Cristina M. T. Santana

Positive and negative affect schedule: psychometric properties for the Brazilian Portuguese version.

This study is about the validity and item analysis for the Positive and Negative Affect Schedule (PANAS), respectively through the Exploratory Factor Analysis (principal components method) and the Partial Credit Model (PCM). The scale has been largely used in areas ranging from clinical to social psychology since its release in 1988 by Watson, Clark, and Tellegen. In order to assess validity and item properties (Item Response Theory paradigm), this is study administered PANAS to 354 respondents, 115 male and 239 female subjects, with an average age of 29.5 (SD = 10,18). The results show PANASs excellent psychometric properties, with consistent dimensions and reliable item functioning, considering the Rasch measurement paradigm expressed in the PCM as an Item Response Theory model for polytomous data. The study considers important cultural issues and the results support more cautious translations for scales as well as further studies concerned with cross-cultural differences on the perception of affect states.

Insight in bipolar mania: evaluation of its heterogeneity and correlation with clinical symptoms

BACKGROUND Studies on insight in bipolar mania are not numerous and usually consider insight as a unitary construct. OBJECTIVE Evaluate how different facets of insight are affected in bipolar mania and investigate correlations between insight for each specific object in bipolar disorder and manic symptomatology. METHOD A group of 165 bipolar patients were followed during a year, with 51 patients having manic episodes according to DSM-IV-TR criteria. Patients underwent a clinical assessment and insight was evaluated through the Insight Scale for Affective Disorders. RESULTS The study found that insight regarding symptoms is worse than insight of having bipolar disorder, social relationships and self esteem. Moreover, poor global insight (total ISAD) correlates with more severe changes in mood, speech and thought structure, with worse insight about symptoms correlating with the same alterations and also with more severe symptoms of agitation/energy. LIMITATIONS Although a large sample of bipolar patients was followed up, the final sample composed of patients with at least one manic episode was relatively smaller. Moreover, the fact that the study was performed in a university hospital may have led to selection biases. CONCLUSION Results suggest that patients with BD are reasonably capable of identifying that their condition implies consequences but have more impaired awareness of their energy and activity levels. A lower level of insight specifically about symptoms correlates with more severe symptoms of agitation/energy, which suggests a psychomotor nucleus able to impair insight in mania.

Tradução e adaptação semântica do questionário de controle atencional para o contexto brasileiro

The ability to control attention is a complex task that requires different mental processes. The present study aims to translate and adapt the Attentional Control Scale to Brazil. The research was conducted with the support of two multidisciplinary panels: one formed by Experimental Psychologists and Neuroscientists who were responsible to help throughout the semantic adaptation process, and another one formed by Attention Psychology specialists responsible to judge items in three aspects: comprehensiveness, coherence and semantic compatibility. The Content Validity Coefficient was used to assess items from judges scores. Among 20 items, only three did not hold values above the 0.80 criteria: items 3, 16 and 20. Results were discussed considering the problems faced throughout the adaptation of the instrument. It was concluded that the Attentional Control Scale was adequately translated and it shows semantic equivalency with the American original scale.

Clinical correlates of loss of insight in bipolar depression

INTRODUCTION Affective state may influence insight, especially regarding mania. Nevertheless, studies have so far suggested that depression seems not to significantly impair insight. To the best of our knowledge, this study pioneers the evaluation of how insight variations in bipolar depression correlate with clinical variables. METHOD A group of 165 bipolar patients, 52 of whom had depressive episodes according to DSM-5 criteria, were followed during a year. All patients underwent clinical assessment, and insight was evaluated through the Insight Scale for Affective Disorders (ISAD). Repeated-measures ANOVA was calculated comparing scores on the four ISAD factors (insight into symptoms, the condition itself, self-esteem and social relationships) in order to investigate differences in insight according to different objects. Correlational analysis explored which clinical symptoms were linked to reduced insight. RESULTS Worse total insight correlated with suicide attempt/ideation and fewer subsyndromal manic symptoms such as mood elevation, increased energy and sexual interest. Worse self-esteem insight was associated with not only suicide ideation/attempt but also with activity reduction and psychomotor retardation. Worse symptom insight also correlated with psychomotor retardation. Better insight into having an affective disorder was associated with more intense hypochondria symptoms. Finally, worse insight into having an illness was associated with psychotic episodes. CONCLUSION Our study found that symptoms other than psychosis - suicide ideation, psychomotor retardation and reduction of activity and work - correlate with insight impairment in bipolar depression.

Changes in energy and motor activity: core symptoms of bipolar mania and depression?

Objective: To evaluate how well symptom rating scales differentiate bipolar disorder (BD) episode types. Methods: One hundred and six patients with BD were followed for 13 years. At each visit, the following clinical scales were administered: Young Mania Rating Scale (YMRS), Hamilton Depression Scale (HAM-D) and Clinical Global Impressions scale for use in bipolar illness (CGI-BP). To perform a comparison between the affective states of BP, three time points in each patient’s follow-up period were chosen for evaluation: the most severe manic episode, the most severe depressive episode, and the euthymic period with least symptoms. Canonical discriminant analyses (CDA) were performed to identify which symptoms best discriminated episodes. Results: CDA revealed HAM-D was worse than YMRS and CGI-BP to discriminate mood states. The items evaluating increased motor activity in YMRS (2, increased motor activity/energy) and HAM-D (9, agitation) were the best to distinguish mania, depression, and euthymia. In contrast, HAM-D item 8 (retardation) and the HAM-D and YMRS items related to mood symptoms were less important and precise. Conclusion: Higher levels of energy or activity should be considered a core symptom of mania. However, our results do not confirm the association between a decrease in energy or activity and depression. HAM-D probably does not assess motor activity adequately.

The relationship between insight and affective temperament in bipolar disorder: an exploratory study

INTRODUCTION In recent years, the association between temperament and clinical characteristics of mood disorders has been studied. Most bipolar patients show deficits in their awareness of signs and symptoms. The relationship between affective temperament and insight in bipolar patients has not been carried out in the literature so far. OBJECTIVE To evaluate the relationship between affective temperament and insight in bipolar disorder. METHOD A group of 65 bipolar patients were followed during a year. Patients underwent a clinical assessment and were diagnosed using criteria from the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). Insight was evaluated through the Insight Scale for Affective Disorders (ISAD), and affective temperament, through the TEMPS-Rio de Janeiro. The relationship between affective temperament and insight was explored with Spearman rho correlations between scores on each item of the ISAD and on the TEMPS-Rio de Janeiro subscales. RESULTS In euthymic phases, bipolars with depressive temperament were associated with a higher level of insight about the consequences of the disorder; when in mania, patients showed better insight about having an affective disorder, presenting psychomotor alterations, and suffering from guilt or grandiosity. Similarly, bipolar patients with higher scores of anxious temperament, when in mania, had better insight on alterations in attention. Bipolar patients with higher scores of hyperthymic temperament, when in mania, showed the worst insight about thought disorder. CONCLUSION In addition to being determined by the phase of the disease and several varying symptoms, the level of insight in bipolar patients is also influenced by affective temperament.

The influence of current mood state, number of previous affective episodes and predominant polarity on insight in bipolar disorder

Abstract Background: Although many studies have explored the effect of current affective episodes on insight into bipolar disorder, the potential interaction between current mood state and previous affective episodes has not been consistently investigated. Objective: To explore the influence of dominant polarity, number of previous affective episodes and current affective state on insight in bipolar disorder patients in euthymia or mania. Methods: A total of 101 patients with bipolar disorder were recruited for the study, including 58 patients in euthymia (30 with no defined predominant polarity and 28 with manic predominant polarity) and 43 in mania (26 with no defined predominant polarity and 17 with manic predominant polarity). Patients underwent a clinical assessment and insight was evaluated through the Insight Scale for Affective Disorders. Results: Bipolar disorder patients in mania had worse insight than those in euthymia, with no effect of dominant polarity. In addition, positive psychotic symptoms showed a significant effect on insight and its inclusion as a covariate eliminated differences related to mood state. Finally, the number of previous manic or depressive episodes did not correlate with insight level. Conclusions: Mania is a predictor of loss of insight into bipolar disorder. However, it is possible that its contribution is linked to the more frequent presence of psychotic symptoms in this state. Dominant polarity and number/type of previous affective episodes have a limited impact on insight.

Catatonia and psychosis related to epilepsy: A case report

Although a variety of metabolic, toxic, psychiatric, and neurologic conditions can produce catatonic syndromes, it is less widely recognized that this state may be caused by epilepsy. We present the case of a woman with catatonic behavior, which she could not recall. She also exhibited olfactory, auditory and visual hallucinations. An EEG demonstrated diffuse abnormal electrical activity, mainly on left temporal and frontal areas. Treatment with anticonvulsant drugs yielded excellent response.

Ages & Stages Questionnaire–Brazil–2011 Adjustments on an Early Childhood Development Screening Measure

Introduction. Professionals who assess early childhood development highly benefit from reliable development screening measures. The Ages & Stages Questionnaire was adapted Brazil in 2010 and named ASQ-BR. Modifications in some items were required to improve the instrument’s psychometric properties. The present study modified the ASQ-BR to verify if those changes increase its characteristics. Method. This study researched 67 522 children from 972 public day care centers and preschools. Changes in items were made considering Cronbach’s α and item-to-total correlations. Reliability, dimensionality, and item-to-total correlations were calculated. Results. Regarding dimensionality, 86.2% of the scales in ASQ-BR-2011 were unidimensional. Internal consistency showed improvement from 2010 to 2011: 53.8% of the scales increased the α statistics against 41.2% that decreased, and 5.0% remained the same. Finally, 65.2% of the modified items showed improvement. Conclusions. Overall, the instrument’s psychometrics improved from 2010 to 2011, especially in the personal/social domain. However, it still leaves room for improvement in future studies.

Desenvolvimento e propriedades psicométricas de uma nova medida de depressão

Abstract The Filgueiras Depression Inventory is proposed as a new instrument, created speci fi cally for the Brazi-lian culture, for screening of Major Depressive Episodes according to the categories of the DSM-V. Two studies were conducted for this purpose. Study’s 1 sample consisted of 326 undergraduate psychology students. Single words or expressions were asked to represent overall depressive symptoms. The most cited formed the fi rst version of the Filgueiras Depression Inventory. Study 2 reported the psychome-tric properties of this new scale. The sample consisted of 471 volunteers recruited on the Internet and 238 volunteers undergraduate students. Factor analyses, convergent and discriminant validity and other Classical Test Theory indices revealed results consistent to expectations in the present study. Andrich’s Rating Scale Modeling was used as an Item Response Theory method of analysis. The overall psycho-metric properties of the Filgueiras Depression Inventory were shown to be good, and this study supports the effectiveness of this scale as a new instrument that measures depressive episodes in the Brazil.