Alina Gomide Vasconcelos

Tradução e adaptação cultural da Barratt Impulsiveness Scale (BIS-11) para aplicação em adultos brasileiros

OBJECTIVES: The objective of this study was to translate, make transcultural adaptation and assess the semantic, idiomatic and literal equivalence of the Barratt Impulsiveness Scale (BIS-11). METHODS:This scale assesses the presence of impulsive manifestations from the theoretical model proposed by Ernst Barratt. Firstly, the BIS-11 original version in English was translated to Portuguese by six bilingual researches. After this, was made the back-translation to English by a translator that was born in United States. Then, the three versions (original, translated and back-translated) were assessed by a specialists committee which made and analyze and comments about the process and then we reach the final translated version of BIS-11. The original and translated version of BIS-11 was applied in two samples from general population with proficiency both in English and Portuguese. This method was adopted to assess the literal, semantic e idiomatic equivalence of these versions by mean of correlation analyses. CONCLUSION: The final results of quantitative analyses show that the final version of BIS-11 is satisfactory.

Affective temperaments and antidepressant response in the clinical management of mood disorders

BACKGROUND The aim of this study was to investigate the presence of a relationship between affective temperament and antidepressant treatment response in mood disorder patients. METHODS The lifetime history of antidepressant response of 90 bipolar disorder patients and 88 major depressive disorder patients were retrospectively evaluated and then assigned to one of four subgroups: complete response (CR), partial response (PR), no response (NR), and antidepressant associated mania response (AAMR). Using TEMPS-Rio de Janeiro - the brief Brazilian version of TEMPS-A - we compared affective temperament subscale scores across these groups. RESULTS We observed a statistically significant relationship between depressive and anxious affective temperaments and no antidepressant response. In bipolar disorder patients, cyclothymic temperament (p<0.01) and hyperthymic temperament (p<0.05) were associated with antidepressant-associated mania. Hyperthymic temperament was associated with complete antidepressant responses in major depressive disorder patients. LIMITATIONS The evaluation of antidepressant response was retrospective. CONCLUSIONS Our data are consistent with the theory that affective temperament traits are factors that can influence the antidepressant response and the recovery from depressive episodes, but more longitudinal studies are needed to confirm this theory and our findings.

Affective temperaments: Familiality and clinical use in mood disorders

BACKGROUND The affective temperament profiles among patients with mood disorders may be an important parameter in the clinical evaluation of these patients. It has been proposed that temperament traits have familiality and may represent vulnerability markers to identify the risk to developing specific clinical type of mood disorders. To test these theories, measures of temperament were examined in bipolar patients (BP), unipolar major depressive patients (UP), healthy relatives of these patients (HRP) and normal controls (NC). METHODS We compared affective temperament scores, using the brief Brazilian version of TEMPS-A--TEMPS-Rio de Janeiro, between 90 BP, 88 UP, 132 HRP and 136 NC. A MANCOVA model was constructed. Dependent variables were the six subscales of the TEMPS-RJ (depressive, cyclothymic, irritable, hyperthymic, anxious and worrying temperaments). The effects of age and gender were adjusted as covariates. Furthermore, we performed a comparison between a subgroup of 68 HRP, relatives of bipolar patients (HRBP), and the remainders 64 HRP, relatives of unipolar patients (HRUP) and controls. RESULTS The clinical group (BP, UP) showed higher temperament scores than NC, except for hyperthymic scores. BP showed higher cyclothymic (p<0.001), hyperthymic (p<0.001) and lower anxious (p<0.01) temperament scores than UP. HRP showed lower scores than clinical groups. HRBP scored higher cyclothymic subscale than HRUP and NC groups. LIMITATIONS Bipolar I and II subjects were placed in the same group. CONCLUSIONS The cyclothymic and hyperthymic traits were associated with bipolarity in patients and cyclothymic temperament could be a characteristic trait of the healthy relatives of bipolar patients. Our data support that affective temperament might become a useful tool for clinical evaluation and research purposes in mood disorders.

When self-report diverges from performance: The usage of BIS-11 along with neuropsychological tests

Impulsivity has been fractionated into multiple independent, but correlated, components. Personality and neuropsychological studies have consistently shown its multidimensional nature. Each theoretical approach uses different techniques such as self-report questionnaires and neuropsychological tests to assess impulsivity, respectively. Our main objective was to investigate if there is evidence of convergent validity for impulsivity as assessed by both types of measures. We administered the Barratt Impulsivity Scale 11 and two neuropsychological tests (Iowa Gambling Task and Continuous Performance Task) to 266 participants to measure inhibition control and non-planning impulsivity dimensions. Results from an exploratory factorial analysis and group comparison indicated there was little evidence of convergent validity between the two types of measures. These findings are discussed in terms of impulsivity as a multi-factorial construct as well as the specific instruments used for assessment. Implications for psychological theory and impulsivity assessment were also proposed.

Normative data of the Barratt Impulsiveness Scale 11 (BIS-11) for Brazilian adults

OBJECTIVE The Barratt Impulsiveness Scale (BIS-11) is a valid and reliable instrument, and one of the most often used tools to assess impulsivity. This study assesses the performance of a large sample of adults by using a version of BIS-11 adapted to Brazilian Portuguese. METHODS We assessed 3,053 adults from eight Brazilian states. Internal consistencies and performance data were presented for two correction criteria of BIS-11: original and the two-factor score. RESULTS The associations between age, sex, region, and education and the BIS-11 scores present very small effect sizes. Therefore, we provided a percentile rank parameter for the different BIS-11 subscores considering the whole sample. Given the internal consistency of the two correction systems, we found that only the two-factor system fulfills the psychometric criteria of Cronbachs alpha (cutoff value of at least 0.6). CONCLUSION Our results support the use of the Brazilian adaptation of BIS-11 in different regions of the country as a measure of impulsivity. Since high impulsiveness is a characteristic of several dysfunctional behaviors, the establishment of normative parameters is of utmost relevance and should be extended to other age ranges and populations in future studies.

Perfil cognitivo, déficits motores e influência dos facilitadores para reabilitação de crianças com disfunções neurológicas

OBJETIVO: Investigar se criancas e adolescentes saudaveis e com doencas neurologicas podem ser reunidas em grupos distintos e homogeneos, usando como criterios o desempenho cognitivo, o funcionamento motor e as percepcoes dos pais quanto aos facilitadores para a reabilitacao. METODOS: Participaram deste estudo 15 criancas saudaveis (C) e 43 pacientes (28 com paralisia cerebral e 15 com acidente vascular cerebral), entre cinco e 18 anos. Foi aplicado aos pais o instrumento denominado Avaliacao dos Fatores Ambientais relacionados a Reabilitacao Neurologica Infantil (AFARNI). O comprometimento cognitivo foi avaliado por meio do Mini-Exame do Estado Mental, adaptado para essa faixa etaria, e o comprometimento motor foi investigado por avaliacao clinica. Para comparar os resultados, foi realizada uma analise de conglomerados e ANOVA. RESULTADOS: A analise de conglomerados identificou quatro grupos de pacientes com caracteristicas clinicas e sociodemograficas distintas, confirmados pela ANOVA (p<0,001). Houve dissociacao entre os grupos com relacao ao comprometimento cognitivo e motor. Os pais de criancas com maior comprometimento avaliaram de forma mais positiva os facilitadores para a reabilitacao. CONCLUSOES: A qualificacao dos facilitadores para a reabilitacao por meio da AFARNI e a avaliacao cognitiva com auxilio do Mini-Exame do Estado Mental podem contribuir para identificar as necessidades de suporte para criancas com deficiencias neurologicas que apresentam comprometimento cognitivo e motor.

Maintaining quality of life in multiple sclerosis: fact, fiction, or limited reality?

Health-related quality of life (HRQOL) is an important marker for health-related impacts on individuals with chronic diseases. This HRQOL study compares multiple sclerosis (MS) patients to a socio-demographically-matched healthy control group. HRQOL was assessed by means of a modular instrument (DEFU/DEFIS), which allows comparisons between diseased and healthy individuals. Main goal of the study was to obtain pertinent data to build a more reliable theoretical framework concerning HRQOL in MS. Another aim was to test the hypothesis of the so-called happiness paradox, according to which disabled individuals could maintain reasonable levels of HRQOL. Results show that MS individuals present lower levels of HRQOL in comparison to healthy controls, arguing against the happiness paradox hypothesis. Preservation of HRQOL levels against certain levels of disability may be restricted to a group of patients.

Relationship between neuropsychological and clinical aspects and suicide attempts in euthymic bipolar patients

Alguns estudos investigaram a possivel relacao entre tentativas de suicidio e impulsividade em pacientes com transtorno bipolar. O objetivo do estudo foi avaliar a relacao entre caracteristicas neuropsicologicas e clinicas e o comportamento suicida em pacientes bipolares eutimicos. Utilizamos o Iowa Gambling Task e o Conners Continuous Performance Test para avaliar a impulsividade em 95 pacientes eutimicos com transtorno bipolar (42 com tentativas de suicidio) e 155 controles normais. Uma analise fatorial avaliou a adequacao dos instrumentos e foi criado um modelo para previsao do numero de tentativas de suicidio usando regressao linear multipla. Nossos resultados apontam para um tipo especifico de impulsividade relacionada a tomada de decisoes, falta de planejamento e para a comorbidade Transtorno de Personalidade Borderline. A impulsividade por nao planejamento e um fator de risco para tentativas de suicidio em pacientes com Transtorno Bipolar.

Traços de temperamento associados ao transtorno afetivo bipolar: uma revisão integrativa da literatura

Studies have suggested an association between temperament characteristics and adjustment and psychiatric disorders, describing them as different manifestations of vulnerability to psychopathology. The objective of this study was to conduct an integrative review of the literature on temperament traits typical of bipolar patients in relation to the general population. A systematic search was conducted on the MEDLINE, PsycINFO and LILACS databases, using the headings bipolar disorder, temperament and/or personality, between January 2000 and December 2010. The search was performed in January 2011. A total of 199 articles were identified for potential inclusion in the review. After application of the exclusion criteria, a total of 15 articles were selected and their full texts analyzed. Review of the selected studies revealed heterogeneity in terms of sample profile and specific temperament traits assessed with the appropriate instruments. Temperament traits in bipolar patients are identified based on different theoretical models. The results of five studies consistently showed that neuroticism is a distinct personality trait in the temperament profile of bipolar patients. Future reviews should use more specific keywords and limit the search to studies with a longitudinal design.

Impulsivity components measured by the Brazilian version of the Barratt Impulsiveness Scale (BIS-11)

The main purpose of this study was to investigate the psychometric properties of the Barratt Impulsiveness Scale (BIS-11). Content item analysis was conducted by seven doctoral students. A convenience sample of 897 students was submitted to BIS-11 and they also filled self-reports about Minor Mental Disorder and ADHD symptoms, alcohol use and cigarette smoking. Mean age was 27.32 (SD=8.69) years, 56% were female and 52% had incomplete college degree. Content and factorial analyses revealed that impulsivity was best represented by two latent factors labeled non-planning and inhibition behaviors. Test retest agreement tended to produce similar score patterns seven months after the first evaluation. Additionally, BIS-11 scores discriminated subjects in terms of cigarette smoking and psychopathological symptoms, which indicated evidences regarding criterion-related validity. The theoretical discussion was present based on the neuropsychological model of hot and cool aspects of executive function.