Helena Espirito-Santo
I am a neurosciences and neuropsychology teacher/investigator at Miguel Torga Higher Institute of Coimbra (ISMT).
I am the coordinator of the Department of Research and Development and a consultant of the Psychological Support Department at ISMT.
At the present I am also coordinating the Development and Mental Health Research Line at ISMT.
One of mine interests is trauma and dissociation, and I have investigated these phenomena in both clinical and non-clinical subjects. My current focus is to determine what precisely is the dissociative process and which are the best ways to study it.
Another of my interests is the study of the neuropsychological profiles of different mental illnesses. Currently I am studying the neuropsychological differences of mood disorders, particularly of depressive episodes.
I am also conducting an investigation project on aging. At Miguel Torga Higher Institute we are developing studies on the cognitive and emotional state of elderly in the district of Coimbra. We performed neuropsychological and emotional evaluations of institutionalized elderly and elderly of the community, in order to implement rehabilitation programs. During the course of these studies, we are developing a program of group cognitive rehabilitation that, in its experimental phase, has shown promising results.
Phone: (+351) 239 488 030
Address: Largo da Cruz de Celas, 1
3000-132 Coimbra
Portugal
I am the coordinator of the Department of Research and Development and a consultant of the Psychological Support Department at ISMT.
At the present I am also coordinating the Development and Mental Health Research Line at ISMT.
One of mine interests is trauma and dissociation, and I have investigated these phenomena in both clinical and non-clinical subjects. My current focus is to determine what precisely is the dissociative process and which are the best ways to study it.
Another of my interests is the study of the neuropsychological profiles of different mental illnesses. Currently I am studying the neuropsychological differences of mood disorders, particularly of depressive episodes.
I am also conducting an investigation project on aging. At Miguel Torga Higher Institute we are developing studies on the cognitive and emotional state of elderly in the district of Coimbra. We performed neuropsychological and emotional evaluations of institutionalized elderly and elderly of the community, in order to implement rehabilitation programs. During the course of these studies, we are developing a program of group cognitive rehabilitation that, in its experimental phase, has shown promising results.
Phone: (+351) 239 488 030
Address: Largo da Cruz de Celas, 1
3000-132 Coimbra
Portugal
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Books by Helena Espirito-Santo
Este livro inclui um manual para o terapeuta, um caderno de registos para o terapeuta e um caderno com os materiais para os sujeitos.
O programa é para ser implementado ao longo de 10 sessões de periodicidade semanal. Cada sessão inicia-se com um exercício de Reminiscência e termina com um exercício de memória e linguagem expressiva Orientado para a Realidade. As sessões incluem exercícios de atenção, linguagem, memória, gnosias, praxia e funcionamento executivo.
Using the latest research, this book covers the main issues arising from changes in brain function and provides suggestions for neuropsychological assessment of these problems.
CONTENTS:
INTRODUCTION: rationale and methods in Neuropsychology
ASSESSMENT of HIGHER PSYCHOLOGICAL FUNCTIONS: Neuropsychological testing, and batteries
LEADING CAUSES of NEUROLOGICAL DISEASE: Traumatic brain injuries, intracranial tumors, cerebrovascular diseases, dementia, epilepsy, and demyelinating diseases.
HIGHER BRAIN FUNCTION DISORDERS: Disturbances in verbal and written language, movement disorders, memory disorders, disorders of gnosis, and executive dysfunction.
NEUROPSYCHIATRIC DISORDERS: Schizophrenia, Tourette's syndrome, obsessive-compulsive disorder, unipolar depression, bipolar Disorders; post-traumatic stress disorder, and panic disorder.
Methods: We evaluated 74 elderly subjects between 65 and 95 years (M = 80.64 ± 6.61) with the Frontal Assessment Battery (executive functions), the Geriatric Anxiety Inventory (anxiety symptoms) and the Mini-Mental State Examination (cognitive impairment).
Results: Most of the subjects was very old (51.4% > 81 years), female (73%), unmarried (78.4%), and illiterate/low education (83.8%). The prevalence was high for the executive deficit (81.1%), and the anxiety symptoms (82.4%), but not for the cognitive impairment (39.2%). Executive deficit was related with cognitive impairment (χ2 = 4.49, p <0.05), educational level (χ2 = 6.42, p <0.05) and sex (χ2 = 4.62, p <0.05) but not with anxiety symptoms (χ2 = 1.56, p = 0.212), age (χ2 = 1.69, p = 0.194) or marital status (χ2 = 0.49, p = 0.483). Among elderlies with executive deficit, 36.5% had cognitive impairment, 41.9% were illiterate or had low education, and 63.5% were women. Finally, after controlling for the independent contribution of gender, we found that educational level (β = 2.07, p <0.05) and cognitive impairment (β = -1.94, p < 0.05) contributed significantly to the variance of the executive deficit.
Conclusion: changes in executive functioning are expected in elderly people with low educational and cognitive decline. The cognitive rehabilitation is mandatory, but it is important to replicate the study with non-institutionalized elderly.
We measured dissociation through Portuguese versions of the Dissociative Experience Scale (DES) and Somatoform Dissociation Questionnaire (SDQ-20); the clinical evaluation and sub-scales of the BSI indicated mental health.
Pathological dissociation was significantly more frequent in dissociative and conversion disorder than in somatization disorder and controls. There were no significant differences
between dissociative and conversion patients. Conversion disorder is closely related to dissociative disorders. These results support the ICD-10 categorization of conversion disorder among dissociative disorders and the hypothesis of analogous
psychopathological processes in conversion and dissociative disorders versus somatization disorder.
Na segunda parte do nosso trabalho tentaremos mostrar a transição a que temos vindo a fazer referência através da investigação prática. Procuraremos demonstrar as nossas hipóteses de que:
— no distúrbio de personalidade (D.P.) a maneira como se vêem é
diferente da maneira como os outros os vêem.
— no D.P. o modo como pensam que os outros o vêem tem semelhanças
com a maneira como os vêem realmente.
— nas pessoas sem D.P. a maneira como se vêem é semelhante à maneira
como os outros os vêem.
— nas pessoas sem D.P. o modo como pensam que os outros o vêem é
diferente da maneira como os vêem realmente.
Conference presentations by Helena Espirito-Santo
Cognitive rehabilitation techniques, reminiscence therapy, and reality orientation therapy, have shown an impact on cognition, life satisfaction, mood, and on the progression of cognitive decline in elderly.
Objectives
To test the effectiveness of a NRGP on the cognitive and emotional functioning of institutionalized elderly.
Design
Single blind randomized controlled study with paired groups.
Participants
Coimbra institutionalized elderly, aged between 64-92 (N = 88) with cognitive impairment no dementia, mostly women (75.0%).
Intervention
randomization of participants to the rehabilitation group/RG (n = 41) and to the comparison/waiting-list group/CG (n = 23). NRGP involved groups of five elders, and took 90 min. per day, once a week, for 10 weeks.
Measurements
Mini-Mental State Examination/MMSE, Frontal Evaluation Battery/FAB, Geriatric Depression Scale/GDS.
Analysis
We used general linear model with repeated measures analysis of variance.
Results
RG improved significantly on cognitive, and executive function (p < 0.001), and CG worsened on cognitive, executive function, and mood (p < 0.01). There was a significant effect on the MMSE, FAB, and GDS scores, after excluding pre-rehabilitation scores as covariates [F (1, 81) = 43.98, p < 0.001; η2 = 0.35; F(1, 80) = 28.37, p < 0.001; η2 = 0.26; F(1, 79) = 19.66, p < 0.001; η2 = 0.20].
Conclusions
A NRGP including cognitive rehabilitation, reminiscence therapy, and reality orientation proved to be effective on cognitive and executive functioning, and on depressive symptoms of institutionalized elders with cognitive impairment no dementia.
This study sought to examine the severity of dissociative and traumatic experiences, as well as relationships between types of crime, types of trauma, and dissociation.
Twenty-nine inmates (mean age = 37.8 ± 10.0) were examined using the Dissociative Experiences Scale (DES) and the Traumatic Experiences Checklist (TEC), 12 committed property crimes and 17 crimes against people. A crime severity index (CSI) included sentence length, plus number of crimes, number of sentences, multiplied by type of crime (property crimes = 1; crimes against the person = 2). Two groups were created based on CSI mean plus one standard deviation (25.95 + 16.61): “severe crime” (17.2%), and “moderated serious crime” (82.8%).
In total sample, the intensity of traumatic (7.36 ± 3.74) and dissociative (16.70 ± 14.6) experiences were high comparing with a study with a general sample (p < 0.05). Types of crimes were not associated with trauma or dissociation. Physical abuse and trauma with body threat were significantly linked to high levels of dissociation.
In conclusion, traumatic and dissociative experiences are severe in inmate population. Dissociative experiences in inmates are specially linked to trauma with physical abuse and with body threat. Type of crime is not associated with trauma or dissociation."
chairperson Anita A. Riecher-Rössler - Switzerland
chairperson Anita A. Riecher-Rössler - Switzerland
Este livro inclui um manual para o terapeuta, um caderno de registos para o terapeuta e um caderno com os materiais para os sujeitos.
O programa é para ser implementado ao longo de 10 sessões de periodicidade semanal. Cada sessão inicia-se com um exercício de Reminiscência e termina com um exercício de memória e linguagem expressiva Orientado para a Realidade. As sessões incluem exercícios de atenção, linguagem, memória, gnosias, praxia e funcionamento executivo.
Using the latest research, this book covers the main issues arising from changes in brain function and provides suggestions for neuropsychological assessment of these problems.
CONTENTS:
INTRODUCTION: rationale and methods in Neuropsychology
ASSESSMENT of HIGHER PSYCHOLOGICAL FUNCTIONS: Neuropsychological testing, and batteries
LEADING CAUSES of NEUROLOGICAL DISEASE: Traumatic brain injuries, intracranial tumors, cerebrovascular diseases, dementia, epilepsy, and demyelinating diseases.
HIGHER BRAIN FUNCTION DISORDERS: Disturbances in verbal and written language, movement disorders, memory disorders, disorders of gnosis, and executive dysfunction.
NEUROPSYCHIATRIC DISORDERS: Schizophrenia, Tourette's syndrome, obsessive-compulsive disorder, unipolar depression, bipolar Disorders; post-traumatic stress disorder, and panic disorder.
Methods: We evaluated 74 elderly subjects between 65 and 95 years (M = 80.64 ± 6.61) with the Frontal Assessment Battery (executive functions), the Geriatric Anxiety Inventory (anxiety symptoms) and the Mini-Mental State Examination (cognitive impairment).
Results: Most of the subjects was very old (51.4% > 81 years), female (73%), unmarried (78.4%), and illiterate/low education (83.8%). The prevalence was high for the executive deficit (81.1%), and the anxiety symptoms (82.4%), but not for the cognitive impairment (39.2%). Executive deficit was related with cognitive impairment (χ2 = 4.49, p <0.05), educational level (χ2 = 6.42, p <0.05) and sex (χ2 = 4.62, p <0.05) but not with anxiety symptoms (χ2 = 1.56, p = 0.212), age (χ2 = 1.69, p = 0.194) or marital status (χ2 = 0.49, p = 0.483). Among elderlies with executive deficit, 36.5% had cognitive impairment, 41.9% were illiterate or had low education, and 63.5% were women. Finally, after controlling for the independent contribution of gender, we found that educational level (β = 2.07, p <0.05) and cognitive impairment (β = -1.94, p < 0.05) contributed significantly to the variance of the executive deficit.
Conclusion: changes in executive functioning are expected in elderly people with low educational and cognitive decline. The cognitive rehabilitation is mandatory, but it is important to replicate the study with non-institutionalized elderly.
We measured dissociation through Portuguese versions of the Dissociative Experience Scale (DES) and Somatoform Dissociation Questionnaire (SDQ-20); the clinical evaluation and sub-scales of the BSI indicated mental health.
Pathological dissociation was significantly more frequent in dissociative and conversion disorder than in somatization disorder and controls. There were no significant differences
between dissociative and conversion patients. Conversion disorder is closely related to dissociative disorders. These results support the ICD-10 categorization of conversion disorder among dissociative disorders and the hypothesis of analogous
psychopathological processes in conversion and dissociative disorders versus somatization disorder.
Na segunda parte do nosso trabalho tentaremos mostrar a transição a que temos vindo a fazer referência através da investigação prática. Procuraremos demonstrar as nossas hipóteses de que:
— no distúrbio de personalidade (D.P.) a maneira como se vêem é
diferente da maneira como os outros os vêem.
— no D.P. o modo como pensam que os outros o vêem tem semelhanças
com a maneira como os vêem realmente.
— nas pessoas sem D.P. a maneira como se vêem é semelhante à maneira
como os outros os vêem.
— nas pessoas sem D.P. o modo como pensam que os outros o vêem é
diferente da maneira como os vêem realmente.
Cognitive rehabilitation techniques, reminiscence therapy, and reality orientation therapy, have shown an impact on cognition, life satisfaction, mood, and on the progression of cognitive decline in elderly.
Objectives
To test the effectiveness of a NRGP on the cognitive and emotional functioning of institutionalized elderly.
Design
Single blind randomized controlled study with paired groups.
Participants
Coimbra institutionalized elderly, aged between 64-92 (N = 88) with cognitive impairment no dementia, mostly women (75.0%).
Intervention
randomization of participants to the rehabilitation group/RG (n = 41) and to the comparison/waiting-list group/CG (n = 23). NRGP involved groups of five elders, and took 90 min. per day, once a week, for 10 weeks.
Measurements
Mini-Mental State Examination/MMSE, Frontal Evaluation Battery/FAB, Geriatric Depression Scale/GDS.
Analysis
We used general linear model with repeated measures analysis of variance.
Results
RG improved significantly on cognitive, and executive function (p < 0.001), and CG worsened on cognitive, executive function, and mood (p < 0.01). There was a significant effect on the MMSE, FAB, and GDS scores, after excluding pre-rehabilitation scores as covariates [F (1, 81) = 43.98, p < 0.001; η2 = 0.35; F(1, 80) = 28.37, p < 0.001; η2 = 0.26; F(1, 79) = 19.66, p < 0.001; η2 = 0.20].
Conclusions
A NRGP including cognitive rehabilitation, reminiscence therapy, and reality orientation proved to be effective on cognitive and executive functioning, and on depressive symptoms of institutionalized elders with cognitive impairment no dementia.
This study sought to examine the severity of dissociative and traumatic experiences, as well as relationships between types of crime, types of trauma, and dissociation.
Twenty-nine inmates (mean age = 37.8 ± 10.0) were examined using the Dissociative Experiences Scale (DES) and the Traumatic Experiences Checklist (TEC), 12 committed property crimes and 17 crimes against people. A crime severity index (CSI) included sentence length, plus number of crimes, number of sentences, multiplied by type of crime (property crimes = 1; crimes against the person = 2). Two groups were created based on CSI mean plus one standard deviation (25.95 + 16.61): “severe crime” (17.2%), and “moderated serious crime” (82.8%).
In total sample, the intensity of traumatic (7.36 ± 3.74) and dissociative (16.70 ± 14.6) experiences were high comparing with a study with a general sample (p < 0.05). Types of crimes were not associated with trauma or dissociation. Physical abuse and trauma with body threat were significantly linked to high levels of dissociation.
In conclusion, traumatic and dissociative experiences are severe in inmate population. Dissociative experiences in inmates are specially linked to trauma with physical abuse and with body threat. Type of crime is not associated with trauma or dissociation."
chairperson Anita A. Riecher-Rössler - Switzerland
chairperson Anita A. Riecher-Rössler - Switzerland
Emotion dysregulation has been consistently linked to psychopathology, and the relationship between disability and depressive symptomatology in old age is well-known.
Objective
To examine the mediational role of emotional dysregulation in the relationship between perceived disability and depressive symptomatology in older adults.
Methods
Two hundred eighty-three participants, aged 60–96 years (M ± SD = 74.22 ± 8.69; 62.9% women; 29.0% with long-term care support [LTC-S] and 71.0% community residents without LTC-S), were assessed with the Geriatric Depression Scale-8 (GDS-8), the World Health Organization Disability Assessment Schedule-2 (WHODAS-2), and the Difficulties in Emotion Regulation Scale-16 (DERS-16).
Results
A mediation model was established, which revealed: (1) a moderate association between WHODAS-2 and GDS-8 (β = 0.20; p < .001); (2) DERS-16 partially and weakly mediated the relationship between WHODAS-2 and GDS-8 (β = 0.003; p < .01). The model explained 31.9% of the variance of depressive symptoms. An inconsistent mediation model was obtained in the LTC-S group.
Conclusions
Globally, our findings indicate that disability has an indirect relationship with depressive symptomatology through emotional dysregulation (except for those in the LTC-S). Accordingly, we present suggestions for the treatment of depressive symptoms and for the inclusion of other emotion regulation variables in the study of the disability-depressive symptom link in future studies with older people in the LTC-S.
Foram objetivos investigar a influência de um Programa de Reabilitação Neuropsicológico Grupal/PRNG no funcionamento cognitivo (Mini Mental State Examination/MMSE), executivo (Frontal Assessment Battery/FAB), e emocional (Geriatric Depression Scale e UCLA Loneliness Scale) em idosos institucionalizados com DCSD.
Não existiam, inicialmente, diferenças estatisticamente significativas entre os grupos alvo e de comparação (p < 0,05).
Destacaram-se evoluções mais significativas nas pontuações da FAB e da UCLA no grupo alvo, com tamanhos do efeito entre o médio (d = 0,59) e o grande (d = 1,88). Em sentido inverso, no grupo de comparação salientaram-se a pioria significativa no MMSE e GDS, com tamanhos do efeito entre o trivial e o pequeno. As pontuações do MMSE foram significativamente influenciadas pelo PRNG depois de contabilizar o efeito da pontuação do MMSE (pré-reabilitação) como covariável (F(1, 21) = 7,49; p < 0,05; ƞ2 = 0,26). O Programa de Reabilitação Neuropsicológico Grupal aplicado em idosos institucionalizados com Declínio Cognitivo sem Demência promove uma melhoria no funcionamento cognitivo, executivo e nos sentimentos de solidão.
This paper reviews the basic tastes and their potential implications for eating behavior. The various tastes (sweet, salty, bitter, sour, umami, watery, fat) are the first line of detection of essential nutrients to life, but are also determinants of acceptance or rejection of foods. With the processing of food permitted by the use of fire in Neolithic, the hominid diet changed and the taste became stimulated in a way not foreseen by evolution. Genetically, some humans are more susceptible to certain tastes (supertasters) and can therefore avoid richer foods (usually bitter). In terms of learning, agreeable flavors (sweet, salty, fat, and umami) are natural reinforcements and are, therefore, potentially addictive. The combination of these aspects may explain many eating disorders. Now, it is important to understand how the physical environment of gustatory stimuli (temperature, viscosity, tonicity, lubrication, texture, and graininess) and astringent, menthol and capsaicin tastes, just to name a few, contribute to the acceptance or rejection of food.
Verificámos que depressão é um problema sério entre idosos institucionalizados. Mostrámos também que o sexo feminino, a ansiedade e a afetividade negativa são correlatos da depressão em idosos institucionalizados. Finalmente, constatámos que ansiedade e a afetividade negativa são fatores preditivos da depressão.
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This study aimed to determine whether anxiety is predictive of depression, independently of demographic and clinical characteristics.
We noticed that depression is a serious problem among institutionalized elderly. We have shown that female sex, anxiety and negative affectivity are correlates of depression in institutionalized elderly. Finally, we found that anxiety and negative affectivity are predictors of depression.
Metodologia: 556 idosos (M= 80.2, SD=5.23; variação=60-100) preencheram o FAB, ROCF, MoCA e um questionário sociodemográfico.
Resultados: Uma maior proporção de idosos com DC apresentou défice executivo leve a moderado (FAB), défice práxico leve a moderado e défice mnésico visual a curto prazo leve (ROCF).
Discussão: O DC associa-se a resultados inferiores numa prova que avalia as funções executivas (FAB). Recorrendo a uma prova que de forma menos óbvia avalia estas funções (ROCF), dado avaliar a capacidade visuo-construtiva e práxica e a memória imediata, o DC também se associa a resultados inferiores nas suas sub-provas.
Metodologia: Foram inquiridos 256 idosos. As FV foram avaliadas pelos testes de FV e as FE foram avaliadas pelo FAB.
Resultados: Os valores médios nas fluências fonémicas totais foram de 4,13 (DP = 2,81) e na semântica de 7,64 (DP= 3,47). As FV e a componente alternância, foram significativamente diferentes nos grupos definidos pela escolaridade e pela profissão. As fluências e a alternância correlacionam-se de forma significativa com o funcionamento FE.
Discussão: Sendo a avaliação do funcionamento executivo importante para o diagnóstico precoce de deteorização frontal, saber quais as variáveis que se lhe associam é importante
para a reabilitação cognitiva.
Metodologia: 721 idosos [620 institucionalizados/idade
M=80.41; DP=7.14) e 101 não institucionalizados/idade M=73.46; DP=8.95] responderam a questões sociodemográficas, ao MMSE e ao MoCA.
Resultados: O sexo, a idade, escolaridade e estado civil associam-se à institucionalização. Idosos mais velhos, sem escolaridade e sem companheiro são mais propensos a desenvolver declínio. Controladas as variáveis sociodemográficas, a institucionalização continua a determinar declínio.
Conclusão: Certas variáveis sociodemográficas determinam o desenvolver de declínio e contribuem para a institucionalização. Mas o facto do idoso se encontrar institucionalizado parece pesar no desenvolver/agravar do declínio.
Objectives: We want to describe the evolution of depression over two years and analyze which factors predict depression evolution.
Methods: In the institutionalized-based Aging Trajectories Study of the Instituto Superior Miguel Torga at Coimbra, we followed up a sample of 83 non-demented persons, 50-100 years old at baseline (M ± SD age = 79.51 ± 6.58; men: 17; women: 66). We only had access to the medication information of 31.1% of the elders, and of these, all were taking some kind of medication, including antidepressants (3.6%). A 2-year prospective cohort analysis took place in 2010-2011, and in 2013. We assessed depression using the Geriatric Depressive Scale/GDS as screening tool and the Mini International Neuropsychiatric Interview (Is a structured interview used to confirm the diagnosis of psychopathology) to diagnose depression. Other measures included the UCLA Loneliness Scale, the Geriatric Anxiety Inventory/GAI, and the Positive And Negative Affect Scale/PANAS. We included sociodemographics, and health (sleep, cardiovascular issues, medication) as control variables. We performed a multinomial logistic regression to identify the factors influencing depression evolution.
Results: Fifty participants had depression at baseline. Nine participants developed depression, 49 maintained major or non-major depression, nine remitted from major or non-major depression, and 16 maintained without depression.
Having depression was associated with worse scores in UCLA, GAI, and PANAS. Not having depression was correlated with higher positive affects.
Adolescent Dissociative Experiences Scale/A-DES was widely studied around the world, allowing to understand the prevalence of dissociation in many countries (3,6-14), however, this study is yet to be done in Portuguese adolescents .
OBJECTIVES
We intend to analyze the psychometric properties of the A-DES 11-item response format; compare between normal/NA with psychological disturbed adolescents/PDA, across age (12 to 18 years), sex, education level, and with the results obtained in other countries; and determine the variables that correlate with A-DES.
METHOD
A sample of NA (n = 69) and PDA (n = 45) aged between 11 to 18 years, 55.3% boys and 44.7% girls, education mean years 8.96 (SD = 2.74), completed the A-DES and the Youth Self Report/YSR. Eight PDA had been institutionalized between 12-14 mo. The internal reliability and construct validity, frequency, and differences by groups were examined.
RESULTS
The A-DES had a very good internal consistency (α = 0.94), and confirmatory factor analysis suggested a 1-factor structure explaining 38.8% of the variance (KMO = 0.87).
A-DES presented significant large correlations with YSR Total (r = 0.67), and with Internalizing and Externalizing, anti-social, attention, isolation, anxiety-depression, somatic, and thought problem scales (r = 0.59 to 0.42).
The mean scores (2.78 ± 1.82; range = 0.00 to 8.80) were equivalent to those obtained by the American, English, Japanese, and Turkish adolescents.
The A-DES significantly discriminated (t = 6.02; p < 0.001; Cohen’s d = 1.12) between the nonclinical (M = 2.06 ± 1.41) and psychological disturbed adolescents (M = 3.89 ± 1.84), being specially high among those who externalize more (M = 5.06 ± 1.80), and those who have more thought problems (M = 7.18 ± 1.91). Twénty-four youngsters (21.1%) had mean scores above cut-off 4.00.
There were differences between the sexes in the non-clinical sample (t = 2.66; p < 0.01; Cohen’s d = 0.54), but not in the psychological disturbed one.
The younger, with less education, and institutionalized significantly (p < 0.05) had more dissociative experiences (r = 0.21 to 0.30).
Hierarchical multiple regression including age, education, and YSR, reveals that only YSR was statistically significant in predicting levels of A-DES (Beta = 0.64; p < 0.001).
CONCLUSIONS
The Portuguese A-DES version seems a valid and reliable screening for dissociation amongst adolescents. It would be important to test the A-DES in clinical identified adolescents.
Participantes e instrumentos: 99 idosos (média de idades, M=78,65 anos; DP= 6,92) sob resposta social em instituições do Conselho de Coimbra aceitaram participar voluntariamente tendo sido avaliados por uma série de instrumentos incluindo questões sociodemográficas, testes neuropsicológicos, um questionário de sono composto por um índice de qualidade de sono (adaptado de um índice usado em estudantes universitários) e questões que avaliam correlatos de sono tais como a higiene do sono, prática de exercício físico, entre outros.
Índice de qualidade de sono: O índice original foi desenvolvido para estudantes universitários. Adaptámos os itens para a população idosa (ex. alterámos “a altura das durante as aulas acorda quantas vezes por noite?”). É composto por sete itens que avaliam os seguintes aspectos da qualidade do sono: Latência do sono, dificuldade em adormecer, número de vezes que acorda durante a noite, acordar espontaneamente demasiado cedo, perceção subjectiva de que acordar demasiado cedo é um problema, dois itens que avaliam a qualidade geral subjectiva do sono e a profundidade do sono, a qualidade do sono e a profundidade do sono.
Análise estatística: A medida de adequação da amostragem Kaiser-Meyer-Olkin (deveria ser ≥ 0,6 e foi de 0,830), o valor do teste de Bartlett de esfericidade (deveria ser ≤ 0,05; foi de ≤ 0,001), isto permitiu-nos verificar adequadamente os dados para a análise factorial. O índice revelou boa consistência interna (coeficiente do alfa de Cronbach: α = 0,812).
Conclusões: Este índice de qualidade do sono, apresenta boas propriedades psicométricas. Visto que nas avaliações deste género de população é importante não haver sobrecarga dos sujeitos, este instrumento breve constitui uma boa opção para avaliar a qualidade subjetiva do sono, preenchendo uma lacuna no que toca a instrumentos nesta área.
Cognitive rehabilitation techniques, reminiscence therapy, and reality orientation therapy, have shown an impact on cognition, life satisfaction, mood, and on the progression of cognitive decline in elderly.
Objectives
To test the effectiveness of a NRGP on the cognitive and emotional functioning of institutionalized elderly.
Methods
.
Design
single blind randomized controlled study with paired groups.
Participants
Coimbra institutionalized elderly, aged between 64-92 (N = 88) with cognitive impairment no dementia, mostly women (75.0%).
Intervention
randomization of participants to the rehabilitation group/RG (n = 41) and to the comparison/waiting-list group/CG (n = 23). NRGP involved groups of five elders, and took 90 min. per day, once a week, for 10 weeks.
Measurements
Mini-Mental State Examination/MMSE, Frontal Evaluation Battery/FAB, Geriatric Depression Scale/GDS.
Analysis
We used general linear model with repeated measures analysis of variance.
Results
RG improved significantly on cognitive, and executive function (p < 0.001), and CG worsened on cognitive, executive function, and mood (p < 0.01). There was a significant effect on the MMSE, FAB, and GDS scores, after excluding pre-rehabilitation scores as covariates [F (1, 81) = 43.98, p < 0.001; η2 = 0.35; F(1, 80) = 28.37, p < 0.001; η2 = 0.26; F(1, 79) = 19.66, p < 0.001; η2 = 0.20].
Conclusions
A NRGP including cognitive rehabilitation, reminiscence therapy, and reality orientation proved to be effective on cognitive and executive functioning, and on depressive symptoms of institutionalized elders with cognitive impairment no dementia.
The progressive increase in the prevalence of anxiety disorders in advanced ages advises the extensive use of of screening measurements in this population, that, everywhere in the world, has raised numerically.
Objectives
The aim of this study was to examine the psychometric properties of a Portuguese version of the Geriatric Anxiety Inventory-Short Form (GAI-SF, 5-item format) in a sample of 932 elders.
Methods
Quantitative and cross-sectional study with descriptive and correlational planning. Translation and back-translation was performed by language proficiency experts. The reliability was assessed through Cronbach's alpha coefficient and the factorial validity through Principal Components Analysis. The convergent validity was conducted with the Geriatric Depression Scale (GDS) and the Positive and Negative Affects Scale (PANAS-Negative sub-scale), while discriminant validity was performed with the PANAS-Positive sub-scale and the Satisfaction With Life Scale (SWLS). A Confirmatory Factor Analysis, using a structural equation modeling, was performed to test the fit of the model with the five items.
Results
The GAI-SF showed good internal consistency (α = 0.77), good convergent, and discriminant validity (p < 0.05). The factorial structure presented a single factor that explained 52% of the variance. The model showed a good fit to the data (χ2= 1.233, TLI = 0.997, CFI = 0.999, RMSEA = 0.020).
Conclusions
The GAI-SF, a brief self-report scale, has good validity and reliability, and factorial qualities adequate to measure anxiety symptoms in epidemiological surveys and in geriatric settings.
Depression is very common among institutionalized elders. Because of the increased risk of cognitive impairment/dementia, and mortality we want to describe the evolution of depression and analyze predictive factors.
Methods
In the Aging Trajectories Study (Instituto Superior Miguel Torga - Coimbra), we followed up a sample of 83 nondemented persons (M ± SD baseline age = 79.51 ± 6.58; men: 17; women: 66). In a 2-year prospective cohort analysis (2010-2011, and 2013), we assessed depression using the Geriatric Depressive Scale/GDS as screening tool and the Mini International Neuropsychiatric Interview to diagnose depression. We also used the UCLA Loneliness Scale, the Geriatric Anxiety Inventory/GAI, the Positive And Negative Affect Scale/PANAS. Sociodemographics, and health were control variables. We performed a multinomial logistic regression to identify predicitive factors.
Results
Fifty participants had depression at baseline, nine developed, 49 maintained, nine remitted, and 16 maintained without depression.
Having depression was associated with worse scores in UCLA, GAI, and PANAS. Not having depression was correlated with higher positive affect.
Baseline higher GAI and UCLA, and lower positive affect and satisfaction predicted recurrent depression.
Improvement in GDS, GAI, and positive affect predicted depression remission.
Conclusion
Results show that depression is a concern issue for professionals working with institutionalized elderly. Anxiety, loneliness, low positive affect and satisfaction constitute a risk factor for maintaing depression in institutionalized elderly and low anxiety and depressive symptoms are a protective factors for depression. These results could be used in depression prevention programs.
Adolescence is a critical period for dissociation, until more effective coping strategies are developed. Dissociate in a chronic manner is likely to interfere with the construction of a cohesive sense of self, and may potentiate later psychopathology. Adolescent Dissociative Experiences Scale/A-DES is yet to be studied in Portugal.
Objectives
Analyze the psychometric properties of the A-DES 11-item format; compare between nonclinical with psychological disturbed adolescents/PDA; and determine the variables that associate with A-DES.
Methods
A sample of nonclinical (n = 69) and PDA (n = 45) aged between 11 to 18 years, 55.3% boys and 44.7% girls, education mean years 8.96 (SD = 2.74), completed the A-DES and the Youth Self Report/YSR.
Results
The A-DES had a very good internal consistency (α = 0.94), presenting significant large correlations with YSR (r = 0.67). Confirmatory factor analysis suggested a 1-factor structure.
The mean scores (2.78 ± 1.82) were equivalent to other countries, and significantly discriminated (t = 6.02; p < 0.001; Cohen's d = 1.12) between the nonclinical (M = 2.06 ± 1.41) and PDA (M = 3.89 ± 1.84).
There were no differences between the sexes, but the younger, less educated, and institutionalized had more dissociative experiences (r = 0.21 to 0.30). Hierarchical multiple regression revealed that only YSR was statistically significant in predicting levels of A-DES (Beta = 0.64; p < 0.001).
Conclusions
The Portuguese A-DES version seems a valid and reliable screening for dissociation amongst adolescents.
The concepts of well-being and hope are associated with life satisfaction. Public policies should include the promotion of quality of life in the elderly.
Objectives
The current study sought out to address the concepts of hope and well-being in the elderly, analysing the role of socio-demographic variables. It also aimed to characterize this population in terms of other quality of life indicators such as perception of general health status, loneliness and degree of activity.
Method
The sample included 130 elderly people, both from the community and institutionalized, with ages between 65 and 94 years old. Participants answered questions about socio-demographic data, quality of life indicators, cognitive functioning and measures of hope (HP; Snyder et al.; 1991), life satisfaction (SWLS; Diener et al, 1985), and positive and negative affect (PANAS; Watson, Clark, & Tellegen, 1998).
Results
The majority of participants perceived their health status as reasonable and mentioned feelings of loneliness. Only 20% considered themselves active. Men presented higher levels of hope when compared with women. Participants who were not institutionalized showed higher levels of hope and positive affect, considering themselves more active when compared to the ones living in nursing homes or attending day centres. Hope showed to be positively correlated with life satisfaction, positive affect, health status perception and degree of activity, and negatively correlated with negative affect. Negative affect showed to be correlated with the perception of loneliness.
Conclusion
This study enhances the importance of socio-demographic and psychological variables in the promotion of well-being in the elderly.
Previous studies concerning early experiences in childhood show that these play a crucial role in the individuals’ development and may lead to a decrease in the vulnerability to show psychological problems. Mindfulness skills and feelings of hope seem to function as mechanisms that promote adjustment and psychological well-being.
Objectives
The aim of this study was to explore the relationship between early positive emotional memories, hope, and mindfulness skills, as well as their role in the psychological well-being.
Method
A sample of 402 adolescents with ages ranging from 12 to 18 years old completed four self-report instruments: the Early Memories of Warmth and Safeness Scale, the Children and Adolescent Mindfulness Measure, the Children Hope Scale and the Positive and Negative Affect Schedule.
Results
Girls exhibited more negative affect when compared to boys. Age and years of education were not correlated with any of the study variables. Students with no school disapprovals showed more positive emotional memories and more hope. Mindfulness skills, hope, warmth and safety memories, and positive and negative affect were significantly correlated in an expected way. The set of variables that better predicted positive affect was: hope, early warmth and safety memories, and mindfulness skills. For negative affect, mindfulness was the best predictor followed by hope and lastly by positive emotional memories.
Conclusions
The current study heightened the role of positive emotional memories, mindfulness, and hope in affective states, suggesting that they may be addressed in intervention programs for the adjustment or the psychological well-being of the adolescents.
Social relationships (e.g. family, friendships and romantic relationships) are fundamental to human development and well-being.
Objectives
The current study aimed to explore the psychometric properties of the Social Values Questionnaire (SVS; Blackledge & Ciarrochi, 2006) in a sample of Portuguese adolescents. Furthermore we sought to understand motives for and commitment to social values and how these elements are associated with well-being across age and gender.
Methods
The sample included 268 adolescents (150 girls and 118 boys) with ages ranging from 14 to 18 years old, attending high school. Participants completed a set of self-report measures: the SVS, the Positive and Negative Affect Schedule (PANAS-C; Sadin, 1997), the Students’ Life Satisfaction Scale (SLSS;Huebner 1991) and the Children's Hope Scale (CHS; Snyder, Hoza, Pelham, Rapoff, Ware, Danovsky, Highberger, Rubinstein & Stahl, 1997).
Results
The Portuguese version of the SVS showed high internal consistency: Intrinsic motivation (α=0,91), extrinsic motivation (α=0,90), commitment (α=0,79). It also showed adequate test retest reliability. Gender revealed a relevant role with girls presenting more intrinsic motivation, less extrinsic motivation and a higher degree of commitment when compared with boys. Age was positively correlated with intrinsic motivation and commitment. Significant and expected relationships were also found between SVS subscales and positive and negative affect, life satisfaction, and hope.
Conclusions
The SVS seems to be a valid and reliable instrument for the assessment of social values in adolescents. This construct is an important one in the context of mindfulness and acceptance based therapies and thus its assessment is pertinent.
Traumatic experiences are a decisive factor for the manifestation of dissociative symptoms and, in turn, dissociative symptoms are often part of severe psychopathology.
Objectives
Given the lack of research in Portugal examining dissociation and trauma in patients with Schizophrenia and Bipolar Disorders, we intended to determine if these patients dissociate and what kind of traumatic experiences they had, to analyze associations between dissociation and trauma, and check if there are differences by gender and formal education.
Methods
We assessed, through Dissociative Experiences Scale and Traumatic Experiences Checklist, 30 patients (M ± SD age = 42.6 ± 12.38; range 20-65 years) with Schizophrenia (n = 22) and Bipolar Disorder (n = 8) from a Residence for mentally ill (Mini International Neuropsychiatric Interview confirmed diagnoses).
Results
Twelve patients (40%) revealed pathological dissociation (M ± SD = 33.52 ± 17.74), scoring highest in DES absorption factor, and had more traumatic experiences between 7-12 years of age. Dissociation correlated moderately with traumatic experiences (?? = 0.40). Significantly, women had more dissociation and traumatic experiences (M ± SD = 34.55 ± 18.60; 2.14 ± 2.53) than men (M ± SD = 27.55 ± 16.48; 1.51 ± 1.91). There were no significant differences by education.
Conclusion
Many schizophrenic and bipolar Portuguese patients dissociate and had traumatic experiences in childhood, which is supported by the literature, but is necessary to replicate with bigger samples, and compare the two disorders to draw more conclusive interpretations. Nevertheless, therapeutic interventions should consider these aspects.
Metodologia: Avaliámos 283 idosos institucionalizados através de itens específicos do Montreal Cognitive Assessment/MoCA e do Mini Mental State Examination/MMSE. A maioria era do sexo feminino (76,7%), com médias de idade de 80,2 (DP = 6,58), sem parceiro (80,2%), frequentou a escola (53,4%), e estava em centro de dia (68,2%). Resultados: Não existem associações estatisticamente significativas entre o tipo de resposta social e a memória a curto-prazo. Existem associações entre a escolaridade e a memória a curto-prazo de acordo com o MoCA (ró = -0,181; p = 0,002) e o MMSE (ró = -0,129; p = 0,029), e os idosos que não frequentaram a escola apresentam pontuações mais baixas no MoCA e no MMSE, respetivamente M = 0,6 (DP = 1,27) e M = 4,1 (DP = 1,38). Quanto { idade, os idosos com idade ≥ 81 anos apresentam uma pontuação mais baixa no MMSE (M = 4,1; DP = 1,38) do que os idosos com idade ≤ 80 anos [M = 4,5; DP = 1,39; t (281) = 2,24; p = 0,026].
Conclusão/Discussão: Não confirmámos as diferenças na MCP entre Centros de Dia e Lares, contudo, como seria de esperar, encontrámos associações entre a MCP e as variáveis idade e escolaridade. Assim, parece-nos importante a realização de reabilitação cognitiva particularmente nos idosos mais velhos e com menor escolaridade.
Objetivos: avaliar a prevalência dos sintomas depressivos em idosos institucionalizados com e sem défice cognitivo, verificar a relação entre sintomas depressivos e défice cognitivo e o impacto dos sintomas depressivos no défice cognitivo, controlando o potencial papel das variáveis sociodemográficas na análise preditiva.
Métodos: avaliámos 378 idosos institucionalizados através do Mini-Mental State Examination (MMSE) e da Geriatric Depression Scale (GDS); 34,9% apresentaram défice cognitivo, 76,5% são mulheres, 80,4% não têm companheiro, 46,6% não tem instrução; idades entre os 65 e 100 anos (M = 80,17 ± 6,67).
Resultados: Na amostra global, a prevalência de sintomas depressivos é alta (67,5%), mas maior nos idosos sem défice cognitivo (41,5%; χ2 = 4,25; p< 0,05). Existe somente relação entre os sintomas depressivos e escolaridade, tendo os idosos analfabetos mais sintomas depressivos (r = 0,16, p< 0,01). O GDS e o MMSE correlacionam-se negativamente (r = -0,16; p< 0,001). A regressão logística multietápica mostra que a escolaridade não explica significativamente a variância no défice cognitivo (β = 0,32; p = 0,14), somente os sintomas depressivos contribuem significativamente para a variância no MMSE (β = 0,54; p< 0,05).
Conclusão: À semelhança de investigações anteriores, os sintomas depressivos são comuns. Em contraste com outros estudos, o maior risco de ter défice cognitivo encontra-se entre os idosos sem sintomas depressivos. Impõe-se a replicação do estudo com idosos não-institucionalizados.
Assim foram os nossos principais objetivos descrever a qualidade subjetiva do sono e analisar a intensidade dos sintomas depressivos e dos sintomas de solidão em idosos institucionalizados, comparar com uma subamostra de idosos não institucionalizados e analisar a relação entre estas variáveis nas duas subamostras.
Cento e quarenta idosos, com 70 institucionalizados e 70 não institucionalizados foram emparelhados por idade, sexo, escolaridade, estado civil e sem défice cognitivo. A média de idades foi de 76,58 (DP = 6,10), sendo 104 mulheres e 36 homens. Como instrumentos para a análise utilizámos um Questionário Sociodemográfico, o Questionário sobre o Sono na Terceira Idade, o Inventário de Depressão Geriátrica e a Escala de Solidão da Universidade da Califórnia, Los Angeles.
Verificou-se que os idosos institucionalizados apresentavam mais sentimentos de solidão do que os não institucionalizados. Contudo, não se verificaram diferenças entre as duas subamostras em relação aos sintomas depressivos e à qualidade subjetiva do sono. Através de uma análise correlacional verificou-se nas duas subamostras que quanto pior a qualidade subjetiva do sono mais sintomas depressivos se observavam e quanto mais sintomas depressivos, mais sentimentos de solidão.
Concluímos que não houve diferenças na qualidade subjetiva do sono pelo tipo de resposta social ainda que haja mais sintomas depressivos e sintomas de solidão nos idosos institucionalizados. Não encontrámos também relação entre o sono e a solidão nos idosos institucionalizados. / There seems to be an association between loneliness and poor subjective sleep quality. In support of this idea, some studies have shown that feelings of loneliness are associated with less satisfaction with sleep, even if its duration is not diminished. Others have shown that loneliness is associated with depressive symptoms. It is known that in institutionalization there are frequent problems with sleeping, mood and loneliness. However, it is not known what is happening in the Portuguese social responses. So our main objetives were to describe the subjective quality of sleep and analyze the intensity of depressive symptoms and loneliness symptoms in institutionalized elderly, to compare with a non-institutionalized elderly subsample and analyze the relationship between these variables in both subsamples. One hundred and forty older adults, with 70 institutionalized and 70 non-institutionalized were matched by age, sex, education, marital status and without cognitive impairment. The average age was 76.58 (SD = 6.10), including 104 women and 36 men. Assessment included a sociodemographic questionnaire, the Subjective Sleep Quality Index for elderly, the Geriatric Depression Scale and the Loneliness Scale of the University of California, Los Angeles. It was found that the institutionalized older adults had more feelings of loneliness than the non-institutionalized. However, there were no differences between the two subsamples in relation to depressive symptoms and subjective sleep quality. The subjective sleep quality correlated with depressive symptoms.
In clonclusion, there are no differences in subjective sleep quality by the type of social response even though there are more depressive symptoms and symptoms of loneliness in the institutionalized elderly. Alço there is no relationship between sleep and loneliness in elderly people.
Método: A amostra é constituída por 749 pessoas (345 homens e 404 mulheres), com idades compreendidas entre os 18 e os 94 anos. Todos os participantes preencheram uma declaração de consentimento informado e uma bateria de testes neuropsicológicos.
Resultados: A média no Teste do Desenho do Relógio foi de 4,10 (DP = 1,25). Os resultados demonstraram que as variáveis sociodemográficas (idade, escolaridade, profissão, regiões e tipologia de áreas urbanas) apresentaram ter influência significativa nas pontuações do Teste do Desenho do Relógio. A confiabilidade e a estabilidade temporal revelaram-se adequadas.
Conclusão: Os dados do nosso estudo indicam que o Teste do Desenho do Relógio pode ser utilizado pela população portuguesa. / Purpose: To study the psychometric properties of the Clock Drawing Test in a Portuguese sample.
Method: The sample consists of 749 people (345 men and 404 women), aged between 18 and 94 years. All participants filled an informed consent form and a battery of neuropsychological tests.
Results: The average in Clock Drawing Test was 4.10 (SD = 1.25). The results showed that the sociodemographic variables (age, education, profession, region, and typology of urban areas) showed significant influence on Clock Drawing Test scores. The reliability and temporal stability of Clock Drawing Test proved appropriate.
Conclusion: The data from our study indicate that the Clock Drawing Test may be used by the Portuguese population.
Esta investigação tem como objetivo avaliar as propriedades psicométricas da FCR-O, numa amostra de adultos da população portuguesa.
O protocolo de investigação incluiu uma bateria de testes neuropsicológicos: Figura Complexa de Rey (FCR-O), Teste do Desenho do Relógio (TDR), Bateria de Avaliação Frontal (FAB), Rey 15 Item, Matrizes Progressivas de Raven (MPR) e a Escala de Auto-Avaliação da Ansiedade de Zung.
A amostra deste estudo abrangeu 453 sujeitos, 192 homens e 261 mulheres, com idades compreendidas entre os 18 e os 90 anos (M = 40,44; DP = 19,78).
Os resultados principais deste estudo indicam que a FCR-O é influenciada por diversas variáveis, tais como a idade, sexo, escolaridade, profissão, residência e regiões, apresentando uma validade convergente adequada, com correlações positivas com o TDR, FAB e MPR.
A título conclusivo, verificámos que a FCR-O tem caraterísticas psicométricas satisfatórias, especificamente da consistência interna, concordância entre juízes e estabilidade temporal, sugerindo a sua utilização em populações não clínicas. / The Rey–Osterrieth complex figure (ROCF) is a neuropsychological test which was conducted in three phases to assess visuospatial ability, perceptive organization, constructive visuospatial ability, visual memory, attention, planning and motor function. This investigations aims to evaluate the psychometric properties of ROCF, in an adult sample of the Portuguese population. The investigation protocol includes a battery of neuropsychological tests: Complex Figure of Rey, Clock Drawing Test, Frontal Assessment Battery, Rey Item 15, Raven Progressive Matrices and the Zung Self-Rating Anxiety Scale.
The sample of this study consisted of 453 subjects, 192 men and 261 women, aged between 18 and 90 years old (M = 40.44, SD = 19.78).
The result of this study indicate that the ROCF is influenced by several variables, such as age, sex, education, profession, residence and regions. It also has adequate convergent validity, with positive correlations with TDR, FAB and MPR.
In conclusion, we verified that the ROCF is a useful instrument to early detect some neuropsychological deficits. It revealed satisfactory psychometric characteristics, specifically in internal consistency, agreement between judges and temporal stability, suggesting its usage in no clinical populations.
De forma a contribuir para o avanço dos estudos normativos em Portugal, esta dissertação tem como objetivo avaliar as propriedades psicométricas da FAB, numa amostra de adultos da população portuguesa.
O protocolo abrangeu a seguinte bateria de testes neuropsicológicos: Bateria de Avaliação Frontal, Figura Complexa de Rey, Matrizes Progressivas de Raven e Teste do Desenho do Relógio. A amostra deste estudo incluiu 376 indivíduos, 155 do sexo masculino e 221 do sexo feminino.
Os resultados desta investigação sugerem que a pontuação da FAB é influenciada por algumas variáveis sociodemográficas, designadamente a idade, escolaridade, profissões e região. A análise correlacional mostrou que há apenas uma correlação positiva moderada entre a FAB e as Matrizes Progressivas de Raven. Apesar da consistência interna da FAB ser baixa, existe uma estabilidade temporal moderada.
Ao finalizar, consideramos que a FAB reúne os requisitos para se apresentar como uma bateria útil e eficaz, demonstrando um grau razoável de estabilidade temporal, mas fraca consistência interna, sugerindo que a FAB não é indicada para amostra não clínica. / The Frontal Assessment Baterry (FAB) is a neuropsychological test, composed of six subtests, whose aim is to assess the overall executive dysfunction, namely functions related to the frontal lobe, such as conceptualization, mental flexibility, motor programming, sensitivity to interference, inhibitory control and environmental autonomy.
In order to contribute to the advancement of normative studies in Portugal, this dissertation aim to evaluate the psychometric properties of the FAB, in an adult sample of the portuguese population.
The protocol included the following battery of neuropsychological tests: Frontal Assessment Battery, Complex Figure of Rey, Raven's Progressive Matrices and Clock Drawing Test. The sample this study included 376 individuals, 155 male and 221 female.
The results of this investigation suggest that FAB is influenced by some sociodemographic variables, namely age, education, profession and region.
The correlational analysis showed that there is only a moderate positive correlation between the FAB and the Raven Progressive Matrices. However, also they found low positive correlations between the FAB and the Complex Figure of Rey, and Clock Drawing Test. Although the FAB has a low internal consistency, there is a moderate temporal stability.
Finally, we consider that the FAB gathers the requirements to present itself as a useful and effective battery, demonstrating a reasonable degree of temporal stability, but weaker internal consistency, suggesting that the FAB is not indicate for non-clinical sample.
Métodos: Selecionámos e inquirimos 671 sujeitos. As variáveis independentes estudadas foram idade, sexo, escolaridade e profissão. Foram utilizados vários testes neste estudo, contribuindo para a obtenção de validade convergente: Bateria de Avaliação Frontal-FAB, Figura Complexa de Rey-Osterrieth e Teste do Relógio. Foram estudadas a consistência interna e a estabilidade temporal do Teste Stroop.
Resultados: A nossa amostra ficou constituída por 310 sujeitos (46,2%) do sexo masculino e 361 (53,8%) do sexo feminino, com idades compreendidas entre os 18 e 100 anos (M = 41,12; DP = 20,85). No que se refere ao nível de escolaridade (M = 5,71; DP = 1,45), este variou entre o 1º Ciclo do Ensino Básico e o Ensino Superior. As profissões, exercidas inseriram-se maioritariamente na categoria das profissões intelectuais (N = 281; 84,9%). Relativamente às variáveis sociodemográficas, verificámos que a idade, sexo, escolaridade e profissão influenciam nas provas de Leitura e Nomeação de Cor do Teste Stroop. No que diz respeito à validade convergente, observámos que a prova de Nomeação de Cor apresentou correlações
positivas fracas com o FAB, Figura Complexa de Rey-Cópia (FCR-Cópia) e Teste do Relógio, e correlações positivas moderadas com a prova de Leitura. A consistência interna do Teste Stroop apresentou uma elevada confiabilidade (α = 0,99). A correlação teste-reteste apenas se mostrou significativa para a prova de Nomeação de Cor.
Conclusão: Este estudo mostra que o Teste Stroop é promissoriamente confiável como instrumento de avaliação neuropsicológica, podendo potencialmente ser utilizado para qualquer faixa etária da população. Em estudos futuros são necessárias amostras com números mais elevados de participantes nas faixas etárias acima dos 30 anos, representativas dos níveis de escolaridade abaixo do 9ºano, a exercerem profissões manuais, e com residência noutras regiões geográficas para além do Centro. / Objectives: The present study is part of the Project - Estudos Normativos de Instrumentos Neuropsicologicos (ENIN) and aims to analyze the psychometric properties of the Stroop test.
Methods: We have selected, and we also enquired 671 subjects. The independent variables studied were age, gender, education and profession. Several tests were used in this study for analysis of convergent validity: convergent validity: Frontal Assessment Battery-FAB, Complex Figure Rey-Osterrieth and the clock test. We also studied the internal consistency and the temporal stability of the Stroop test.
Results: Our sample was composed of 310 subjects (46.2%) male and 361 (53.8%) females, with ages between 18 and 100 years (M = 41.12; SD = 20.85). The level of schooling (M = 5.71; SD = 1.45) ranged between the 1st cycle and the Higher Education. The professions were mainly intellectual ones (N = 281; 84.9%). On sociodemographic variables, we found that the age, sex, education and profession influenced reading and Color naming of Stroop test. Regarding convergent validity, Color naming showed weak positive correlations with the FAB, Complex Figure Rey-Copy, and the clock test. Color naming moderate positive correlations with the reading. The internal consistency of the Stroop test was high (α = 0.99). The test-retest
correlation was significant only for Color naming.
Conclusion: This study shows that the Stroop test is promissory reliable instrument of neuropsychological assessment and may potentially be used for any age range of the population. In future research, it is necessary to enroll samples with higher numbers of participants above 30 years, representative of the levels of schooling below the 9º grade, with more manual professions represented, and with residence in other geographic regions in addition to the Center region of Portugal.
Matrizes Progressivas de Raven numa amostra da comunidade da população portuguesa.
Método: A amostra é constituída por 697 pessoas (314 homens e 383 mulheres), com idades
compreendidas entre os 12 e os 90 anos. Todos os participantes preencheram uma declaração
de consentimento informado e uma bateria de testes neuropsicológicos, incluindo a Forma
Geral das Matrizes Progressivas de Raven (FG-MPR), Teste de Memória de 15-Item de Rey,
Escala de Autoavaliação de Ansiedade de Zung, Bateria de Avaliação Frontal e Figura
Complexa de Rey.
Resultados: A média na FG-MPR foi de 44,47 (DP = 10,78). Os resultados demonstraram
que todas as variáveis sociodemográficas (idade, sexo, escolaridade, profissão, regiões e
tipologia de áreas urbanas), exceto o estado civil, apresentaram ter influência significativa nas
pontuações da FG-MPR. A confiabilidade e a estabilidade temporal da FG-MPR revelaram-se
adequadas. A análise fatorial exploratória e confirmatória mostrou que o modelo para um fator
não é adequado. Um modelo a quatro fatores continua a não ser adequado.
Conclusão: Os dados do presente estudo sugerem que se trata de um instrumento com
potencialidades na sua utilização junto da população portuguesa. / Purpose: To study the psychometric properties and date normative of the Raven’s Standard
Progressive Matrices in a Portuguese community sample.
Method: The sample consists of 697 people (314 men and 383 women), aged between 12 and
90 years. All participants filled an informed consent form and a battery of neuropsychological
tests, which included Raven’s Standard Progressive Matrices (RSPM), Rey 15-Item Memory
Test, Zung Self-Rating Anxiety Scale, Frontal Assessment Battery, and Rey Complex Figure
Test.
Results: The average in RSPM was 44.47 (SD = 10.78). The results showed that all of the
sociodemographic variables (age, sex, education, profession, region, and typology of urban
areas), with the exception of civil status, showed significant influence on RSPM scores. The
reliability and temporal stability of RSPM were adequate. Exploratory and Confirmatory
factor analysis showed that the model is not better explained by one factor. A two-factor
model was not also suitable.
Conclusion: The data from this study suggest that it is an instrument with potential for its use
among the Portuguese population.
Apesar do seu uso amplo, em Portugal não existem estudos que avaliem a sua validade e fidedignidade.
Objetivos: Estudar as propriedades psicométricas do Inventário de Lateralidade de Edinburgh numa amostra da população portuguesa.
Métodos: A amostra é constituída por 290 pessoas (135 homens e 155 mulheres), com idades compreendidas entre os 18 e os 65 anos. Todos os participantes preencheram uma declaração de consentimento informado e uma bateria de testes neuropsicológicos
Resultados: A média no EHI foi de 62,36 (DP = 38,00). Os resultados demonstraram que das seis variáveis sociodemográficas (idade, sexo, escolaridade, zona de residência, regiões e profissão) três apresentaram ter influência significativa nas pontuações do EHI: idade, zona de residência e regiões. A confiabilidade e a
estabilidade temporal do EHI apresentaram resultados adequados. A análise fatorial confirmatória mostrou que o modelo não é melhor explicado por um fator. Para dois fatores o modelo continua a não ser adequado.
Conclusão: Apesar de termos obtido uma boa consistência interna não nos é possível considerar este teste como o mais adequado para medir o constructo da lateralidade. / Introduction: The handedness is the difference in the control capacity between the two sides of the body. The methods used to evaluate the manual handedness include the effective observation of the use of dominant member or application of inventories answered by the person assessed. The Edinburgh Handedness Inventory (EHI) is the most used to evaluate manual handedness. Even though being widely used, in Portugal there are no studies that measure its validity and reliability.
Objective: To study the psychometric properties of Edinburgh Handedness Inventory in a Portuguese sample.
Methods: The sample consists of 290 people (135 men and 155 women), aged between 18 and 65 years. All participants filled an informed consent form and a battery of neuropsychological tests.
Results: The average in EHI was 62.36 (SD = 38.00). The results showed that 3 of 6 sociodemographic variables showed significant influence in EHI scores. The reliability and temporal stability of EHI were adequate. Confirmatory factor analysis showed that the model is not better explained by one factor. A two-factor model was not also suitable.
Conclusion: Even though we got a good internal consistency we cannot consider this test as the most appropriate for measuring the handedness construct.
Objetivo: O nosso objetivo neste estudo foi explorar o papel mediador de vivências positivas Compaixão, Esperança, Otimismo e Mindfulness na relação entre Experiências Dissociativas e Traumáticas, a fim de percebermos se existe atenuação ou não, nos sintomas de depressão, ansiedade e stress.
Metodologia: A amostra total incluiu 145 sujeitos, 40 do sexo masculino (27,6%) e 105 do sexo feminino (72,4%), com idades compreendidas entre os 18 e os 57 anos de idade (M = 28,06; DP = 9,48). A maioria da nossa população da amostra possui uma licenciatura (n = 67; 46,2%). Todos os sujeitos responderam a uma bateria de testes constituída por um questionário sociodemográfico, a Traumatic Experiences Checklist (TEC) para avaliar a frequência e intensidade das experiências traumáticas e a Dissociative Experiences Scale (DES) para avaliar as experiências dissociativas. Na avaliação dos estados emocionais negativos foi aplicada a Depression, Anxiety and Stress Scale-21 (DASS-21), enquanto, para a avaliação de experiências positivas foram utilizados a Escala da Auto-Compaixão (SELFCS), a Versão Reduzida do Inventário de Mindfulness de Freiburg (FMI), a Escala de Otimismo e a Escala sobre a Esperança.
Resultados: Verificou-se, na DASS-21, que a pontuação superior se registou na subescala ansiedade com uma média de 11,03 (DP = 2,93). Os participantes com mais experiências traumáticas apresentam níveis mais altos de depressão, ansiedade e stress e de experiências dissociativas (p < 0,001). Por outro lado, as experiências traumáticas parecem associar-se a níveis inferiores de compaixão e otimismo nos participantes da presente amostra (p < 0,001). Os resultados da mediação indicam a presença valores significativos na autocompaixão (Sobel = 2,064) e no otimismo (Sobel = 1,973). De acordo com esta análise, os sentimentos de autocompaixão e otimismo apresentam um efeito mediador entre as experiências traumáticas e o desenvolvimento de sintomas de depressão, ansiedade e stress.
Conclusões: Com base na presente investigação, concluímos que os indivíduos que usufruem de um traço autocompassivo e otimista facilitam a perceção das suas dificuldades e problemas de uma forma saudável, contribuindo para o funcionamento psicológico adaptativo.
Introduction: It is widely known the relationship between traumatic experiences and dissociation. Traumatic and dissociative experiences are two of the conditions leading to symptoms of psychopathology.
Objective: Our aim is this study was to explore of the mediating role, from positive experiences as Compassion, Hope, Optimism and Mindfulness in the relationship between Traumatic and Dissociative Experiences in order to realize if there is paper cut or not, symptoms of depression, anxiety and stress.
Methodology: The sample included 145 people, 40 males (27,6%) and 105 females (72,4%), aged between 18 and 57 years (M = 28,06; DP = 9,48). The majority of our sample population has a degree (n = 67; 46,2%). All subjects completed a battery of tests consisting of a socio-demographic questionnaire; a Traumatic Experiences Checklist (TEC) to evaluate the frequency and intensity of traumatic experiences, and the Dissociative Experiences Scale (DES) to assess dissociative experiences. In the assessment of negative emotional state it was applied to the Depression, Anxiety and Stress Scale-21 (DASS-21), while for assessing positive experiences were used in the Self-Compassion Scale (SELFCS), a Reduced Version of Inventory of Mindfulness of Freiburg (FMI), the Scale of Optimism and the Scale about Hope.
Results: It was verified, in the DASS-21, that the top score was recorded on the anxiety subscale with an average of 11,03 (DP = 2,93). Participants with more traumatic experiences have higher levels of depression, anxiety and stress dissociative experiments (p < 0,001). On the other hand, the traumatic experiences seem to be associated with lower levels of compassion and optimism in participating in this sample (p < 0001). The mediation results indicate the presence of significant values of self-pity (Sobel = 2,064) and in optimism (Sobel = 1,973). According to this analysis, the feelings of self-pity and optimism have a mediating effect between traumatic experiences and the development of symptoms of depression, anxiety and stress.
Conclusions: Based on this investigation, we concluded that individuals who enjoy a Self-compassionate and optimistic trace that facilitate the perception of their difficulties and problems in a healthy way, contributing to adaptive to adaptive psychological functioning.
Objetivo: Este estudo pretendeu investigar se há diferenças nas dimensões positivas, Esperança, Otimismo, Mindfulness e Autocompaixão pelo tipo de dificiência visual, congénita ou adquirida. Pretendemos ainda estudar a intensidade e gravidade da dissociação que frequentemente se associa à presença de experiências traumáticas e ainda da sintomatologia depressiva, ansiedade e stress, verificar se haverá diferenças entre os dois grupos de cegueira. Temos como último objetivo verificar se há relação entre as variáveis positivas e as variaveis negativas.
Metodologia: A amostra é constituida por um total de 20 sujeitos, tendo 11 sujeitos deficiência visual congénita (n = 11; idade média: M = 39,09; DP = 8,8) e 9 sujeitos deficiência visual adquirida (n = 9; idade média: M = 44,8; DP = 14,3). Todos os sujeitos responderam a uma bateria de testes composta por: um questionário sóciodemográfico, a Dissociative Experiences Scale (DES) para avaliar as experiências dissociativas, a Depression, Anxiety and Stress Scale-21/DASS-21 para avaliar os estados emocionais negativos e para avaliação das experiências traumáticas utilizamos a TEC - Escala de Experiências Traumáticas. Para avaliação das experiências positivas foram utilizadas: a Escala da Auto-Compaixão (SELFCS), o Inventário de Mindfulness de Freiburg (FMI) – Versão Reduzida, a Escala do Otimismo e a Escala sobre a Esperança.
Resultados: Verificou-se que os sujeitos com deficiência adquirida reportam um número de esperiências traumáticas significativamente mais elevado que os sujeitos com deficiência congénita (respetivamente, M ± DP = 6,22 ± 1,99 vs. M ± DP = 3,60 ± 2,32; t = 2,632; p < 0,05). Através da análise do tamanho do efeito entre os dois grupos, analisado através do modelo de Hedges (g), os resultados obtidos apresentam tamanhos de efeito alto no total das experiências traumáticas (g = 1,16) e no item da TEC abuso fisíco (g = 0,87). O item da escala FMI presença apresenta um valor médio (g = 0,77). Comparando as médias obtidas no
nosso estudo com as médias dos estudos originais, nas escalas DES, DASS-21 e TEC, no nosso estudo encontrámos médias superiores. Nas escalas de construtos positivos SELFCS, FMI e Otimismo as médias encontradas no nosso estudo são inferiores a outros estudos que usaram os mesmo instrumentos.
Conclusões: Com base na presente investigação, concluímos que os indivíduos com deficiência visual adquirida apresentam um número mais elevado de experiências traumáticas, do que os indivíduos com deficiência congénita. Potencialmente, este resultado mostra que a aquisição de deficiência visual poderá constituir uma experiência traumática ou propiciar a ocorrência de experiências traumáticas. Dada a importância deste achado para a intervenção, sugere-se a replicação deste estudo com amostras maiores, e comparação com sujeitos não reabilitados e/ou sujeitos com outro tipo de deficiências congénitas e adquirida.
Introduction: Visual impairment it’s classified in two categories: blindness and amblyopia. Blindness from a developmental point of view is also classified in two categories: congenital and acquired. Studies aim for the existence of cognitive limitations, badly adapted personality profiles and a risk of psychopathology, superior in subjects with acquire visual impairment. The relation between traumatic experiences and dissociation are known as well as this two conditions leading to psychopathologic symptoms. Other studies in the range of positive psychology have shown that optimism, self-love, mindfulness and hope will positive influence depression, anxiety and stress.
Goal: This study aim was to investigate if there are any differences in the positive dimensions, hope, optimism, mindfulness and self-love regarding the type of visual impairment, congenital or acquired. We also aimed to study the intensity and seriousness of the dissociation that is usually associated with traumatically experiences and also of the depressive symptomatology, anxiety and stress and check if there are any difference in the two types of blindness. Our final point is to check if there are any relation between the positive and negative variables.
Methodology: The sample is constituted of a total of 20 subjects, where 11 subjects have congenital visual impairment (n = 11; average age: M = 39,09; DP = 8,8) and 9 subjects have acquire visual impairment (n = 9; average age: M = 44,8; DP = 14,3). Every subject responded to a series of tests that included: a social demographic questionnaire, a Dissociative Experiences Scale (DES) in order to evaluate the dissociative experiences, a Depression, Anxiety and Stress Scale -21/DASS-21 to evaluate the negative emotional states and in order to evaluate traumatic experiences we used TEC- Traumatic Experiences Scale. To evaluate the positive experiences we used: a Self-Compassion Scale (SELFCS), the Inventory of Mindfulness from Freiburg (FMI) - reduced version, the Optimism Scale and a Hope Scale regarding hope.
Results: We were able to verify that the subjects with acquire visual impairment report a much higher number of traumatic experiences than the subjects with congenital visual impairment (respectively, M ± DP = 6,22 ± 1,99 vs. M ± DP = 3,60 ± 2,32; t = 2,632; p < 0,05). Through the analyses of the size in the effect of the two groups, analysing through the Hedges model (g), the final findings present high effect in the total of the traumatically experiences (g = 1,16) and in the item of TEC physical abuse (g = 0,87). The FMI scale presented and medium value (g = 0,77). Comparing the obtain averages in our study with the avatars of the original studies, on the DES scales, DASS-21 and TEC, in our study we found higher averages. On the positive constructs SELFCS, FMI and optimism the averages found in our study are inferior than the ones found in the other studies that used the same tools.
Conclusions: Based on the present investigation, we can conclude that the individuals with visual impairment acquired present a higher level of traumatically experiences than the individuals with congenital impairment. Potentially, this result shows that the acquisition of a visual impairment can constitute a traumatic experience or help in the occurrence of traumatic experiences. Give the importance of this finding, it is suggested the reapplication of this study in higher samples and the comparison with subjects non rehabilitated and/or subjects with other types of acquired and congenital impairments.
Método: Foi do nosso interesse avaliar os resultados apresentados no Mini Mental State Examination (MMSE) e Geriatric Depression Scale (GDS). Avaliámos 639 idosos, em que 271 eram do meio urbano e 368 do meio rural. As pontuações do MMSE foram significativamente superiores no meio urbano (M = 21,93; DP = 5,52) comparadas com o meio rural (M = 20,52; DP = 5,6; p < 0,01). As pontuações médias do GDS foram superiores no meio rural (M = 14,51; DP = 6,66) em comparação com o meio urbano (M = 13,97; DP = 6,44), estas diferenças não foram significativas.
Resultados: Com recurso à regressão múltipla hierárquica, verificámos que a escolaridade (β = 0,38; p = 0,00) e a profissão (β = 0,08; p = 0,04) são os principais aspetos com efeito no funcionamento cognitivo. Para os sintomas depressivos, os principais aspetos com efeito foram o sexo (β = 0,13; p = 0,001), escolaridade (β = -0,11; p = 0,01) e a profissão (β = -0,13; p = 0,002). Assim verificámos que, o meio urbano e/ou rural não se revelou como preditor do MMSE e do GDS.
Conclusão: Estes resultados salientam a necessidade de estratégias de prevenção e intervenção, quer para o declínio cognitivo, quer para a sintomatologia depressiva, principalmente nos idosos com baixa escolaridade e nos que exerceram profissão manual, com objetivo de proteger o declinar das funções cognitivas e dos sintomas depressivos.
Objetivos: Esta investigação debruça-se no impacto de um Programa de Reabilitação Neuropsicológico Grupal (PRNG) em idosos institucionalizados com DCSD nos aspetos emocionais e afetivos.
Metodologia: A amostra foi constituída por 42 idosos, entre os 66 e os 92 anos, dividida em dois grupos em que 23 idosos foram submetidos ao PRNG (Grupo Experimental) e 19 idosos não foram submetidos ao programa (Grupo de Comparação). O estudo foi quase- experimental e não-cego na reavaliação. As dez sessões tiveram uma duração de 90 minutos, duas vezes por semana, num grupo de cinco idosos. Foram avaliados pré e pós intervenção, através da Avaliação Cognitiva de Montreal (MoCA), da Avaliação Breve do Estado Mental (MMSE), do Inventário de Ansiedade Geriátrica (GAI) da Escala da Depressão Geriátrica (GDS), da Escala de Satisfação com a Vida (SWLS), da Escala de afetos positivos e negativos (PANAS) e da Escala da Solidão (UCLA).
Resultados: A comparação pré e pós PRNG não revelaram diferenças estatisticamente significativas ao nível dos sintomas de ansiedade (GAI), da sintomatologia depressiva (GDS), dos sentimentos de satisfação com a vida (SWLS), dos afetos positivos e negativos (PANAS), exceto nos sentimentos de solidão (UCLA).
Conclusão: Concluímos que o Programa de Reabilitação Neuropsicológico Grupal teve impacto em idosos institucionalizados estabilizando/retardando as capacidades cognitivas, na redução dos sentimentos depressivos, nos sentimentos de solidão e no aumento dos afetos positivos.
Metodología: Evaluamos 682 ancianos con una edad media de 79,00 años (DP = 8,14), subdivididos en dos grupos que incluyeron ancianos Institucionalizados (n = 540; 79,2%) y ancianos No-Institucionalizados activos (n = 142; 20,8%), a través del Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Figura Compleja de Rey (FCR), Prueba de la Fluência Verbal (Fónemica, FVF; Semântica, FVS), Frontal Assessment Batery (FAB), Geriatric Depression Scale (GDS), y Geriatric Anxiety Inventory (GAI). Como metodología estadística fueron usados análisis de covariancia.
Resultados: Independientemente de algunas de las variables sociodemográficas puedan tener efecto en el funcionamiento neuropsicológico y contribuir para la Institucionalización del anciano, controlando su efecto, Lo Institucionalizado sólo por sí tiene impacto en el funcionamiento mnésico, lingüístico y ejecutivo, así como, en la sintomatología depresiva y ansiosa.
Discusión/Conclusión: Los resultados siguen la literatura en cuanto al impacto negativo que Lo Institucionalizado tiene en el anciano, tanto al nivel cognitivo como al nivel emocional, independientemente de los factores que lo envuelven."
Objective: In this study we intend to investigate the impact of a Neuropsychological Group Rehabilitation Program (NGRP) in cognitive and executive functioning of institutionalized elderly with CIND interacting with children.
Method: This study investigated the impact of a NGRP, composed of several practical exercises that intended to empower elders with compensatory strategies, leading to improved cognitive and executive functioning. The study had an almost-experimental design, being conducted with an experimental group and a control group in two stages: pre and post-rehabilitation for all participants and rehabilitation with the experimental group. Participated in this study thirty individuals of both sexes (6 men and 24 women), aged between 65 and 90 years. All participants were submitted neuropsychological evaluation pre and post-rehabilitation. The rehabilitation consisted of 10 group sessions lasting 60 minutes each.
Results: The comparison between experimental group and control group in the two evaluation moments (pre and post-rehabilitation) revealed significant differences both at a cognitive level (MMSE) and executive (FAB), and even the emotional level (GDS, GAI and UCLA). Verifying that the experimental group improved significantly in mean scores cognitive, executive and emotional; the control group deteriorated significantly in mean scores cognitive and not significantly in mean scores executive and emotional.
Conclusion: We conclude that the NGRP in interaction with children has a significant impact, because it is possible to stabilize or even recover cognitive and executive abilities of institutionalized elderly with CIND, and reduce symptoms of depression and anxiety and
feelings of loneliness.
Objectives: To describe the evolution of depressive symptoms over a period of about two years and see what factors are associated with the development of depression.
Methods: We evaluated 83 elderly institutionalized in two moments two years of interval, an initial age ranging from 50 to 100 years, 79.5% women, 86.7% unmarried, 72.3% received some education and 88.0% manual occupations. We assessed depression through the GDS, loneliness through UCLA, anxiety through the GAI, and affectivity through the PANAS.
Results: We found that 59.0% remained depressed and 10.8% developed depression. Demographics, unlike the emotional factors, were not associated with the presence/absence of depressive symptoms at baseline. Elderly people with depression had significantly worse scores at the UCLA, the GAI, and at the PANAS and those without depression had higher positive affect.
Regarding the evolution of depression, elderly who kept depressed had initially higher scores on the GDS, GAI, UCLA, and PANAS negative subscale, and low scores on the PANAS positive subscale. These elderly, associatively, have had a worsening of feelings of loneliness, anxiety symptoms and negative affect throughout the two years. The elderly who developed depression had higher scores on UCLA at baseline.
Conclusion: We conclude that depression and/or loneliness at baseline, the worsening of loneliness, anxiety, and positive and negative affects throughout time may all be risk factors for the maintenance of depressive symptoms. And loneliness can be a risk factor for the development of depression. Thus, depressed elderly that have higher scores on the GDS and/or UCLA at baseline are likely to develop chronic symptoms, and should be focused for treatment. To prevent the development of depression, it will be essential to intervene in elderly patients with higher scores at the UCLA.
Objectives: This study aimed to investigate the influence of a Group Rehabilitation Neuropsychological Program (RNPG) on the cognitive and executive functioning of institutionalized elderly with CIND.
Methodology: The sample included 24 elderly individuals, with ages between 67 and 92 years, divided into two groups. Twelve elderly individuals were submitted to RNPG (Experimental Group) and twelve elderly individuals were on the waiting list to be rehabilitated (Control Group). The study had a quasi-experimental design and was blind in the revaluation. The ten interventions took 90 minutes per session, once a week, in groups of up to five elderly. The pre and post-intervention assessment included the Montreal Cognitive Assessment for the classification of the cognitive level, the Mini Mental State Examination for the assessment of cognitive functioning, the Frontal Assessment Battery for the analysis of the executive functioning, the Geriatric Anxiety Inventory, the Geriatric Anxiety Inventory, and the Loneliness Scale.
Results: We used ANCOVAS to compared pre and post-intervention, and we have found significant differences at the level of cognitive and executive functioning. Significant improvement was also found at the level of depressive symptoms and feelings of loneliness.
Conclusion: The RNPG applied in institutionalized elderly with CIND has impact on cognitive and executive functioning, given the fact that through its application it is possible to stabilize or even recover cognitive and executive skills, as well as, to reduce depressive symptoms and feelings of loneliness.""
For this study, we were interested to evaluate the results obtained in the Sleep Questionnaire for the Elderly, the Geriatric Depression Scale and the Positive and Negative Affect Schedule.
Through a sample of 334 seniors aged between 50 and 100 years, we have observed a high average of depressive symptoms (M = 14.74; SD = 6.73), and of negative affectivity (M = 25.69; SD = 9.08), and a low mean on subjective sleep quality (M = 20.13; SD = 5.65) and on positive affectivity (M = 29.68; SD = 7.68).
The results showed that the oldest old age, the low educational level, and the depressive symptomatology, and the feminine sex could be influential on subjective sleep quality in elderly. The results also showed that negative affect is related to subjective sleep quality.
We hope that our results will allow a reflection about possible intervention strategies to promote good sleep quality of these individuals, acting specifically in older women, with low educational level, with depression.
The adaptation and validation consisted in the administration of an assessment protocol to a sample of 555 institutionalized elderly between 65 and 100 years. Analyzes revealed a significant decrease in positive affect with age, the others measures did not suffer any change with age. PANAS revealed an adequate internal consistency (α = 0.75), including the dimension of positive affect (α = 0.79), and negative affect (α = 0.84). The results of the factorial analysis support the existence of two factors.
The internal consistency of SWLS is also adequate (α = 0.76). The factor analysis confirms the existence of a single factor for this scale. Test-retest reliability was calculated demonstrating that the scale SWLS was stable for one year interval. PANAS scale wasn’t stable for the same lapse of time. The study of inter-correlations shows the negative association between SWLS and PANAS
negative and a positive association between positive PANAS and SWLS. The association between both PANAS dimensions is significantly negative. These results are similar to those found in other studies with the PANAS and SWLS: with other population these instruments are reliable and valid evaluation tools for use with the institutionalized elderly.
A pessoa, durante grande parte do tempo, e num período mínimo de seis meses (menos do que isso e já estamos perante uma doença diferente), passa a funcionar num nível bastante abaixo ao seu funcionamento prévio com pelo menos dois dos sintomas indicados nos quadros em baixo.
É uma doença que atinge cerca de uma pessoa em cada 100 e tem elevada prevalência familiar (1 em cada 10 de familiares diretos), o que aponta para uma causalidade genética, ainda que os fatores ambientais também tenham um papel relevante (especialmente infeções e traumatismos cranianos precoces).
Muitas pessoas com esta doença conseguem manter-se funcionais conservando os seus empregos ou a frequência da escola, embora o mais frequente seja que a esquizofrenia interfira com a atividade ocupacional do doente.
O tratamento, especialmente medicamentoso, ajuda aliviar a maioria dos sintomas da esquizofrenia, mas muitas pessoas aprendem a lidar com os seus sintomas ao longo das suas vidas.
A investigação sobre esta doença é muito intensa e novos medicamentos mais eficazes têm surgido nos últimos anos, esperando-se que com o futuro se perceba melhor as causas desta doença e, assim, tornar os tratamentos ainda mais eficazes.
Na realidade, a designação técnica de défice de atenção não é a melhor, deveria designar-se por atenção inconsistente ou atenção variável.
Por isso é também conhecido pelo Síndrome dos Paradoxos: a pessoa pode ser numa altura hiperativa e noutra revelar uma quietude de sonho acordado; muito atenta com estímulos novos e distraída com rotineiros; por vezes muito sensível aos sentimentos dos outros e noutras retirada da dinâmica interpessoal; muito criativa numas alturas e sem ideias noutras; otimista/pessimista; boa em matemática num dia e má noutro.
As pessoas com DDA nem inibem, nem modelam as suas respostas tão automaticamente como as pessoas sem este problema. Isto conduz, mais ou menos diretamente, aos outros sintomas associados ao DDA. Também conduz a qualidades positivas, tais como criatividade, espontaneidade, justiça, bondade, energia alta e abertura.
Os critérios para considerar a procrastinação como um problema incluem a gravidade e a extensão do comportamento. Se não existir uma reflexão sobre as causas do adiamento, este comportamento pode converter-se num padrão. A procrastinação é também uma forma de se lidar com emoções e sintomas físicos que acompanham alguns problemas mentais, como Distúrbio de Défice de Atenção, Perturbação Depressiva, Perturbação de Ansiedade Generalizada, ou Perturbação Obsessivo-Compulsiva.
Nas pessoas com doença bipolar as variações do humor muito intensas, envolvem fases de depressão e de mania ou hipomania. Uma fase pode predominar numa mesma pessoa e demorar dias, semanas ou meses.
A doença pode começar em qualquer idade, durante ou depois da adolescência, mas metade de todos os casos começa antes dos 25 anos de idade. Algumas pessoas têm os primeiros sintomas na infância, enquanto noutras a doença começa mais tarde.
Duas pessoas podem passar pela mesma situação de stress extremo e uma pessoa pode ficar traumatizada enquanto a outra pessoa pode ficar relativamente incólume. A situação traumática é sempre uma experiência subjetiva em que é ultrapassada a capacidade da pessoa integrar o que sentiu ou é uma experiência subjetiva de ameaça à vida, à integridade física ou à sanidade. Quanto mais a pessoa acreditar que esteve em perigo, mais traumatizada vai ficar.
Assim, uma situação traumática cria trauma psicológico quando se destrói a capacidade do indivíduo de ultrapassar e o leva a temer a morte, mutilação ou psicose. O indivíduo pode sentir-se emocionalmente, cognitivamente e fisicamente oprimido. As circunstâncias da situação geralmente incluem abuso de poder, traição da confiança, encarceramento, impotência, dor, confusão e/ou perda.
O trauma acontece de muitas formas, e não há grandes diferenças entre as pessoas que sofrem de trauma, mas as semelhanças e padrões de resposta atravessam a variedade de situações e de vítimas.
As situações que podem provocar trauma incluem incidentes poderosos que aconteceram uma única vez, como acidentes, desastres naturais, crimes, cirurgias, mortes e outras situações violentas. Estas situações incluem também acontecimentos repetitivos, tais como abuso infantil, negligência, combate, violência urbana, relações de violência e de privação. Infelizmente, os efeitos traumáticos são muitas vezes cumulativos.
A ansiedade por sua vez, é uma emoção que se define como uma emoção antecipatória, muitas vezes irreal ou excessiva relativamente a situações futuras.
Quando o medo e a ansiedade estão presentes de uma forma persistente, excessiva e num grau elevado de intensidade, estas tornam-se patológicas, interferindo negativamente no bem-estar e qualidade de vida da pessoa.
Muitas pessoas sofrem de uma perturbação do sono sem o saberem e quase todas as pessoas vivenciam problemas de sono em algum momento da sua vida. A sonolência diurna excessiva é um indicador importante de que sofre de sono insuficiente (privação do sono) ou de que tem o sono fragmentado (perturbação de sono).
As perturbações do sono são muito comuns, são graves pelas consequências na saúde, mas também são tratáveis (psicoterapia e/ou medicação)."
A depressão é muito mais que uma tristeza prolongada e é diferente das mudanças de humor que nos acompanham ao longo da nossa vida. A depressão não escolhe idades, e pode durar meses ou mesmo alguns anos. "
O seu uso é livre, não sendo necessárias permissões especiais para a sua utilização em contexto clínico ou de investigação.
Em caso de investigação, agradece-se que seja comunicado o título do estudo, a caracterização da amostra e os resultados principais para helenum@gmail.com
O seu uso é livre, não sendo necessárias permissões especiais para a sua utilização em contexto clínico ou de investigação.
Em caso de investigação, agradece-se que seja comunicado o título do estudo, a caracterização da amostra e os resultados principais para helenum@gmail.com
Participant requirements: Age > 18
Video gamers (people that play any game available for computer, PDA, mobile phones, TV consoles, or portable devices)
Online survey / Taking part link: https://forms.gle/r9tcixFAGHeVxbxX8
Instructions: The questionnaire takes about 15 minutes to complete, with no right or wrong answers. In no case will there be any sharing of the specific information understood under professional confidentiality. Participation in this study is voluntary, and you can withdraw at any time by closing your browser window.
Number of Participants: 300
Ethical approval: This study has been approved by the Instituto Superior Miguel Torga ethics committee on March 31st, 2021
We appreciate it if you take 15 min. of your time to participate.