Dartiu Xavier da Silveira

Internal validity, dimensionality and performance of the Body Shape Questionnaire in a group of Brazilian college students

OBJECTIVE To adapt the Body Shape Questionnaire for use in the Brazilian population; to study the internal validity and the dimensionality of the scale when used in a non- clinical Brazilian population. METHOD A cross- sectional study was accomplished comprising 164 students in the first 3 years of the School of Medicine conveniently selected at the Universidade Federal de São Paulo. The 34- item Body Shape Questionnaire version and a questionnaire to assess demographic and anthropometric information were used. RESULTS The internal consistency of the Body Shape Questionnaire measured by Cronbachs alpha was 0.97, indicating that the questions of the scale converge to the same construct. The factor analysis of the scale resulted in a four- dimension solution accounting for 66.4% of the total data variability. Regarding the final score of Body Shape Questionnaire, the mean score was 58.7 +/- 25.1 for men and 89.7 +/- 31.3 for women. DISCUSSION We found statistically significant gender differences in the means of the Body Shape Questionnaire scores. Women showed higher dissatisfaction than did men as to their appearance as measured by the Body Shape Questionnaire. The adapted version of the scale seems to maintain the characteristics of the original scale.

Crack cocaine: an increase in use among patients attending clinics in São Paulo: 1990-1993

Unsubstantiated reports suggest that the availability and use of crack are increasing in São Paulo. To investigate this claim we used the databases from two outpatient clinics for drug users at a public hospital and examined the changes in the reported routes of administration of cocaine among 245 patients who had attended between 1990 and 1993. The proportion reporting crack use increased from 17% in 1990 to 64% in 1993 (p < .01). It does not seem that this increase was simply due to changes in demographic variables. Treatment policies need to be reviewed and HIV harm-reduction programs should focus more on the risks of sexual transmission.

Report on Psychoactive Drug Use Among Adolescents Using Ayahuasca Within a Religious Context

Abstract Ritual use of ayahuasca within the context of the Brazilian ayahuasca churches often starts during late childhood or early adolescence. Premature access to psychoactive drugs may represent a risk factor for drug misuse. Conversely, religious affiliation seems to play a protective role in terms of substance abuse. The objective of this study was to describe patterns of drug use in a sample of adolescents using ayahuasca within a religious setting. Forty-one adolescents from a Brazilian ayahuasca sect were compared with 43 adolescents who never drank ayahuasca. No significant differences were identified in terms of lifetime substance consumption. Throughout the previous year period, ayahuasca adolescents used less alcohol (46.31%) than the comparison group (74.4%). Recent use of alcohol was also more frequent among the latter group (65.1%) than among ayahuasca drinkers (32.5%). Although not statistically significant, slight differences in terms of patterns of drug use were definitely observed among groups. Despite their early exposure to a hallucinogenic substance, adolescents using ayahuasca in a controlled setting were mostly comparable to controls except for a considerably smaller proportion of alcohol users. Religious affiliation may have played a central role as a possible protective factor for alcohol use. Thus, ayahuasca seems to be a relatively safe substance as far as drug misuse is concerned.

Ayahuasca in adolescence: a preliminary psychiatric assessment.

Abstract Ayahuasca is believed to be harmless for those (including adolescents) drinking it within a religious setting. Nevertheless controlled studies on the mental/ psychiatric status of ritual hallucinogenic ayahuasca concoction consumers are still lacking. In this study, 40 adolescents from a Brazilian ayahuasca sect were compared with 40 controls matched on sex, age, and educational background for psychiatric symptomatology. Screening scales for depression, anxiety, alcohol consumption patterns (abuse), attentional problems. and body dysmorphic disorders were used. It was found that, compared to controls, considerable lower frequencies of positive scoring for anxiety, body dismorphism, and attentional problems were detected among ayahuasca-using adolescents despite overall similar psychopathological profiles displayed by both study groups. Low frequencies of psychiatric symptoms detected among adolescents consuming ayahuasca within a religious context may reflect a protective effect due to their religious affiliation. However further studies on the possible interference of other variables in the outcome are necessary.

Therapeutic Use of Cannabis by Crack Addicts in Brazil

This study ensued from clinical observations based on spontaneous accounts by crack abusers undergoing their first psychiatric assessment, where they reported using cannabis in an attempt to ease their own withdrawal symptoms. Throughout a period of nine months, the researchers followed up on 25 male patients aged 16 to 28 who were strongly addicted to crack, as diagnosed through the Composite International Diagnostic Interview (CIDI), according to CID-10 and DSM-IV diagnostic criteria. Most of the subjects (68%, or 17 individuals) ceased to use crack and reported that the use of cannabis had reduced their craving symptoms, and produced subjective and concrete changes in their behavior, helping them to overcome crack addiction. The authors discuss some psychological, pharmacological and cultural aspects of these findings.

Ayahuasca in Adolescence: A Neuropsychological Assessment

Abstract The purpose of the study was to evaluate neuropsychologically adolescents who use ayahuasca in a religious context. A battery of neuropsychological tests was administered to adolescents who use ayahuasca. These subjects were compared to a matched control group of adolescents who did not use ayahuasca. The controls were matched with regards to sex, age, and education. The neuropsychological battery included tests of speeded attention, visual search, sequencing, psychomotor speed, verbal and visual abilities, memory, and mental flexibility. The statistical results for subjects from matched controls on neuropsychological measures were computed using independent t-tests. Overall, statistical findings suggested that there was no significant difference between the two groups on neuropsychological measures. Even though, the data overall supports that there was not a difference between ayahuasca users and matched controls on neuropsychological measures, further studies are necessary to support these findings.

Freqüência de jogo patológico entre farmacodependentes em tratamento

OBJECTIVE To investigate the frequency of pathological gambling among alcohol and other substance abusers who sought specialized treatment. METHODS Seventy-four outpatients from three different substance abuse treatment services were interviewed. The South Oaks Gambling Screen (SOGS) scale was used for the diagnosis of pathological gambling. The diagnosis of alcohol and other substances abuse was established according to the DSM-IV criteria and the Short Alcohol Dependence Data (SADD) scale. The Portuguese version of the Self-Report Questionnaire (SRQ) scale was used to detect psychiatric symptoms and the Center for Epidemiological Studies Depression Scale (CES-D) for depressive symptoms. Average scores obtained from the application of these scales were compared using the Student t-test. RESULTS All subjects met the criteria for drug abuse, 61.6% met the alcohol dependence criteria, 60.3% for cocaine/crack, and 34.2% for cannabis. According to the SOGS scale, the majority of drug addicts (70.3%) were classified as social gamblers, 10.8% as problem gamblers and 18.9% as pathological gamblers. Psychiatric and depression symptoms were found in the sample. Pathological gambling patients showed more depression symptoms than non-pathological gambling patients. CONCLUSIONS A high frequency of pathological gambling was found among the drug addicts interviewed. It is emphasized the importance of investigating pathological gambling among patients under treatment of drug abuse and to include strategies for the treatment of this disorder.

Validity Study of the South Oaks Gambling Screen (SOGS) among distinct groups of Brazilian gamblers

OBJETIVOS: O objetivo desse estudo e avaliar a consistencia interna e a dimensionalidade da versao da South Oaks Gambling Screen (SOGS) adaptada para uso em populacao brasileira e sua capacidade de discriminar diferentes tipos de jogadores. METODO: O estudo envolveu 217 jogadores ¾ contatados no Jockey Clube de Sao Paulo, em casas de bingo e de video poquer ¾, sendo que 46 deles haviam procurado tratamento no Ambulatorio de Jogo Patologico do Programa de Orientacao e Atendimento a Dependentes da Universidade Federal de Sao Paulo.Entre eles 96 eram jogadores sociais e 75 eram classificados como provaveis jogadores patologicos. RESULTADOS: As diferencas das medias de pontuacoes das subamostras foram estatisticamente significantes, discriminando jogadores sociais e jogadores patologicos entrevistados em local de jogo e amostra clinica. A SOGS, em sua versao integral de 20 itens, apresentou consistencia interna medida pelo modelo Alfa de Cronbach de 0,9304. A analise fatorial da estrutura da escala resultou em uma solucao de tres dimensoes, respondendo por 58,6% da variabilidade total dos dados na amostra: um primeiro fator constituido preponderantemente por questoes referentes a consequencias do comportamento de jogar; um segundo fator reunindo predominantemente questoes relativas ao proprio comportamento de jogar dos jogadores patologicos; e um terceiro fator, menos decisivo no conjunto e composto de apenas duas questoes, parecendo ser um fator hibrido de dificil interpretacao. CONCLUSOES: A versao adaptada para o Brasil da SOGS mostrou-se um instrumento util para discriminar jogadores brasileiros patologicos de jogadores nao-patologicos, como tambem diferenciou os grupos clinico e nao-clinico de jogadores patologicos, identificando graus distintos de gravidade.

Internal consistency and factor structure of the Portuguese version of the Liebowitz Social Anxiety Scale among alcoholic patients

OBJECTIVE Liebowitz Social Anxiety Scale is an instrument used to evaluate the severity of social phobia. It has been widely used in different contexts and cultures, presenting variable psychometric properties. The objective of this article is to investigate the internal consistency and the factor structure of this scale. METHOD In a sample of 300 alcoholic patients hospitalized in 3 mental clinics in Southern Brazil, 74 of them were social phobics (24.6%). The Structured Clinical Interview for DSM-IV-Axis I Disorders - Patient Edition, a semi-structured clinical interview based on DSM-IV, was used to check for the diagnosis of social phobia. The internal consistency was measured by Cronbachs alpha. Data were subjected to a factor analysis with the principal component method of parameter estimation. Questionnaire items loading at 0.35 or above were considered in the final factor solution. RESULTS The coefficient of internal consistency was 0.95. All items showed corrected item-total correlation coefficient above 0.15, considered the minimum requested index. The factor analysis resulted in 5 dimensions which corresponded to 52.9% of the total variance. The five factors extracted were: factor I - speaking in a group, factor II - activity in public, factor III - social interaction with unknown person, factor IV - attitude of disagreement or disapproval and factor V - social interaction in leisure activity. CONCLUSIONS The scale proved to be reliable and structurally valid instrument for use in a population of alcoholic patients. The possibility of screening for social phobia through the use of the instrument may be helpful in identifying probable cases of the disorder among alcoholics.

Validation of the portuguese version of the Questionnaire on Eating and Weight Patterns: revised (QEWP-R) for the screening of binge eating disorder

OBJECTIVE The present paper describes the validation of the Questionnaire on Eating and Weight Patterns-Revised (QEWP-R) designed for the diagnosis of binge eating disorder (BED) and sub-clinical binge eating. METHODS 89 overweight women seeking treatment for binge eating and/or obesity were assessed with the Portuguese version of the Questionnaire of Eating and Weight Patterns and were, subsequently, interviewed with the eating disorders module of the Structured Clinical Interview for DSM-IV (SCID-I/P). Rates of binge eating disorder and sub-clinical cases of binge eating obtained with the Questionnaire on Eating and Weight Patterns-Revised were then compared to those obtained with the Structured Clinical Interview for DSM-IV. RESULTS In the identification of binge eating, irrespective of the presence of all criteria for binge eating disorder the QEWP-R Questionnaire on Eating and Weight Patterns-Revised yielded a sensitivity value of 0.88, a specificity value of 0.63 and a positive predictive value of 0.825. Rates for the identification of the full syndrome of binge eating disorder were: sensitivity value of 0.548, a specificity value of 0.8 and a positive predictive value of 0.793. CONCLUSIONS The Questionnaire on Eating and Weight Patterns-Revised can be useful in a first-step screening procedure to identify probable cases of binge eating. It can be useful as a screening tool and as a first step of clinical assessment of patients seeking treatment for binge eating and/or obesity.