Diogo Araújo DeSousa

Pediatric anxiety disorders: from neuroscience to evidence-based clinical practice

The objective of this narrative review of the literature is to describe the epidemiology, etiology, pathophysiology, diagnosis, and treatment of pediatric anxiety disorders. We aim to guide clinicians in understanding the biology of anxiety disorders and to provide general guidelines for the proper diagnoses and treatment of these conditions early in life. Anxiety disorders are prevalent, associated with a number of negative life outcomes, and currently under-recognized and under-treated. The etiology involves both genes and environmental influences modifying the neural substrate in a complex interplay. Research on pathophysiology is still in its infancy, but some brain regions, such as the amygdala and the prefrontal cortex, have been implicated in fear and anxiety. Current practice is to establish diagnosis based purely on clinical features, derived from clinical interviews with the child, parents, and teachers. Treatment is effective using medication, cognitive behavioral therapy, or a combination of both. An introduction to the neuroscience behind anxiety disorders combined with an evidence-based approach may help clinicians to understand these disorders and treat them properly in childhood.

Brazilian Portuguese version of the Spence Children's Anxiety Scale (SCAS-Brasil)

OBJECTIVE To describe the cross-cultural adaptation of the Spence Childrens Anxiety Scale (SCAS) for use in Brazil. METHODS Cross-cultural adaptation followed a four-step process, based on specialized literature: 1) investigation of conceptual and item equivalence; 2) translation and back-translation; 3) pretest; and 4) investigation of operational equivalence. All these procedures were carried out for both the child and the parent versions of the SCAS. RESULTS A final Brazilian version of the instrument, named SCAS-Brasil, was defined and is presented. CONCLUSION The SCAS-Brasil instrument seems to be very similar to the original SCAS in terms of conceptual and item equivalence, semantics, and operational equivalence, suggesting that future cross-cultural studies may benefit from this early version. As a result, a new instrument is now available for the assessment of childhood anxiety symptoms in community, clinical, and research settings.

Psychometric properties of the Brazilian-Portuguese version of the Spence Children's Anxiety Scale (SCAS): Self- and parent-report versions

This study examined the psychometric properties of the Spence Childrens Anxiety Scale (SCAS) self- and parent-report versions in a community (n=712) and a clinical (n=70) sample of Brazilian children and adolescents. Confirmatory factor analysis conducted in the community sample provided support to the original six correlated factors model of the SCAS. Moreover, the SCAS demonstrated good internal consistency, convergent and divergent validity, and a significant informant effect on the total score with higher anxiety levels in the self-report than in the parent-report version. Considering the clinical sample, we could demonstrate that the SCAS total scores have good discriminant validity differentiating: (a) anxious, community, and negative screening groups; and (b) children diagnosed with different severity levels of anxiety disorders. Our findings suggest that the SCAS (self- and parent-report versions) is suitable for assessing anxiety symptoms in Brazilian children and adolescents in community and clinical settings.

Perfil dos Bolsistas de Produtividade em Pesquisa do CNPQ em Psicologia

Este estudio tuvo como objetivo analizar el perfil de los becarios de productividad en investigacion del CNPq del area de psicologia segun los datos declarados en la Plataforma Lattes. El numero de articulos, libros y capitulos de libro, asi como orientaciones de iniciacion cientifica, maestria, doctorado y pos doctorado de 297 investigadores becarios del area fueron recolectados en el transcurso de la ultima semana de abril de 2011. Tambien fueron recolectados datos acerca de las instituciones a las cuales los becarios estan vinculados. Fueron realizados analisis estadisticos descriptivos (relevamiento de frecuencias, promedios y desviacion estandar) para caracterizacion de la productividad de la muestra, e inferenciales (Ji-cuadrado y ANOVA) para comparar los becarios de cada categoria en relacion al numero de publicaciones y de orientaciones y de datos demograficos e institucionales. Los resultados muestran que hubo predominio del sexo femenino (63%) y de la beca tipo 2 (58,6%) entre los becarios. La mayoria de los becarios estan vinculados actualmente a instituciones publicas (79,1%). La Region Sudeste presento el mayor numero de becarios (53,6%), seguida de la Region Sur (18,5%). Investigadores con becas de categorias mas altas (1A y 1B) presentaron promedios significativamente mayores en relacion a la produccion de articulos, libros y capitulos de libro asi como al numero de orientaciones concluidas. Las implicaciones y las limitaciones del estudio son discutidas.

Aggression and Pro-Sociability: Risk and Protective Dynamics in Popularity and Bullying Processes

Estudios anteriores han identificado caracteristicas psicologicas positivas que pueden moderar la relacion entre la agresion y los procesos de desarrollo. En esta investigacion se evaluo si la prosociabilidad modera la asociacion entre agresion y victimizacion, y agresion y popularidad. Una muestra de conveniencia de 253 ninos brasileros de nivel socioeconomico bajo (M de edad = 11,82, DE = 1,41) participaron en el estudio. El analisis de ecuaciones estructurales mostro que la interaccion entre la agresividad y la pro-sociabilidad no protege a los ninos de sufrir bullying y tampoco modifica la asociacion entre agresion y popularidad. La agresion parece haber sido un predictor del bullying y la pro-sociabilidad, de la popularidad. Esos hallazgos difieren de los resultados de estudios anteriores que muestran una asociacion entre agresion y comportamientos positivos, como pro-sociabilidad. Mas investigaciones son necesarias que permitan destacar las diferencias culturales y contextuales, comparando estos resultados con los de otras muestras latinoamericanas.

Measuring child maltreatment using multi-informant survey data: a higher-order confirmatory factor analysis

OBJECTIVE To investigate the validity and reliability of a multi-informant approach to measuring child maltreatment (CM) comprising seven questions assessing CM administered to children and their parents in a large community sample. METHODS Our sample comprised 2,512 children aged 6 to 12 years and their parents. Child maltreatment (CM) was assessed with three questions answered by the children and four answered by their parents, covering physical abuse, physical neglect, emotional abuse and sexual abuse. Confirmatory factor analysis was used to compare the fit indices of different models. Convergent and divergent validity were tested using parent-report and teacher-report scores on the Strengths and Difficulties Questionnaire. Discriminant validity was investigated using the Development and Well-Being Assessment to divide subjects into five diagnostic groups: typically developing controls (n = 1,880), fear disorders (n = 108), distress disorders (n = 76), attention deficit hyperactivity disorder (n = 143) and oppositional defiant disorder/conduct disorder (n = 56). RESULTS A higher-order model with one higher-order factor (child maltreatment) encompassing two lower-order factors (child report and parent report) exhibited the best fit to the data and this models reliability results were acceptable. As expected, child maltreatment was positively associated with measures of psychopathology and negatively associated with prosocial measures. All diagnostic category groups had higher levels of overall child maltreatment than typically developing children. CONCLUSIONS We found evidence for the validity and reliability of this brief measure of child maltreatment using data from a large survey combining information from parents and their children.

Relacionamentos de amizade e coping entre jovens adultos

This article describes a study of existing relations between friendship characteristics of young adults and their coping resources and strategies. The participants of this study were 98 young adults, aged 18 to 30 years (M=23.01; SD=6.57), 45.9% man. The sampling was based on the Respondent Driven Sampling technique. A self-assessment questionnaire composed of socio-demographics and three self-report scales (concerning friendship relationships, coping strategies and social support perception) were administered. Confrontive and positive reappraisal coping were positively correlated with friendships toward female friends. Self-controlling was correlated positively with male friends. Friendship qualities showed a positive correlation with perceived social support. The higher the quality of the friendships, the more friends are able to provide coping resources.

Internalizing disorders and quality of life in adolescence: evidence for independent associations

OBJECTIVE To investigate whether internalizing disorders are associated with quality of life (QoL) in adolescents, even after accounting for shared risk factors. METHODS The sample comprised 102 adolescents from a community cross-sectional study with an oversampling of anxious subjects. Risk factors previously associated with QoL were assessed and divided into five blocks organized hierarchically from proximal to distal sets of risk factors. RESULTS Multiple regression analysis yielded a hierarchical model accounting for 72% of QoL variance. All blocks were consistently associated with QoL (p < 0.05), accounting for the following percentages of variance: 12% for demographics; 5.2% for family environment; 37.8% for stressful events; 10% for nutritional and health habits; and 64.2% for dimensional psychopathological symptoms or 22.8% for psychiatric diagnoses (dichotomous). Although most of the QoL variance attributed to internalizing symptoms was explained by the four proximal blocks in the hierarchical model (43.2%), about 21% of the variance was independently associated with internalizing symptoms/diagnoses. CONCLUSIONS QoL is associated with several aspects of adolescent life that were largely predicted by our hierarchical model. Our findings reinforce the hypothesis that internalizing disorders and internalizing symptoms in adolescents have a high impact on QoL and deserve proper clinical attention.

Screen for Child Anxiety Related Emotional Disorders: Are subscale scores reliable? A bifactor model analysis

The aim of this study was to investigate the utility of creating and scoring subscales for the self-report version of the Screen for Child Anxiety Related Emotional Disorders (SCARED) by examining whether subscale scores provide reliable information after accounting for a general anxiety factor in a bifactor model analysis. A total of 2420 children aged 9-18 answered the SCARED in their schools. Results suggested adequate fit of the bifactor model. The SCARED score variance was hardly influenced by the specific domains after controlling for the common variance in the general factor. The explained common variance (ECV) for the general factor was large (63.96%). After accounting for the general total score (ωh=.83), subscale scores provided very little reliable information (ωh ranged from .005 to .04). Practitioners that use the SCARED should be careful when scoring and interpreting the instrument subscales since there is more common variance to them than specific variance.

Cross-cultural adaptation and preliminary psychometric properties of the Affective Reactivity Index in Brazilian Youth: implications for DSM-5 measured irritability

OBJECTIVE To describe the cross-cultural adaptation of the Affective Reactivity Index (ARI) to Brazilian Portuguese and to investigate preliminary psychometric properties of the adapted version. METHODS Cross-cultural adaptation was based on the investigation of the theoretical and operational equivalences of the original ARI in the Brazilian context, followed by a process of translation, back-translation, and review by a committee of experts. Data analysis was carried out in a community sample of 133 schoolchildren aged 8 to 17 years to investigate the following characteristics of the ARI: 1) factor structure; 2) internal consistency; 3) construct validity comparing differential relationships between irritability and anxiety dimensions and impairment; and 4) item response theory (IRT) parameters. RESULTS A final Brazilian Portuguese version of the instrument was defined and is presented. Internal consistency was good, and our analysis supported the original single-factor structure of the ARI. Correlations of the ARI with distress-related anxiety dimensions were higher than with phobic-related anxiety dimensions, supporting its construct validity. In addition, higher ARI scores were associated with higher irritability-related impairment. IRT analysis underscored frequency of loss of temper as essential to inform about pathological states of irritability. CONCLUSION The Brazilian Portuguese version of the ARI seems to be very similar to the original instrument in terms of conceptual, item, semantic, and operational equivalence. Our preliminary analysis replicates and extends previous evidence confirming promising psychometric properties for the ARI.