Edwiges Ferreira de Mattos Silvares

International Epidemiology of Child and Adolescent Psychopathology II: Integration and Applications of Dimensional Findings From 44 Societies

OBJECTIVE To build on Achenbach, Rescorla, and Ivanova (2012) by (a) reporting new international findings for parent, teacher, and self-ratings on the Child Behavior Checklist, Youth Self-Report, and Teachers Report Form; (b) testing the fit of syndrome models to new data from 17 societies, including previously underrepresented regions; (c) testing effects of society, gender, and age in 44 societies by integrating new and previous data; (d) testing cross-society correlations between mean item ratings; (e) describing the construction of multisociety norms; (f) illustrating clinical applications. METHOD Confirmatory factor analyses (CFAs) of parent, teacher, and self-ratings, performed separately for each society; tests of societal, gender, and age effects on dimensional syndrome scales, DSM-oriented scales, Internalizing, Externalizing, and Total Problems scales; tests of agreement between low, medium, and high ratings of problem items across societies. RESULTS CFAs supported the tested syndrome models in all societies according to the primary fit index (Root Mean Square Error of Approximation [RMSEA]), but less consistently according to other indices; effect sizes were small-to-medium for societal differences in scale scores, but very small for gender, age, and interactions with society; items received similarly low, medium, or high ratings in different societies; problem scores from 44 societies fit three sets of multisociety norms. CONCLUSIONS Statistically derived syndrome models fit parent, teacher, and self-ratings when tested individually in all 44 societies according to RMSEAs (but less consistently according to other indices). Small to medium differences in scale scores among societies supported the use of low-, medium-, and high-scoring norms in clinical assessment of individual children.

Child Behavior Checklist (CBCL),Youth Self-Report (YSR) and Teacher's Report Form(TRF): an overview of the development of the original and Brazilian versions

O Sistema de Avaliacao de Base Empirica de Achenbach para criancas/adolescentes em idade escolar inclui tres instrumentos para avaliar problemas emocionais e/ou comportamentais: Child Behavior Checklist (CBCL) [pais], Youth Self-Report (YSR) [adolescentes] e Teachers Report Form (TRF) [professores]. Este artigo de revisao fornece informacoes detalhadas sobre o desenvolvimento desses instrumentos nos Estados Unidos e no Brasil, descrevendo as principais alteracoes em itens, escalas e pontos de corte na pontuacao, ocorridas nas versoes originais de 1991 a 2001, e o processo de traducao, retrotraducao e adaptacao cultural dos questionarios originais para desenvolver as atuais versoes brasileiras oficiais do CBCL, YSR e TRF. A utilidade desses instrumentos em pesquisa e na pratica clinica e salientada, mencionando estudos epidemiologicos e de avaliacao de intervencoes conduzidos no Brasil. Pesquisadores e clinicos sao instruidos a respeito do uso correto das atuais versoes brasileiras oficiais, dando exemplos de perguntas frequentes, relevantes para o contexto brasileiro.

A construção da identidade em adolescentes: um estudo exploratório

Adolescents identity construction: an exploratory study. According to Eriksons psychosocial theory, the most important task during adolescence is identity construction. Based on this assertion, this study, undertaken with 25 high school students (15 to 17 years old), compared the Groningen Identity Development Scale (GIDS), a identity evolution scale, with the Youth Self-Report (YSR), a screening mental problems checklist. Most of the teenagers were on two initial identity phases: diffusion and foreclosure. A significant relationship between low commitment and behavior problems was also found.According to Eriksons psychosocial theory, the most important task during adolescence is identity construction. Based on this assertion, this study, undertaken with 25 high school students (15 to 17 years old), compared the Groningen Identity Development Scale (GIDS), a identity evolution scale, with the Youth Self-Report (YSR), a screening mental problems checklist. Most of the teenagers were on two initial identity phases: diffusion and foreclosure. A significant relationship between low commitment and behavior problems was also found.

Perfil e principais queixas dos clientes encaminhados ao Centro de Atendimento e Apoio Psicológico ao Adolescente (CAAA) - UNIFESP/EPM

This study draws the social demographic profile of the adolescent referred to the service of Psychology of the Center of Assistance and Support to Adolescents (CAAA) of the Pediatrics Department of Unifesp/EPM with a population, consisting of 13 to 15 year old individuals, equally distributed by sex, attending elementary school with academic failure. The study shows the most common adolescents complains (learning problems) and the most frequent referrals (medical doctor). Based on this assessment the authors discuss several adolescent problems such as health, personal development, family and social environment with special focus on school progress and family relationship.

Behavioural/emotional problems in Brazilian children: findings from parents' reports on the Child Behavior Checklist

Background. To compare Child Behavior Checklist (CBCL) findings for a large Brazilian general population sample with those for US children considering: (a) mean problem item ratings; (b) fit of the US-derived CBCL 8-syndrome model; (c) scale internal consistency measured by Cronbachs alphas; (d) effects of society, age, gender on CBCL problem scores; and (e) ability to discriminate referred from non-referred children. Methods. Parents of 1228 non-referred 6-to-11-year-olds from three different regions of Brazil and 247 referred 6-to-11-year-olds from one clinic rated their childrens behavioural and emotional problems using the CBCL/6-18. Results. Results for mean item ratings and scale internal consistencies were very similar to those found in the US and in Uruguay. Confirmatory factor analysis indicated that Brazilian data showed the best fit to the US 8-syndrome model of all countries studied to date. Gender patterns were comparable to those reported in other societies, but mean problem scores for non-referred Brazilian children were higher than those for US children. Therefore, the CBCL discriminated less well between non-referred and referred children in Brazil than in the US. Conclusions. Overall, our findings replicated those reported in international comparisons of CBCL scores for 31 societies, thereby providing support for the multicultural robustness of the CBCL in Brazil.

O julgamento de pares de crianças com dificuldades interativas após um modelo ampliado de intervenção

The literature on social competence has demonstrated that rejection by peers during childhood is a factor of influence in the development of antisocial behaviors. The present study aimed to measure the effectiveness of an extended clinical intervention model, involving parents, teachers and peers of children with interaction difficulties. The intervention was developed at a public

Crianças Enuréticas e Crianças Encaminhadas para Clínicas-Escola: Um Estudo Comparativo da Percepção de seus Pais

The Child Behavior Checklist (CBCL) was completed by the parents of 66 children age six to ten years old with nocturnal primary enuresis (i.e., children who wet the bed only at night and have never attained nocturnal urinary control), under treatment at the Enuresis Project of the Institute of Psychology of the Universidade de Sao Paulo, and by the parents of 235 children referred for psychological counseling services at five Brazilian mental health centers for a comparison of their perceptions regarding to their childrens behavior profile. In most cases, enuretical children have obtained better results than the referred children regarding social competence as a whole and to academic, social contact and attention problems. These results seem to show that distinct psychological counseling strategies should be adopted for the two populations, focused on the primary enuresis problem in the first group and on the social and academic problems in the second group.

Syndromes of Self-Reported Psychopathology for Ages 18–59 in 29 Societies

This study tested the multi-society generalizability of an eight-syndrome assessment model derived from factor analyses of American adults’ self-ratings of 120 behavioral, emotional, and social problems. The Adult Self-Report (ASR; Achenbach and Rescorla 2003) was completed by 17,152 18–59-year-olds in 29 societies. Confirmatory factor analyses tested the fit of self-ratings in each sample to the eight-syndrome model. The primary model fit index (Root Mean Square Error of Approximation) showed good model fit for all samples, while secondary indices showed acceptable to good fit. Only 5 (0.06%) of the 8,598 estimated parameters were outside the admissible parameter space. Confidence intervals indicated that sampling fluctuations could account for the deviant parameters. Results thus supported the tested model in societies differing widely in social, political, and economic systems, languages, ethnicities, religions, and geographical regions. Although other items, societies, and analytic methods might yield different results, the findings indicate that adults in very diverse societies were willing and able to rate themselves on the same standardized set of 120 problem items. Moreover, their self-ratings fit an eight-syndrome model previously derived from self-ratings by American adults. The support for the statistically derived syndrome model is consistent with previous findings for parent, teacher, and self-ratings of 1½–18-year-olds in many societies. The ASR and its parallel collateral-report instrument, the Adult Behavior Checklist (ABCL), may offer mental health professionals practical tools for the multi-informant assessment of clinical constructs of adult psychopathology that appear to be meaningful across diverse societies.

Caracterização do atendimento psicológico prestado por um serviço de psicologia a crianças com dificuldades escolares

O objetivo deste estudo e caracterizar o atendimento psicologico fornecido a criancas que apresentaram queixas quanto a dificuldades escolares, encaminhadas ao Servico de Psicologia de um Hospital-Escola do interior de Sao Paulo. Foram os sujeitos deste estudo 25 criancas (n= 15-sexo masculino; n= 10-sexo feminino) com idade variavel entre 7 e 12 anos (IM=9, 12 anos; DP= 1,69).Os dados de identificacao da crianca e dos seus pais, a origem do encaminhamento, a queixa, o diagnostico e a recomendacao de tratamento foram extraidos dos prontuarios das criancas encaminhadas de 1996 a 1997. Os resultados encontrados demonstraram que a maior parte da amostra foi encaminhada por profissionais da saude (n=14). A queixa mais frequente foi aquela relativa aos disturbios especificos de desenvolvimento e as habilidades escolares (n=22); seguida por disturbios de comportamento explicito (n=19). O diagnostico mais frequente foi retardo mental (n=9), seguido por disturbio de aprendizagem (n=6). A recomendacao de tratamento mais frequente foi a orientacao dos pais (n=21). Tambem encontrou-se uma correlacao entre tipo de queixa e recomendacao de tratamento. Compreendeu-se a existencia de um consenso quanto a recomendacao de orientacao dos pais e de um atendimento multiprofissional como conduta terapeutica para essas criancas; mas sugeriu-se a necessidade de pesquisas para avaliar os resultados dessa forma de atuacao.

Programas preventivos de comportamentos anti-sociais: dificuldades na pesquisa e na implementação

Os programas preventivos de comportamentos anti-sociais em criancas e adolescentes sao predominantemente marcados por dificuldades de duas ordens: a primeira e metodologica e dificuldades refere-seas a demonstracao empirica de sua efetividade; enquanto que a segunda e pratica e diz respeito aos obstaculos que o psicologo costuma encontrar ao implementa-los em clinicas psicologicas publicas. Neste trabalho, sugerem-se alguns fatores de risco e de protecao sabidamente correlacionados ao desenvolvimento de comportamentos anti-sociais. Tais fatores podem nortear medidas proximais de suo efeito de programas preventivos daqueles comportamentos ao se delinear metodologia de pesquisa sobre o assunto. No que se refere a implementacao de programas preventivos em clinicas-escola, levantam-se algumas alternativas para contornar obstaculos mais frequentes. A oferta de servicos em locais mais acessiveis a populacao e o fornecimento de informacoes por meio de eventos de curta duracao promovidos nas clinicas-escola sao exemplos de alternativas.