Gene - maltreatment interplay in adult ADHD symptoms: main role of a gene-environment correlation effect in a Brazilian population longitudinal study.

Childhood maltreatment correlates with attention-deficit/hyperactivity disorder (ADHD) in previous research. The interaction between ADHD genetic predisposition and maltreatment's impact on ADHD symptom risk remains unclear. We aimed to elucidate this relationship by examining the interplay between a polygenic score for ADHD (ADHD-PGS) and childhood maltreatment in predicting ADHD symptoms during young adulthood. Using data from the 2004 Pelotas (Brazil) birth cohort comprising 4231 participants, we analyzed gene-environment interaction (GxE) and correlation (rGE). We further explored rGE mechanisms through mediation models. ADHD symptoms were assessed at age 18 via self-report (Adult Self Report Scale - ASRS) and mother-reports (Strength and Difficulties Questionnaire - SDQ). The ADHD-PGS was derived from published ADHD GWAS meta-analysis. Physical and psychological child maltreatment was gauged using the Parent-Child Conflict Tactics Scale (CTSPC) at ages 6 and 11, with a mean score utilized as a variable. The ADHD-PGS exhibited associations with ADHD symptoms on both ASRS (ß = 0.53; 95% CI: 0.03; 1.03, p = 0.036), and SDQ (ß = 0.20; 95% CI: 0.08; 0.32, p = 0.001) scales. The total mean maltreatment score was associated with ADHD symptoms using both scales [(ßASRS = 0.51; 95% CI: 0.26;0.77) and (ßSDQ = 0.24; 95% CI: 0.18;0.29)]. The ADHD-PGS was associated with total mean maltreatment scores (ß = 0.09; 95% CI: 0.01; 0.17; p = 0.030). Approximately 47% of the total effect of ADHD-PGS on maltreatment was mediated by ADHD symptoms at age 6. No evidence supported gene-environment interaction in predicting ADHD symptoms. Our findings underscore the significant roles of genetics and childhood maltreatment as predictors for ADHD symptoms in adulthood, while also indicating a potential evocative mechanism through gene-environment correlation.

The lifetime costs of perinatal depression and anxiety in Brazil.

BACKGROUND: Each year, an estimated 860,000 Brazilian women experience depression and anxiety perinatally. Despite well-known devastating impacts of these conditions on mothers and children, they remain neglected in low- and middle-income countries. Knowing the costs of untreated perinatal depression and anxiety can inform decision-making. METHODS: Simulation modelling is used to examine lifetime costs of perinatal depression and anxiety for a hypothetical cohort of women and their children, followed until children are aged 40 years. Costs are measured from a societal perspective, including healthcare expenditure, productivity and health-related quality of life losses; 2017 data are taken from country-specific sources. Present values are calculated using a discount rate of 3 %. RESULTS: Lifetime cost of perinatal depression and anxiety in Brazil are USD 4.86 billion or R$ 26.16 billion, including costs linked to poorer quality of life (USD 2.65 billion), productivity loss (USD 2.16 billion) and hospital care (USD 0.05 billion). When the costs associated with maternal suicide are included, total costs increase to USD 4.93 billion. LIMITATIONS: Several costs could not be included in the analysis because of a lack of data. The study is reliant of longitudinal data on associations between perinatal depression and anxiety and impacts on mothers and children. Therefore, no causality can be inferred. CONCLUSION: Our findings illustrate the economic rationale for investment in this area. This is the first study that estimates the costs of perinatal mental health problems in a low- or middle-income country setting.

Association between attention, nonverbal intelligence and school performance of school-age children with Autism Spectrum Disorder from a public health context in Brazil.

BACKGROUND: Autism Spectrum Disorder (ASD) is characterized by impairments in social interaction, restricted and repetitive behaviour, interests or activities. Difficulties in a broad spectrum of cognitive skills is often present, including attentional processes and nonverbal intelligence, which might be related to academic difficulties. AIMS: In this study, the association between attentional skills and nonverbal intelligence to school performance of children with ASD was assessed. METHODS AND PROCEDURES: 32 children/adolescents between 8-14 years old, who attended a treatment unit linked to the public health system of São Paulo-Brazil participated in the study. The following instruments were utilized: Cancellation Attention Test; Raven's Coloured Progressive Matrices; and School Performance Test. OUTCOMES AND RESULTS: After correlation analysis, statistically significant associations were found between attention and nonverbal intelligence with school performance. Regression analysis showed that attention drives school performance irrespective of nonverbal intelligence. CONCLUSIONS AND IMPLICATIONS: Results evidence the link between attention and school performance in ASD, suggesting that attentional mechanisms may be a promising route to follow in the design of interventions for school improvement of children and adolescents with ASD.

Attention training in children with autism spectrum disorder improves academic performance: A double-blind pilot application of the computerized progressive attentional training program.

Atypical attention has been reported in individuals with autism spectrum disorder (ASD) with studies pointing to an increase in attention deficit and hyperactivity disorder-like symptomatology. Individuals with ASD may also present academic difficulties and it is possible that they face a double-barrier for academic attainment from both core ASD symptomatology and from attention atypicalities, which are directly linked to academic performance. This raises the possibility that academic difficulties in ASD may benefit from cognitive training targeting attention. To test this possibility, we used the computerized progressive attentional training (CPAT) intervention in a double-blind, active control with follow-up intervention study in Brazil. The CPAT is a computerized attention training program that was recently piloted with schoolchildren with ASD in the UK. Twenty-six participants (8-14 years) with ASD in the São Paulo's ASD Reference Unit were assigned to either the CPAT (n = 14) or active control group (n = 12), which were matched at baseline. Two 45-min intervention sessions per week were conducted over a 2-month period. School performance, attention, fluid intelligence, and behavior were assessed before, immediately after and 3 months following the intervention. Significant group by time interactions show improvements in math, reading, writing and attention that were maintained at follow-up for the CPAT (but not the active control) group, while parents of children from both groups tended to report behavioral improvements. We conclude that attention training has the potential to reduce obstacles for academic attainment in ASD. Combined with the previous pilot study, the current results point to the generality of the approach, which leads to similar outcomes in different cultural and social contexts. LAY ABSTRACT: Attention difficulties tend to occur in ASD and are linked to academic performance. In this study, we demonstrate that school performance in math, reading and writing in children with ASD can improve following an intervention that trains basic attention skills (the CPAT intervention). The improvements we report are stable and were maintained 3-months following the intervention. This study, which was conducted in a public-health setting in Brazil, extends previous research in schools in the UK pointing to the cross-cultural and cross-settings efficacy of the intervention.

Preliminary evidence of the validity process of the Autism Diagnostic Observation Schedule (ADOS): translation, cross-cultural adaptation and semantic equivalence of the Brazilian Portuguese version.

OBJECTIVES: To translate and back-translate the Autism Diagnostic Observation Schedule (ADOS) into Brazilian Portuguese, to assess its cross-cultural semantic equivalence, and to verify indicators of quality of the final version by analyzing the inter-rater reliability of the ADOS scores. METHODS: This study had three stages: 1) translation and back-translation; 2) semantic equivalence analysis; and 3) pre-test to verify the agreement between mental health specialists and an ADOS senior examiner regarding the scoring procedure. Authorization to translate and carry out the cultural adaptation of the instrument was first obtained from the Western Psychological Services, publishers of the instrument. RESULTS: The main preliminary results pointed to good equivalence between the original English version and the final version and the Brazilian version following the cultural adaptation process. Some semantic differences were found between the original version and the back-translation into English, but they did not interfere with the first translation into Portuguese or into the final version. One of the limitations of the study was the small sample size; for that reason, the inter-rater reliability of the ADOS scores between the specialists and the senior examiner using the kappa coefficient was adequate for 7 out of 10 areas. CONCLUSIONS: We conclude that the creation of an official Brazilian version of ADOS will help to strengthen clinical and scientific research into ASD, and deter the use of other unauthorized versions of ADOS in the country.

Preliminary evidence of the validity process of the Autism Diagnostic Observation Schedule (ADOS): translation, cross-cultural adaptation and semantic equivalence of the Brazilian Portuguese version / Evidências preliminares do processo de validação da Autism Diagnostic Observation Schedule (ADOS): tradução, adaptação transcultural e equivalência semântica para a versão em português do Brasil

Abstract Objectives: To translate and back-translate the Autism Diagnostic Observation Schedule (ADOS) into Brazilian Portuguese, to assess its cross-cultural semantic equivalence, and to verify indicators of quality of the final version by analyzing the inter-rater reliability of the ADOS scores. Methods: This study had three stages: 1) translation and back-translation; 2) semantic equivalence analysis; and 3) pre-test to verify the agreement between mental health specialists and an ADOS senior examiner regarding the scoring procedure. Authorization to translate and carry out the cultural adaptation of the instrument was first obtained from the Western Psychological Services, publishers of the instrument. Results: The main preliminary results pointed to good equivalence between the original English version and the final version and the Brazilian version following the cultural adaptation process. Some semantic differences were found between the original version and the back-translation into English, but they did not interfere with the first translation into Portuguese or into the final version. One of the limitations of the study was the small sample size; for that reason, the inter-rater reliability of the ADOS scores between the specialists and the senior examiner using the kappa coefficient was adequate for 7 out of 10 areas. Conclusions: We conclude that the creation of an official Brazilian version of ADOS will help to strengthen clinical and scientific research into ASD, and deter the use of other unauthorized versions of ADOS in the country.

Resumo Objetivos: Traduzir e retrotraduzir a Autism Diagnostic Observation Schedule (ADOS) para a língua portuguesa do Brasil, verificar sua equivalência semântica transcultural e verificar indicadores de qualidade da versão final analisando a confiabilidade interavaliadores na pontuação da ADOS. Métodos: O estudo teve três etapas: 1) tradução e retrotradução; 2) análise de equivalência semântica; e 3) pré-teste para verificar a concordância entre especialistas em saúde mental e um examinador sênior em relação ao procedimento de pontuação. A realização do estudo foi feita com a autorização da Western Psychological Services, distribuidor oficial do instrumento. Resultados: Os principais resultados preliminares indicaram uma boa equivalência entre a versão original em inglês e a versão brasileira após o processo de adaptação cultural. Algumas diferenças semânticas foram encontradas entre a versão original e a retrotradução, mas que não interferiram na primeira tradução para o português nem na versão final. Uma das limitações do estudo foi o tamanho amostral pequeno; em razão disso, a confiabilidade interavaliadores entre as pontuações da ADOS dadas pelos especialistas e pelo examinador sênior utilizando o coeficiente kappa foi adequada para 7 das 10 áreas. Conclusão: Conclui-se que, com a versão brasileira da ADOS, oficializa-se uma versão única da escala em português, fortalecendo os campos clínicos e científicos de pesquisa em TEA e impedindo que no país sejam utilizadas outras versões não autorizadas da ADOS.

[Life-long domestic violence against women: prevalence and immediate impact on health, work, and family]. / Violência conjugal física contra a mulher na vida: prevalência e impacto imediato na saúde, trabalho e família.

OBJECTIVES: To estimate the lifetime prevalence of domestic violence against women (DVAW) in a low-income urban community and evaluate the immediate impact of DVAW on health, work, and family life. METHODS: The present cross-sectional study was carried out in the city of Embu (state of São Paulo, Brazil) as part of an international multicenter project (World Studies of Abuse in the Family Environment, WorldSAFE). A probabilistic sample of census sector-based clusters including all eligible households identified was used. A total of 784 women (age 16-49 years) with at least one child younger than 18 years and a lifetime resident husband/partner were included. We evaluated the occurrence of any kind of DVAW (slapping, kicking, hitting, beating, threatening to use or using a weapon, other aggressions mentioned spontaneously), of severe DVAW (same items, except slapping and other aggressions informed spontaneously), and of immediate impacts on the health, work, and family of the victims. RESULTS: The prevalence of DVAW was 26.0% for any kind of violence and 18.5% for severe DVAW. Among the victims of any kind of DVAW, 38.7% judged that they needed medical care, 4.4% were hospitalized, 18.1% were incapacitated for work (paid work or household chores), 51.5% left their partner due to the aggression and 66.7% had children who witnessed the violence. For severe violence, these rates were 51.0, 5.5, 23.4, 59.3 and 75.9%, respectively. Shame and fear of retaliation obstructed access to medical care. CONCLUSIONS: The frequency of DVAW is high in the studied community and produces immediate impacts on the victim's health, work, and family life. These impacts decrease the victim's ability to look for help and hinder the breaking of the cycle of violence.

Análise da produção científica de dez anos da revista Psicologia: Teoria e Prática / Analyses of ten years of scientific production of the journal Psicologia: Teoria e Prática / Análisis de la producción científica de diez años de la revista Psicologia: Teoria e Prática

Fundada em 1999, a revista Psicologia: Teoria e Prática, do curso de Psicologia e do Programa de Pós-Graduação em Distúrbios do Desenvolvimento da Universidade Presbiteriana Mackenzie, é um veículo de difusão científica em psicologia e áreas afins. O presente estudo visa a descrever sua produção científica, além de identificar/discutir critérios classificatórios desse periódico. Os resultados da análise dos 213 artigos publicados no período de 1999-2009 apontam que, desde 2002, há predomínio de autores vinculados a outras instituições, diferentes da instituição à qual a revista pertence (81 por cento). Do total de 213 artigos, 19 por cento deles são de autoria interinstitucional. Desde 2003, artigos com pesquisas de campo passam a ser maioria. Os temas ligados às áreas de tratamento/prevenção em psicologia e psicologia social foram os mais frequentes, e o tempo médio de tramitação se revelou inferior a cinco meses. A revista possui Qualis B1, segundo WebQualis da Capes, e está classificada entre as 33 por cento melhores no campo da psicologia.

Launched in 1999, the journal Psicologia: Teoria e Prática, from the Faculty of Psychology and the Developmental Disorder Post Graduation Program from the Mackenzie Presbyterian University is scientific instrument of dissemination in psychology and related areas. This study aims to describe its production, in addition to identify/discuss classification criteria of this journal. The results of the analysis of 213 papers published between 1999-2009 shows that 2002 there is a predominance of authors associated to other institutions (81 percent). Of the total 213 articles, 19 percent are institutional authorship. Articles with empirical data became majority since 2003. Topics related to treatment and prevention in psychology and to social psychology were the most frequent and the average processing time was less than five months. The journal has Qualis B1, according to WebQualis Capes, ranking among the top 33 percent in psychology.

Fundada en 1999, la revista Psicologia: Teoria e Prática, del curso de Psicología y del Programa de Postgraduación en Trastornos del Desarrollode la Universidad Presbiteriana Mackenzie, es un medio de divulgación científica de la psicología y áreas afines. Este estudio tiene como objetivo describir su producción e identificar/discutir los criterios de clasificación de esta revista. Los resultados del análisis de los 213 artículos publicados en el período de 1999-2009 indican que, desde 2002, hay predominio de autores vinculados a otras instituciones, diferentes de la institución a la cual esta revista pertenece (81 por ciento). Del total de 213 artículos, 19 por ciento de estos son de autoría interinstitucional. Desde 2003, artículos con investigaciones de colecta de datos en campo pasan a ser mayoría. Los temas relacionados con las áreas de tratamiento y prevención en psicología y psicología social fueron los más frecuentes y el tiempo de procesamiento promedio fue de menos de cinco meses. La revista tiene Qualis B1, de acuerdo con WebQualis Capes, y se encuentra entre los mejores 33 por ciento en la psicología.

[Lifetime prevalence and help seeking behavior in physical marital violence]. / Prevalência e procura de ajuda na violência conjugal física ao longo da vida.

OBJECTIVE: To estimate the lifetime prevalence of physical marital violence among women from a low-income urban community and to investigate help-seeking behavior among victims. METHODS: This is the Brazilian pilot cross-sectional study for an international multicenter study conducted in 1999, and is based on a probabilistic cluster sample from the municipality of Embu, São Paulo State. We considered as eligible women aged 15 to 49 years, living with children under age 18 years, who had lived with a husband or partner in lifetime. Information was collected using standardized questionnaires (n=86), administered by trained interviewers. We investigated three types of physical violence: severe (kicking, hitting with fist, beating, and/or use/threat to use weapon), non-severe (slapping in the absence of severe violence), and any type (severe and/or non-severe and/or other physical aggressions spontaneously referred), as well as the type of help sought by the victim (from people or institutions). We calculated frequency and 95% confidence intervals for each type of violence. RESULTS: Subjects reported slapping (32.6%), hitting with fist (17.5%), beating (15,2%), use/threat to use weapon (13.9%), and kicking (10.6%). Prevalence of marital violence was high: 22.1% (13.3-30.9) for severe violence, 10.5% (4.0-17.0) for non-severe violence, and 33.7% (32.7-34.7) for any type of violence. Victims of severe violence were more likely to seek help from the police (36.8%) or from traditional healers (21.1%) than from health care facilities (5.3%), despite the availability of these services in the area. CONCLUSIONS: Physical marital violence is frequent and severe among the population studied, and help was sought preferentially from the police or traditional healers rather than from health care services.