Estrategias de afrontamiento y alteraciones emocionales en pacientes con dolor crónico de la espalda: Cienfuegos 2020 (Cuba) / Coping strategies and emotional alterations in patients with chronic back pain. Cienfuegos 2020. (Cuba)

Introducción: El dolor crónico de la espalda forma parte de los síntomas que afectan la salud musculoesquelética. Las estrategias de afrontamiento van a determinar la experiencia del dolor actuando como mediador de las emociones. Objetivo General: Caracterizar las estrategias de afrontamiento y las alteraciones emocionales en pacientes con dolor crónico de la espalda, Cienfuegos 2020. Material y Método: Se realizó un estudio descriptivo, de serie de casos, en el Hospital Provincial Dr. Gustavo Aldereguía Lima de la provincia de Cienfuegos, Cuba, en los meses de septiembre de 2019 a enero de 2020. Se realizó un muestreo no probabilístico casual o a conveniencia de participantes voluntarios, con los pacientes que fueron atendidos en consulta de Ortopedia durante el periodo de investigación declarado. El análisis estadístico de la información se realizó en el paquete estadístico SPSS. Resultados: Se obtuvo un predominio de estrategias de afrontamiento pasivas, así como alteraciones emocionales donde predomina la ansiedad y la depresión en niveles moderado-alto, mientras que en la ira se obtuvieron valores inferiores. Conclusión: Las estrategias de afrontamiento utilizadas por los pacientes de estudio se caracterizan por ir dirigidas fundamentalmente a la modificación de las reacciones emocionales que genera el dolor, pero no a lograr una adaptación a las nuevas circunstancias impuestas por la enfermedad, ni a un control instrumental del mismo.

Introduction: Chronic back pain is one of the symptoms that affect musculoskeletal health. Coping strategies will determine the experience of pain acting as a mediator of emotions. General aim: To characterize coping strategies and the emotional alterations in patients with chronic back pain, Cienfuegos 2020. Material and method: It was carried out a descriptive study, series of cases, in the University Hospital "Dr. GustavoAldereguía Lima", Cienfuegos municipality, Cuba, from September, 2019 to January, of 2020. It was done a non-probabilistic sampling to convenience. The patients who were treated at the outpatient orthopedics consulting office and voluntarily accepted to participate in the study during the declared period of investigation were chosen. The statistical analysis of the information was carried out in the statistical package SPSS. Results: A prevalence of passive coping strategies was obtained, so much in the interview semiestructurada as in the Coping Reduced Questionnaire to the pain. Regarding the negatives emotional states prevailed the anxiety and depression in moderate-high levels, while in anger lower values were obtained. Conclusions: The most frequent coping strategies in the studied patients were the passive ones, aimed to regulate emotional states, but not to control pain.

Psychotic and affective symptoms of early-onset bipolar disorder: an observational study of patients in first manic episode

Objective: Presence of psychotic symptoms seems to be a commonplace in early-onset bipolar disorder (BD). However, few studies have examined their occurrence in adolescent-onset BD. We sought to investigate the frequency of affective and psychotic symptoms observed during the first manic episode in adolescents. Methods: Forty-nine adolescents with bipolar I disorder (DSM-IV criteria) were admitted to a psychiatric hospital during their first acute manic episode. Assessment for current psychiatric diagnosis was performed by direct clinical interview and the DSM-IV version of the Diagnostic Interview for Children and Adolescents (DICA). Results: Teenage inpatients with BD consistently exhibited typical manic features, such as euphoria, grandiosity, and psychomotor agitation. In addition, disorganization and psychotic symptoms were present in 82 and 55% of the total sample, respectively. There was no significant difference in symptoms between early- and late-adolescent subgroups. Remarkably, most patients (76%) reported previous depressive episode(s); of these, 47% had prominent psychotic features in the prior depressive period. Conclusion: These findings suggest that disorganization and psychotic symptoms during the first manic episode are salient features in adolescent-onset BD, and that psychotic depression frequently may precede psychotic mania. Nevertheless, differential diagnosis with schizophrenia should be routinely ruled out in cases of early-onset first psychotic episode.

Prefrontal symptomatology in People with Amyotrophic lateral Sclerosis: Clinical Utility and Psychometric Properties of Prefrontal Symptoms Inventory (PSI)

The Amyotrophic Lateral Sclerosis (ALS) is a multisystemic disorder. It is considered a neuromuscular disease but also involves cognitive (executive functions, social cognition, attention, memory and language), emotional or behavior changes in over 50% of the reported cases and to of frontotemporal diagnosis lobar degeneration of behavioral variant in up to 15% of the cases. For this reason, the presence of cognitive and motivational problems was analysed in a Spanish sample of ALS patients through the prefrontal symptoms inventory (PSI) to determine applicability in this disease STI. A sample of 31 patients with a potential ALS or definitive diagnostic criteria according to El Escorial was used. Obtained results ISP were compared with a sample of 31 healthy people in the same proportions of gender, age and education level. Obtained results showed a not significant difference between the two populations in the motivational factor problems, related to the depression symptomatology frequently associated with ALS. A significant positive correlation between age at diagnosis and the scale of the motivational problems was observed, with a not significant trend related to problems in the executive control and in social the behavior control and with the age at diagnosis, in the same sense with age at diagnosis. Therefore, it can be concluded that, despite the results obtained, emotional and behavioral deficits in ALS patients and symptoms related to frontotemporal dementia (among others, anosognosia or lack of consciousness symptoms) could have interfered in patient perception about their symptomatology

Contexto familiar de niños con autismo: Implicaciones en el desarrollo social y emocional / Family context of children with autism. Implications for emotional and social development

Las familias de niños con trastorno del espectro del autismo (TEA) pueden diferenciarse en función de indicadores sociodemográficos y del clima familiar caracterizado por el nivel de estrés parental, el uso de estrategias de afrontamiento y la búsqueda de apoyo social. El objetivo de este estudio fue analizar las diferencias conductuales, emocionales y sociales de niños con TEA en relación con distintas tipologías de familias caracterizadas en función de los factores de riesgo como de riesgo alto, moderado y bajo. Los participantes fueron 52 madres y sus hijos de entre 7 y 11 años, con TEA sin discapacidad intelectual, que aportaron información del desarrollo socioemocional de los hijos mediante el Cuestionario de Cualidades y Dificultades, que valora síntomas emocionales, problemas de conducta, hiperactividad/ problemas de atención, problemas de relación con los compañeros y conducta prosocial. Los análisis de comparación entre grupos que se llevaron a cabo, indicaron que los niños con familias de riesgo alto mostraron puntuaciones significativamente más bajas en conductas prosociales y experimentaron un nivel significativamente superior de problemas emocionales que los niños de las familias del grupo de bajo riesgo. Por consiguiente, los resultados mostraron la relación que tiene el contexto familiar con el desarrollo socioemocional de niños con TEA. Subrayan asimismo la importancia del asesoramiento a las familias para potenciar las habilidades de regulación emocional y las conductas prosociales, debido a su impacto en la adaptación social a largo plazo.

Families of children with autism spectrum disorder (ASD) can be differentiated according to socio-demographics and environmental risk factors characterized by stress parental, the use of coping strategies and social support. The aim of this study was to analyze the behavioral, emotional and social manifestations of children with ASD, related to different types of families characterized according risk factors as families with "high risk", with "moderated risk" and with "low risk". Participants were 52 mothers and their children between 7 and 11 years old with ASD without intellectual disability. All mothers provided information about children's behavior through the Strengths and Difficulties Questionnaire, which includes the following scales: emotional symptoms, behavioral problems, hyperactivity/inattention, peer problems and prosocial behavior. Comparisons analysis showed that children belonging to the high family risk group exhibited less prosocial behaviors and a higher level of emotional problems compared to the low risk group. The findings from the present study illustrate the importance of considering the characteristics of entire family system in the emotional and social development of children with ASD. The role of family counseling to enhance emotional regulation skills and prosocial behaviors is underlined due to their impact on long-term social adjustment.

Psychometric properties of the Brazilian version of the Difficulties in Emotion Regulation Scale (DERS) / Propriedades psicométricas da versão Brasileira da Difficulties in Emotion Regulation Scale (DERS)

Abstract Introduction: Emotion regulation can be defined as the process by which individuals manage their emotional experience. It has been demonstrated that deficits in this ability are associated with various psychiatric disorders. In this direction, the Difficulties in Emotion Regulation Scale (DERS) was developed to measure difficulties in emotion regulation. Objective: To examine the psychometric properties of the Brazilian Portuguese version of the DERS. Method: A total of 377 individuals from the general population, selected by convenience, completed a sociodemographic form, the adapted Brazilian Portuguese DERS and the Depression Anxiety Stress Scale (DASS-21). Factor structure, reliability, and concurrent validity of the adapted version of the instrument were investigated. Results: The confirmatory factor analysis replicated the six-factor structure originally proposed for the instrument and confirmed the acceptability of a hierarchical model where all DERS subscales loaded on a general emotion dysregulation factor. Internal consistency indicators had adequate values for the general factor and subscales. The positive association between DERS and DASS-21 scores supports the instrument's concurrent validity. Conclusion: These results suggest that the Brazilian version of the DERS is reliable both as a general measure of difficulties in emotion regulation and as a measure of the constituents of this construct. Future research should investigate the psychometric properties of the scale in clinical and nonclinical populations, with equal gender proportions and diverse backgrounds, and preferably employing longitudinal designs.

Resumo Introdução: Regulação emocional pode ser definida como o processo pelo qual os indivíduos regulam sua experiência emocional. Tem sido demonstrado que déficits na regulação emocional podem estar associados a vários transtornos psiquiátricos. Nesta linha, a Difficulties in Emotion Regulation Scale (DERS) é um instrumento que foi desenvolvido para acessar dificuldades na regulação emocional. Objetivo: Examinar as propriedades psicométricas de uma versão da DERS adaptada ao português brasileiro. Método: Um total de 377 indivíduos da população geral foram selecionados por conveniência para completar um questionário sociodemográfico, a versão adaptada ao português brasileiro da DERS e a Depression Anxiety Stress Scale (DASS-21). Foram investigadas a estrutura fatorial, confiabilidade e validade concorrente da versão adaptada da DERS. Resultados: A análise fatorial confirmatória replicou a estrutura de seis fatores originalmente proposta para o instrumento e confirmou a aceitabilidade de um modelo hierárquico em que todas as subescalas são carregadas em um fator de desregulação emocional geral. Os indicadores de consistência interna apresentaram valores adequados para o fator geral e subescalas. A associação positiva entre os escores obtidos na DERS e na DASS-21 dá suporte à validade concorrente do instrumento. Conclusão: Esses resultados sugerem que a versão brasileira da DERS é confiável como medida geral de dificuldades na regulação emocional e como medida dos constituintes desta construção. Pesquisas futuras devem investigar as propriedades psicométricas da escala em populações clínicas e não clínicas, com igual proporção de gênero e diversas origens e, de preferência, empregando desenhos longitudinais.

High levels of alexithymia in patients with multiple sclerosis / Altos índices de alexitimia foram observados em pacientes com esclerose múltipla

ABSTRACT: Alexithymia is a personality trait characterized by difficulties identifying and describing feelings. Some researchers describe high levels of alexithymia among patients with multiple sclerosis (MS) but literature data on this subject are scarce. Objective: The objective of the present study was to characterize findings of alexithymia in patients with MS. Methods: This cross-sectional case-control study included 180 patients with MS and a matched control group. Data for patients with MS included disease duration, number of demyelinating relapses and degree of neurological disability, as assessed by the Expanded Disability Scale Score (EDSS). In addition, the Hospital Anxiety and Depression (HAD) scale and the Toronto Alexithymia Scale (TAS) were used. Results: There were 126 women and 54 men in each group, with median age of 37 years and median education of 16 years. Patients with MS had higher degrees of depression (p<0.01), anxiety (p=0.01) and alexithymia (p<0.01) than did control subjects. For individuals with MS, depressive traits (p<0.01), anxious traits (p=0.03), higher age (p=0.02), lower education level (p=0.02), higher degree of disability (p<0.01) and not being actively employed (p=0.03) were associated with higher rates of alexithymia. Conclusion: Alexithymia was a relevant finding in patients with MS.

RESUMO: Alexitimia é um traço de personalidade caracterizado pelas dificuldades na identificação e descrição dos sentimentos. Alguns pesquisadores descrevem altos índices de alexitimia em pacientes com esclerose múltipla (EM), porém os dados na literatura são escassos. Objetivo: O objetivo do presente estudo foi caracterizar achados de alexitimia em pacientes com EM. Métodos: Este estudo transversal incluiu 180 pacientes com EM e um grupo controle pareado. Dados de pacientes com EM incluíram a duração da doença, número de surtos clínicos de desmielinização e grau de incapacidade neurológica avaliados pela Escala Expandida do Grau de Incapacidade (EDSS). Foram também utilizadas a escala Hospitalar de Ansiedade e Depressão (HAD) e a escala de Alexitimia de Toronto (TAS) foram utilizadas. Resultados: Cada grupo era constituído por 126 mulheres e 54 homens, com mediana de idade de 37 anos e mediana de escolaridade de 16 anos. Pacientes com EM apresentaram maior grau de depressão (p<0.01), ansiedade (p=0.01) e alexitimia (p<0.01) que os controles. Para pessoas com EM, traços depressivos (p<0.01), ansiosos (p=0.03), maior idade (p=0.02), menor nível educacional (p=0.02), maior grau de incapacidade (p<0.01) e o fato de não estar ativamente trabalhando (p=0.03) levaram a maiores níveis de alexitimia. Conclusão: Alexitimia foi um importante achado em pacientes com EM.

Adaptación al español y validación de criterio de una escala para la tamización de problemas emocionales y del comportamiento en la primera infancia / Adaptation to Spanish and criterion validity of a scale for the screening of emotional and behavioral problems in early childhood

Resumen Introducción. La detección temprana del riesgo de problemas emocionales y del comportamiento en niños puede contribuir al desarrollo de estrategias que promuevan la salud mental desde la primera infancia. En Colombia no existe una herramienta validada para dicha detección. Objetivos. Seleccionar, adaptar y establecer la validez de criterio de una escala de tamización de problemas emocionales y del comportamiento en niños menores de seis años. Materiales y métodos. A partir de una revisión de la literatura y un consenso de expertos, se seleccionó la herramienta Early Childhood Screening Assessment (ECSA). Posteriormente, se llevó a cabo su adaptación lingüística y se determinó la validez de criterio mediante una curva de características de recibidor-operador (Receiver Operating Characteristic, ROC), y se la comparó con el cuestionario Child Behavior Checklist (CBCL 1,5-5). En el estudio participaron 206 cuidadores de niños entre el año y medio y los seis años de edad de la ciudad de Tunja y el municipio de Sopó. Resultados. La puntuación del ECSA presentó una buena correlación con la puntuación t total del CBCL 1,5-5 (ro de Spearman=0,75; p<0,01). La escala ECSA tuvo una sensibilidad de 86 % y una especificidad de 82 % al establecer un punto de corte de 24 para la población estudiada. Conclusión. En este primer estudio de adaptación y validación de la versión en español de la escala ECSA, se detectaron buenos valores de sensibilidad y especificidad para la tamización de problemas emocionales y del comportamiento en la primera infancia.

Abstract Introduction: Early identification of emotional and behavioral risk in children can contribute to the development of strategies that promote mental health from early childhood. In Colombia, we do not count with a validated screening tool for emotional and behavioral problems in this population. Objectives: To identify, adapt, and establish evidence for the criterion validity of a screening tool for emotional and behavioral problems in less than 6-year-old children. Materials and methods: We selected the Early Childhood Screening Assessment (ECSA) after a literature review and expert consensus and then we undertook its linguistic adaptation. For criterion validity, we used the Receiver Operating Characteristic (ROC) comparing the scale with the Child Behavior Checklist (CBCL 1,5-5). The sample included 206 caregivers of children between 1.5 and 6 years of age from the city of Tunja and the municipality of Sopó. Results: The ECSA showed a good correlation with the total t-score of the CBCL 1,5-5 (Spearman rho= 0,75, p<0,01). The scale showed a sensitivity of 86% and a specificity of 82% at a cut-off point of 24. Conclusion: In this first adaptation to Spanish and validation study of the ECSA scale, we found good sensitivity and specificity values for the screening of emotional and behavioral problems in early childhood.

Psychopathology and alexithymia in patients with psoriasis

Abstract: Background: Psoriasis is a chronic, inflammatory, relapsing skin disease that has a psychosocial impact on the patients' life. Objective: This study aimed to investigate psychopathology in patients with psoriasis based on a valid psychometric instrument, as well as on the relationship between psychopathology and alexithymia. Methods: 108 patients with psoriasis were included in the study. Psychopathology was evaluated with the Symptom Checklist-90-Revised (SCL-90-R) and alexithymia with the Toronto Alexithymia Scale (TAS-20). Disease severity was clinically assessed using the Psoriasis Area and Severity Index. Results: As regards the psychopathological dimensions, female patients presented with statistically significant higher somatization, depression, anxiety, phobic anxiety, and psychoticism than males. Patients with alexithymia presented with statistically significant higher somatization, interpersonal sensitivity, anxiety, and phobic anxiety than non-alexithymic patients. Alexithymia positively correlated with somatization (r = 0.26, p < 0.01), interpersonal sensitivity (r = 0.24, p < 0.05), depression (r = 0.27, p < 0.01), anxiety (r = 0.26, p < 0.01), and phobic anxiety (r = 0.26, p < 0.01). In addition, alexithymia also contributed to the prediction of these conditions. Study Limitations: A larger study sample could yield safer generalized results. Nevertheless, to the best of our knowledge, this was the first study to investigate various psychopathological dimensions in patients with psoriasis. Conclusions: Our study results indicate that alexithymia and female sex were associated with several psychopathological dimensions in patients with psoriasis. It may be suggested that alexithymia constitutes an important factor in the development of mental disorders among patients with psoriasis.

Trastornos neuropsiquiátricos en la población con VIH: una revisión narrativa / Neuropsychiatric Disorders in the People Living with HIV: A Narrative Review

Introducción: el sistema nervioso central es uno de los órganos afectados, de manera directa e indirecta, por el VIH; adicionalmente, los trastornos psiquiátricos son más frecuentes en esta población. Objetivo: comprender la patogénesis, las manifestaciones clínicas y el manejo de las enfermedades neuropsiquiátricas en la población con VIH. Métodos: se realizó una búsqueda en las bases de datos Medline, Embase, SciELO, LILACS y Psychlnfo utilizando término libres y MeSH. Resultados: los trastornos neuropsiquiátricos generan un impacto negativo en el tratamiento y seguimiento de los pacientes con VIH, lo cual disminuye su adherencia al tratamiento y aumenta las dificultades en su manejo integral. Llamativamente, existe una falta de estudios latinoamericanos en esta área.

Introduction: HIV is the infectious disease with the biggest worldwide impact in the last decades. For this reason, the control of this disease was induded in the millennium objectives of the UN. There has been a long time interest for studying the psychiatric comorbidities in these patients due to its impact in survival. Níethods: A research in the data bases Medline, Embase, SciELO, LILACS, and Psychlnfo was made using free terms and MeSH terms. Results: The neuropsychiatric disorders have a negative impact in the treatment and control of HIV positive patients, reducing their adherence and increasing the difficulties in the comprehensive treatment. There is a déficit in studies that could clear up this relationship in Colombian population.

Association between the Catechol-O-Methyltransferase (COMT) Val(158)Met Polymorphism and Alexithymia in Patients with Obsessive-Compulsive Disorder

PURPOSE: Alexithymia, defined as a deficit in the ability to recognize and describe one's own feelings, may be related to the development and maintenance of obsessive-compulsive symptoms. The aim of this study was to evaluate the association between the catechol-O-methyltransferase (COMT) Val158Met polymorphism and alexithymia in patients with obsessive-compulsive disorder (OCD). MATERIALS AND METHODS: We recruited 244 patients with OCD (169 males, 75 females). Alexithymia was assessed using the 20-item Toronto Alexithymia Scale (TAS-20), and genotyping of the COMT Val(158)Met polymorphism was evaluated. RESULTS: Patients with the COMT Val/Val genotype had significantly higher total and "difficulty identifying feelings" (DIF) subdimension scores than those with the Val/Met or Met/Met genotypes. Patients with the COMT Val/Val genotype had significantly higher "difficulty describing feelings" (DDF) subdimension scores than those with the COMT Val/Met genotype. However, there were no differences in the scores for the "externally oriented thinking" (EOT) subdimension among the three genotypes. CONCLUSION: These results indicate that the high-activity Val allele of the COMT Val(158)Met polymorphism is associated with increased alexithymic traits in patients with OCD. The present finding suggests that alexithymia is an endophenotype of OCD that is mediated by the COMT Val(158)Met polymorphism.

Regulación emocional en adolescentes con hipertensión arterial esencial / Emotional regulation in adolescents with essential hypertension

INTRODUCCIÓN: las investigaciones actuales constatan la necesidad, desde el punto de vista asistencial, de brindar una atención oportuna e integral a los menores que presentan hipertensión arterial esencial. En estudios realizados con adolescentes hipertensos, se ha perfilado la regulación emocional, como posible factor de riesgo asociado al curso y evolución de la enfermedad. OBJETIVO: caracterizar la regulación emocional en adolescentes con hipertensión arterial esencial. MÉTODOS: se estudiaron 20 adolescentes hipertensos, los cuales fueron comparados con 20 adolescentes normotensos. Las técnicas psicológicas empleadas fueron: escala dificultades en la regulación emocional, en español, para adolescentes; entrevista estructurada; inventario de ansiedad rasgo­estado, versión infantil (IDAREN); inventario de depresión infantil de Kovacs (CDI) e inventario de expresión de la ira estado-rasgo, versión niño-adolescente (STAXI-II CA). Para el análisis de los datos, se empleó el paquete estadístico SPSS versión 15.0, a través de la estadística descriptiva e inferencial. RESULTADOS: los adolescentes hipertensos presentaron dificultades en su regulación emocional y un escaso repertorio de estrategias y su utilización fue poco flexible, predominaron la rumiación y la represión. Estas dificultades tuvieron mayor incidencia en los niveles de ansiedad y depresión con tendencia a la inadaptabilidad, lo cual afectó el bienestar emocional de los pacientes. Las características de la regulación emocional encontradas en los adolescentes hipertensos, los distinguió del grupo de adolescentes normotensos. CONCLUSIONES: los adolescentes hipertensos se caracterizan por presentar una regulación inefectiva de sus emociones, principalmente de la ansiedad y la tristeza, lo cual afecta su bienestar emocional y aumenta su vulnerabilidad ante la enfermedad.

INTRODUCTION: current researches acknowledge the need to provide timely and comprehensive care to children who have essential hypertension from the health care standpoint. In studies with hypertensive adolescents, emotional regulation has emerged as a possible risk factor associated with the course and outcome of this disease. OBJECTIVE: To characterize emotion regulation in adolescents with essential hypertension. METHODS: 20 hypertensive adolescents were studied. They were compared with 20 normotensive adolescents. Psychological techniques used were such as: scale difficulties in emotional regulation, in Spanish, for teens; structured interview; trait anxiety inventory-state, the kid version (IDAREN); Kovacs Children's Depression Inventory (CDI), and inventory of expressions of the state-trait anger, child-teen (STAXI-II CA) version. For data analysis, SPSS version 15.0 was used, through descriptive and inferential statistics. RESULTS: hypertensive adolescents had difficulties in emotion regulation and poor repertoire of strategies, their use was inflexible, rumination and repression predominated. These difficulties had the greatest impact on levels of anxiety and depression prone to adjustment problems, which affected the emotional well-being of these patients. The found characteristics of emotion regulation in hypertensive adolescents distinguished them from the group of normotensive adolescents. CONCLUSIONS: hypertensive adolescents are characterized by ineffective regulation of emotions, especially anxiety and sadness, which affects their emotional well-being and increases their vulnerability to disease.

Validez y confiabilidad de la versión adaptada al español de la escala de dificultades de regulación emocional (DERS-E) en población chilena / Validity and reliability of the adapted spanish version of the difficulties in emotion regulation scale in chilean population

El objetivo de esta investigación fue examinar la confiabilidad y validez de la versión adaptada al español de la Escala de Dificultades de Regulación Emocional (DERS-E), en población chilena. Este es un instrumento de auto-reporte que evalúa las dificultades en el proceso de regulación emocional en adultos. El estudio se realizó a partir de dos muestras: la primera compuesta por 1018 estudiantes universitarios y la segunda por 1161 adultos de población general. Los participantes completaron el DERS-E y una medida de ajuste socioemocional a través del Outcome Questionnaire OQ-45.2. Los índices de confiabilidad fueron adecuados en ambas muestras y la estructura factorial congruente con la versión adaptada al español. Además, hubo diferencias en las dificultades de regulación emocional en función del ajuste socioemocional. Los resultados confirmaron que el DERS-E es un instrumento confiable y válido en la evaluación de las dificultades de regulación emocional en adultos.

This study sought to examine the validity and reliability of the Difficulties in Emotion Regulation Scale Spanish version (DERS-S) in chilean population. This is a self-report instrument that measures difficulties in emotion regulation in adults. Two samples were evaluated: one composed of 1018 university students and the second one composed of 1161 participants from general population. Individuals completed the DERSE and Outcome Questionnaire OQ-45.2. Reliability indices were adequate in both samples and the factor structure consistent with the spanish version adaptation. In addition, there were differences in emotional regulation difficulties according to socio-emotional adjustment. The results confirmed that the psychometric properties of the DERS-E make it a reliable and valid instrument to assess difficulties in emotion regulation.

Evaluation of the Pediatric Symptom Checklist as a screening tool for the identification of emotional and psychosocial problems / Evaluacion del uso de la Lista de Sintomas Pediatricos como instrumento de rastreo para identificar problemas emocionales y psicosociales / Avaliacao da Lista de Sintomas Pediatricos como instrumento de triagem para identificar problemas emocionais e psicossociais

OBJECTIVE To investigate the Brazilian version of Pediatric Symptom Checklist (PSC) as a screening tool to identify psychosocial and emotional problems in schoolchildren from six to 12 years old. METHODS Diagnostic test conducted in a public school of Curitiba, Paraná (Southern Brazil), to evaluate the PSC accuracy and consistency, considering the Child Behavior Checklist (CBCL) as the gold standard. Among 415 parents invited for the study, 145 responded to both PSC and CBCL. The results of the two instruments were compared. PSC and CBCL were considered positive if scores ≥28 and >70 respectively. RESULTS Among the 145 cases, 49 (33.8%) were positive for both PSC and CBCL. The ROC curve showed the PSC score of 21 as the best cutoff point for screening psychosocial and emotional problems, with a sensitivity of 96.8% and a specificity of 86.7%. Regarding the reference cutoff (score ≥28 points), the sensitivity was 64.5% and the specificity, 100.0%, similar to those found in the original version of the tool. CONCLUSIONS The Portuguese version of PSC was effective for early identification of emotional and/or psychosocial problems in a schoolchildren group and may be useful for pediatricians. .

OBJETIVO Investigar la Lista de Síntomas Pediátricos (LSP) como instrumento de rastreo para identificar problemas emocionales y psicosociales en escolares de 6 a 12 años. MÉTODOS Estudio de tipo prueba diagnóstica, realizado en una escuela pública de Curitiba, Paraná (Brasil), para evaluar la precisión y la consistencia de la LSP, considerando el Child Behavior Checklist (CBCL) como patrón oro. De los 415 padres invitados a participar del estudio, 145 contestaron a la LSP y al CBCL, constituyendo la muestra, y los resultados de los dos instrumentos fueron comparados. Se consideró como positivo el escore de LSP ≥28 y del CBCL >70 puntos. RESULTADOS De los 145 cuestionarios, 49 (33,8%) tanto de la LSP como del CBCL se mostraron positivos. La curva ROC indicó 21 como el mejor punto de corte para rastreo de problemas emocionales y psicosociales, con sensibilidad del 96,8% y especificidad del 86,7%. En el punto de corte de referencia (≥28), se observó la sensibilidad del 64,5% y especificidad del 100%, similares a las en contradas en la versión americana del instrumento. CONCLUSIONES La LSP se mostró eficaz para la identificación temprana de problemas emocionales y/o psicosociales en un grupo de escolares, pudiendo ser una herramienta útil al pediatra. .

OBJETIVO Investigar a Lista de Sintomas Pediátricos (LSP) como instrumento de triagem para identificar problemas emocionais e psicossociais em escolares de seis a 12 anos. MÉTODOS Estudo do tipo teste diagnóstico, realizado em uma escola pública de Curitiba, Paraná, para avaliar a acurácia e a consistência da LSP, considerando-se o Child Behavior Checklist (CBCL) como padrão-ouro. Dos 415 pais convidados a participar do estudo, 145 responderam à LSP e ao CBCL, constituindo a amostra. Os resultados dos dois instrumentos foram comparados. Considerou-se como positivo o escore da LSP ≥28 e o do CBCL >70 pontos. RESULTADOS Dos 145 questionários, 49 (33,8%) tanto da LSP como do CBCL mostraram-se positivos. A curva ROC indicou 21 como o melhor ponto de corte para triagem de problemas emocionais e psicossociais, com sensibilidade de 96,8% e especificidade de 86,7%. No ponto de corte de referência (≥28), observou-se sensibilidade de 64,5% e especificidade de 100,0%, similares às encontradas na versão americana do instrumento. CONCLUSÕES A LSP mostrou-se eficaz para a identifição precoce de problemas emocionais e/ou psicossociais em um grupo de escolares, podendo ser uma ferramenta útil ao pediatra. .

Extinción diferencial de los acontecimientos vitales en pacientes depresivos / Differential extinction of life events in depressed patients

Introducción: La pérdida constituye un aspecto central de la mayoría de los acontecimientos vitales (AV) que llevan a la depresión. En este trabajo investigamos si aquellos AV que suponen una pérdida importante generan un mayor impacto en la génesis de la enfermedad y si tienen un mayor tiempo de extinción que el resto de los sucesos. Método: Utilizamos una muestra de casos y controles de 50 pacientes deprimidos que habían sido diagnosticados con un episodio depresivo en los 6 meses previos a la entrevista, 50 controles sanos y una muestra comunitaria de 609 mujeres. La Life Events and Difficulties Schedule (LEDS) se aplicó a todos los sujetos. Se utilizó un método estadístico de extinción diferencial que segrega los AV según la existencia de acontecimientos importantes de pérdida. Resultados: En ambas muestras, los pacientes depresivos presentaban un incremento significativo de AV graves en las 52 semanas previas al desencadenamiento del trastorno. La mejor diferenciación entre grupos se correspondió con los tiempos de extinción más elevados. La diferencia de medias de la amenaza residual en la muestra comunitaria entre AV con pérdida y sin ella en sujetos depresivos y controles fue significativamente más alta en los AV con pérdida. Conclusiones: El método de extinción diferencial que segrega los AV en función de la existencia de pérdida o no permite una mejor diferenciación entre pacientes depresivos y controles. Aquellos AV que suponen una pérdida importante generan un mayor impacto en la génesis de la enfermedad y tienen un mayor tiempo de extinción que el resto de los sucesos

Prevalência de transtornos emocionais e comportamentais em adolescentes com asma / Prevalence of emotional and behavioral disorders in adolescents with asthma

OBJETIVO: Determinar a prevalência de transtornos emocionais e comportamentais em adolescentes com asma e compará-la com a prevalência em adolescentes sem asma. MÉTODOS: Estudo transversal através de um questionário de transtornos psicológicos (Strengths and Difficulties Questionnaire) aplicado a adolescentes de 14 a 16 anos, com e sem asma, selecionados aleatoriamente em escolas municipais de Belo Horizonte (MG) Brasil. RESULTADOS: A prevalência de transtornos emocionais e comportamentais em adolescentes com e sem asma foi 20,4 por cento (IC95 por cento: 14,5-27,8 por cento) e 9 por cento (IC95 por cento: 6,1-12,8 por cento), respectivamente. Entre os adolescentes com asma, 56,6 por cento (IC95 por cento: 48,3-64,5 por cento) apresentavam escores dentro da faixa de normalidade e 23 por cento (IC95 por cento: 16,8-30,7 por cento), valores limítrofes. Entre os que não tinham asma, 75 por cento (IC95 por cento: 69,7-79,6 por cento) apresentavam escores normais e 16 por cento (IC95 por cento: 12,2-20,7 por cento), limítrofes. A mediana no escore total do questionário foi 14 nos portadores de asma e 12 nos sem asma (p < 0,01). Na análise multivariada (regressão logística), controlado para variáveis socioeconômicas, permaneceram significativas as associações entre transtornos emocionais e comportamentais e as seguintes variáveis: sexo feminino (OR = 1,98; IC95 por cento: 1,10-3,56, p = 0,02), e ter asma (OR = 2,66; IC95 por cento: 1,52-4,64, p = 0,001). CONCLUSÕES: A prevalência de transtornos emocionais e comportamentais em adolescentes portadores de asma é significativamente maior do que naqueles que não tem asma, reforçando a necessidade de uma abordagem interdisciplinar e sistêmica.

OBJECTIVE: To determine the prevalence of emotional and behavioral disorders in adolescents with asthma and to compare it with that of adolescents without asthma. METHODS: A transversal study using the Strengths and Difficulties Questionnaire, administered to adolescents with or without asthma, ranging from 14 to 16 years of age and randomly selected from schools in the city of Belo Horizonte, Brazil. RESULTS: The prevalence of emotional and behavioral disorders in adolescents with and without asthma was 20.4 percent (95 percent CI: 14.5-27.8 percent) and 9.0 percent (95 percent CI: 6.1-12.8 percent), respectively. Among adolescents with asthma, 56.6 percent (95 percent CI: 48.3-64.5 percent) presented normal scores, and 23.0 percent (95 percent CI 16.8-30.7 percent) presented borderline scores. Among adolescents without asthma, 75.0 percent (95 percent CI: 69.7-79.6 percent) presented normal scores, and 16.0 percent (95 percent CI: 12.2-20.7 percent) presented borderline scores. The median total score on the questionnaire was 14 and 12 among subjects with and without asthma, respectively (p < 0.01). In the final logistic regression model, adjusted for socioeconomic variables, the association between emotional/behavioral disorders and the following variables remained significant: being female (OR = 1.98; 95 percent CI: 1.10-3.56; p = 0.02) and having asthma (OR = 2.66; 95 percent CI: 1.52-4.64; p = 0.001). CONCLUSIONS: The prevalence of emotional and behavioral disorders is higher in adolescents with asthma than in those without asthma, underscoring the need for a holistic, interdisciplinary approach.

Validity of a frustration-induction procedure

OBJECTIVE: To test a reliable and easily administered frustration-induction procedure for experimental research. METHOD: One hundred volunteers (81 women, mean age ± SD 34.2 ± 8 years) physically and psychiatrically healthy submitted to the frustration induction procedure were prevented from reaching reward level scores. Subjective aggressiveness feelings related to frustration were self-rated in a 13-item visual analogue scale before and after the procedure. RESULTS: Significant increases in aggressiveness-related feelings were detected in 12 of the 13 items. This was consistent with the observed overt behavior of the subjects during the task. CONCLUSIONS: The frustration-induction procedure is a simple, easy to administer frustration-induction procedure that can be used in experimental studies in normal subjects.

OBJETIVO: Testar um procedimento de indução de frustração confiável e de simples aplicação para a pesquisa experimental. MÉTODO: Cem voluntários (81 mulheres, idade média ± DP 34,2 ± 8 anos), física e psiquiatricamente saudáveis, submetidos ao procedimento de indução de frustração, foram impedidos de atingir escores de recompensa. Os sentimentos de agressividade subjetivos relacionados à frustração foram autoclassificados em um escala analógica visual de 13 itens antes e após o procedimento. RESULTADOS: Foram detectados aumentos significativos nos sentimentos relacionados à agressividade em 12 dos 13 itens. Isto foi consistente com o comportamento manifestado pelos indivíduos e observado durante a tarefa. CONCLUSÕES: O procedimento de indução de frustração é simples, facilmente aplicável e que pode ser utilizado em estudos experimentais com indivíduos normais.

Obesidad: una epidemia del siglo XXI / Obesity: an epidemic of the 21st century

La OMS considera a la obesidad como la epidemia del siglo XXI, con alta prevalencia en la población pediátrica. La obesidad, además del sustrato biológico está ligada a factores culturales, acceso a alimentos y cambios en el modo de comer de ciertas sociedades. Salvo en un pequeño porcentaje, la obesidad no responde a una etiología única; es de origen multifactorial. No es una enfermedad en sí, pero es un factor de riesgo para numerosas patologías, tanto de la niñez como del adulto. Se describe la obsidad extrema o Síndrome de Picwick, así como algunas enfermedades que causan obesidad. Se mencionan algunos conocimientos actuales sobre fisiopatología, diagnóstico y trartamiento, así como las dificultades terapéuticas y sus frecuentes fallos en el largo plazo. Se enfatiza finalmente la importancia de la prevención y la responsabilidad del equipo de salud en la misma, especialmente en la edad pediátrica

Questionário de capacidades e dificuldades (SDQ) / Strengths and difficulties questionnaire (SDQ)

O Questionário de Capacidades e Dificuldades, o Strengths and Difficulties Questionnaire em inglês, e uma medida de psicopatologia breve e útil, aplicável a populaçäo de 4 a 16 anos. Embora tenha sido publicado apenas em 1997, já se encontra disponível em mais de quarenta idiomas, incluindo o português. Este artigo é uma breve introduçäo ao SDQ, revendo suas características principais e resumindo os principais estudos que já foram publicados sobre este questionário.

Prevalencia de alexitimia en adultos con asma / The prevalence of alexithimia in patients with asthma

El constructo Alexitimia se utiliza para describir un estilo cognitivo caracterizado por la dificultad para discriminar y verbalizar sentimientos. Ante situaciones conflictivas presentan síntomas signos orgánicos, así como tendencia hacia la acción. Tienen pobreza para la abstracción, la fantasía y la instrospección. Analizamos la presencia de alexitimia en pacientes con asma. En el grupo de adultos utilizamos la escala autoadministrada de Alexitimia de Taylor de Toronto (TAS) y en el grupo de chicos realizamos psicodiagnóstico con técnicas proyectivas. En ambos grupos fué significativa la prevalencia de alexitimia, siendo notablemente mayor en el grupo de chicos con asma (80 por ciento). El diagnóstico de Alexitimia en pacientes con asma posibilita el abordaje de un factor de vulnerabilidad psíquica que incide en el trastorno somático y las conductas de acción