Sonia Regina Loureiro

Comparability between telephone and face-to-face Structured Clinical Interview for DSM-IV in assessing social anxiety disorder

PURPOSE This article evaluates the comparability of the telephone and in-person Structured Clinical Interview for DSM-IV (SCID) interviews in assessing patients with social anxiety disorder (SAD) as an independent anxiety diagnosis. DESIGN AND METHODS One hundred subjects were randomly selected and interviewed with the SCID, once by telephone and once in person (1-3 months later). FINDINGS The prevalence of SAD assessed with the telephone interviews was 56%, whereas the in-person prevalence was 52%, with no statistically significant difference. The test-retest kappa for the 200 interviews was .84, indication of excellent agreement. PRACTICE IMPLICATIONS These findings, along with the existing evidence of their validity, should encourage the use of SCID by telephone for SAD diagnostic interviews.

Study of the Discriminative Validity of the PHQ-9 and PHQ-2 in a Sample of Brazilian Women in the Context of Primary Health Care

PURPOSE This study aimed to assess the discriminative validity of the Brazilian version of the Patient Health Questionnaire (PHQ-9) and of its reduced version (PHQ-2). DESIGN AND METHODS The sample consisted of 177 women (60 cases of depression and 117 noncases). The SCID-IV was used as the gold standard. FINDINGS For the PHQ-9, a cutoff score equal to or higher than 10 proved to be the most adequate for the screening of depression, whereas the best cutoff score for the PHQ-2 was found to lie between 3 and 4. PRACTICE IMPLICATIONS The systematic use of these instruments in nursing and in the context of primary health care could favor the early detection of depression.

Reliability and validity of a Portuguese version of the Young Mania Rating Scale

The reliability and validity of a Portuguese version of the Young Mania Rating Scale were evaluated. The original scale was translated into and adapted to Portuguese by the authors. Definitions of clinical manifestations, a semi-structured anchored interview and more explicit rating criteria were added to the scale. Fifty-five adult subjects, aged 18 to 60 years, with a diagnosis of Current Manic Episode according to DSM-III-R criteria were assessed using the Young Mania Rating Scale as well as the Brief Psychiatric Rating Scale in two sessions held at intervals from 7 to 10 days. Good reliability ratings were obtained, with intra-class correlation coefficient of 0.97 for total scores, and levels of agreement above 0.80 (P < 0.001) for all individual items. Internal consistency analysis resulted in an alpha = 0.67 for the scale as a whole, and an alpha = 0.72 for each standardized item (P < 0.001). For the concurrent validity, a correlation of 0.78 was obtained by the Pearson coefficient between the total scores of the Young Mania Rating Scale and Brief Psychiatric Rating Scale. The results are similar to those reported for the English version, indicating that the Portuguese version of the scale constitutes a reliable and valid instrument for the assessment of manic patients.

Is the Full Version of the AUDIT Really Necessary? Study of the Validity and Internal Construct of Its Abbreviated Versions

BACKGROUND This study was aimed at assessing the psychometric qualities of the abbreviated versions of the Alcohol Use Disorders Identification Test (AUDIT-3, AUDIT-4, AUDIT-C, AUDIT-PC, AUDIT-QF, FAST, and Five-Shot) and at comparing them to the 10-item AUDIT and the CAGE in 2 samples of Brazilian adults. METHODS The validity and internal consistency of the scales were assessed in a sample of 530 subjects attended at an emergency department and at a Psychosocial Care Center for Alcohol and Drugs. The Structured Clinical Interview for DSM-IV was used as the diagnostic comparative measure for the predictive validity assessment. The concurrent validity between the scales was analyzed by means of Pearsons correlation coefficient. RESULTS The assessment of the predictive validity of the abbreviated versions showed high sensitivity (of 0.78 to 0.96) and specificity (of 0.74 to 0.94) indices, with areas under the curve as elevated as those of the AUDIT (0.89 and 0.92 to screen for abuse and 0.93 and 0.95 in the screening of dependence). The CAGE presented lower indices: 0.81 for abuse and 0.87 for dependence. The analysis of the internal consistency of the AUDIT and its versions exhibited Cronbachs alpha coefficients between 0.83 and 0.94, while the coefficient for the CAGE was 0.78. Significant correlations were found between the 10-item AUDIT and its versions, ranging from 0.91 to 0.99. Again, the results for the CAGE were satisfactory (0.77), although inferior to the other instruments. CONCLUSIONS The results obtained in this study confirm the validity of the abbreviated versions of the AUDIT for the screening of alcohol use disorders and show that their psychometric properties are as satisfactory as those of the 10-item AUDIT and the CAGE.

Percepção de tamanho e forma corporal de mulheres: estudo exploratório

The objective of the present study was to investigate womens size and shape body perception using the Nine-figure Outline Scale. A total of 150 women were divided into five groups according to body mass index (BMI): non-obese, overweight and grade I, II and III obese women. The options were classified in representations of normal, real and ideal body size and shape. It was evident that the men and womens choice for normal sizes, in the five groups, were predominantly connected to the representation of low body weight. In the self-assessment of the real body size and shape, it was noticed a broad distribution of choices, although with the exception of the pre-obesity group, the majority of women from the other groups made compatible choices with their BMI. The ideal body size and shape was associated with representative figures of low body weight. The data indicate the relevance of the differences between the adequacy of real and ideal perception, pointing at the difficulties related to body self-perception.

A structured interview guide increases Brief Psychiatric Rating Scale reliability in raters with low clinical experience

Objective: To assess the beneficial impact of a structured interview on the reliability of BPRS ratings in raters with low clinical experience.

Social anxiety disorder: what are we losing with the current diagnostic criteria?

Filho AS, Hetem LAB, Ferrari MCF, Trzesniak C, Martín‐Santos R, Borduqui T, de Lima Osório F, Loureiro SR, Busatto Filho G, Zuardi AW, Crippa JAS. Social anxiety disorder: what are we losing with the current diagnostic criteria?

Autoconceito de crianças com dificuldades de aprendizagem e problemas de comportamento

The aim of this study was to assess the self-concept of children with learning disability in comparison with children without learning disability. Fifty- eight school-age children were assessed, including: 32 Learning Disabled children, distinguished by behavior problems, and 26 No Learning Disabled children. The child self-concept was assessed by Piers Harris Self-Concept Scale and the child behavior was assessed by Rutter´s Child Behavior Scale-A2. Children with learning disability showed significantly more negative self-concept than children without it in both total and partial scale scores. No differences was found between learning disabled children distinguished by the presence of behavior problems.

A auto-eficácia e os aspectos comportamentais de crianças com dificuldade de aprendizagem

The aim of the present study was to assess the relationship among school performance, sense of self-efficacy, and behavioral aspects in 52 children of both sexes, aged from eight to 11 years and 11 months. The children were enrolled in the first to fourth grade and their intelligence level was assessed as of lower medium level at least. Subjects were divided in two groups: G1-26 children with learning difficulties referred to a Psychology Ambulatory of a School Hospital, and G2-26 children with good achievement, assessed by an academic performance test. The instruments used were: Self-Efficacy Assessment Form and Rutter Child Behavior Scale, as well as a school achievement test. G1 showed a significantly lower score for self-efficacy sense, compared to G2. A significant difference was also observed in the assessment made by parents, who characterized G1 children as having more behavioral difficulties. Academic performance was found to be related to self-efficacy sense and to indicators of behavioral problems.

Social anxiety disorder women easily recognize fearfull, sad and happy faces: The influence of gender

BACKGROUND It has been suggested that individuals with social anxiety disorder (SAD) are exaggeratedly concerned about approval and disapproval by others. Therefore, we assessed the recognition of facial expressions by individuals with SAD, in an attempt to overcome the limitations of previous studies. METHODS The sample was formed by 231 individuals (78 SAD patients and 153 healthy controls). All individuals were treatment naïve, aged 18-30 years and with similar socioeconomic level. Participants judged which emotion (happiness, sadness, disgust, anger, fear, and surprise) was presented in the facial expression of stimuli displayed on a computer screen. The stimuli were manipulated in order to depict different emotional intensities, with the initial image being a neutral face (0%) and, as the individual moved on across images, the expressions increased their emotional intensity until reaching the total emotion (100%). The time, accuracy, and intensity necessary to perform judgments were evaluated. RESULTS The groups did not show statistically significant differences in respect to the number of correct judgments or to the time necessary to respond. However, women with SAD required less emotional intensity to recognize faces displaying fear (p=0.002), sadness (p=0.033) and happiness (p=0.002), with no significant differences for the other emotions or men with SAD. CONCLUSIONS The findings suggest that women with SAD are hypersensitive to threat-related and approval-related social cues. Future studies investigating the neural basis of the impaired processing of facial emotion in SAD using functional neuroimaging would be desirable and opportune.