Cinema brasileiro e o ensino dos transtornos da personalidade / Brazilian cinema and the teaching of personality disorders

Resumo: Introdução: O uso de filmes comerciais em sala de aula é uma prática comum e acessível. A prática de exibição de filmes para o ensino é definida pelo termo cinemeducation. Objetivo: O presente estudo partiu da hipótese de que o cinemeducation, como metodologia ativa, poderia contribuir para o aprendizado dos transtornos da personalidade (TP) na graduação. Foram ministradas aulas presenciais para 213 estudantes de Medicina, Enfermagem, Psicologia, Fisioterapia e Fonoaudiologia, para avaliar o conhecimento desenvolvido sobre TP. Método: O estudo é transversal e quantitativo, composto por amostras pareadas e dependentes (antes e depois). As etapas foram: 1. aplicação de instrumento avaliativo em forma de questionário (antes); 2. aula composta por exibição de cenas de filmes brasileiros e reflexão e discussão sobre elas; 3. aplicação do mesmo questionário (depois); e 4. análise estatística comparativa entre os resultados. Resultados: O método se mostrou efetivo para o processo ensino-aprendizagem, havendo melhora autorreferida no conhecimento dos estudantes após a aula (questão 1) e melhora observável ao identificarem e conceituarem os TP (questão 3). Além disso, os estudantes referiram, em média, que a estratégia contribuía para a aprendizagem, antes da aula, e mantiveram em média essa opinião, depois (questão 2). Conclusões: Alcançou-se o objetivo proposto porque se utilizou amostra estatisticamente significativa de estudantes, e os resultados confirmaram que o método é efetivo para o ensino. Além disso, a discussão evidenciou que o uso dos filmes pode contribuir para o o aprendizado, condizendo com as características de estudantes da geração atual, uma vez que valoriza o uso de tecnologias em sala de aula e permite o aprendizado crítico-reflexivo e a participação ativa dos sujeitos. As limitações do estudo se referem à escassez de filmes brasileiros contemporâneos que exemplifiquem todos os TP, não havendo cenas representativas para TP esquizotípica, dependente e esquiva. Além disso, considera-se necessário estudo comparativo entre o método tradicional de ensino dos TP e o cinemeducation, de forma a investigar a eficácia deste quando comparado às aulas tradicionais.

Abstract: Introduction: The use of commercial films in the classroom is a common and accessible practice. The practice of showing films for teaching is defined by the term cinemeducation. Objective: The present study was based on the hypothesis that cinemeducation, as an active methodology, could contribute to the learning of Personality Disorders (PD) during undergraduate training. Face-to-face classes were given to 213 students of medicine, nursing, psychology, physiotherapy and speech therapy, to assess the knowledge developed about PD. Method: The study is cross-sectional and quantitative, composed of paired and dependent samples (before and after). The steps were: a) application of an assessment tool in the form of a questionnaire (before); b) class, consisting of exhibition, reflection and discussion of scenes from Brazilian films, c) application of the same questionnaire (after), and d) comparative statistical analysis between the results. Results: The results showed that the method is effective for the teaching-learning process, with self-reported improvement in students' knowledge after class (question 1), and an observable improvement when identifying and conceptualizing PD (question 3). Furthermore, students reported, on average, that the strategy contributed to learning, before class, and they maintained that opinion, on average, afterwards (question 2). Conclusions: The proposed objective was achieved by using a statistically significant sample of students and the results confirmed that the method is effective for teaching. The discussion showed that the use of films can improve learning, and it is consistent with the characteristics of students of the actual generation, since it values the use of technologies in the classroom, allowing critical-reflective teaching and the active student participation. The limitations of the study include the scarcity of contemporary Brazilian films that exemplify all PDs, with no representative scenes for schizotypical, dependent and avoidant PD. Furthermore, a comparative study between the traditional method of teaching PD and cinemeducation is considered necessary in order to investigate its effectiveness when compared to traditional classes.

Diagnóstico de la organización de la personalidad: una actualización teórico-empírica de la propuesta de Otto F. Kernberg / Diagnosis of personality organization: a theoretical empirical update of Otto F. Kernberg's proposal

Resumen El diagnostico estructural propuesto por el Dr. Otto F. Kernberg y su equipo de trabajo del Instituto de Trastornos de Personalidad en Nueva York ha sido una gran contribución tanto para la comprensión de la personalidad como para el tratamiento de estos casos. El objetivo del presente artículo es realizar una revisión actualizada de este enfoque, abordando una comprensión general de la personalidad, y posteriormente profundizar en el diagnóstico diferencial de la organización neurótica y limítrofe. Además, dentro del espectro limítrofe se distinguirá aquellos cuadros de funcionamiento alto, medio, y bajo, considerando su grado de severidad, y pronostico. Finalmente, se hará una síntesis del proceso de evaluación que consiste en la entrevista estructural.

Personality Organization Diagnosis, proposed by Dr. Otto F. Kernberg and his team from the Personality Disorder Institute in New York, has been an important contribution to the understanding and treatment of personality disorders. The aim of this article is to make an updated review of this approach, addressing a general understanding of what is personality, and subsequently deepening the differential diagnosis of the neurotic and borderline personality organization. Furthermore, within de borderline spectrum, those high, medium, and low functioning will be distinguished, considering its severity and prognosis. Finally, a synthesis of the personality assessment process will be carried put, which consist of the Structural Interview

Translation and cultural adaptation of the DSM-5 Personality Inventory - Brief Form (PID-5-BF)

Abstract Introduction The Personality Inventory for the DSM-5 - Brief Form (PID-5-BF) - is an instrument for assessment of the five pathological personality traits from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) alternative model of personality disorders. Objectives To determine the psychometric properties of the version of the PID-5-BF translated and adapted to Brazilian Portuguese. Methods The process of translating and cross-culturally adapting the text was carried out by independent translators and the resulting version was administered to 176 patients in two hospitals in Rio Grande do Sul. The internal structure was tested by means of confirmatory factor analysis. Evidence of reliability was tested by examining the internal consistency of the scales and their convergent and concurrent validity with other methods of psychopathology. Results The five factors were replicated in the present sample with adequate indicators of fit of the data to the model. Appropriate reliability coefficients for the scales and evidence of validity were observed, indicating the clinical usefulness of the PID-5-BF in the Brazilian context. Conclusion The psychometric properties of PID-5-BF proved satisfactory in an initial sample of Brazilians.

Personality Inventory for DSM-5 (PID-5): cross-cultural adaptation and content validity in the Brazilian context / Inventário de Personalidade para o DSM-5 (PID-5): adaptação transcultural e validade de conteúdo para o contexto brasileiro

Abstract Objective To describe the process of cross-cultural adaptation of the Personality Inventory for DSM-5 (PID-5) to the Brazilian context. Methods Cross-cultural adaptation involved the steps of independent translation of the instrument, synthesis version, and back-translation. Analysis of content validity was conducted by a multidisciplinary expert committee and consisted of quantitative assessment of agreement indicators. The test was then applied to a target population. Results All the steps required for a cross-cultural adaptation were followed and satisfactory agreement values (≥ 4.75) were reached for most of the structures assessed. Most of the changes suggested by the experts were followed; these changes consisted primarily of adjustments to verb tense and agreement and the inclusion of letters and words to allow gender inflection. In the pre-test, no suggestions were made and the instrument was considered comprehensible. Conclusion The Brazilian version of the PID-5 was found to be adequate to the Brazilian context from semantic, idiomatic, cultural, and conceptual perspectives. The Brazilian version assessed here can be freely used, was approved by the publishers who hold the copyright on the instrument, and is considered the official version of the instrument. New studies are underway to determine the validity and reliability of the PID-5.

Resumo Objetivo Apresentar o processo de adaptação transcultural do Personality Inventory for DSM-5 (PID-5) para o contexto brasileiro. Métodos A adaptação transcultural envolveu as etapas de tradução independente, versão síntese e retrotradução. A validade de conteúdo foi realizada por um comitê multidisciplinar de especialistas, com avaliação quantitativa dos índices de concordância. Por fim, o pré-teste foi conduzido com a população-alvo. Resultados Todos os estágios da adaptação transcultural foram seguidos, e na maioria das estruturas avaliadas, os valores de concordância foram satisfatórios (≥ 4.75). Grande parte das sugestões de modificações feitas pelos especialistas foram acatadas, sendo as principais relacionadas a ajustes no tempo e concordância verbal e a inclusão de letras e palavras para permitir a flexão de gênero. No pré-teste nenhuma sugestão foi apresentada e o instrumento foi considerado compreensível. Conclusão A versão brasileira do PID-5 mostrou-se adequada ao contexto brasileiro sob as perspectivas semântica, idiomática, cultural e conceitual. A versão brasileira avaliada é de uso livre, foi aprovada pelas editoras responsáveis pelos direitos autorais do instrumento e é considerada oficial. Novos estudos estão sendo conduzidos para aprimorar a busca por evidencias de validade e confiabilidade.

Investigating the Spectra constellations of the Hierarchical Taxonomy of Psychopathology (HiTOP) model for personality disorders based on empirical data from a community sample

Objective: The Hierarchical Taxonomy of Psychopathology (HiTOP) posits that psychopathology is hierarchically structured. For personality disorder (PD) traits, there are five spectra: internalizing, thought disorder, disinhibited externalizing, antagonistic externalizing, and detachment. Empirical findings suggest a sixth group, compulsivity. In this research, we tried to recover the five HiTOP spectra, plus compulsivity, specifically for PD traits. Methods: The sample was composed of 4,868 Brazilians (54.9% women, age ranging from 18 to 70; mean = 25.7; SD = 9.64). All participants answered the Dimensional Clinical Personality Inventory 2 (IDCP-2), a self-report inventory for adults, developed in Brazil, for assessment of pathological personality traits. Results: Parallel analysis yielded up to nine factors. On exploratory structural equation modeling (E-SEM), the balance between interpretability and fit index suggested the six-factor solution as the best solution. The fit indexes for the confirmatory factor analysis were slightly less adjusted in comparison to the empirical model. Conclusion: The hypothesis was confirmed, as we did find the groups proposed at the spectrum level of the HiTOP. We also found a compulsivity factor, encompassing the main traits from the conscientiousness dimension of IDCP-2, which is related to obsessive-compulsive PD. Finding the six groupings of traits in the HiTOP model contributes to the validity of this model, and confirms the existence of proposed spectra.

Dependency, mood instability, and inconsequence traits for discriminating borderline personality disorder / Traços de dependência, instabilidade de humor e inconsequência para discriminação do transtorno da personalidade borderline

Abstract Introduction Borderline personality disorder (BPD) is one of the most widely studied personality disorders (PDs). It recurrently shows traits of emotional lability, anxiety, separation insecurity, depressiveness, impulsiveness, risk exposure, and hostility, mainly affecting the domains of negative affectivity and antagonism. Objectives To investigate the most discriminant dimensions of the Dimensional Clinical Personality Inventory (Inventário Dimensional Clínico da Personalidade 2 [IDCP-2]) to distinguish people diagnosed with BPD from people without this diagnosis. Methods A total of 305 participants were included in this study: psychiatric outpatients diagnosed with BPD (n = 30), psychiatric outpatients diagnosed with other PDs (n = 75), and a community sample (n = 200). BPD traits were assessed using the dependency, mood instability, and inconsequence dimensions of the IDCP-2. Results Analysis of variance (ANOVA) comparisons indicated highest mean measures in the BPD group, and mood instability factors were the most discriminant ones when considering all groups. Applying the multiple regression analysis, we found an adjusted r 2 = 0.50, and hopelessness was the most predictive measure (β = 0.32; t = 6.19; p < 0.001). Conclusions We found discriminatory capacity for factors of all dimensions, although at different levels, and more consistent results to discriminate the BPD group from the community sample.

Resumo Introdução O transtorno da personalidade borderline (TPB) tem sido um dos transtornos de personalidade (TPs) mais estudados. O TPB recorrentemente apresenta traços de instabilidade emocional, ansiedade, insegurança de separação, depressividade, impulsividade, exposição ao risco e hostilidade, afetando principalmente os domínios relacionados à afetividade negativa e ao antagonismo. Objetivos Investigar as dimensões mais discriminativas do Inventário Dimensional Clínico da Personalidade 2 (IDCP-2) para distinguir pessoas diagnosticadas com TPB de pessoas sem esse diagnóstico. Métodos Foram incluídos no estudo 305 participantes: pacientes psiquiátricos com TPB (n = 30), pacientes psiquiátricos com outros TPs (n = 75) e amostra da população geral (n = 200). Os traços de TPB foram avaliados utilizando as dimensões dependência, instabilidade de humor e inconsequência do IDCP-2. Resultados As comparações com análise de variância (ANOVA) indicaram que o grupo TPB apresentou as maiores médias, e os fatores da dimensão instabilidade de humor foram os mais discriminativos ao se comparar os três grupos. Usando a análise de regressão múltipla, foi encontrado um r 2 ajustado = 0,50, e o fator desesperança foi o mais preditivo (β = 0,32; t = 6,19; p < 0,001). Conclusões Foi encontrada capacidade discriminativa para fatores de todas as dimensões, embora em diferentes níveis, e resultados mais consistentes quanto à discriminação foram observados para a distinção entre o grupo com TPB e a população geral.

Revisión de caso clínico desde una mirada sistémica / Clinical case review from a systemic view: clinical meeting

Paciente ELENA, 21 años. embarazo 27 semanas, separada, 4 intentos suicidas previos. Fue usuaria del programa de salud mental infantil y adulto Hospital el Pino (HEP). Hospitalizada en H. de día el año 2017. Año 2013, Alucinaciones auditivas y visuales y desajustes conductuales: Grita, rompe cosas, se pega en la cabeza. Comienza a aislarse y a faltar al colegio y atribuye sus síntomas a consumo de marihuana. Principales focos de terapia son: Disminuir situaciones de crisis y adherencia al tratamiento. Presenta mala adherencia a controles y fármacos de salud mental. Se deriva a Hospital de día. Rorschach muestra desarrollo anormal de la personalidad con rasgos histriónicos, juicio de realidad conservado y dificultad en capacidad de empatizar. Salud mental adulto: (Julio, 2015): Heridas autolíticas (cortes y rasguños), Ideas pasivas de muerte. Intervenciones desde hospital de día: Manejo de crisis, trabajar en vínculo simbiótico con madre; recibe atención por psiquiatra, terapeuta ocupacional, psicólogo y nutricionista, incluyendo intervenciones en equipo. Controles en ambulatorio (Nov 2015): Impresiona mayor conciencia de enfermedad. Abandona fármacos al sentirse mejor. Foco orientado a: Autorregulación emocional y entrenamiento cognitivo para manejo de síntomas ansiosos.

ELENA, 21 years old. Pregnancy 27 weeks, separate, 4 previous suicide attempts. She was a member of the children and mental health program Hospital el Pino (HEP). Hospitalized in Day Hospital in year 2017. 2013: Auditory and visual hallucinations and behavioral maladjustments: Screams, breaks things, hits herself in the head. She begins to isolate and to miss to the school and attributes her symptoms to consumption of marijuana. Main focuses of therapy are: To reduce crisis situations and adherence to treatment. She has poor adherence to mental health drugs and controls. She is derived to day hospital. Rorschach shows abnormal personality development with histrionic traits, a reality-preserved judgment, and difficulty in empathizing. Adult mental health: (July, 2015): Self-injuries (cuts and scratches), Passive death ideas. Interventions in day hospital: Crisis management, working in symbiotic relationship with mother; receives attention by psychiatrist, occupational therapist, psychologist and nutritionist, Including team interventions. Outpatient Control (Nov 2015): Increased awareness of illness. Abandon drugs because of feeling better. Focus oriented to: Emotional self-regulation and cognitive training for the management of anxious symptoms.

Investigation of the clinical functioning of the Dimensional Clinical Personality Inventory 2 criticism avoidance dimension / Investigação do funcionamento clínico da dimensão evitação a críticas do Inventário Dimensional Clínico da Personalidade 2

Abstract Objective: To investigate the clinical functioning of the criticism avoidance dimension from the Dimensional Clinical Personality Inventory 2 (Inventário Dimensional Clínico da Personalidade 2 [IDCP-2]), establishing a clinically relevant cut-off for the typical traits of avoidant personality disorder (AvPD) for screening purposes. Methods: We administered the IDCP-2 to a sample of 2,276 subjects aged 18 to 90 years (mean = 26.95, standard deviation = 9.71). Of the total sample, 1,650 were women (67%) and most were college students (72.7%). The sample was divided into psychiatric patients diagnosed with other personality disorders (PDs) (n = 53), patients diagnosed with AvPD without comorbidities (n = 10), patients with AvPD with comorbidities (n=42) and those without a known diagnosis of PD (nonpsychiatric patients; n=2,171). Results: We checked for psychometric properties, assessed the adequacy of psychometric assumptions, and proceeded to focus analyses. The Wright item-person map showed the predominance of patients with AvPD in high levels of the scale. Analysis of variance (ANOVA) post hoc comparisons pointed to significant and expressive differences for almost all the comparisons; in the receiver operating characteristic (ROC) curve, we observed a sensitivity of 79% and a specificity of 87%. Conclusion: We found a suitable cut-off for the dimension, and results suggest that the dimension may help clinicians discriminate between patients with and without high levels in the symptoms of AvPD.

Resumo Objetivo: Investigar o funcionamento clínico da dimensão evitação a críticas do Inventário Dimensional Clínico da Personalidade 2 (IDCP-2), estabelecendo um ponto de corte relevante para traços típicos do transtorno da personalidade evitativa (avoidant personality disorder - AvPD), para finalidade de triagem. Métodos: Nós aplicamos o IDCP-2 em uma amostra de 2.276 pessoas com idade entre 18 e 90 anos (média=26,95; desvio padrão=9,71). Dessa amostra, 1.650 eram mulheres (67%) e a maioria era de universitários (72,7%). A amostra foi dividida em pacientes psiquiátricos com outros transtornos de personalidade (PD; n = 53), pacientes com AvPD sem comorbidades (n = 10), pacientes com AvPD com comorbidades (n=42) e aqueles sem diagnóstico conhecido de PD (pacientes não psiquiátricos; n=2.171). Resultados: Foram verificadas as propriedades psicométricas, investigando a adequação dos pressupostos psicométricos, e então procedemos às análises principais. O mapa Wright de itens-pessoas mostrou a predominância de pacientes com AvPD nos níveis mais altos da escala. Análises post hoc, pela análise de variância (ANOVA), apontou para diferenças significativas e expressivas para quase todas as comparações; na curva ROC, nós observamos sensibilidade de 79% e especificidade de 87%. Conclusão: Foi encontrado um ponto de corte adequado para a dimensão, e os resultados sugerem que a dimensão pode auxiliar clínicos a discriminar pacientes com elevação nos traços do AvPD de pacientes sem elevação nesses traços.

Review Study of the Impulsiveness Dimension of the Dimensional Clinical Personality Inventory / Estudio de revisión de la dimensión Impulsividad del Inventario Dimensional Clínico de la Personalidad

Abstract The present study aimed to review the Impulsiveness dimension from Dimensional Clinical Personality Inventory (IDCP) as well as to verify its psychometric properties in a non-clinical sample. The procedures were performed in 2-stages. Step 1 was directed at the development of new items and Step 2 intended for testing the psychometric properties of the revised version. As a result of the first step, we selected a set of 38 items. In the second step, the items were tested in a sample of 225 subjects (70.1% females), aged 18 to 66 years (M = 26.2, SD = 8.1), mostly undergraduate students (58.9%). All subjects answered the IDCP, and the Brazilian versions of both, the Revised NEO Personality Inventory (NEO-PI-R) and the Personality Inventory for DSM-5 (PID-5). As result, we obtained a set of 18 items in three interpretable factors, Inconsequence, Risk Taking, and Deceitfulness, with internal consistency coefficients (Cronbach's α) of .89 for the total score. The correlations of the Impulsiveness factors with NEO-PI-R and PID-5 revealed consistent and expected relations. The data reveal the adequacy of the revised dimension of IDCP.

Resumen El presente estudio tuvo como objetivo revisar la dimensión Impulsividad del Inventario Dimensional Clínico de la Personalidad (IDCP), así como para comprobar las propiedades psicométricas en una muestra no clínica. El procedimiento se realizó en dos etapas: paso 1, dirigido al desarrollo de nuevos productos y el paso 2 destinado a probar las propiedades psicométricas de la versión revisada. Como resultado de la primera etapa, se seleccionó un conjunto de 38 artículos. En el segundo paso, los elementos fueron probados en una muestra de 225 sujetos (70.1 % mujeres), con edades comprendidas entre 18 y 66 años (M = 26.2, DE = 8.1), en su mayoría estudiantes universitarios (58.9 %). Todos los sujetos respondieron el IDCP y las versiones brasileñas de ambos: el Inventario Revisado NEO Personality (NEO-PI-R) y el Inventario de Personalidad para el DSM-5 (PID-5). Como resultado, se obtuvo un conjunto de 18 artículos en tres factores interpretables, Inconsecuencia, Asunción de riesgos y Falsedad, con coeficientes de consistencia interna (α de Cronbach) de 0.89 para la puntuación total. Las correlaciones de los factores de Impulsividad con NEO-PI-R y PID-5 revelaron relaciones consistentes y esperadas. Los datos ponen de manifiesto la idoneidad de la nueva dimensión Impulsividad del IDCP.

La evaluación de la identidad en el DSM-5: una propuesta que está pasando inadvertida / Assessment of identity in the DSM-5: a proposal is happening inadvertent

Objectives: The latest edition of DSM-5 proposed the inclusion of the evaluation of the identity as a criteria common to severe personality disorders, this paper will attempt to rescue the doomed interest to this alleged incorporation, for which we will have a brief theoretical review of Identity Criterion of ego as a diagnostic priority item that allows the distinction between Neurotic Organization versus Borderline. This paper deals with the revision of the Criteria of the Self Identity such as a priority diagnosis element.

Objetivos: Para la última edición del DSM-5 se propuso la inclusión de la evaluación de la Identidad como criterio común a todos los Trastornos Severos de la Personalidad. Dicha propuesta no logró incorporarse como Criterio General, quedando toda esa información contenida en el área destinada a futuras investigaciones (sección III del DSM-5). En este trabajo procuraremos rescatar el interés abocado a esta pretendida incorporación, para lo cual realizaremos una breve revisión teórica del Criterio Identidad del Yo como elemento diagnóstico prioritario que permite la distinción entre Organización Neurótica versus Limítrofe.

Revision of the grandiosity dimension of the Dimensional Clinical Personality Inventory and verification of its psychometric properties / Revisão da dimensão grandiosidade do Inventário Dimensional Clínico da Personalidade e verificação de suas propriedades psicométricas

Abstract Introduction: Personality disorders are among the most common disorders seen in clinical psychology. However, in Brazil there are few instruments for assessing the pathological characteristics of personality. Objective: To revise the grandiosity dimension of the Brazilian Dimensional Clinical Personality Inventory (Inventário Dimensional Clínico da Personalidade [IDCP]) and investigate its psychometric properties. Methods: A total of 225 people participated in this study. Their ages ranged from 18 to 66 years (mean [M] = 26.2, standard deviation [SD] = 8.1) and the majority were female (n = 162, 70.1%). The IDCP and the Brazilian versions of the Revised NEO Personality Inventory (NEO PI-R) and the Personality Inventory for DSM-5 (PID-5) were administered to all participants. Results: A total of 285 new items were developed and content analysis was used to select 33 of these to comprise the final version destined for administration. The results of parallel analysis and factor analysis identified four interpretable factors. Internal consistency coefficients were deemed acceptable and varied from 0.73 to 0.84 for the factors. Additionally, the expected correlations between the IDCP Inventory and the other tests were observed. Conclusion: This study demonstrates the revised dimension's suitability for assessment of the pathological traits of narcissistic personality disorder.

Resumo Introdução: Os transtornos da personalidade estão entre os distúrbios mais comuns na clínica psicológica. Porém, ainda são escassos os instrumentos para avaliação das características patológicas da personalidade no Brasil. Objetivo: Revisar a dimensão grandiosidade do Inventário Dimensional Clínico da Personalidade (IDCP), investigando também suas propriedades psicométricas. Métodos: Participaram do estudo 225 sujeitos com idade variando entre 18 e 66 anos [média (M) = 26,2; desvio padrão (DP) = 8,1], sendo a maior parte do sexo feminino (n = 162; 70,1%). Todos os participantes responderam o IDCP e as versões brasileiras do Inventário de Personalidade NEO Revisado (NEO PI-R) e do Personality Inventory for DSM-5 (PID-5). Resultados: Foram desenvolvidos 285 novos itens e selecionados, por meio de análise de conteúdo, 33 para compor a versão final de aplicação. Com base em análise paralela e análise fatorial, quatro fatores interpretáveis foram encontrados. Os coeficientes de consistência interna mostraram-se adequados, variando entre 0,73 e 0,84 para os fatores. Ainda, foram encontradas correlações esperadas entre o IDCP e os outros testes utilizados. Conclusões: Ressalta-se a adequabilidade da dimensão revisada na avaliação de traços patológicos do funcionamento narcisista da personalidade.

Niveles de ansiedad y su relación con los trastornos temporomandibulares / Anxiety levels and their relationship to temporomandibular disorders

El diagnóstico de los trastornos temporomandibulares es un tema muy controvertido dentro del campo de la salud, desde una perspectiva psicológica son muy escasas las referencias en este sentido, sobretodo las enfocadas a analizar los niveles de ansiedad en estos pacientes. En los últimos años se han realizado diferentes investigaciones que validan la inclusión de factores psicológicos como parte de la etiología del diagnóstico, dentro de los factorespsíquicos más asociados se presentan la ansiedad como rasgo y la ansiedad como estado. El propósito de este trabajo es presentar una revisión sobre la relación existente entre los niveles de ansiedad y los trastornos temporomandibulares.

The diagnosis of temporomandibulardisorders is very controversial within the fieldof health issue, from a psychological perspectiveare very few references in this regard,especially focused on analyzing anxiety levelsin these patients. In recent years there have beenvarious studies that validate the inclusionof psychological factors as part of the etiology,diagnosis, within the psychological factorsmost associated trait anxiety and state anxietyas presented. The purpose of this paper is topresent a review of the relationship betweenanxiety levels and temporomandibular disorders.

Personality disorders in euthymic bipolar patients: a systematic review

Objective: To identify, by means of a systematic review, the frequency with which comorbid personality disorders (PDs) have been assessed in studies of euthymic bipolar patients. Methods: PubMed, ciELO and PsychINFO databases were searched for eligible articles published between 1997 and 2013. After screening 1,249 empirical papers, two independent reviewers identified three articles evaluating the frequency of PDs in patients with bipolar disorders assessed in a state of euthymia. Results: The total sample comprised 376 euthymic bipolar patients, of whom 155 (41.2%) had at least one comorbid PD. Among them, we found 87 (23.1%) in cluster B, 55 (14.6%) in cluster C, and 25 (6.6%) in cluster A. The frequencies of PD subtypes were: borderline, 38 (10.1%); histrionic, 29 (7.7%); obsessive-compulsive, 28 (7.4%); dependent, 19 (5%); narcissistic, 17 (4.5%); schizoid, schizotypal, and avoidant, 11 patients each (2.95%); paranoid, five (1.3%); and antisocial, three (0.79%). Conclusion: The frequency of comorbid PD was high across the spectrum of euthymic bipolar patients. In this population, the most common PDs were those in cluster B, and the most frequent PD subtype was borderline, followed by histrionic and obsessive-compulsive. .

É preciso diagnosticar patologias de personalidade? / Is it necessary to diagnose personality pathologies?

Inúmeras mudanças ocorreram na cultura principalmente no pós-guerra. Fatores sociais, econômicos e psicológicos parecem estar na base dessas transformações. Em relação ao binômio saúde-doença mental, os autores indagam se houve mudanças nos quadros psicopatológicos ou se as formas de diagnosticar os transtornos mentais é que foram aperfeiçoadas à medida que se avançou no conhecimento clínico. A partir dessas questões se faz uma discussão sobre o impacto que os manuais diagnósticos (DSM) tiveram e têm na formação e no treinamento clínico de psicólogos e psiquiatras nos últimos 30 anos. Os autores sugerem ter havido um aumento na tendência a privilegiar o diagnóstico de outros transtornos mentais em vez de em relação às patologias de personalidade. Finalizam indicando os possíveis benefícios aos pacientes quando se considera a avaliação da personalidade e os riscos quando esse diagnóstico é desconsiderado.(AU)

Several cultural changes have occurred, especially during post-war years. Social, economic and psychological factors seem to be the basis of these transformations. Concerning the health-mental disease binomial, the authors question whether there were changes in psychopathological conditions or whether the diagnosis methods for mental disorders were enhanced as clinical knowledge advanced. Based on these questions, there is a discussion regarding the impact of diagnosis manuals (DSM) on the clinical training of psychologists and psychiatrists in the last 30 years. The authors suggest there was an increase in the tendency to privilege the diagnosis of other mental disorders instead of personality pathologies. They conclude by indicating the possible benefits to patients when considering personality assessment and the existing risks when this diagnosis is neglected.(AU)

La evaluación de los trastornos de la personalidad según el DSM-5: recursos y limitaciones / Assessment of personality disorders according to DSM-5: available instruments and limitations

El objetivo de este artículo es hacer una revisión sobre los instrumentos de medida disponibles en español para la evaluación de los trastornos de personalidad (TP) según el DSM-5. El enfoque actual de los TP figura en la Sección II del DSM-5 y no registra cambios respecto al DSM-IV. Sin embargo, se presenta en la Sección III un modelo alternativo dimensional-categorial. Las categorías diagnósticas derivadas de este modelo en la Sección III incluyen sólo los TP antisocial, evitativo, límite, narcisista, obsesivo-compulsivo y esquizotípico y se evalúan con entrevistas clínicas estructuradas, tales como el SCID-II o el IPDE. A su vez, los rasgos de personalidad patológicos se evalúan con autoinformes diseñados específicamente para el sistema clasificatorio del DSM-5, como el PID-5, o con autoinformes más genéricos, como el MMPI-2-RF, el MCMI-III o el PAI. Sin embargo, los autoinformes presentan una tendencia al sobrediagnóstico. Se desarrollan algunas sugerencias para la investigación futura.

This paper aims at reviewing interviews and self-reports avalaible in Spanish for the assessment of personality disorders (PD) according to DSM-5. The current approach to PD appears in Section II of DSM-5 and has not changed from that in DSM-IV, except that they are moved to the main disorder section from Axis II. However, there is an alternative model developed in Section III. PD are characterized by impairments in personality functioning and by pathological personality traits. Diagnostic categories derived from this model include only antisocial, avoidant, borderline, narcissistic, obsessive-compulsive and schizotypal personality disorders. Diagnostic categories are assessed with structured clinical interviews, such as SCID-II or IPDE. In turn pathological personality traits are assessed with self-reports specifically designed for DSM-5 alternative dimensional model, such as PID-5, or with more general self-reports, such as MMPI-2-RF, MCMI-III or PAI. Self-reports have a tendency to over-diagnose personality disorders. Suggestions for future research are outlined.

Psychometric properties of the revised conscientiousness dimension of Inventário Dimensional Clínico da Personalidade (IDCP) / Propriedades psicométricas da versão revisada da dimensão conscienciosidade do Inventário Dimensional Clínico da Personalidade (IDCP)

This study investigated the psychometric properties of the revised scale of conscientiousness of a clinical personality inventory (Inventário Dimensional Clínico da Personalidade, IDCP). One hundred and twenty participants (68 women; 56.7%) aged 18 to 53 years (mean = 22.58, standard deviation = 6.19) were recruited by convenience and answered the IDCP and the NEO Personality Inventory - Revised. The analysis of internal structure, association with external variables and reliability of the dimension under review confirmed its validity. The psychometric characteristics of the revised dimension seem to be more adequate than those of the original version and more focused on pathological functioning, which was expected and desirable (AU)

O presente estudo teve como objetivo investigar as propriedades psicométricas da versão revisada da dimensão conscienciosidade do Inventário Dimensional Clínico da Personalidade (IDCP). Para tanto, participaram da pesquisa 120 sujeitos, recrutados por conveniência, com idade variando entre 18 e 53 anos (média = 22,58; desvio padrão = 6,19), sendo 68 mulheres (56,7%). Todos os sujeitos responderam o IDCP e o Inventário de Personalidade NEO-PI Revisado. Os dados encontrados no estudo foram favoráveis quanto às evidências de validade com base na estrutura interna e na relação com variáveis externas, bem como em relação à fidedignidade da dimensão revisada do instrumento. A partir disso, aponta-se que a dimensão revisada é mais adequada do ponto de vista psicométrico quando comparada com a versão original da mesma e, além disso, apresenta conteúdos mais voltados para o funcionamento patológico, o que era esperado e desejável (AU)