Sensory Profile-2 in Autism Spectrum Disorder: An Analysis within the International Classification of Functioning, Disability and Health Framework.

Autism spectrum disorder (ASD) is characterized by impairments in many functional areas requiring long-term interventions to promote autonomy. This study aims to map The Sensory Profile™ 2 (SP-2), one of the most widely used assessment tools in children with ASD, with the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY), developed by the World Health Organization (WHO). This will allow the identification of the functional dimensions covered by this instrument and the comparison with the ICF shortlist proposed for autism (ICF Core Set [ICF-CS]). The deductive content analysis described in the ICF Linking Rules was followed, along with a systematized process including statistical and reasoning techniques that could contribute to the improvement of ICF linking studies (Cohen's Kappa and percentage of agreement). 218 codes were identified, 71% of them were codes related to the body functions chapters, mainly linked to perceptual functions (b160), emotional functions (b152), and temperament and personality functions (b126). Concerning activities and participation chapters (29%) the most frequently used codes were: focusing attention (d160), carrying out daily routine (d230), and walking (d450). Even though the SP-2 items do not assess most of the functional features regarded as essential in the ASD ICF-CS, SP-2 encompasses a majority of problems concerning body functions. This instrument may be considered as part of a multidimensional assessment approach, to complement other sources that are more likely to assess activity and participation dimensions and guide a functional intervention.

Instrumentos en español para la evaluación del funcionamiento y las actividades de la vida diaria en esquizofrenia: ¿qué miden? / Spanish Versions of assessment tools for functioning and activities daily living in schizophrenia: What do they measure?

Desde la perspectiva de la rehabilitación psicosocial, para la recuperación de las personas diagnosticadas de esquizo-frenia es fundamental el uso de instrumentos basados en un marco teórico que evalúen el nivel de funcionamiento en las actividades de la vida diaria y que cuenten con buenas propiedades clinimétricas. En España, es muy frecuente el uso de escalas traducidas de otros idiomas, fundamental-mente el inglés. Esto supone que el instrumento debe pasar por un proceso de adaptación, no solo traducción. El objeti-vo de este estudio fue realizar una revisión y comparación de diferentes instrumentos utilizados para la evaluación del funcionamiento psicosocial en la población española centra-dos en las actividades de la vida diaria. Se han seleccionado instrumentos adaptados al español en los últimos 19 años y dirigidos a personas diagnosticadas con un trastorno men-tal grave, principalmente esquizofrenia. Los resultados del estudio muestran la escasez de instrumentos adaptados a población española, así como deficiencias en el proceso de adaptación, relacionadas con la traducción, la confusión de conceptos o las propiedades métricas de la escala. En conclu-sión, la conceptualización y evaluación del funcionamiento en este ámbito continúa siendo un tema complejo y con-trovertido. La creación de nuevos instrumentos desarrollados desde una aproximación teórica, como la Clasificación Inter-nacional de la Discapacidad, el Funcionamiento y la Salud (CIF)1, pueden ser de gran ayuda para mejorar la evaluación y, en consecuencia, el tratamiento psicosocial de personas diagnosticadas de un trastorno psicótico

From the psychosocial rehabilitation perspective, the use of instruments based on a theoretical framework to assess the level of functioning in activities of daily living with good clinimetric properties is essential for people diagnosed with schizophrenia. In Spain, scales translated from other languages, usually English, are very frequently used; this involves a process of adaptation, beyond translation. The objective of this study was to review and compare a series of different scales used in psychosocial func-tioning assessment in the Spanish population focused on daily living activities. The selected instruments have been adapted into Spanish over the last 19 years and are aimed at people diagnosed with a severe mental disorder, usually schizophrenia. The results showed that the number of instruments adapted to the Spanish population was small, with several shortcomings in the adaptation process, either in translation, the confusion of concepts or metric properties of the scale. In conclusion, the conceptualisation and assessment of functioning in this field remains a complex and controversial issue. The development of new instruments based on a theoretical approach, such as the International Classification of Functioning, Disability and Health (ICF)1 may be a great help in improving the psychosocial treatment of people diagnosed with a psychotic disorder

Spanish versions of assessment tools for functioning and activities daily living in schizophrenia: What do they measure?

From the psychosocial rehabilitation perspective, the use of instruments based on a theoretical framework to assess the level of functioning in activities of daily living with good clinimetric properties is essential for people diagnosed with schizophrenia. In Spain, scales translated from other languages, usually English, are very frequently used; this involves a process of adaptation, beyond translation. The objective of this study was to review and compare a series of different scales used in psychosocial functioning assessment in the Spanish population focused on daily living activities. The selected instruments have been adapted into Spanish over the last 19 years and are aimed at people diagnosed with a severe mental disorder, usually schizophrenia. The results showed that the number of instruments adapted to the Spanish population was small, with several shortcomings in the adaptation process, either in translation, the confusion of concepts or metric properties of the scale. In conclusion, the conceptualisation and assessment of functioning in this field remains a complex and controversial issue. The development of new instruments based on a theoretical approach, such as the International Classification of Functioning, Disability and Health (ICF)1 may be a great help in improving the psychosocial treatment of people diagnosed with a psychotic disorder.

[Development and validation of BECAD. An instrument derived from the international classification of functioning, disability and health]. / Desarrollo y validación de la BECAD: un instrumento de evaluación basado en la Clasificación Internacional del Funcionamiento, de la Discapacidad y de la Salud.

BACKGROUND: The International Classification of Functioning, Disability and Health (ICF) provides a useful theoretical framework for the rehabilitation of chronic diseases with complex problems that require interdisciplinary teams. The aim of this study was the development of a set of scales based on ICF for treatment planning and outcome assessment. METHODS: A group of experts conducted several changes of the elements from the Activities and Participation ICF chapter. Tasks and questions were designed and then, submitted to review from another group of experts. An online application was designed. The sample consisted of 116 participants, 34 of them with brain injury, 38 with severe mental disorders and 44 controls. Trained psychologists and other health professionals administered the scales. Exploratory factor analysis of the scales "Learning and applying knowledge and general tasks and demands", "Self-care" and "Mobility" besides reliability coefficients, MANCOVAs and regression analyses were performed. RESULTS: In the scale "Learning and applying knowledge and general tasks and demands" three factors have been extracted, which explain 52,58% of variance. In the scale "Mobility" two factors have been extracted, explaining 76,91 % of variance; and in "Self-care", another two factors were extracted, explaining 77,60 % of variance. MANCOVAs showed significant differences between the three groups in all seven new factors. All factors presented coefficients between 0.91 and 0.99. CONCLUSIONS: These results showed appropriate metric properties of the new scales, whose factors discriminate between groups and have a high reliability.

Desarrollo y validación de la becaD, un instrumento de evaluación basado en la clasificación internacional del funcionamiento, de la discapacidad y de la salud / Development and validation of BECAD. An Instrument derived from the International Classification of Functioning, Disability and Health

Fundamentos: La Clasificación Internacional del Funcionamiento, de la Discapacidad y la Salud (CIF) proporciona un marco conceptual muy útil en la rehabilitación de personas con trastornos crónicos, con problemas complejos y atendidos por equipos interdisciplinares. El objetivo de este trabajo fue el desarrollo de una batería de escalas basadas en la CIF para la planificación de tratamientos y la evaluación de resultados. Métodos: Un grupo de expertos realizó una modificación de los elementos de las Actividades de la CIF. Se diseñaron preguntas y tareas que fueron sometidas a valoración por un segundo grupo. Se diseñó una aplicación informática en línea. La muestra estuvo formada por 116 participantes, 34 con daño cerebral adquirido, 38 con trastorno mental grave y 44 controles. La administración de las escalas la realizaron psicólogos entrenados y profesionales sanitarios. Se realizaron análisis factoriales exploratorios de tres escalas: “Aprendizaje, aplicación del conocimiento y tareas y demandas generales”, “Autocuidado y “Movilidad”, análisis de consistencia interna, MANCOVAs y análisis de regresión. Resultados: En Aprendizaje, aplicación del conocimiento y tareas y demandas generales se obtuvieron tres factores que explicaron el 52,58% de la varianza. En Movilidad se obtuvieron dos factores que explicaron el 76,91 % y en “Autocuidado” se obtuvieron otros dos, que explicaron el 77,60 %. Los test de MANCOVAs mostraron diferencias entre las tres muestras en todos los factores y los coeficientes de fiabilidad tuvieron valores entre 0,91 y 0,99. Conclusiones: Los resultados de este estudio indicaron adecuadas propiedades métricas de las nuevas escalas, cuyos factores discriminaron entre muestras y tuvieron alta fiabilidad(AU)

Background: The International Classification of Functioning, Disability and Health (ICF) provides a useful theoretical framework for the rehabilitation of chronic diseases with complex problems that require interdisciplinary teams. The aim of this study was the development of a set of scales based on ICF for treatment planning and outcome assessment. Methods: A group of experts conducted several changes of the elements from the Activities and Participation ICF chapter. Tasks and questions were designed and then, submitted to review from another group of experts.An online application was designed. The sample consisted of 116 participants, 34 of them with brain injury, 38 with severe mental disorders and 44 controls. Trained psychologists and other health professionals administered the scales. Exploratory factor analysis of the scales “Learning and applying knowledge and general tasks and demands”, “Self-care” and “Mobility” besides reliability coefficients, MANCOVAs and regression analyses were performed. Results: In the scale “Learning and applying knowledge and general tasks and demands” three factors have been extracted, which explain 52,58% of variance. In the scale “Mobility” two factors have been extracted, explaining 76,91 % of variance; and in “Self-care”, another two factors were extracted, explaining 77,60%of variance.MANCOVAs showed significant differences between the three groups in all seven new factors. All factors presented coefficients between 0.91 and 0.99. Conclusions: These results showed appropriate metric properties of the newscales,whose factors discriminate between groups and have a high reliability(AU)

[Confabulations (II): explicative models]. / Confabulaciones (II): Modelos explicativos.

INTRODUCTION: Confabulations, or the production of false memories without deliberate intent to lie, is an intriguing phenomenon for which an attempt has been made to explain it since they were first described. Confabulations are a good example for illustrating the reconstructive character of memory. Nevertheless, their exact nature and the way in which they are produced are still controversial. OBJECTIVE: To review the different models proposed to explain the appearance of confabulations. DEVELOPMENT: Neuropsychological models that currently have some theoretical development and empirical evidence are reviewed. In addition, a brief reference to motivational models, that have recently begun to recover popularity, are presented. We conclude by presenting the last version of the strategic retrieval model that makes it possible to integrate the relevant elements from the others. CONCLUSIONS: Early models of confabulations, which considered them a result of the need to fill memory gaps, are outdated nowadays. Nevertheless, emotional processes are taken into account to explain their content. From neuropsychological approaches, it is possible to distinguish models that consider confabulation as a result of a temporal or contextual problem, and those which consider that the main problem is on the memory retrieval process. More specifically, the strategic retrieval hypothesis states that confabulations are the result of a dysfunction in a complex system of monitoring the recovered information. This model would make it possible to integrate explanations and evidences coming from the other proposals.

Confabulaciones (II): Modelos explicativos / Confabulations (II): Explicative models

Introducción. Las confabulaciones o la producción de falsos recuerdos, sin la intención de mentir de forma deliberada, resultan un fenómeno intrigante que se ha intentado explicar desde que fueran descritas por primera vez. El fenómeno de las confabulaciones es un buen ejemplo del carácter reconstructivo de la memoria, sin embargo, aún es controvertida su naturaleza exacta y la forma en que se producen. Objetivo. Revisar los diferentes modelos propuestos para explicar la aparición de confabulaciones. Desarrollo. Se revisan los modelos neuropsicológicos que en la actualidad cuentan con cierto desarrollo teórico y evidencia empírica. También se hace referencia a modelos motivacionales, que han empezado a recuperar su popularidad recientemente, para terminar desarrollando la última versión del modelo de recuperación estratégica, que permite integrar los elementos relevantes de los otros. Conclusiones. Los primeros modelos sobre confabulaciones, que las consideraban resultado de la necesidad de rellenar lagunas de memoria, están hoy día superados, aunque los elementos emocionales se están teniendo en cuenta para explicar su contenido. Dentro de la neuropsicología, podríamos distinguir aquellos modelos que consideran la confabulación como resultado de un problema temporal o contextual, y aquellos que ponen el problema en los procesos de recuperación de la memoria. En concreto la hipótesis de recuperación estratégica plantea que las confabulaciones son el resultado de una disfunción de complejos sistemas de monitorización de la información recuperada. Este modelo permitiría integrar explicaciones y evidencias procedentes de otras propuestas (AU)

Introduction. Confabulations, or the production of false memories without deliberate intent to lie, is an intriguing phenomenon for which an attempt has been made to explain it since they were first described. Confabulations are a good example for illustrating there constructive character of memory. Nevertheless, their exact nature and the way in which they are produced are still controversial. Objective. To review the different models proposed to explain the appearance of confabulations. Development. Neuropsychological models that currently have some theoretical development and empirical evidence are reviewed. In addition, a brief reference to motivational models, that have recently begun to recover popularity, are presented. We conclude by presenting the last version of the strategic retrieval model that makes it possible to integrate the relevant elements from the others. Conclusions. Early models of confabulations, which considered them a result of the need to fill memory gaps, are outdated nowadays. Nevertheless, emotional processes are taken into account to explain their content. From neuropsychological approaches, it is possible to distinguish models that consider confabulation as a result of a temporal or contextual problem, and those which consider that the main problem is on the memory retrieval process. More specifically, the strategic retrieval hypothesis states that confabulations are the result of a dysfunction in a complex system of monitoring the recovered information. This model would make it possible to integrate explanations and evidences coming from the other proposals (AU)

Confabulaciones (I): Concepto, clasificación y neuropatología / Confabulations (I): Concept, classification and neuropathology

Introducción. Una definición operativa de confabulaciones sería aquella que los describe como falsos recuerdos resultado de un problema de recuperación, de los que el paciente no es consciente, y cuya creencia en la veracidad del recuerdo es genuina. Han sido descritos varios tipos de confabulaciones, utilizando una gran diversidad de criterios. Las confabulaciones pueden llegar a verse en trastornos neurológicos muy distintos, existiendo controversia en torno a sus mecanismos patofisiológicos. Objetivo. Realizar una revisión actualizada en castellano sobre la definición, tipos, regiones cerebrales implicadas y correlatos neuropsicológicos de las confabulaciones. Desarrollo. Tras revisar el concepto y los distintos tipos de confabulaciones, se describen las regiones cerebrales dañadas en dos patologías donde pueden aparecer confabulaciones, el síndrome de Korsakoff y pacientes con rupturas de aneurismas de la arteria comunicante anterior. Se revisan posteriormente los correlatos neuropsicológicos asociados a las mismas. Conclusiones. Las confabulaciones son un fenómeno complejo y de difícil definición. Probablemente la clasificación más aceptada es la que, atendiendo al modo en que aparecen, distingue las confabulaciones espontáneas de las provocadas, aunque no está clara la validez de esta distinción. En cuanto a las regiones cerebrales cruciales implicadas en las confabulaciones, parece que lesiones en el córtex prefrontal, específicamente en áreas ventromediales y orbitofrontales, son necesarias para que el fenómeno aparezca. La evidencia neuropsicológica sugiere la presencia, en la mayoría de los casos, de disfunción ejecutiva y al menos cierto grado de disfunción de memoria como mecanismos subyacentes a las mismas; sin embargo, las características específicas de estas disfunciones neuropsicológicas no son bien conocidas (AU)

Introduction. A working definition of confabulation could be that of describing them as false memories due to a recovery problem, where the patient is unaware that he/she is confabulating, and has the belief that the memory is true. Several types of confabulations have been described, according to a broad variety of criteria. Confabulations can be seen in very different neurological conditions, which have lead to a controversy on their pathophysiological mechanisms. Objective: To obtain an updated revision in Spanish of the definitions, types, brain regions involved and neuropsychological correlates of the confabulations. Development. After reviewing the concept and several types of confabulations, the damaged brain regions associated to two conditions where confabulations occur, such as Korsakoff syndrome and patients with anterior communicating artery aneurysm, are described. The neuropsychological correlates associated to them are then reviewed. Conclusions. Confabulations are a difficult-to-define complex phenomenon. Probably, the most accepted classification, in accordance with how they appear, would be that which distinguishes spontaneous from provoked confabulations, although the validity of this distinction is not clear. Regarding to crucial cerebral regions involved in the confabulations, it seems that prefrontal cortex lesions, specifically in ventromedial and orbitofrontal areas, are necessary. Neuropsychological evidence suggests the presence in most of the cases of executive dysfunction and at least some degree of memory dysfunction as an underlying mechanism of confabulation. Nevertheless, the specific characteristics of these neuropsychological dysfunctions are not well-known (AU)

Confabulations (I): concept, classification and neuropathology.

INTRODUCTION: A working definition of confabulation could be that of describing them as false memories due to a retrieval problem, where the patient is unaware that he/she is confabulating, and has the belief that the memory is true. Several types of confabulations have been described, according to a broad variety of criteria. Confabulations can be seen in very different neurological conditions, which have lead to a controversy on their pathophysiological mechanisms. OBJECTIVE: To obtain an updated revision in Spanish of the definitions, types, brain regions involved and neuropsychological correlates of the confabulations. DEVELOPMENT: After reviewing the concept and several types of confabulations, the damaged brain regions associated to two conditions where confabulations occur, such as Korsakoff syndrome and patients with anterior communicating artery aneurysm, are described. The neuropsychological correlates associated to them are then reviewed. CONCLUSIONS: Confabulations are a difficult-to-define complex phenomenon. Probably, the most accepted classification, in accordance with how they appear, would be that which distinguishes spontaneous from provoked confabulations, although the validity of this distinction is not clear. Regarding to crucial cerebral regions involved in the confabulations, it seems that prefrontal cortex lesions, specifically in ventromedial and orbitofrontal areas, are necessary. Neuropsychological evidence suggests the presence in most of the cases of executive dysfunction and at least some degree of memory dysfunction as an underlying mechanism of confabulation. Nevertheless, the specific characteristics of these neuropsychological dysfunctions are not well-known.