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OBJECTIVES: This study investigated behavioral self-regulation problems using the Children's Hostility Inventory (CHI) in pediatric bipolar disorder (PBD), healthy offspring of bipolar disorder patients (HOBD), and healthy controls (HC) without previous history of psychiatric disorders. METHODS: The CHI was administered to 41 consecutive children and adolescents diagnosed with PBD, to 16 HOBD, and to 22 HC. The inventory assessed irritability, expression, hostility, and aggression and was completed by the children with the help of their mothers. Adolescents and their respective parents were interviewed separately using the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL). RESULTS: All subscales of the CHI presented statistically significant differences, except for the subscale assessing feelings of suspicion. Pairwise comparisons revealed consistently significant differences between the PBD group and controls, indicating more self-regulation difficulties in the PBD group, represented by high levels of hostility and aggressive behavior. There were no significant differences between the PBD and HOBD groups. CONCLUSIONS: Future studies should further investigate if such behavior is state-dependent or a trait of bipolar juvenile expression. Expression of hostility and irritability should be considered relevant targets in psychosocial approaches addressing this population.

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BACKGROUND: Physical exercise (PE) is a recommended lifestyle intervention for different mental disorders and has shown specific positive therapeutic effects in unipolar depressive disorder. Considering the similar symptomatology of the depressive phase in patients with bipolar disorder (BD) and unipolar depressive disorder, it is reasonable to suggest that PE may also be beneficial for bipolar depression. However, there is an absence of studies evaluating the antidepressant effect of a structured PE intervention in BD. METHODS: This is an open-label, single-arm study trial. Fifteen patients with a diagnosis of BD Type I or Type II, presenting a depressive episode were included in the study. After physical and functional evaluation, patients participated in supervised training sessions with aerobics followed by strength exercises, three times per week, for 12 weeks (36 training sessions). Depressive and manic symptoms were assessed at baseline and 2, 4, 8, and 12 weeks. Additionally, quality of Life and functioning were assessed at baseline and 4, 8, and 12 weeks). Finally, we tested cardiorespiratory fitness, muscle strength and body composition at baseline and week-12. RESULTS: The mean (± SD) Montgomery Asberg Depression Rating Scale (MADRS) score at baseline was 23.6 ± 8.3 points and after 12 weeks of PE the mean score was 10.2 ± 4.8 points. Nine patients (82%) presented an antidepressant response defined as a reduction of more than 50% of depressive symptoms at week 12 with five of those patients (45%) presenting criteria for full remission. A large and significant Cohen's D Effect Size (pre-post) was verified for MADRS reduction [1.98 (95% Confidence interval = 0.88 to 3.08)]. We did not detect a significant change in manic symptoms, functioning, and quality of life during the 12-week follow-up. At week-12, all patients increased their muscular strength (one repetition maximal test - 1RM) and reduced the percentage of body fat (spectral bioelectrical impedance analysis). CONCLUSIONS: This study, using rigorous criteria and a structured intervention, provides valid pilot data, showing the feasibility of a structured PE intervention for the treatment of depressive symptoms in BD, and suggesting a potential adjunctive antidepressant effect. Moreover, PE showed a positive impact on muscle strength and body composition. This should be further verified by randomized controlled studies.

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Objectives: To examine the composition of self-regulation in pediatric bipolar disorder (PBD) through the relationship between executive functions, emotion processing, and family environmental factors. Methods: 58 participants (36 with PBD and 22 controls), ages 12-17, were assessed using the Barratt Impulsiveness Scale (BIS), Conners' Continuous Performance Test (CPT-II), Wisconsin Cards Sorting Test (WCST), Computerized Neurocognitive Battery Emotion Recognition Test-Facial Emotion Recognition Test (PENNCNB ER-40), and Expressed Emotion Adjective Checklist Questionnaire (EEAC). Results: Adolescents with PBD displayed significant deficits in all three spheres when compared to the control group. Emotion processing correlated negatively with inhibition and attention, and correlated positively with mental flexibility/working memory. Family environmental factors correlated negatively with mental flexibility/working memory and emotion processing, and positively with attention and inhibition. These correlations indicate that better inhibitory control, attention, and mental flexibility/working memory are associated with greater emotion processing and a fitter family environment. Conclusion: This study is the first to investigate all of the components of self-regulation deficits simultaneously in patients with PBD. Results suggest that self-regulation is essential for a comprehensive perspective of PBD and should be assessed in an integrative and multifaceted way. Understanding that self-regulation is impacted by the abovementioned factors should influence treatment and improve the functional impairments of daily life observed in this population.

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OBJECTIVES: To examine the composition of self-regulation in pediatric bipolar disorder (PBD) through the relationship between executive functions, emotion processing, and family environmental factors. METHODS: 58 participants (36 with PBD and 22 controls), ages 12-17, were assessed using the Barratt Impulsiveness Scale (BIS), Conners' Continuous Performance Test (CPT-II), Wisconsin Cards Sorting Test (WCST), Computerized Neurocognitive Battery Emotion Recognition Test-Facial Emotion Recognition Test (PENNCNB ER-40), and Expressed Emotion Adjective Checklist Questionnaire (EEAC). RESULTS: Adolescents with PBD displayed significant deficits in all three spheres when compared to the control group. Emotion processing correlated negatively with inhibition and attention, and correlated positively with mental flexibility/working memory. Family environmental factors correlated negatively with mental flexibility/working memory and emotion processing, and positively with attention and inhibition. These correlations indicate that better inhibitory control, attention, and mental flexibility/working memory are associated with greater emotion processing and a fitter family environment. CONCLUSION: This study is the first to investigate all of the components of self-regulation deficits simultaneously in patients with PBD. Results suggest that self-regulation is essential for a comprehensive perspective of PBD and should be assessed in an integrative and multifaceted way. Understanding that self-regulation is impacted by the abovementioned factors should influence treatment and improve the functional impairments of daily life observed in this population.

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Objectives: This study investigated behavioral self-regulation problems using the Children's Hostility Inventory (CHI) in pediatric bipolar disorder (PBD), healthy offspring of bipolar disorder patients (HOBD), and healthy controls (HC) without previous history of psychiatric disorders. Methods: The CHI was administered to 41 consecutive children and adolescents diagnosed with PBD, to 16 HOBD, and to 22 HC. The inventory assessed irritability, expression, hostility, and aggression and was completed by the children with the help of their mothers. Adolescents and their respective parents were interviewed separately using the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL). Results: All subscales of the CHI presented statistically significant differences, except for the subscale assessing feelings of suspicion. Pairwise comparisons revealed consistently significant differences between the PBD group and controls, indicating more self-regulation difficulties in the PBD group, represented by high levels of hostility and aggressive behavior. There were no significant differences between the PBD and HOBD groups. Conclusions: Future studies should further investigate if such behavior is state-dependent or a trait of bipolar juvenile expression. Expression of hostility and irritability should be considered relevant targets in psychosocial approaches addressing this population.

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The objective of this work was to assess validity and reliability of the Desiderative Questionnaire with adolescent offenders and victims. The sample comprised 200 adolescents, of both genders, between 12 and 16 years of age, of whom 50 were sentenced to correctional measures, 50 were victims of domestic violence and 100 without suspected violence or transgression. Data analysis was performed using the Pearson Chi-Square Test, Kappa Concordance Index and Cronbach's Alpha. The results showed statistically significant differences between the clinical and control groups in several categories, with more difficulties among adolescent victims and offenders. They also revealed precision of the technique used and of the evaluation system with high correlations among the judges as well as high internal consistency, with adequate reliability coefficients.

O objetivo deste trabalho foi realizar estudos de validade e de fidedignidade do Questionário Desiderativo com adolescentes infratores e vitimizados. Compuseram a amostra 200 adolescentes, de ambos os sexos, entre 12 e 16 anos, sendo 50 cumprindo medida socioeducativa, 50 vítimas de violência doméstica e 100 sem suspeitas de sofrerem violência ou terem praticado ato infracional. A análise dos dados foi realizada por meio do Teste Qui-Quadrado de Pearson, Índice de Concordância Kappa e Alfa de Cronbach. Os resultados mostraram que o teste diferenciou de forma estatisticamente significante os grupos clínicos e de controle em várias categorias, identificando mais dificuldades entre os adolescentes vitimizados e infratores, com menor força de ego. Também revelaram precisão da técnica e do sistema de avaliação com elevadas correlações entre os juízes e alta consistência interna, com adequados coeficientes de fidedignidade.

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ABSTRACT Objective: We examined the association between personality traits and parenting styles in boys victims of sexual abuse (SA). Methods: Sixty-two (62) boys were divided into two groups: 32 (Victims of SA group, age 11.7±1.28) and 30 non-victims of SA (Comparison group, age 11.6±1.22). All participants completed the Eysenck Personality Questionnaire (EPQ-J) and the Parenting Styles Inventory (PSI). The intelligence quotient (IQ) was also assessed. Results: Both groups did not differ in terms of IQ. In the SA group, men (97%) were the biggest abusers, 85% of the parents were divorced and the father was the biggest aggressor (44%). The SA victims had higher neuroticism (p <0.001) and identified riskier parental practices, while the comparison group reported good parental practices (p<0.05). The results of the logistic regression analysis showed that higher negative paternal parental style scores increase the chance of belonging to the victims group. Discussion: Victims of SA present a higher risk of neuroticism and perception of dysfunctional family dynamics, with seriously reversed social roles. Further studies are needed to investigate the behavioral, cognitive, emotional, personality and parental styles, and the development of psychological intervention programs and other professional practices for victims of SA and their families in various contexts of violence.

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Studies suggest that the engagement of aged participants in cognitive stimulation programs can reduce expected cognitive decline associated with age. OBJECTIVE: To evaluate the effects of memory training (MT) associated with three-dimensional multiple object tracking (3D-MOT) NeuroTracker (NT) in the elderly. METHODS: Forty-four participants (>60 years of age) were recruited and randomly distributed into two groups: experimental (EG; n=22) and comparative (CG; n=22). Both groups performed 12 one-hour MT sessions, twice a week, consisting of specific computerized stimuli associated with teaching of mnemonic strategies; 10 minutes of NT was part only of the EG's sessions. In pre- and post-training periods, both groups were evaluated using a sociodemographic questionnaire, neuropsychological assessment, as well as a specific measure offered by NT. RESULTS: Both groups benefited from the MT and reported more positive feelings regarding their memory and quality of life. However, the EG obtained better results in tests consistent with the strategies trained and which involved attentional resources, reaction time, visual processing speed, episodic, semantic, subjective and working memory as well as aspects of social cognition. CONCLUSIONS: This study showed that the combination of MT and 3D-MOT contributed for a better cognitive performance in the EG. Thus, the results of the present study encourage further research and the development of combined cognitive interventions for the elderly population with and without cognitive deficits.

Estudos sugerem que o envolvimento de idosos em programas de estimulação cognitiva pode reduzir o declínio cognitivo esperado associado à idade. OBJETIVO: Avaliar os efeitos de um treinamento de memória (TM) associado a um estímulo visuoespacial tridimensional (3D-MOT) NeuroTracker (NT) em idosos. MÉTODO: Quarenta e quatro participantes (>60 anos) foram recrutados e distribuídos aleatoriamente em dois grupos: experimental (GE; n=22) e comparativo (GC; n=22). Ambos os grupos realizaram 12 sessões do TM de uma hora, duas vezes por semana, consistindo em estímulos computadorizados específicos associados ao ensino de estratégias mnemônicas; apenas nas sessões do GE foram utilizados 10 minutos com o NT. Nos períodos pré- e pós-treinamento, ambos os grupos foram avaliados por meio de questionário sociodemográfico, avaliação neuropsicológica e medidas cognitivas específicas do NT. RESULTADOS: Ambos os grupos se beneficiaram do TM e relataram sentimentos mais positivos em relação à memória e à qualidade de vida. No entanto, o GE obteve melhores resultados em testes consistentes com as estratégias treinadas e que envolviam recursos atencionais, tempo de reação, velocidade de processamento visual, memória episódica, semântica, subjetiva e de trabalho, além de aspectos da cognição social. CONCLUSÕES: Este estudo mostrou que a combinação do TM e 3D-MOT contribuiu para um melhor desempenho cognitivo no GE. Dessa forma, os resultados do presente estudo incentivam novas pesquisas e o desenvolvimento de intervenções cognitivas combinadas para a população idosa com e sem déficits cognitivos.

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ABSTRACT. Studies suggest that the engagement of aged participants in cognitive stimulation programs can reduce expected cognitive decline associated with age. Objective: To evaluate the effects of memory training (MT) associated with three-dimensional multiple object tracking (3D-MOT) NeuroTracker (NT) in the elderly. Methods: Forty-four participants (>60 years of age) were recruited and randomly distributed into two groups: experimental (EG; n=22) and comparative (CG; n=22). Both groups performed 12 one-hour MT sessions, twice a week, consisting of specific computerized stimuli associated with teaching of mnemonic strategies; 10 minutes of NT was part only of the EG's sessions. In pre- and post-training periods, both groups were evaluated using a sociodemographic questionnaire, neuropsychological assessment, as well as a specific measure offered by NT. Results: Both groups benefited from the MT and reported more positive feelings regarding their memory and quality of life. However, the EG obtained better results in tests consistent with the strategies trained and which involved attentional resources, reaction time, visual processing speed, episodic, semantic, subjective and working memory as well as aspects of social cognition. Conclusions: This study showed that the combination of MT and 3D-MOT contributed for a better cognitive performance in the EG. Thus, the results of the present study encourage further research and the development of combined cognitive interventions for the elderly population with and without cognitive deficits.

RESUMO. Estudos sugerem que o envolvimento de idosos em programas de estimulação cognitiva pode reduzir o declínio cognitivo esperado associado à idade. Objetivo: Avaliar os efeitos de um treinamento de memória (TM) associado a um estímulo visuoespacial tridimensional (3D-MOT) NeuroTracker (NT) em idosos. Método: Quarenta e quatro participantes (>60 anos) foram recrutados e distribuídos aleatoriamente em dois grupos: experimental (GE; n=22) e comparativo (GC; n=22). Ambos os grupos realizaram 12 sessões do TM de uma hora, duas vezes por semana, consistindo em estímulos computadorizados específicos associados ao ensino de estratégias mnemônicas; apenas nas sessões do GE foram utilizados 10 minutos com o NT. Nos períodos pré- e pós-treinamento, ambos os grupos foram avaliados por meio de questionário sociodemográfico, avaliação neuropsicológica e medidas cognitivas específicas do NT. Resultados: Ambos os grupos se beneficiaram do TM e relataram sentimentos mais positivos em relação à memória e à qualidade de vida. No entanto, o GE obteve melhores resultados em testes consistentes com as estratégias treinadas e que envolviam recursos atencionais, tempo de reação, velocidade de processamento visual, memória episódica, semântica, subjetiva e de trabalho, além de aspectos da cognição social. Conclusões: Este estudo mostrou que a combinação do TM e 3D-MOT contribuiu para um melhor desempenho cognitivo no GE. Dessa forma, os resultados do presente estudo incentivam novas pesquisas e o desenvolvimento de intervenções cognitivas combinadas para a população idosa com e sem déficits cognitivos.

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Sexual abuse (SA) is associated with significant psychological problems in childhood, making it increasingly important to develop evaluation protocols. This study examined clinical aspects and cognitive measures of 49 children (24 with SA history and 25 controls). It employed a SA assessment questionnaire, clinical evaluations of posttraumatic stress disorder, risk indicators and neuropsychological tests in order to elaborate a specific forensic psychological evaluation protocol for this population. Conflicting couples (80%), separated parents (68%) and parents' alcohol/drug abuse (76%) were revealed as major risk factors. Fathers represented the primary perpetrator (24%). The main cognitive complaint was difficulty concentrating. Regarding the association between clinical and cognitive variables, it was observed that children who were anxious or referred to having fear, difficulties with operational memory and difficulty sleeping, had more trouble performing tasks that required attention and memory (operational, immediate and late). Children with SA history demonstrated inferior performance in visual attention/task switching and memory; with an emphasis in the loss of set in the Wisconsin test. The findings suggest the possibility of a primary attention deficit in children with SA history, possibly influencing the performance of other cognitive functions.

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BACKGROUND: Personality traits have been associated with a series of dysfunctional behaviors, ranging from violence to drug abuse and other risky behaviors. However, few studies have investigated motorcycle riders' personality traits, and no research using the psychobiological model of personality was found. Thus, we investigated the association between temperament and character traits and the occurrence of Motorcycle Accidents (MAs). METHODS: This cross-sectional study was conducted with a randomly selected of 153 Brazilian motorcycle riders (116 male and 37 female) with a mean age of 31.8randomly selected from the driver's license register, between 2015 and 2018. A sociodemographic questionnaire and the Temperament and Character Inventory (TCI) were used. RESULTS: Of the 153 participants, 146 (95.4%) reported having been involved in previous accidents, with the main causes as follows: "other drivers' careless behavior" (34.9%); "personal disrespect of traffic rules" (18.5%) and "personal careless behavior" (20.6%). Motorcyclists exhibited higher scores for the temperament factors of novelty seeking and persistence and lower scores for harm avoidance and reward dependence in comparison to the Brazilian population). Considering the reason for motorcycle use, the group of riders that used their motorcycles for work exhibited more temperament factors associated with risk behaviors than those who did not. It was observed that 68.9% of them had low Harm Avoidance (HA) factor scores, whereas 72.1% had high Novelty Seeking (NS) factor scores. DISCUSSION: The present study highlighted the influences of different personality traits on behaviors, decision-making and risk attitudes that can be potentially harmful to an individual and others. The results provided evidence that a lack of knowledge and experience in riding a motorcycle or any other vehicle, combined with personality traits, contribute to the adoption of risky behaviors that may act as triggers for most causes of Motorcycle Accidents.

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O presente estudo objetivou mapear os traços de personalidade (Psicoticismo, Neuroticismo e Extroversão) de adolescentes brasileiros vítimas de abuso intrafamiliar, nas modalidades física e/ou sexual, e autores de ato infracional. A amostra foi composta por um total de 200 adolescentes de ambos os sexos na faixa etária entre 12 e 16 anos, divididos em três grupos: a) 50 adolescentes infratores, b) 50 adolescentes vítimas de abuso intrafamiliar físico e/ou sexual, c) 100 adolescentes sem suspeitas de sofrerem violência doméstica ou terem praticado ato infracional. Como instrumento, foi utilizado o Eysenck Personality Questionnaire Junior (EPQ-J). Os dados foram avaliados pela análise da significância da diferença entre os grupos de pesquisa por meio do teste de comparação múltipla de Tukey. Foram encontradas diferenças significantes entre os grupos de pesquisa nos tres fatores analisados (Psicotisismo p<0,001; Extroversão p<0,015; Neuroticismo p<0,027), indicando principalmente nos grupos clínicos tendência a reagir de forma desajustada, impulsiva e agressiva. Também se mostraram mais introvertidos, não sociáveis, com isolamento social, além de apresentarem hipersensibilidade emocional, com excitabilidade e traços de ansiedade, que podem desencadear transtornos de humor, principalmente a depressão. Conclui-se que as experiências de vitimização intrafamiliar e de prática de atos infracionais, além de se mostrarem como faces de uma mesma moeda, prejudicam a adaptação do indivíduo e interferem na forma como atuam no ambiente, podendo levar ao comprometimento da saúde mental de sujeitos e ao desencadeamento de transtornos de humor ou de carater.

The present study aimed to map the personality traits (Psychoticism, Neuroticism and Extroversion) of Brazilian adolescents victims of intrafamilial abuse, in physical and/or sexual modalities, and perpetrators of an infrational act. The sample consisted of a total of 200 adolescents of both sexes aged 12 to 16 years, divided into three groups: a) 50 young offenders, b) 50 adolescents victims of physical and/or sexual intrafamilial abuse, c) 100 adolescents who are not suspected of experiencing domestic violence or have committed an infraction act. As an instrument, the Eysenck Personality Questionnaire Junior (EPQ-J) was used. Data were evaluated by analyzing the significance of the difference between the research groups using Tukey's multiple comparison test. Significant differences were found between the research groups in the three analyzed factors (Psychoticism p <0.001; Extroversion p <0.015; Neuroticism p <0.027), indicating mainly in the clinical groups a tendency to react inappropriately, impulsively and aggressively. They were also more introvert, non-sociable, with social isolation, besides presenting emotional hypersensitivity, excitability and anxiety traits, which can trigger mood disorders, especially depression. It is concluded that the experiences of intrafamilial abuse and the practice of infraction act, besides being shown as two sides of the same coin, impair the individual's adaptation and interfere the way they act in the environment, which may lead to impairment of the mental health of subjects. and triggering mood or character disorders.

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The neuropsychological deficits in attention-deficit/hyperactivity disorder (ADHD) may present clinical features similar to mild and/or major neurocognitive disorder and may act as a confounding factor, making it difficult to detect cognitive decline. In this paper, we present the results of longitudinal neuropsychological evaluations in two elderly women with ADHD. Three neuropsychological assessments were performed in two women with ADHD (60 and 77 years old) between 2010 and 2013 at intervals varying from 12 to 15 months. We used structural magnetic resonance imaging to rule out significant abnormalities that could account for cognitive impairment. The results showed two different cognitive profiles with fluctuations in performance over these 2 years, sometimes with improvement and sometimes with decline of some functions such as attention, memory, inhibitory control, and reaction time. To minimize confounding aspects of these fluctuations in clinical practice, we used a longer follow-up with the application of a reliable change index and a minimum of three spaced assessments to provide a more consistent baseline cognitive profile. Our findings did not indicate a consistent cognitive decline, suggesting a less pessimistic perspective about cognitive impairments that could be a prodrome of ADHD-related dementia.

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BACKGROUND: Bipolar disorder (BD) is commonly associated with cognitive and functional impairments even during remission periods, and although a growing number of studies have demonstrated the benefits of psychotherapy as an add-on to pharmacological treatment, its effectiveness appears to be less compelling in severe presentations of the disorder. New interventions have attempted to improve cognitive functioning in BD patients, but results have been mixed. METHODS: The study consists of a clinical trial comparing a new structured group intervention, called "Cognitive-Behavioral Rehabilitation," with treatment as usual (TAU) for bipolar patients. The new approach is a combination of cognitive behavioral strategies and cognitive remediation exercises, consisting of 12 weekly group sessions of 90 min each. To be included in the study, patients must be diagnosed with BD type I or II, aged 18-55 years, in full or partial remission, and have an IQ of at least 80. A comprehensive neuropsychological battery, followed by mood, social functioning, and quality of life assessments will occur in three moments: pre and post intervention and 12 months later. The primary outcome of the study is to compare the time, in weeks, that the first full mood episode appears in patients who participated in either group of the study. Secondary outcome will include improvement in cognitive functions. DISCUSSION: This is the first controlled trial assessing the validity and effectiveness of the new "Cognitive-Behavioral Rehabilitation" intervention in preventing new mood episodes and improving cognitive and functional impairments. TRIAL REGISTRATION: Clinicaltrial.gov, NCT02766361 . Registered on 2 May 2016.

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BACKGROUND: Bipolar disorder (BD) patients exhibit cognitive impairments during euthymic states. Studies suggest that manic episodes may be correlated to cognitive impairments. The present study investigated the relationship between predominant polarity and the cognitive deficits frequently detected in bipolar patients. We hypothesize that mania predominant polarity (MPP) patients should exhibit greater cognitive impairments in comparison to depressive (DPP) and indefinite predominant polarity (IPP) patients and healthy control (HC) individuals. METHODS: The study evaluated 55 euthymic BD patients, type I and II, and 31 HCs. Patients were divided into 3 groups: MPP (n = 17), DPP (n = 22), and IPP (n = 16), and compared regarding demographic and clinical variables, and performance on a 7-test neuropsychological battery. RESULTS: MPP patients demonstrated greater cognitive impairments in alternating attention, verbal fluency, and delayed memory in comparison to DPP, IPP, and HC. Compared to HC, IPP patients exhibit cognitive deficits in verbal fluency and alternating attention and DPP patients solely in verbal fluency. Furthermore, DPP patients did not exhibit, in none of the seven neuropsychological tests, significant poorer performances than MPP or IPP patients, although having significant more episodes than MPP patients. CONCLUSION: MPP patients exhibit increased cognitive impairments in comparison to DPP, IPP, and HC subjects. Manic episodes may play an important role in the development of cognitive deficits and thus, in potential neuroprogression. Predominant polarity may be an important specifier for predicting future cognitive impairments.