de apoyo percibidos por las madres. Fueron evaluadas 40 madres, con diagnóstico de depresión recurrente mediante cuestionario, entrevistas y escalas y 40 niños, de ambos los géneros, en edad escolar. Las parejas (madre-hijo) fueron distribuidas en dos grupos, de acuerdo con las evaluaciones especificas: G1, 25 niños con dificultades de socialización y G2, 15 niños sin dificultades. Los servicios religiosos y de salud fueron los principales recursos utilizados por los grupos. En la comparación entre los grupos, fue posible observar que las familias del G1 reciben menor apoyo de las relaciones sociales, indicando la importancia del apoyo como factor protector en la socialización de niños en edad escolar...

Anxiety and joint hypermobility association: a systematic review / Associação entre ansiedade e hipermobilidade articular: uma revisão sistemática

BACKGROUND: Anxiety disorders are often associated with several non-psychiatric medical conditions. Among the clinical conditions found in association with anxiety stands out the joint hypermobility (JH). OBJECTIVES: To carry out a systematic review of the clinical association between anxiety disorders and JH. METHOD: A survey was conducted in MEDLINE, PsychINFO, LILACS e SciELO databases up to December 2011. We searched for articles using the keywords 'anxiety', 'joint' and 'hypermobility' and Boolean operators. The review included articles describing empirical studies on the association between JH and anxiety. The reference lists of selected articles were systematically hand-searched for other publications relevant to the review. RESULTS: Seventeen articles were included in the analysis and classified to better extract data. We found heterogeneity between the studies relate to the methodology used. Most of the studies found an association between anxiety features and JH. Panic disorder/agoraphobia was the anxiety disorder associated with JH in several studies. Etiological explanation of the relationship between anxiety and JH is still controversial. CONCLUSION: Future research in large samples from the community and clinical setting and longitudinal studies of the association between anxiety and HA and the underlying biological mechanisms involved in this association are welcome.

INTRODUÇÃO: Os transtornos de ansiedade estão frequentemente associados a vários quadros clínicos não psiquiátricos. Dentre os quadros clínicos associados à ansiedade destaca-se a hipermobilidade articular (HA). Objetivo: Realizar uma revisão sistemática da associação entre os transtornos de ansiedade e a HA. MÉTODO: Foi realizada uma pesquisa nos bancos de dados MEDLINE, PsychINFO, LILACS e SciELO em busca de artigos publicados até dezembro de 2011. Usamos as palavras-chave anxiety , joint e hypermobility e os operadores boolianos. A revisão incluiu artigos que descrevem estudos empíricos sobre a associação entre ansiedade e HA. As listas de referências dos artigos selecionados foram sistematicamente pesquisadas à mão em busca de publicações relevantes para a revisão. RESULTADOS: Dezessete artigos foram incluídos na análise e classificados para uma melhor extração dos dados. Encontramos heterogeneidade entre os estudos relacionada à metodologia utilizada. A maioria dos estudos encontrou associação entre as características de ansiedade e HA. Transtorno do pânico com agorafobia foi o transtorno de ansiedade associado à HA em vários estudos. A explicação etiológica da relação entre ansiedade e HA permanece controversa. CONCLUSÃO: Estudos futuros com amostras maiores de indivíduos da comunidade e de cenários clínicos e estudos longitudinais da associação entre ansiedade e HA e dos mecanismos biológicos subjacentes envolvidos nessa associação são bem-vindos.

Aspectos cognitivos do falar em público: validação de uma escala de autoavaliação para universitários brasileiros / Cognitive aspects of public speaking: validation of a self-assessment scale for Brazilian university students

CONTEXTO: O falar em público é o medo mais prevalente na população geral e no Transtorno de Ansiedade Social (TAS). Assim sendo, estudos que dimensionem essa situação específica são necessários. OBJETIVOS: Validar a Self Statements during Public Speaking (SSPS) em amostra da população geral de estudantes universitários (PG - n = 2.314), casos (C - n = 88) e não casos de TAS (NC - n = 90) do Brasil. MÉTODOS: Conduziu-se o estudo em duas fases: a) preenchimento dos questionários autoaplicados em sala de aula; b) participação em entrevista telefônica e ao vivo. RESULTADOS: Evidenciaram-se correlações baixas/moderadas entre SSPS e Inventário de Fobia Social (PG = 0,22-0,65; C = 0,28-0,32; NC = 0,21-0,30), Inventário de Ansiedade de Beck (PG = 0,18-0,53; C = 0,25-0,33; NC = 0,22-0,25) e Escala Breve de Fobia Social (C = não significativa, NC = 0,23-0,31) nas diferentes amostras, especialmente para a PG. A análise fatorial apontou a presença de dois fatores, associados à autoavaliação positiva e negativa. O estudo da validade discriminativa evidenciou a capacidade da SSPS de discriminar os casos dos não casos de TAS. CONCLUSÃO: A SSPS é adequada para uso no contexto brasileiro, sendo que a subescala autoavaliação positiva parece ser mais efetiva para a avaliação de amostras identificadas ou suspeitas de TAS e a subescala autoavaliação negativa ter uma característica mais rastreadora quando aplicada em amostras da população geral.

BACKGROUND: Fear of public speaking is the most prevalent fear in the general population and among persons with a social anxiety disorder (SAD). Nevertheless, studies about the assessment of this specific phenomenon are still needed. OBJECTIVES: To examine the validity of the Self Statements during Public Speaking (SSPS) scale in a general population of Brazilian university students (GP, n = 2314), in an SAD sample (n = 88), and in a non-SAD sample (n = 90). METHODS: The study was conducted in two phases: a) completing a self-administered questionnaire in the classroom, b) participating in a telephone and face-to-face interview. RESULTS: The SSPS showed low/median correlations with the Social Phobia Inventory (GP = 0.22-0.65; SAD = 0.28-0.32; non-SAD = 0.21-0.30), the Beck Anxiety Inventory (GP = 0.18-0.53; SAD = 0.25-0.33; non-SAD = 0.22-0.25), and the Brief Social Phobia Scale (SAD = not significant, non-SAD = 0.23-0.31) in all the samples, especially in the GP sample. Factorial analysis indicated the presence of two factors associated with positive and negative self-assessment. The study of discriminative validity demonstrated that the SSPS has the ability to differentiate between cases and non-cases of SAD. DISCUSSION: The SSPS is an adequate instrument to be used within the Brazilian context. The positive self-assessment subscale seems to be more effective for the evaluation of SAD samples. The negative self-assessment subscale appears to have a better screening characteristic in the general population of university students.

Tratamentos farmacológicos para o transtorno de ansiedade social: existem novos parâmetros na atualidade? / Pharmacological treatments for social anxiety disorder: are there new parameters today?

CONTEXTO: O transtorno de ansiedade social (TAS), apesar da baixa taxa de detecção e do alto índice de comorbidades associadas, é considerado uma condição tratável. Apesar da resposta estabelecida a diversas classes de medicamentos, os algoritmos para o tratamento do TAS necessitam de atualização constante. OBJETIVO: Realizar revisão sistemática da literatura no que diz respeito à eficácia dos tratamentos farmacológicos relativos ao TAS, a partir de estudos controlados, conduzidos no período de 2005 a 2010. MÉTODO: Foram utilizados os indexadores eletrônicos PsycoInfo, Lilacs e Medline, utilizando-se as palavras-chave: "social phobia or social anxiety and treatment". RESULTADOS: De acordo com critérios de inclusão adotados, 29 artigos foram incluídos e analisados. Mostram-se eficazes para o tratamento do TAS as seguintes drogas, de acordo com a classe: a) ISRSs: escitalopram, fluvoxamina, citalopram, GR205171 e sertralina; b) ISRSN: venlafaxina; c) IMAOs: fenelzina, moclobemina; d) aminoácidos: d-cicloserina; f) anticonvulsivantes: tiagabina. CONCLUSÃO: Os ISRSs e os ISRSNs têm seu uso estabelecido e ainda continuam sendo considerados primeira opção de tratamento. Porém, destaca-se o potencial futuro da d-cicloserina e dos anticonvulsivantes, com necessidade de um número maior de estudos controlados que confirmem os achado iniciais. A ação das diferentes drogas em nível neurobiológico, bem como dos tratamentos associados, necessita ainda ser mais explorada.

BACKGROUND: Social anxiety disorder (SAD), despite its low detection rates and high level of associated comorbidities, is considered a treatable condition. Although the condition's response to several drug classes is well established, the algorithms for the treatment of SAD require regular updating. OBJECTIVE: To perform a systematic literature review on the efficacy of pharmacological treatments for SAD based on controlled trials published between 2005 and 2010. METHOD: Searches were performed in the electronic databases PsycInfo, Lilacs, and Medline using the search terms "social phobia or social anxiety and treatment". RESULTS: In accordance with the inclusion criteria adopted, 29 articles were included and analyzed. The following drugs, grouped according to class, proved efficient to treat SAD: a) SSRIs: escitalopram, fluvoxamine, citalopram, GR205171, and sertraline; b) SNRI: venlafaxine; c) MAOIs: phenelzine, moclobemide; d) amino acids: f-cycloserine; and (e) anticonvulsants: tiagabine. DISCUSSION: The use of SSRIs and SNRIs to treat SAD is well established and these are still considered the first-line treatment for the condition; however, evidence suggests the future potential of D-cycloserine and anticonvulsants, whose efficacy must be confirmed by further controlled trials. The action profiles of the different medications used to treat SAD at the neurobiological level, as well as that of associated treatments, need to be explored in greater depth.

Estudos de validaçâo de instrumentos no transtorno de ansiedade social para o contexto brasileiro / Social anxiety disorder: studies of instrument validation for the brazilian context

O transtorno de ansiedade social (TAS) é uma condição com alta prevalência, apesar de seu reconhecimento e diagnóstico serem subestimados por portadores e clínicos. Considerando-se a importância das escalas de avaliação para o diagnóstico sistemático em Psiquiatria, objetiva-se apresentar estudos de validação para a população brasileira de três instrumentos de avaliação de diferentes aspectos do TAS. Procedeu-se aos seguintes estudos psicométricos: a) validade discriminativa do Mini Inventário de Fobia Social (Mini-SPIN- MS), um instrumento reduzido para o rastreamento do TAS; b) confiabilidade e validade discriminativa da Escala Breve de Fobia Social (BSPS), instrumento hétero-aplicado para avaliação de diferentes aspectos do TAS e; c) validade discriminativa dos itens e subescalas da Escala para Auto Avaliação ao Falar em Público (SSPS), instrumento para avaliação dos aspectos cognitivos relacionados ao falar em público. Todos os instrumentos mostraram excelentes qualidades psicométricas, especialmente, indicadores de discriminação entre portadores e não portadores do TAS, com confirmação diagnóstica pela Entrevista Clínica Estruturada para o DSM-IV (SCID-IV). Concluiu-se que este conjunto de instrumentos, com especificidades quanto à seus objetivos, podem ser de grande utilidade clínica, especialmente para a população brasileira, que carecia, até então, de tais recursos para a mensuração e avaliação dos diferentes aspectos do TAS. Novos estudos multicêntricos e interculturais poderão ampliar o conhecimento sobre as influências culturais para o TAS.