RESUMO
Chronic minor childhood stress in the form of corporal punishment predicts adult psychopathology in the United States but has not been demonstrated in a country where corporal punishment is normative. We tested whether adult psychopathology was predicted by recalled frequency of childhood corporal punishment and recalled controllability of punishment in Saudi Arabia. Two hundred and fifty nine Saudi men with substance addictions (who for cultural reasons were at risk for depression) completed a survey measuring: demographic variables, frequency of beating and controllability of punishment as a child, depression and borderline personality disorder symptoms (BPD). Beating frequency and punishment control were uncorrelated and unrelated to patients’ or parents’ education. 92 men (36%) had major depression (PHQ-9 ≥15). Compared to those never beaten, those experiencing infrequent beating (once or twice a year) were significantly more likely to have major depression and higher BPD symptoms, after controlling for demographic variables. Those experiencing frequent beating (monthly or more frequent) were more likely to have major depression and higher BDP symptoms compared to those never beaten, but only when perceived control was low. Perceived punishment control was not significantly related to outcome for those who never had or had infrequent corporal punishment. These results provide evidence in a culture where corporal punishment is normative that corporal punishment, even when infrequent, predisposes to adult psychopathology and that uncontrollability increases the pathogenic effect of frequent corporal punishment. These results support the hypothesis that frequent minor stressors in childhood act as kindling factor for later depression.
RESUMO
OBJETIVO: Traduzir para o português e adaptar para a cultura brasileira o Breathing Problems Questionnaire (BPQ, questionário para problemas respiratórios), assim como avaliar a sua reprodutibilidade em pacientes com DPOC. MÉTODOS: Após a tradução e a adaptação do BPQ para a cultura brasileira por um tradutor, a primeira versão foi aplicada em oito pacientes visando conhecer suas dúvidas e dificuldades. O questionário foi analisado por uma comissão de especialistas e sua versão final foi definida. Foi realizada a retrotradução por um segundo tradutor, que foi enviada para o autor original com intuito de assegurar o sentido original do questionário. Após a aprovação final do autor, 50 pacientes portadores de DPOC responderam o BPQ para avaliar sua reprodutibilidade. RESULTADOS: O tempo médio de resposta foi 9,5 min. Dos 50 pacientes, 21 eram do sexo feminino e 29 do sexo masculino, com média de idade de 65,8 ± 7,5 anos. A maioria foi classificada com DPOC moderada (29,16%) e grave (52%). O coeficiente de correlação intraclasse (CCI) para o escore total foi de 0,94. Os onze domínios do BPQ e as suas duas subescalas também tiveram valores de CCI acima de 0,70. Houve correlações moderadas entre os domínios e as subescalas do BPQ. CONCLUSÕES: A tradução e adaptação do BPQ para uso no Brasil foi adequada, pois os pacientes não apresentaram dificuldades para entendê-lo e respondê-lo. Além disso, o BPQ mostrou-se confiável por apresentar boa reprodutibilidade.
OBJECTIVE: To translate the Breathing Problems Questionnaire (BPQ) into Portuguese and adapt it to the Brazilian culture, as well as to evaluate its reproducibility in patients with COPD. METHODS: After the BPQ had been translated and adapted to the Brazilian culture, it was administered to a subgroup of 8 patients in order to identify their uncertainties and difficulties. The questionnaire was reviewed by an expert committee, and its final version was arrived at. A second translator back-translated the final version into English, which was sent to the original author in order to verify that the original meaning of the questionnaire had been maintained. After the approval of the original author, the final Portuguese-language version of the questionnaire was administered to 50 patients with COPD, in order to evaluate its reproducibility. RESULTS: The mean response time was 9.5 min. Of the 50 patients, 21 were female and 29 were male. The mean age was 65.8 ± 7.5 years. Most of the patients were classified as having moderate COPD (29.16%) or severe COPD (52%). The intraclass correlation coefficient (ICC) for the total score was 0.94. The ICCs for the eleven BPQ domains and its two subscales were also above 0.70. Moderate correlations were found between the BPQ domains and subscales. CONCLUSIONS: The translation and cultural adaptation of the BPQ for use in Brazil was deemed appropriate, because the patients could easily understand and answer the questions. In addition, the Brazilian version of the BPQ questionnaire was found to be reliable, showing good reproducibility.