Estresse da hospitalização e seu enfrentamento em crianças / Hospitalization stress and coping in children

A hospitalização é um estressor para crianças e seus familiares que pode afetar os desfechos em saúde, dependendo da forma como elas enfrentam a situação. Este estudo analisou como crianças lidam com indicadores de estresse fisiológico e psicológico relacionados à hospitalização. Participaram 20 crianças com cinco anos de idade em média, a maioria internadas por doenças crônicas, em um hospital público de Cuiabá/MT. Foram aplicados individualmente na briquedoteca: a) Índice de cortisol salivar matutino e vespertino, para medida de estresse fisiológico; b) Roteiro de entrevista sobre doença e hospitalização ­ versão criança; e c) Escala de Coping da Hospitalização (COPE-H). O cortisol salivar estava acima do indicado em quatro crianças. Mais da metade da amostra relatou ter dificuldades causadas pela doença para realizar diversas atividades; sendo mais aversivos os procedimentos médicos invasivos. Apresentaram também respostas de estresse psicológico, com coping de desengajamento involuntário e voluntário dentro da média de idade. Relataram estratégias adaptativas para lidar com a hospitalização, como assistir TV, conversar, tomar remédio e, especialmente, brincar, avaliado como redutor do estresse por quase metade das crianças. Contudo, metade da amostra apresentou um padrão de coping mal adaptativo da hospitalização abaixo do esperado para a idade. Não houve correlações significativas entre o índice de cortisol salivar e o coping. Coerentemente com a literatura da área sobre as limitações impostas pela hospitalização e as consequências psicossociais para a criança e o familiar cuidador, os resultados indicam a importância de intervenções no coping da hospitalização para essa população nessa faixa etária.

Hospitalization is stressful for children and their families that can affect health outcomes, depending on how they face the situation. This study analyzed how children deal with indicators of physiological and psychological stress related to hospitalization. Participants were 20 children aged five years old, most of them hospitalized for chronic diseases, in a public hospital in Cuiabá, MT. The following were applied individually in the playroom library: a) Morning and late afternoon salivary cortisol index to measure physiological stress; b) Interview script on illness and hospitalization - child version; and c) Hospitalization Coping Scale (COPE-H). Salivary cortisol was above that indicated in four children. More than half of the sample reported having difficulties caused by the disease to perform several activities; invasive medical procedures are more aversive. They also presented psychological stress responses, with coping of involuntary and voluntary disengagement within the mean age. They reported adaptive strategies to deal with hospitalization, such as watching TV, talking, taking medication and, especially, playing, evaluated as a stress reducer by almost half of the children. However, half of the sample presented a poorly adaptive coping pattern of hospitalization below that expected for their age. There were no significant correlations between salivary cortisol index and coping. Consistent with the literature of the area on the limitations imposed by hospitalization and psychosocial consequences for the child and the caregiving family, the results indicate the importance of interventions in the coping of hospitalization for this population in this age group.

Statins enhance cognitive performance in object location test in albino Swiss mice: involvement of beta-adrenoceptors.

Statins are inhibitors of the 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase, thereby inhibiting cell synthesis of cholesterol and isoprenoids. Moreover, several studies have been evaluating pleiotropic effects of statins, mainly because they present neuroprotective effects in various pathological conditions. However, knowledge about behavioral effects of statins per se is relatively scarce. Considering these facts, we aimed to analyze behavioral responses of atorvastatin or simvastatin-treated mice in the open field test, elevated plus maze and object location test. Atorvastatin treatment for 7 consecutive days at 1 mg/kg or 10 mg/kg (v.o.) or simvastatin 10 mg/kg or 20 mg/kg enhanced cognitive performance in object location test when compared to control group (saline-treated mice). Simvastatin effects on mice performance in the object location test was abolished by post-training infusion of the beta-adrenoceptor antagonist propranolol. Atorvastatin and simvastatin did not change the behavioral response in open field and elevated plus-maze (EPM) tests in any of the used doses. These data demonstrate the positive effects of both statins in cognitive processes in mice, without any alteration in locomotor parameters in the open field test or anxiolytic-like behavior in EPM. In conclusion, we demonstrate that atorvastatin and simvastatin per se improve the cognitive performance in a rodent model of spatial memory and this effect is related to beta-adrenergic receptors modulation.

Measuring anxiety in zebrafish: a critical review.

Zebrafish are increasingly being used in behavioral neuroscience, neuropsychopharmacology and neurotoxicology. Recently, behavioral screens used to model anxiety in rodents were adapted to this species, and novel models which tap on zebrafish behavioral ecology have emerged. However, model building is an arduous task in experimental psychopathology, and a continuous effort to assess the validity of these measurements is being chased among some researchers. To consider a model as valid, it must possess face, predictive and/or construct validity. In this article, we first review some notions of validity, arguing that, at its limit, face and predictive validity reduce to construct validity. Then we review some procedures which have been used to study anxiety, fear or related processes in zebrafish, using the validity framework. We conclude that, although the predictive validity of some of these models is increasingly being met, there is still a long way in reaching the desired level of construct validity. The refinement of models is an ongoing activity, and behavioral validation and parametric research ought to advance that objective.

Construct validity of behavioral models of anxiety: where experimental psychopathology meets ecology and evolution

In experimental psychopathology, construct validity is usually enhanced by addressing theories from other fields in its nomological network. In the field of anxiety research, this construct is related to antipredator behavior, conserved across phylogeny in its functions and neural basis, but not necessarily on its topography. Even though the relations between behavioral models of anxiety and statements from behavioral ecology and evolutionary biology are commonly made in anxiety research, these are rarely tested, at least explicitly. However, in order to increase construct validity in experimental anxiety, testing predictions from those theories is highly desirable. This article discusses these questions, suggesting a few ways in which behavioral ecological and evolutionary hypotheses of anxiety-like behavior may be tested.

Construct validity of behavioral models of anxiety: where experimental psychopathology meets ecology and evolution

In experimental psychopathology, construct validity is usually enhanced by addressing theories from other fields in its nomological network. In the field of anxiety research, this construct is related to antipredator behavior, conserved across phylogeny in its functions and neural basis, but not necessarily on its topography. Even though the relations between behavioral models of anxiety and statements from behavioral ecology and evolutionary biology are commonly made in anxiety research, these are rarely tested, at least explicitly. However, in order to increase construct validity in experimental anxiety, testing predictions from those theories is highly desirable. This article discusses these questions, suggesting a few ways in which behavioral ecological and evolutionary hypotheses of anxiety-like behavior may be tested.(AU)

Parametric analyses of anxiety in zebrafish scototaxis.

Scototaxis, the preference for dark environments in detriment of bright ones, is an index of anxiety in zebrafish. In this work, we analyzed avoidance of the white compartment by analysis of the spatiotemporal pattern of exploratory behavior (time spent in the white compartment of the apparatus and shuttle frequency between compartments) and swimming ethogram (thigmotaxis, freezing and burst swimming in the white compartment) in four experiments. In Experiment 1, we demonstrate that spatiotemporal measures of white avoidance and locomotion do not habituate during a single 15-min session. In Experiments 2 and 3, we demonstrate that locomotor activity habituates to repeated exposures to the apparatus, regardless of whether inter-trial interval is 15-min or 24-h; however, no habituation of white avoidance was observed in either experiment. In Experiment 4, we confined animals for three 15-min sessions in the white compartment prior to recording spatiotemporal and ethogram measures in a standard preference test. After these forced exposures, white avoidance and locomotor activity showed no differences in relation to non-confined animals, but burst swimming, thigmotaxis and freezing in the white compartment were all decreased. These results suggest that neither avoidance of the white compartment nor approach to the black compartment account for the behavior of zebrafish in the scototaxis test.

Effects of trophic poisoning with methylmercury on the appetitive elements of the agonistic sequence in fighting-fish (Betta splendens).

The aggressive display in Betta splendens is particularly prominent, and vital to its adaptation to the environment. Methylmercury is an organic variation of Hg that presents particularly pronounced neuro-behavioral effects. The present experiments aim to test the effect of acute and chronic poisoning with methylmercury on the display in Bettas. The animals were poisoned by trophic means in both experiments (16 ug/kg in acute poisoning; 16 ug/kg/day for chronic poisoning), and tested in agonistic pairs. The total frequency of the display was recorded, analyzing the topography of the agonistic response. The methylmercury seems to present a dose- and detoxification-dependent effect on these responses, with a more pronounced effect on motivity in acute poisoning and on emotionality in the chronic poisoning. It is possible that this effect could be mediated by alteration in the mono-amino-oxidase systems.