Clientela adulta de serviço psicológico: características clínicas e sociodemográficas

Abstract: In Brazil, there is a clear need for the offer of mental health services meet the needs and the characteristics of the population who seeks them. This study aimed to characterize clinical and demographic aspects of adult clients of a Psychology Clinic School at a university in the southern Brazil. During the 2009-2010 period, 557 adults passed through the process of triage. Of these, 170 (29.46%) participated in the present study. The participants were mostly women (66.5%) and attended college (47.1%). The most prevalent age group was between 20-29 years old (41.8%). The results obtained from the Adult Self-Report showed a higher percentage of individuals classified in the clinical range on the subscales of anxiety, depression, social competence, family and work problems. The co-existence of multiple complains at the same patients was evidenced.Keywords: school-clinics; clinical psychology; psychological assessment; self-assessment scale; adults.Resumen: En Brasil, hay una clara necesidad que la oferta de servicios de salud mental de satisfacer las necesidades y las características de la población que los busca. Este estudio tuvo como objetivo caracterizar los aspectos demográficos y clínicos de los clientes adultos de la escuela clínica de psicología de una universidad del Sur de Brasil. Durante el período 2009-2010, 577 adultos pasaron por el proceso de selección, pero 170 (29,46%) participaron en este estudio. Los participantes eran en su mayoría mujeres (66,5%) y estaban en la universidad (47,1%). El grupo de edad de 20-29 años fue lo más frecuente (41,8%). Los resultados del Adult Self-Report muestran un mayor porcentaje de personas clasificadas en el rango clínico para los problemas de ansiedad, depresión, competencia social y problemas familiares y laborales. La co-existencia de múltiples quejas en el mismo paciente se evidenció.Palabras clave: escuela clínica; psicología clínica; evaluación psicológica; escala de autoevaluación ; adultos. Resumo: No Brasil, é clara a necessidade de que a oferta de serviços de saúde mental vá ao encontro das necessidades e características da população que os procura. Este estudo objetivou caracterizar aspectos sociodemográficos e clínicos da clientela adulta da clínica-escola da faculdade de psicologia de uma universidade do Sul do Brasil. Durante o biênio 2009-2010, 577 adultos passaram pelo processo de triagem, dos quais 170 (29,46%) participaram deste estudo. Os participantes eram majoritariamente do sexo feminino (66,5%) e estavam na faixa do ensino superior (47,1%). A faixa etária de 20-29 anos foi a mais prevalente (41,8%). Segundo os resultados do Adult Self-Report, houve maior porcentagem de pessoas classificadas na faixa clínica nas subescalas que avaliam ansiedade, depressão, competência social e problemas familiares e ocupacionais. A coexistência de múltiplas queixas no mesmo paciente foi evidenciada.Palavras-chave: clínicas-escola; psicologia clínica; avaliação psicológica; escala de autoavaliação; adultos.

Psychometric Properties and Factor Structure of the French Version of the Behavioral Activation for Depression Scale (BADS) in Non-Clinical Adults

peer reviewedBehavioral activation (BA) is a well-established empirical treatment for depression that aims to improve depressive mood by increasing activation and reducing avoidance. Therefore, it is essential to evaluate activation and avoidance when a BA treatment is applied. The Behavioral Activation for Depression Scale (BADS) was developed to measure the changes in activation and avoidance over the course of BA treatment of depression. This study aims to validate the French version of this scale. In a first study, 131 bilingual adults was recruited to explored internal consistency, test-retest reliability and construct validity of the final French version. In a second study, 409 non-clinical adults completed an online survey assessing concurrent measures. Results of the first study suggest good internal consistency, test-retest reliability and construct validity. The second study revealed a confirmatory factor analysis supporting the original four-factor structure, with Activation, Avoidance/Rumination, Work/School Impairment, and Social Impairment subscales. Results also revealed that a 5-factor model distinguishing Behavioral Avoidance and Rumination had a better fit than the original four-factor structure. All subscales showed adequate internal consistency and good construct validity with evidence of convergent validity with depressive symptoms, brooding, psychological flexibility, negative automatic thought, behavioral inhibition and activation system. Furthermore, the French BADS total scale and subscales showed a good ability to predict depressive symptoms. The French version of the BADS appears to be a reliable tool for clinician and researchers to assess mechanisms of change in BA interventions

Matched or nonmatched interventions based on the transtheoretical model to promote physical activity. A meta-analysis of randomized controlled trials

The aim of this study was to examine whether the efficacy of transtheoretical model (TTM)–based interventions on physical activity (PA) varied according to the following criteria: (1) interventions targeted the actual stages of change (SOCs) or did not; (2) participants were selected according to their SOC or were not; and (3) its theoretical constructs (decisional balance, temptation, self-efficacy, processes of change). Thirty-three randomized controlled trials assessing TTM-based interventions promoting PA in adults were systematically identified. The between-group heterogeneity statistic (Qb) did not reveal any differential efficacy either in interventions targeting the actual SOC compared with those that did not (Qb = 1.28, p = 0.22) or in interventions selecting participants according to their SOC compared with those that did not (Qb = 0.01, p = 0.91). TTM-based interventions enhanced PA behavior whether they targeted the actual SOC (Cohen's d = 0.36; 95% confidence interval (CI): 0.22–0.49)) or not (d = 0.23; 95% CI: 0.09–0.38) and whether they selected their participants according to their SOC (d = 0.33; 95% CI: 0.13–0.53) or not (d = 0.32; 95% CI: 0.19–0.44). The moderators of the efficacy of TTM-based interventions were the number of theoretical constructs used to tailor the intervention (Qb = 8.82, p = 0.003), the use of self-efficacy (Qb =6.09, p = 0.01), and the processes of change (Qb = 3.51, p = 0.06). TTM-based interventions significantly improved PA behavior, and their efficacy was not moderated by SOC but by the TTM theoretical constructs

Unravelling socio-motor biomarkers in schizophrenia

We present novel, low-cost and non-invasive potential diagnostic biomarkers of schizophrenia. They are based on the ‘mirror-game’, a coordination task in which two partners are asked to mimic each other’s hand movements. In particular, we use the patient’s solo movement, recorded in the absence of a partner, and motion recorded during interaction with an artificial agent, a computer avatar or a humanoid robot. In order to discriminate between the patients and controls, we employ statistical learning techniques, which we apply to nonverbal synchrony and neuromotor features derived from the participants’ movement data. The proposed classifier has 93% accuracy and 100% specificity. Our results provide evidence that statistical learning techniques, nonverbal movement coordination and neuromotor characteristics could form the foundation of decision support tools aiding clinicians in cases of diagnostic uncertainty

Correlates of hallucinatory experiences in the general population: an international multi-site replication study

Hallucinatory experiences can occur in both clinical and nonclinical groups. However, in previous studies of the general population, investigations of the cognitive mechanisms underlying hallucinatory experiences have yielded inconsistent results. We ran a large-scale preregistered multisite study, in which general-population participants (N = 1,394 across 11 data-collection sites and online) completed assessments of hallucinatory experiences, a measure of adverse childhood experiences, and four tasks: source memory, dichotic listening, backward digit span, and auditory signal detection. We found that hallucinatory experiences were associated with a higher false-alarm rate on the signal detection task and a greater number of reported adverse childhood experiences but not with any of the other cognitive measures employed. These findings are an important step in improving reproducibility in hallucinations research and suggest that the replicability of some findings regarding cognition in clinical samples needs to be investigated

Item-specific overlap between hallucinatory experiences and cognition in the general population: A three-step multivariate analysis of international multi-site data

Hallucinatory experiences (HEs) can be pronounced in psychosis, but similar experiences also occur in nonclinical populations. Cognitive mechanisms hypothesized to underpin HEs include dysfunctional source monitoring, heightened signal detection, and impaired attentional processes. Using data from an international multisite study on non-clinical participants (N = 419), we described the overlap between two sets of variables - one measuring cognition and the other HEs - at the level of individual items. We used a three-step method to extract and examine item-specific signal, which is typically obscured when summary scores are analyzed using traditional methodologies. The three-step method involved: (1) constraining variance in cognition variables to that which is predictable from HE variables, followed by dimension reduction, (2) determining reliable HE items using split-halves and permutation tests, and (3) selecting cognition items for interpretation using a leave-one-out procedure followed by repetition of Steps 1 and 2. The results showed that the overlap between HEs and cognition variables can be conceptualized as bi-dimensional, with two distinct mechanisms emerging as candidates for separate pathways to the development of HEs: HEs involving perceptual distortions on one hand (including voices), underpinned by a low threshold for signal detection in cognition, and HEs involving sensory overload on the other hand, underpinned by reduced laterality in cognition. We propose that these two dimensions of HEs involving distortions/liberal signal detection, and sensation overload/reduced laterality may map onto psychosis-spectrum and dissociation-spectrum anomalous experiences, respectively

Effects of Facial Emotions on Social-motor Coordination in Schizophrenia

Schizophrenia patients are known to be impaired in their ability to process social information and to engage in social interactions. To understand better social cognition in schizophrenia, we investigate the links between these impairments. In this paper, we focus primarily on the influence of social feedback, such as facial emotions, on motor coordination during joint action. To investigate and quantify this influence, we exploited systematically-controlled social and nonsocial feedback provided by a humanoid robot. Humanoid robotics technology offers interactive designs and can precisely control the properties of the feedback provided during the interaction. In this work, a joint-action task with a robot is performed to investigate how social cognition is affected by cognitive capabilities and symptomatology. Results show that positive social feedback has a facilitatory effect on social-motor coordination in the control participants compared to nonsocial positive feedback. This facilitation effect is not present in schizophrenia patients, whose social-motor coordination is similar in social and nonsocial feedback conditions. This result is strongly correlated with performances in the Trail Making Test (TMT), which highlights the link between cognitive deficits and social-motor coordination in schizophrenia

Self and Face : Exploring Their Relationships in Healthy Individuals and Schizophrenia Patients Using Meta-Analysis, Eye Tracking and Behavioral Methods.

La schizophrénie est un trouble psychiatrique complexe et hétérogène caractérisée par des symptômes positifs, les symptômes négatifs et des déficits cognitifs. Elle se caractérise également par des dysfonctionnements sociaux marqués, y compris des déficits dans la reconnaissance des visages. Outre des difficultés à reconnaître le visage d'autres personnes, les déficits de reconnaissance du propre visage ont également été décrits dans la schizophrénie. Notre propre visage est considéré comme un stimulus spécial, car il constitue une des caractéristiques physiques la plus distinctive d’un individu, en plus d'être une partie importante de notre identité. Par conséquent, l'objectif de cette thèse fut de mieux déterminer dans un premier temps les facteurs sous-tendant la spécificité de notre propre visage au regard des autres visages (familiers et étrangers) chez les individus non cliniques, ainsi que dans la schizophrénie, une pathologie mentale sévère altérant de nombreux domaines associés à l’identité. Quatre études ont été réalisées afin de répondre à ces deux objectifs principaux. Premièrement, une meta-analyse menée a pu mettre en évidence que l’avantage en terme de temps de réaction diminué lors du traitement de notre propre visage pourrait être mieux expliqué par un effet de familiarité ou de représentation plus stable de son propre visage plutôt que par des caratéritiques uniques et spécifiques associées à notre propre visage. En revanche, la représentation du propre visage semble être moins stable dans la schizophrénie et spécialement sensible aux contraintes de temps. De plus, nos résultats ont également montré que lorsque les patients regardent leur propre image dans un miroir, ceux-ci rapportent plus souvent des expériences anormales, notamment en lien avec la symptomatologie positive. Ainsi dans leur ensemble, nos résultats indiquent que les patients ayant reçu un diagnostic de schizophrénie sont capables de reconnaître leur visage, bien qu'ils semblent posséder une représentation plus instable de leur propre visage entraînant un sentiment d'étrangeté.Schizophrenia is a complex and heterogeneous psychiatric characterized by positive symptoms, negative symptoms, cognitive deficits and also motor abnormalities. The disease is also characterized by marked social dysfunctions including deficits in face recognition. Besides difficulties in recognize other people’s face, self-face recognition deficits have been also described in schizophrenia. Self-face has been considered a special stimulus since it is individuals' most distinctive physical feature, besides of being an important part of our identity. Therefore, the aim of the present thesis is to further understand self-face specialness and self-face processing in healthy controls, but more importantly in schizophrenia disorder. Four studies were performed in order to respond to this main object. In the one hand, the studies found that self-face processing advantage could be better explained by a familiarity effect or a more stable representation of one's own face rather than self-specialness in healthy controls. In the other hand, the representation of the one's own face seems to be less stable in schizophrenia and especially sensible to time constraint. When no time constraint was imposed, they were capable to recognize their own face under perceptual ambiguity in photographs. Moreover, our results also showed when looking at their own image in the mirror patients reported more often abnormal experiences. All together, our results indicated that patients are capable to recognize their face and discriminate it from other’s people face, although they might possess a more unstable representation of their own face resulting in a feeling of strangeness

Psychosis, trauma and dissociation: evolving perspectives on severe psychopathology

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Translation and Validation of the French Version of the Revised Green et al., Paranoid Thoughts Scale (R-GPTS) in Two Samples: Non-Clinical and Clinical Adults

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