Validation of the Brazilian-Portuguese version of the Clinician Administered Post Traumatic Stress Disorder Scale-5

Objectives: The aim of this study was to validate CAPS-5 for the Brazilian-Portuguese language on a sample of 128 individuals from two centers (from the cities of São Paulo and Porto Alegre) who have been recently exposed to a traumatic event. Methods: We performed a reliability analysis between interviewers (with a subset of 32 individuals), an internal consistency analysis, and a confirmatory factorial analysis for the validation study. Results: The inter-rater reliability of the total PTSD symptom severity score was high [intraclass correlation coefficient =0.994, 95% CI (0.987–0.997), p < 0.001]. Cohen’s Kappa for individual items ranged between 0.759 and 1. Cronbach’s alpha coefficients indicated high internal consistency for the CAPS-5 full scale (α = 0.826) and an acceptable level of internal consistency for the four symptom clusters. The confirmatory factorial analysis for the 20-item original CAPS-5 did not fit the data well. A 15-item model with better results was then established by excluding the following CAPS-5 items: dissociative amnesia, recklessness, distorted cognitions, irritability, and hypervigilance. Conclusion: Despite the limitation of the predominance of female victims, and the high number of sexually assaulted women in our sample, the model with only 15 items provided a good fit to the data with high internal consistency (α = 0.835)

A SYSTEMATIC REVIEW ON the EFFECTIVENESS of COGNITIVE BEHAVIORAL THERAPY for POSTTRAUMATIC STRESS DISORDER

Objective: Cognitive behavioral therapy (CBT) is the most common psychotherapy approach for the treatment of PTSD. Nevertheless, previous reviews on the efficacy of several types of psychotherapy were unable to detect differences between CBT and other psychotherapies. the purpose of this study was to conduct systematic review on the efficacy of CBT in comparison with studies that used other psychotherapy techniques. Method: Databases were searched using the following terms: posttraumatic stress disorder/stress disorder, treatment/psychotherapy/behavior cognitive therapy, randomized trials, and adults. Randomized clinical trials published between 1980 and 2005 and that compared CBT with other treatments for PTSD was included. the main outcomes were remission, clinical improvement, dropout rates and changes in symptoms. Results: the 23 clinical trials included in the review comprised 1,923 patients: 898 in the treatment group and 1,025 in the control group. CBT had better remission rates than EMDR (RR = 0.35; 95%CI: 0.16; 0.79; p = 0.01) or supportive therapies (RR = 0.43; 95%CI: 0.25; 0.74; p = 0.002, completer analysis). CBT was comparable to Exposure Therapy (ET) (RR = 0.90; 95%CI: 0.58; 1.40; p = 0.64), and cognitive therapy (CT) (RR = 1.01; 95%CI: 0.67; 1.51; p = 0.98) in terms of efficacy and compliance. Conclusions: These findings suggest that specific therapies, such as CBT, exposure therapy and cognitive therapy are equally effective, and more effective than supportive techniques in the treatment of PTSD.State of São Paulo Research CouncilFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Millennium Institute, the National Research CouncilConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Universidade Federal de São Paulo, Dept Psiquiatria, BR-04023900 São Paulo, BrazilUniv Fed Rio de Janeiro, BR-21941 Rio de Janeiro, BrazilUniversidade Federal de São Paulo, Dept Psiquiatria, BR-04023900 São Paulo, BrazilFAPESP: 04/15039-0CNPq: 42.122/2005-2Web of Scienc

The accuracy of the Clinician-Administered PTSD Scale (CAPS) to identify PTSD cases in victims of urban violence

As a consequence of the increasing urban violence in Brazil, many cases of posttraumatic stress disorder (PTSD) are now seen in the community and clinical settings. the main aim of this article is to assess the psychometric properties of the Clinician-Administered PTSD Scale (CAPS) to study factors related to the etiology, prognosis, and efficacy of interventions of PTSD in civilian populations. PTSID outpatients from a program of victims of violence and subjects identified in an epidemiological survey conducted in the city of São Paulo completed a battery of validated instruments and the CAPS. Instrument reliability and validity were measured. the comparison between the CAPS scores and the Structured Clinical Interview for DSM IV (SCID) interview resulted in the following validity coefficients: sensitivity = 90%, specificity = 95%, and misclassification rate = 7.1%. the area under the receiver operating characteristic (ROC) curve was 0.97. There was a positive correlation between CAPS scores with Beck Depression Inventory (BDI; 0.70) and Beck Anxiety Inventory (BAI; 0.76) scores. the Kappa coefficients were all higher than 0.63 for all CAPS items. the internal consistency for all CAPS items resulted in a Cronbach's alpha coefficient of 0.97. the CAPS showed to be both an accurate and a reliable research instrument to identify PTSD cases in a civilian population. (C) 2009 Elsevier Ireland Ltd. All rights reserved.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Universidade Federal de São Paulo, Dept Psiquiatria, BR-04026001 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Psiquiatria, BR-04026001 São Paulo, BrazilFAPESP: 2004/15039-0CNPq: 420122/2005-2CAPES: 27909024886Web of Scienc

Reduction of anterior cingulate in adults with urban violence- related PTSD

Background: To evaluate differences in limbic structure volume of subjects exposed to urban violence during adulthood, between those who developed posttraumatic stress disorder (with PTSD) and resilient matched controls (without PTSD).Methods: Limbic volumetric measures of 32 subjects with PTSD and 32 subjects without PTSD who underwent brain MRI were analyzed in an epidemiological study in the city of São Paulo. the hippocampus, amygdala, cingulate, and parahipocampal gyri volumes were estimated using FreeSurfer software. We also investigated the association between limbic volumetric measurements, symptom's severity, and early life stress history (measure by Early Trauma Inventory - ETI).Results: Subjects with PTSD presented reduced volume of the right rostral part of the anterior cingulate, compared to subjects without PTSD, after controlling for iraracranial volume, Eft and depressive symptoms. Subjects with PTSD presented larger bilateral hippocampus and right amygdala, but secondary to the higher EU in PTSD group there was a positive correlation between with bilateral hippocampus, bilateral amygclala, and left parahippocampus.Limitations.: First, the cross-sectional study design precludes causal interpretation of limbic structure reduction in PTSD, consequence of PTSD, or other life events. Finally, since the sample size was not sufficiently large, we could not observe whether or not limbic structure volume could be related to the type of trauma.Conclusions: the present study provides evidence of a reduced anterior cingulate volume in subjects with PTSD than in resilient subjects exposed to urban violence. Enlargement of hippocampus and amygdala volume was observed in subjects with PTSD, however secondary to early trauma experience. (C) 2014 Elsevier B.V. All rights reserved.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Universidade Federal de São Paulo, LiNC, BR-04039032 São Paulo, BrazilUniv Fed Tocantins, Palmas, TO, BrazilUniversidade Federal de São Paulo, LiNC, BR-04039032 São Paulo, BrazilFAPESP: 2004/15039-0CNPq: 420122/2005-2Web of Scienc

Supplemental material for A Longitudinal ¹H-MRS Study of the Anterior Cingulate Gyrus in Child and Adolescent Victims of Multiple Forms of Violence

<p>Supplemental material for A Longitudinal ¹H-MRS Study of the Anterior Cingulate Gyrus in Child and Adolescent Victims of Multiple Forms of Violence by Ana Carolina Coelho Milani, Bernd Foerster, Hugo Cogo-Moreira, Thiago Michel de Brito Farias, Francisco Salido, Henrique Carrete Jr., Marcelo Feijo Mello and Andrea Parolin Jackowski in Chronic Stress</p

Psiconeuroendocrinologia do transtorno de estresse pós-traumático Psychoneuroendocrinology of posttraumatic stress disorder

OBJETIVO: Os autores realizaram uma revisão tradicional da literatura sobre os achados neurobiológicos das disfunções do eixo hipotálamo-pituitária-adrenal associados ao transtorno de estresse pós-traumático. MÉTODO: Os achados científicos relevantes foram descritos de acordo com a ordem cronológica de publicação e as características dos estudos, se eram pré-clínicos, relacio-nados à violência precoce como fator de risco e, finalmente, achados clínicos em pacientes portadores de transtorno de estresse pós-traumático. RESULTADOS: Foi encontrada uma literatura rica de achados a respeito de disfunções do eixo hipotálamo-pituitária-adrenal e transtorno de estresse pós-traumático. Os achados mostraram que o transtorno de estresse pós-traumático está associado a disfunções deste eixo e de estruturas cerebrais como o córtex pré-frontal, hipocampo e amídala. Os pacientes com transtorno de estresse pós-traumático apresentam um aumento da responsividade dos receptores de glicocorticóides, sugerindo que a inibição do feedback negativo tem um papel importante na fisiopatologia do quadro. Estudos pré-clínicos com modelos animais de deprivação maternal evidenciaram que, dependendo de quando o trauma ocorre, a disfunção do eixo será diferente. Os estudos clínicos mostram que o estresse precoce está relacionado ao desenvolvimento de psicopatologia durante a vida adulta. CONCLUSÕES: As disfunções do eixo hipotálamo-pituitária-adrenal relacionadas ao transtorno de estresse pós-traumático são evidências robustas e os mecanismos subjacentes a ele são cada vez mais compreendidos.<br>OBJECTIVE: To review the literature on neurobiological findings related to hypothalamic-pituitary-adrenal axis dysfunctions associated with posttraumatic stress disorder. METHOD: The relevant scientific findings were described according to the date of publication and the characteristics of the studies: preclinical studies, studies on early life violence as a risk factor, and clinical findings related to patients diagnosed with posttraumatic stress disorder. RESULTS: A rich literature on hypothalamic-pituitary-adrenal axis dysfunctions and posttraumatic stress disorder was found. Neurobiological findings showed that posttraumatic stress disorder is associated with hypothalamic-pituitary-adrenal axis dysfunctions and other brain-related structures: prefrontal cortex, hippocampus, and amygdala. Posttraumatic stress disorder patients have low plasma levels of cortisol and present increased responsivity of glucocorticoid receptors, suggesting that the inhibition of negative feedback plays a significant role in the disorder pathology. Preclinical studies using animal models of maternal deprivation showed that depending on the moment the trauma occurred during the development, different hypothalamic-pituitary-adrenal axis dysfunctions were produced. Clinical studies showed that early life stress is related to the development of psychopathologies during adulthood. CONCLUSIONS: There is robust evidence of hypothalamic-pituitary-adrenal axis dysfunctions related to posttraumatic stress disorder, and the mechanisms underlying this association are being better understood

ATLANTIC MAMMAL TRAITS: a data set of morphological traits of mammals in the Atlantic Forest of South America

Univ Estadual Paulista, UNESP, Dept Ecol, Inst Biociencias, BR-13506900 Rio Claro, SP, BrazilUniv Fed Santa Catarina, Ctr Ciencias Biol, Dept Ecol & Zool, Florianopolis, SC, Brazil|Caipora Cooperat, Florianopolis, SC, BrazilUniv Estadual Santa Cruz, Programa Posgrad Ecol & Conservac Biodiversidade, Lab Ecol Aplicada Conservacao, Ilheus, BA, BrazilUniv Estadual Santa Cruz, CMARF, Ilheus, BA, BrazilUniv Brasilia, Dept Ecol, Inst Ciencias Biol, Lab Ecol Vertebrados, Brasilia, DF, BrazilUniv Fed Santa Maria, Dept Ecol & Evolut, Santa Maria, RS, BrazilUniv Sao Paulo, Inst Biociencias, Dept Zool, Sao Paulo, SP, BrazilUniv Fed Espirito Santo, Ctr Ciencias Humanas & Nat, Dept Ciencias Biol, Vitoria, ES, BrazilUniv Fed Minas Gerais, Inst Ciencias Biol, Dept Biol Geral, Belo Horizonte, MG, BrazilUniv Fed Mato Grosso de Sul, Inst Biociencias, Campo Grande, MS, BrazilUniv Fed Parana, Dept Zool, Curitiba, Parana, BrazilUniv Fed Parana, Programa Posgrad Ecol & Conservcao, Curitiba, Parana, BrazilUniv Estado Rio de Janeiro, Dept Ecol, Rio De Janeiro, RJ, BrazilUniv Estadual Paulista, UNESP, Inst Biociencias, Dept Zool, Rio Claro, SP, BrazilUniv Extremo Sul Catarinense, Programa Posgrad Ciencias Ambientais, Criciuma, SC, BrazilUniv Sao Paulo, ESALQ, Dept Ciencias Biol, Piracicaba, SP, BrazilUniv Nacl Misiones, CONICET, Inst Biol Subtrop, Puerto Iguazu, Misiones, ArgentinaAsociac Civil Ctr Invest Bosque Atlantico, Puerto Iguazu, Misiones, ArgentinaFIOCRUZ Amazonas, Inst Leonidas & Maria Deane, Manaus, Amazonas, BrazilUniv Estadual Paulista, UNESP, Dept Zootecnia, Jaboticabal, SP, BrazilField Museum Nat Hist, Integrated Res Ctr, Chicago, IL 60605 USAUniv Fed Pernambuco, Ctr Biociencias, Dept Zool, Lab Ciencia Aplicada Conservacao Biodiversidade, Recife, PE, BrazilInst Chico Mendes Conservacao Biodiversidade, Ctr Nacl Pesquisa & Conservacao Mamiferos Carnivo, Sao Paulo, BrazilUniv Vale Rio dos Sinos, Sao Leopoldo, RS, BrazilUniv Reg Cariri, Dept Biol, Lab Ecol Mamiferos, Crato, CE, BrazilUniv Fed Rio de Janeiro, Dept Ecol, Lab Vertebrados, Rio De Janeiro, RJ, BrazilUniv Federal Mato Grosso do Sul, Programa Posgrad Ecol & Conservacao, Campo Grande, MS, BrazilIPE, Nazare Paulista, SP, BrazilUniv Fed Minas Gerais, Programa Posgrad Zool, Belo Horizonte, MG, BrazilUniv Estado Minas Gerais, Dept Ciencias Biol, Ibirite, MG, BrazilPREA, Programa Educ Ambiental, Juiz De Fora, MG, BrazilChinese Acad Sci, Inst Zool, Key Lab Zool Systemat and Evolut, Beijing, Peoples R ChinaMinist Salud Nacion, Inst Nacl Med Trop INMeT, Puerto Iguazu, Misiones, ArgentinaUniv Fed Vicosa, Dept Engn Florestal, Vicosa, MG, BrazilUniv Fed Goias, Inst Biociencias, Jatai, Go, BrazilInst Chico Mendes Conservacao Biodiversidade ICMB, Ctr Nacl Pesquisa & Conservacao Primatas Brasilei, Joao Pessoa, PB, BrazilCtr Rescate Fauna Silvestre Guira Oga, Puerto Iguazu, ArgentinaFdn Hist Nat Felix de Azara, Buenos Aires, ArgentinaProjeto Carnivoros Iguacu, Foz Do Iguacu, PR, BrazilUniv Estadual Paulista, Dept Med Vet Prevent & Reprod Anim, Fac Ciencias Agr & Vet Jaboticabal, Jaboticabal, SP, BrazilUniv Fed Integracao Latinoamer, Inst Latinoamer Ciencias Vida & Nat, Foz Do Iguacu, PR, BrazilUniv Fed Sao Paulo, Dept Ciencias Ambientais, Diadema, SP, BrazilUniv Fed Paraiba, Dept Sistemat & Ecol, Lab Mamiferos, Joao Pessoa, Paraiba, BrazilIUCN Peccary Specialist Grp, Campo Grande, MS, BrazilWWF Brazil, Campo Grande, MS, BrazilChicago State Univ, Dept Biol Sci, Chicago, IL USAUniv Fed Rio de Janeiro, Nucleo Ecol & Desenvolvimento Socioambiental Maca, Macae, RJ, BrazilUniv Vila Velha, Programa Posgrad Ecol Ecossistemas, Vila Velha, ES, BrazilUniv Fed Rio de Janeiro, Museu Nacl, Dept Vertebrados, Rio De Janeiro, RJ, BrazilUniv Fed Bahia, Programa Posgrad Ecol, Salvador, BA, BrazilUniv Fed Paraiba, Dept Sistemat & Ecol, Programa Posgrad Ciencias Biol Zool, Lab Mamiferos, Joao Pessoa, Paraiba, BrazilUniv Fed Sao Paulo, Dept Ciencias Ambientais, Diadema, SP, BrazilWeb of Scienc