Tabla de la normalidad de las pruebas psicométricas para el diagnóstico de encefalopatía hepática subclínica en la población Dominicana / Score of normality psychometric tests for the diagnosis of subclinical hepatic encephalopathy in the Dominican Population

Introducción: La encefalopatía hepática mínima (EHM), es una enfermedad definida por la existencia de varias alteraciones neurofisiológicas, indetectables a la exploración neurológica y el examen clínico. Dentro de las estrategias diagnosticas para la EHM se contemplan las pruebas psicométricas (PHE), pero para su aplicación es indispensable la estandarización previamente en la población de estudio. Objetivo: El estudio se propuso determinar la tabla de la normalidad de las PHE para diagnosticar la encefalopatía hepática subclínica en una muestra de la población dominicana. Método: Se realizó un estudio descriptivo, prospectivo y transversal en un hospital de referencia nacional. Se analizaron 134 personas clasificados por grupos de edades (18-70 años de edad) y años de escolaridad. Se diseñó una tabla de 5x5. Se estudió la influencia de la edad, sexo, uso de espejuelo y de los años de escolarización en el rendimiento de cada uno de las PHE, para lo cual se utilizaron las siguientes pruebas estadísticas: análisis de varianza (ANOVA), prueba t de Student y regresión lineal. Resultado: La escolaridad y la edad fueron variables determinantes en el desempeño de las 5 pruebas psicométricas. Pero, la correlación univariable de la edad con el desempeño de la prueba TMS no hubo diferencias intra e inter grupos estadísticamente significativas (p>0.171). Conclusión: se confecciono la fórmula de predicción de resultados de los test psicométricos. Ninguno sobrepasó el punto de corte de la puntuación que oscila entre los -4 y los +2 puntos.

Introduction: Minimal hepatic encephalopathy (MHE) is a disease defined by the existence of several neurophysiological alterations, undetectable by neurological examination and clinical examination. Among the diagnostic strategies for EHM, psychometric tests (PHE) are contemplated, but for their application, prior standardization in the study population is essential. Objective: The study will need to determine the normality table of PHE to detect subclinical hepatic encephalopathy in a sample of the Dominican population. Method: A descriptive, prospective and cross-sectional study was carried out in a national reference hospital. 134 people classified by age groups (18-70 years of age) and years of schooling were analyzed. A 5x5 board is recommended. The influence of age, sex, use of glasses and years of schooling on the performance of each one of the PHEs was studied, for which the following statistical tests were used: analysis of variance (ANOVA), Student's t test and linear regression. Result: Schooling and age were determining variables in the performance of the 5 psychometric tests. But, the univariate coincidence of age with the performance of the TMS test, there were no statistically significant intra and inter group differences (p>0.171). Conclusion: the formula for predicting the results of the psychometric tests was made. None exceeded the cut-off point of the score that oscillates between -4 and +2 points.

Aplicación de principios éticos de la psicología en un ejercicio de formación académica sobre el diseño, validación y aplicación de un instrumento psicométrico / Application of Ethical Principles of Psychology in an Academic Training Exercise on the Design, Validation, and Application of a Psychometric Instrument / Aplicação dos princípios éticos da psicologia em um exercício de formação acadêmica sobre a elaboração, validação e aplicação de um instrumento psicométrico

La formación ética y responsable de profesionales en psicología implica reconocer que la comprensión y la aplicación de los principios éticos no solo se deben realizar en el ejercicio profesional, sino también desde el desarrollo de actividades y prácticas durante el proceso de formación académica, en diversos cursos del currículo de los programas de psicología. En Colombia se ha establecido la beneficencia, la no maleficencia, la justicia, la autonomía y la integridad como los cinco criterios de decisión más importantes que deben guiar el quehacer profesional. El presente estudio busca conocer cómo una muestra de estudiantes de psicología comprende y pone en práctica los principios éticos en el desarrollo de un ejercicio académico de diseño, aplicación y análisis de las propiedades psicométricas de un instrumento. Para ello, se realizó un estudio cualitativo con 200 estudiantes de psicología que se encontraban cursando la asignatura de Psicometría durante el segundo semestre de 2020. En algunos casos se observó desconocimiento de los principios éticos, y, por lo tanto, dificultades en su apropiación y aplicación, lo cual llevó a reflexionar sobre el aprendizaje de estos aspectos desde el macro y microcurrículo en los programas de psicología. Además, este tipo de investigaciones permite sensibilizar respecto al manejo ético de las pruebas psicológicas, tanto en su proceso de diseño como de aplicación

The ethical and responsible training of professionals in psychology implies recognizing that the understanding and application of ethical principles should not only be carried out in professional practice but also during the development of academic and practical activities in various courses of the curriculum of psychology programs. In Colombia, beneficence, non-maleficence, justice, autonomy, and integrity have been established as the five most important decision criteria that should guide professional work. The present study seeks to know how a sample of psychology students under-stands and puts into practice the ethical principles in the development of an academic exercise of the design, application, and analysis of the psychometric proper-ties of an instrument. A qualitative study was carried out with 200 psychology students who were taking the psychometry course during the second semester of 2020. In some cases, there was a lack of knowledge of ethical principles and, therefore, difficulties in their appropriation and application, which led to the reflection of these aspects' learning from the perspective of the macro- and microcurriculum in psychology programs. In addition, this type of research allows raising awareness about the ethical management of psychological tests both in their design and application

A formação ética e responsável do profissional em Psicologia implica reconhecer que a compreensão e aplicação dos princípios éticos não devem ser reali-zadas apenas na prática profissional, mas a partir do desenvolvimento de atividades acadêmicas e práticas durante o processo de formação acadêmica de toda a grade curricular dos programas de psicologia. Na Colômbia, beneficência, não maleficência, justiça, auto-nomia e integridade foram estabelecidas como os cinco critérios de decisão mais importantes que devem nortear o trabalho profissional. O presente estudo busca saber como uma amostra de estudantes de psicologia entende e coloca em prática os princípios éticos no desenvol-vimento de um exercício acadêmico de elaboração, aplicação e análise das propriedades psicométricas de um instrumento. Realiza-se um estudo qualitativo com 200 alunos de psicologia que cursavam a disciplina de psicometria durante o segundo semestre de 2020. Em alguns casos há desconhecimento dos princípios éticos e, por conseguinte, dificuldades na sua apropriação e aplicação; o que nos leva a refletir sobre a aprendizagem desses aspectos a partir dos macro e micro currículos nos programas de psicologia, além disso, esse tipo de pesquisa permite a conscientização sobre a gestão ética dos testes psicológicos tanto na sua elaboração quanto no processo de aplicação

Adaptation and validation of content of the sedentary behavior questionnaire / Adaptación y validación de contenido del Sedentary behavior questionnaire / Adaptação e validação de conteúdo do Sedentary behavior questionnaire

Abstract Objective: to validate and adapt the Sedentary Behavior Questionnaire. Materials and methods: content adaptation and validation study, the Delphi technique was used, 18 experts evaluated the items of the questionnaire on a Likert scale regarding their relevance, utility, clarity, written form and length. Results: the questionnaire through its items assesses sedentary activity, the qualitative evaluation showed the need to adapt some questions regarding semantic to the Colombian context, the only item with an alpha lower than 0.70 was 7, the item with the highest Cronbach alpha was 10, the general Cronbach alpha of the instrument was 0.963, which is considered to be of optimal reliability. Conclusions: The content validation process showed that the Sedentary Behavior Questionnaire is a valid instrument in its content that is easy to apply and fill out, it allows a first approach to the sedentary behaviors of the subjects that can be complemented with physical tests to define the level of sedentary lifestyle, the foregoing enables the structuring of promotion and prevention programs by applying an instrument adapted and validated to the Colombian context.

Resumen Objetivo: adaptar y realizar la validación de contenido del Sedentary Behaviour Questionnaire. Materiales y métodos: estudio de adaptación y validación de contenido, se utilizó la técnica Delphi, participaron 18 expertos quienes evaluaron los ítems del cuestionario en una escala likert en cuanto a su pertinencia, relevancia, utilidad, claridad, redacción y extensión Resultados: El cuestionario a través de sus ítems evalúa la conducta sedentaria, la evaluación cualitativa mostró aspectos semánticos a tener en cuenta en algunas preguntas para realizar la adaptación al contexto colombiano, el único ítem con un alfa menor a 0,70 fue el 7, el ítem con mayor alfa de cronbach fue el 10, el alfa de cronbach general del instrumento fue de 0,963 este valor es considerado como de óptimo valor de confiabilidad; la versión definitiva incluye 3 nuevos ítems que complementan la valoración de la variable de interés. Conclusiones: el proceso de validación de contenido evidenció que el Sedentary Behaviour Questionnaire, es un instrumento válido en su contenido de fácil aplicación y diligenciamiento, permite una primera aproximación a las conductas sedentarias de los sujetos, este puede ser complementado con pruebas físicas para definir el nivel de sedentarismo, lo anterior posibilita la estructuración de programas de promoción y prevención, al aplicar un instrumento adaptado y validado al contexto colombiano.

Resumo Objetivo: validar e adaptar o Sedentary Behavior Questionnaire. Materiais e métodos: estudo de adaptação e validação de conteúdo, foi utilizada a técnica Delphi, 18 especialistas avaliaram os itens do questionário em uma escala Likert quanto à relevância, utilidade, clareza, forma escrita e extensão. Resultados: o questionário por meio de seus itens avalia a atividade sedentária, a avaliação qualitativa mostrou a necessidade de adequação de algumas questões semânticas ao contexto colombiano, o único item com alfa inferior a 0,70 foi 7, o item com maior alfa de Cronbach foi 10, o alfa de Cronbach geral do instrumento foi de 0,963, considerado de confiabilidade ótima. Conclusões: O processo de validação de conteúdo mostrou que o Sedentary Behavior Questionnaire é um instrumento válido em seu conteúdo, de fácil aplicação e preenchimento, pois permite uma primeira abordagem dos comportamentos sedentários dos sujeitos que podem ser complementados com testes físicos para definir os nível de sedentarismo, o anterior permite a estruturação de programas de promoção e prevenção por meio da aplicação de um instrumento adaptado e validado para o contexto colombiano.

Brazilian version of the European Cross-Cultural Neuropsychological Test Battery (CNTB-BR): diagnostic accuracy across schooling levels

Objective: To translate, establish the diagnostic accuracy, and standardize the Brazilian Portuguese version of the European Cross-Cultural Neuropsychological Test Battery (CNTB) considering schooling level. Methods: We first completed an English-Brazilian Portuguese translation and back-translation of the CNTB. A total of 135 subjects aged over 60 years - 65 cognitively healthy (mean 72.83, SD = 7.71; mean education 9.42, SD = 7.69; illiterate = 25.8%) and 70 with Alzheimer's disease (AD) (mean 78.87, SD = 7.09; mean education 7.62, SD = 5.13; illiterate = 10%) - completed an interview and were screened for depression. The receiver operating characteristic (ROC) analysis was used to verify the accuracy of each CNTB test to separate AD from healthy controls in participants with low levels of education (≤ 4 years of schooling) and high levels of education (≥ 8 years of schooling). The optimal cutoff score was determined for each test. Results: The Recall of Pictures Test (RPT)-delayed recall and the Enhanced Cued Recall (ECR) had the highest power to separate AD from controls. The tests with the least impact from schooling were the Rowland Universal Dementia Assessment Scale (RUDAS), supermarket fluency, RPT naming, delayed recall and recognition, and ECR. Conclusions: The Brazilian Portuguese version of the CNTB was well comprehended by the participants. The cognitive tests that best discriminated patients with AD from controls in lower and higher schooling participants were RPT delayed recall and ECR, both of which evaluate memory.

Brazilian version of the Cognitive Failures Questionnaire (CFQ): cross-cultural adaptation and evidence of validity and reliability

Objective: Cognitive failures are simple mistakes in routine activities, such as forgetting commitments and experiencing difficulty concentrating. The Cognitive Failures Questionnaire (CFQ) was designed to assess the frequency of these errors in everyday life. Although widely used in psychiatry and psychology, both in clinical and research settings, it has not been adapted for use in Brazil. Our objective was to perform cross-cultural adaptation of the CFQ for the Brazilian reality and assess its validity and reliability. Methods: The original version of the CFQ was translated into Brazilian Portuguese by two independent researchers, analyzed by a multidisciplinary board of experts, and back-translated into English. The final version was administered to 225 adults. Validity was assessed by correlation with the Self Reporting Questionnaire-20 (SRQ-20) and the Adult Attention Deficit/Hyperactivity Disorder Self-Report Scale (ASRS-18). Reliability was analyzed by calculating internal consistency and test-retest stability. Results: The adapted version of the CFQ showed significant correlations with SRQ-20 (r = -0.311), ASRS-18 inattention (r = 0.696), and hyperactivity/impulsivity (r = 0.405) scores. Reliability analysis suggests high internal consistency (0.906) and temporal stability (0.813). Conclusion: The Brazilian Portuguese version of the CFQ showed moderate correlations with other measures of mental health, as well as adequate reliability.

El impacto del tratamiento de la encefalopatía hepática mínima en el pronóstico a largo plazo / The impact of minimal hepatic encephalopathy treatment in long-term prognosis

La encefalopatía hepática mínima (EHm) afecta del 30% al 50% de los pacientes cirróticos. Su detección es esencial por su relación con la encefalopatía hepática clínica, la alteración de la habilidad para conducir, el mayor riesgo de caídas, la alteración de la calidad de vida, la progresión más acelerada de la cirrosis y la supervivencia. A pesar de la información fidedigna de su relevancia clínica, pronóstica y social, la detección de EHm no está generalizada en la práctica clínica. El espectro de la encefalopatía hepática engloba diversas alteraciones de las funciones cerebrales, por lo que se requiere realizar más de un test para su diagnóstico. Además, las alteraciones iniciales difieren de un paciente a otro. Esto ha dificultado el desarrollo de una estrategia diagnóstica universal. Como resultado, no disponemos de datos suficientes para generar recomendaciones basadas en la evidencia del impacto del tratamiento de la EHm en la calidad de vida y la supervivencia, así como de su rentabilidad. Por lo tanto, las guías clínicas actuales sugieren que se evalúe la EHm cuando se afecta la calidad de vida de los pacientes, ya que no se conocen las consecuencias del tamizaje. Las terapias reductoras de amonio se consideran la piedra angular del tratamiento de la EHm. Los disacáridos no absorbibles, la rifaximina y, más recientemente, los probióticos, han mostrado efectos beneficiosos. Se necesitan más ensayos controlados con placebo para evaluar la eficacia, seguridad y rentabilidad de los regímenes de tratamiento disponibles para evaluar el impacto del tratamiento de la EHm en el pronóstico a largo plazo de estos pacientes.

Minimal hepatic encephalopathy (MHE) affects up to 30-50% of cirrhotic patients. The detection of MHE is essential because of its relationship with overt hepatic encephalopathy, impairment of motor vehicle driving abilities, higher risk of falls, quality of life impairment, faster cirrhosis progression and survival. Despite the robust evidence regarding its clinical, prognostic and social relevance, MHE testing is not widespread in routine clinical care. Hepatic encephalopathy spectrum covers various alterations in complex brain functions, requiring more than one test to be quantified. In addition, initial disturbances differ from one patient to another. All this has made it difficult to develop a universal diagnostic strategy. As a consequence, there is a lack of available robust data in the literature to generate evidence-based recommendations related to the impact of MHE treatment on quality of life and survival of these patients, as well as on cost-effectiveness. Therefore, current clinical guidelines suggest MHE testing only when patients have problems with their quality of life, since consequences of the screening procedure are still unclear. Ammonia lowering therapies have been considered the cornerstone of MHE treatment. Beneficial effects of non-absorbable disaccharides (lactulose or lactitol), rifaximin and more recently, probiotics have been reported. Further placebo-controlled trials are needed to assess the efficacy, safety, and cost-effectiveness of available treatment regimes to evaluate the impact of MHE treatment on the long-term prognosis of these patients.

Reappraising the dimensional structure of the PTSD Checklist: lessons from the DSM-IV-based PCL-C

Objective: The dimensional structure of posttraumatic stress disorder (PTSD) has been extensively debated, but the literature is still inconclusive and contains gaps that require attention. This article sheds light on hitherto unvisited methodological issues, reappraising several key models advanced for the DSM-IV-based civilian version of the PTSD Checklist (PCL-C) as to their configural and metric structures. Methods: The sample comprised 456 women, interviewed at 6-8 weeks postpartum, who attended a high-complexity facility in Rio de Janeiro, Brazil. Confirmatory factor analysis (CFA) and exploratory structural equation models (ESEM) were used to evaluate the dimensional structure of the PCL-C. Results: The original three-factor solution was rejected, along with the four-factor structures most widely endorsed in the literature (PTSD-dysphoria and PTSD-numbing models). Further exploration supported a model comprised of two factors (re-experience/avoidance and numbing/hyperarousal). Conclusion: These findings are at odds with the dimensional structure proposed in both DSM-IV and DSM-5. This also entails a different presumption regarding the latent structure of PTSD and how the PCL should be operationalized.

Memory complaint scale (MCS): proposed tool for active systematic search / Escala de queixa de memória (EQM): proposta de um instrumento para busca ativa e sistematizada

Subjective Memory Complaints (SMC) are frequent among adults and elderly and are associated with poor qualityof life. The etiology and clinical significance of SMCs are unclear, but these complaints are associated with objective cognitivedecline or with depression, anxiety and psychosocial stressors. Biological and physiological brain alterations resembling thosein Alzheimer?s Disease have been found in SMC. SMC can evolve with different outcomes and represent the initial symptomor a risk factor of dementia. Active systematic search can be useful for early screening of candidates for preventive ortherapeutic interventions. Objective: To propose a Memory Complaints Scale (MCS) as an instrument for actively searchingfor memory complaints and to investigate its utility for discriminating demented from cognitively normal elderly. Methods: Atotal of 161 patients from a teaching behavioral neurology outpatient unit of a tertiary hospital were studied. The MCS wasused in two ways, by direct application to the patient and by application to the patient?s companion. Cognitive tests assessingdepression and daily living activities were also applied. Results: High Cronbach?s alpha coefficients were found for the twoapplication methods. Correlations between the two versions and the other instruments administered for patients grouped bytype and severity of dementia were also found. Conclusion: The MCS is a useful scale for identifying memory complaintsand discriminating demented from cognitively normal elderly. Further studies confirming these findings are warranted.

Queixa Subjetiva de Memória (QSM) é frequente entre adultos e idosos e está associada a pior qualidade de vida.Etiologia e significado clínico são incertos, sendo associada a perdas cognitivas objetivas ou a depressão, ansiedade eestressores psicossociais. Foram demonstradas alterações biológicas e fisiológicas encefálicas semelhantes às da doençade Alzheimer. Pode ter diferentes desfechos e representar sintoma inicial ou fator de risco para demência. A busca ativae sistematizada pode ser útil na identificação precoce de pessoas que poderão receber intervenções preventivas outerapêuticas. Objetivo: Propor a Escala de Queixa de Memória (EQM) como um instrumento para a busca de queixa dememória e investigar se é útil para discriminar idosos demenciados de normais. Métodos: Foram estudados 161 pacientesde um ambulatório didático de neurologia comportamental de um hospital terciário. A EQM foi utilizada nas duas formas,uma diretamente aplicada ao paciente e a outra aplicada ao acompanhante sobre o paciente. Também foram aplicadostestes cognitivos, para depressão e para atividades diárias. Resultados: Foram encontrados altos coeficientes alfa deCronbach para as duas formas. Também foram encontradas correlações entre as duas formas e os outros instrumentos,para os pacientes agrupados conforme tipo e gravidade da demência. Conclusão: A EQM é uma escala útil para identificarqueixa de memória e pode ser útil para discriminar idosos demenciados de normais. Estudos subsequentes deverão serrealizados para verificar essas informações.

Caracterización psicométrica, motora y funcional en niños con parálisis cerebral / Psychometric, motor and functional description in children with cerebral palsy

Introduction: Cerebral Palsy (CP), the most frequent cause of chronic motor disability among children, is often associated to other alterations of cerebral function, among them cognitive function. International publications show up to 70 percent of children with CP have normal intelligence (IQ). Objective: Determine IQ and motor function in a group of children with CP. Methodology: Prospective descriptive study of 34 children with CP, classified according to type. Psychometric and motor tests were applied. Results: Of these children, 44 percent presented tetraparetic CP, 21 percent diparetic, 35 percent hemiparetic. Among tetraparetic children, 33 percent showed normal IQ, 14 percent mild Mental Retardation (MR), 53 percent severe MR. Among diparetic children, normal IQ, mild MR, severe MR showed in a frequency of 57 percent, 14 percent y 29 percent respectively. Children with hemiparesis showed normal IQ in 92 percent and mild MR in 8 percent. Motor function was usually proportional to IQ. Conclusion: In the full population studied, 59 percent of children showed normal IQ. Children with hemiparetic CP present better IQ, those with tetraparetic CP showed worst cognitive levels. Children with better IQ presented better motor function.

Introducción: La Parálisis Cerebral (PC), causa más frecuente de discapacidad motora crónica en la infancia, se asocia frecuentemente a otras alteraciones de la función cerebral, entre ellas alteraciones cognoscitivas. Publicaciones extranjeras describen que hasta un 70 por ciento de los niños con PC tienen coeficiente intelectual (CI) normal. Objetivo: Determinar CI y Función Motora en un grupo de niños con PC. Metodología: Estudio prospectivo descriptivo de 34 niños con PC. Se les clasificó según tipo de PC, se aplicó test psicométrico y se realizó medición del grado de función motora. Resultados: 44 por ciento tenían PC tetraparética, 21 por ciento diparética y 35 por ciento hemiparética. Los niños con tetraparesia tenían en un 33 por ciento CI normal, 14 por ciento RM leve y 53 por ciento RM severo; los niños con diparesia: CI normal, RM leve y RM severo en 57 por ciento, 14 por ciento y 29 por ciento respectivamente; los niños con hemiparesia tenían CI normal en el 92 por ciento y RM leve en 8 por ciento. En cuanto a función motora, los niños con mejor CI tenían mejor grado de función motora. Conclusión: El 59 por ciento del grupo estudiado presentó CI normal. Los niños con PC hemiparética tienen mejor CI y los niños con PC tetraparética tienen peor CI. Los niños con mejor CI tienen mejor grado de función motora.