The self-compassion conceptualization developed by Neff (2003a, b) and its corresponding 26-item inventory (SCS) has gained interest in recent years. SCS have proven good validity and reliability, but its suggested six-factor model cannot always be replicated. Recent studies have shown a more promising two-factor model for the SCS. The aim of this study was to test the structural validity of a translated Swedish SCS in university students (n = 464; 22% men). The results showed good construct validity, test-retest and internal reliability (ICC = .97; α = .86). Partial confirmatory factor analysis could not confirm the six-factor model but did support the two-factor model consisting of a positively worded (self-compassionate attitude) and a negatively worded (self-critical attitude) factor. The modified scale (SCS-Swe22) showed good reliability and construct validity (ICC = .96; α = .89). Despite promising results, additional work is required to secure the structural construct of SCS-Swe22.

Existem evidências de que as manifestações psicóticas não são vivenciadas apenas por pessoas diagnosticadas com transtornos mentais, mas também por pessoas saudáveis da população geral, as denominadas experiências tipo-psicóticas. A Escala de Avaliação das Experiências Psíquicas na Comunidade (CAPE) é um instrumento usado em pesquisas epidemiológicas e foi desenvolvido especificamente para a detecção e avaliação da frequência de experiências tipo-psicóticas na população geral. A CAPE, em sua apresentação original é composta por 42 itens, distribuídos em três dimensões: positiva, negativa e depressiva. O objetivo deste estudo foi verificar as evidências de fidedignidade e validade da CAPE em uma amostra brasileira e investigar a associação de traumas na infância e uso de cannabis com a ocorrência de experiências tipo-psicóticas em indivíduos da população geral. A amostra foi composta por 217 pacientes em primeiro episódio psicótico, 104 irmãos de pacientes psicóticos e 319 controles de base populacional, todos residentes na área de cobertura do Departamento Regional de Saúde do Estado de São Paulo (DRS XIII). Os participantes responderam a instrumentos de avaliação e diagnósticos, incluindo a Entrevista Clínica Estruturada para o DSM IV (SCID), o Questionário sobre Traumas na Infância (CTQ), Questionário de Experiências com Maconha (CEQ), além da CAPE. Os dados clínicos foram analisados por meio do pacote estatístico SPSS e as evidências psicométricas por meio do software AMOS. Após a retirada de nove itens, a CAPE, com 33 itens, mostrou bons índices de ajustamento [CFI = 0,895; GFI = 0,822; PGFI = 0,761; RMSEA = 0,055 p (rmsea <= 0,05) = 0,04] e boa consistência interna (> 0,70) em todos as suas dimensões. Nas análises realizadas apenas com a amostra de base populacional, não foram encontradas diferenças significativas entre as pontuações totais da CAPE-33 e das suas três dimensões quanto a intervalos de idade, estado civil e escolaridade. Mulheres apresentaram pontuações significativamente mais elevadas do que os homens no escore total (p<0,001) e nas dimensões negativa (p < 0,001) e depressiva (p < 0,001). A vivência de traumas na infância (abuso emocional, abuso físico, abuso sexual, negligência emocional, negligência física) associou-se com pontuações mais elevadas no escore total da CAPE (p <0,001) e nas suas três dimensões (positiva p = 0.001, negativa p = 0,004, depressiva p < 0,001). Indivíduos que relataram uso de cannabis alguma vez na vida apresentaram maiores pontuações na dimensão positiva da CAPE-33, em comparação às pessoas que nunca usaram a substância (p = 0,016). A CAPE adaptada para o Brasil (CAPE-33) mostrou bons índices de ajustamento e consistência interna, como encontrado em outras culturas. Presença de trauma precoce e uso de cannabis associaram-se à ocorrência de experiências tipo-psicóticas, à semelhança do que os estudos epidemiológicos mostram para a esquizofrenia. Nossos dados corroboram a abordagem dimensional das psicoses, com frequência e gravidade das manifestações se distribuindo num continnum na população geral. / There is evidence that psychotic manifestation is not experienced only by people diagnosed with mental disorders but also by healthy people in the general population, known as psychotic-like experiences. The Community Assessment Psychic Experiences (CAPE) is an instrument used in epidemiological research and was developed specifically for the detection and evaluation of the frequency of psychotic-like experiences in the general population. The CAPE, in its original submission, is composed of 42 items, distributed in three dimensions: positive, negative and depressive. The objective of this study was to verify the evidence of reliability and validity the CAPE in a brazilian sample and to investigate the association of childhood traumas and cannabis use with the occurrence of psychotic-like experiences in individuals of the general population. The sample consisted of 217 patients in the first psychotic episode, 104 siblings of psychotic patients and 319 population-based controls, all residents in the coverage area of the São Paulo Regional Health Department (DRS XIII). Participants responded to assessment and diagnostic tools, including the Structured Clinical Interview for DSM IV (SCID), the Childhood Trauma Questionnaire (CTQ), the Cannabis Experience Questionnaire (CEQ), and CAPE. Clinical data were analyzed using SPSS statistical package and the psychometric evidence using AMOS software. After the removal of nine items, CAPE, with 33 items, showed good adjustment indices [CFI = 0.895; GFI = 0.822; PGFI = 0.761; RMSEA = 0.055 p (rmsea <= 0.05) = 0.04] and good internal consistency (> 0.70) in all its dimensions. In the analyzes performed only with the population-based sample, no significant differences were found between the CAPE-33 total scores and its three dimensions regarding age, marital status and schooling intervals. Women presented scores significantly higher than men in the total score (p <0.001) and in the negative (p <0.001) and depressive (p <0.001) dimensions. The experience of childhood traumas (emotional abuse, physical abuse, sexual abuse, emotional neglect, physical neglect) was associated with higher scores in the CAPE total score (p <0.001) and its three dimensions (positive p = 0.001, negative p = 0.004, depressive p <0.001). Individuals who reported cannabis use in their lifetime had higher scores in the positive dimension of the CAPE-33 compared to people who had never used the substance (p = 0.016). The CAPE adapted to Brazil (CAPE-33) showed good adjustment indices and internal consistency, as found in other cultures. Presence of early trauma and use of cannabis were associated with the occurrence of psychotic-like experiences, in accordance with what epidemiological studies show for schizophrenia. Our data corroborate the dimensional approach of the psychoses, with frequency and severity of the manifestations being distributed in a continnum in the general population.

Made available in DSpace on 2016-03-22T17:26:30Z (GMT). No. of bitstreams: 1 DissMestrado Shana.pdf: 338004 bytes, checksum: 8c419b368591b3616b89b27429a39387 (MD5) Previous issue date: 2011-02-18 / This study aim of this study was to verify the Short Form of Wechsler Intelligence Scale for Children third edition (WISC-III) most appropriate for use in the Brazilian context and to present the psychometric characteristics of four models with two, for and eight subtests. The test takes about 90 minutes of application, a long time considered for evaluation. Short Forms can reduce the time of application and interpretation of results, facilitating its use in contexts where the intelligence assessment is secondary or in cases of search. But they are not suitable for classification of intelligence, or clinical purposes. The study was based in the standardization sample to the Brazilian context (n = 801). The reliability coefficients ranged from 0.81 to 0.94 and the validity of 0.66 to 0.93. Such coefficients were significant and acceptable, suggesting that the four Short Forms can be used for a quick estimate of IQ Total / O objetivo deste estudo foi verificar qual a Forma Reduzida da Escala de Inteligência Wechsler para Crianças terceira edição (WISC-III) é mais adequada para a utilização no contexto brasileiro e apresentar as características psicométricas de quatro modelos com dois, quatro e oito subtestes. O teste leva em média 90 minutos de aplicação, um tempo considerado extenso para avaliação. As Formas Reduzidas podem diminuir o tempo de aplicação e interpretação dos resultados, facilitando sua utilização em contextos onde a avaliação da inteligência é secundária ou em casos de pesquisa. O estudo foi baseado na amostra de padronização do instrumento ao contexto brasileiro (n=801). Os coeficientes de fidedignidade variaram de 0,81 a 0,94 e os de validade corrigida de 0,66 a 0,93. Tais coeficientes foram significativos e aceitáveis, sugerindo que as quatro Formas Reduzidas podem ser utilizadas para uma estimativa rápida do QI Total. Contudo, dos modelos estudados, a FR4 formada por Completar Figuras, Informação, Cubos e Vocabulário é a mais indicada para a utilização em função dos índices de validade, fidedignidade e redução de tempo

Submitted by Silvana Teresinha Dornelles Studzinski (sstudzinski) on 2015-10-19T17:16:44Z No. of bitstreams: 1 PERLA ADRIANA DI LEONE_.pdf: 1779929 bytes, checksum: b57d099f6a1eca1392496f9e84d1372d (MD5) / Made available in DSpace on 2015-10-19T17:16:44Z (GMT). No. of bitstreams: 1 PERLA ADRIANA DI LEONE_.pdf: 1779929 bytes, checksum: b57d099f6a1eca1392496f9e84d1372d (MD5) Previous issue date: 2015-08-14 / UNISINOS - Universidade do Vale do Rio dos Sinos / Na terapia intravenosa as complicações podem ser evitadas através da prevenção dos riscos relacionados. O principal desfecho negativo em acessos vasculares é a flebite. Para minimizar a possibilidade de erros de julgamentos subjetivos e transformar um instrumento de avaliação em um instrumento de qualidade, é importante a fidedignidade e a validade do mesmo, condição necessária para sua credibilidade e difusão. OBJETIVO: desenvolver e validar uma escala de classificação de risco para flebite. MATERIAL E MÉTODO: O desenvolvimento metodológico fundamentou-se no modelo da psicometria composto por três etapas de procedimentos: teórico onde foi definido o construto a serem medidos e formulados os itens da ferramenta, empírico onde foram desenvolvidas orientações para os usuários e respondentes, assim como foi testada a confiabilidade e validade da ferramenta (experimentais) e por fim, analítico (estatístico), onde foram analisados os resultados obtidos. A validação do conteúdo foi feita quantificando o grau de concordância dos juízes, utilizando-se o índice de Kappa e a análise de Cronbach foi utilizado para avaliar a consistência interna do instrumento. RESULTADOS: dos 33 itens da escala inicial, permaneceram 18 itens após a avaliação dos juízes. Na segunda rodada, resultaram 15 itens. E após o teste de validação, permanecerem 13 itens. CONCLUSÃO: algumas limitações para que os resultados fossem considerados melhores, tais como o instrumento ser aplicado em um único hospital, a amostra ser pequena e de conveniência, tempo, recursos financeiros e a taxa de flebites encontrada em uma população, conforme recomendação internacional é de 5%, sendo que a taxa de flebite do hospital é de 4,03%. Apesar da escala não apresentar qualidades psicométricas suficientes para sua aplicação momentânea, isto não inviabiliza as etapas já construídas, sendo necessários outros estudos para a sua validação, em outros locais, onde a incidência de flebite seja maior que 5%. / Complications in intravenous therapy can be avoided by preventing related risks. The main negative outcome in vascular access is phlebitis. To minimize errors due to subjective judgments and turn an assessment tool into a quality tool, it is important to consider the tool's reliability and validity, necessary conditions to its credibility and distribution. OBJECTIVE: To develop and validate a risk classification scale for phlebitis. MATERIALS AND METHODOLOGY: The methodological development was based on the model of psychometrics composed by three stages of proceedings: theoretical proceedings, defining the structure to measure and formulate the tool items; empirical proceedings, for developing orientations for users and respondents, as well as testing the (experimental) reliability and validity of the tool; and finally analytical proceedings (statistics), analyzing the results that were obtained. The content was validated by quantifying the degree of agreement of the judges, using the kappa index and the Cronbach analysis to assess the internal consistency of the tool. RESULTS: of the 33 items of the initial scale, 18 items were left after the judges' assessment. On the second round, 15 items resulted. After the validation test, 13 items remained. CONCLUSION: There were some limitations so that the results were better; the tool was applied in a single hospital; the sample was small and convenient; time and financial resources were sufficient; the phlebitis rate found in a population according to the international recommendation is 5%, and the hospital's phlebitis rate is 4.03% Although the scale does not present enough psychometric qualities for its current application, this does not invalidate the stages already developed, and other studies are necessary for its validation in other places, where phlebitis incidence is over 5%.

A crescente importância da QV enquanto desfecho em saúde fez o grupo WHOQOL, da OMS, elaborar medidas de avaliação de QV para utilização internacional. Com a necessidade de instrumentos menores que demandassem pouco tempo para o preenchimento, foi desenvolvido o EUROHIS-QOL 8-ITEM, originado dos itens do WHOQOL- BREF. Objetivos: Testar as propriedades psicométricas do EUROHIS-QOL 8-ITEM em uma amostra brasileira. Métodos: A amostra foi constituída de 325 indivíduos. Eles foram divididos em dois grupos, 151 indivíduos constituiram o grupo dos doentes do Hospital de Clínicas de Porto Alegre, RS, e 174 o grupo dos saudáveis. Para a avaliação das propriedades psicométricas do índice EUROHIS-QOL 8-ITEM, foram realizadas algumas análises. A Consistência Interna, foi avaliada usando o Alpha de Cronbach. A validade discriminante foi avaliada comparando o grupo de doentes e saudáveis e também o de deprimidos e não-deprimidos. A análise da validade convergente ocorreu através da correlação do EUROHIS-QOL 8-ITEM com diferentes medidas de QV já validadas e reconhecidas, o SF-36 e o WHOQOL-BREF. A análise fatorial foi avaliada usando o modelo de equação estrutural (SEM). Avaliou-se a unidimensionalidade usando as propriedades do modelo de Rasch. Resultados: A consistência interna avaliada pelo Alpha de Cronbach (com valor de 0,81) monstrou-se boa. O índice EURO-HIS–QOL 8-ITEM também mostrou boa capacidade discriminativa entre os grupos de doentes e saudáveis (média1=3,32; DP1=0,70; média2=3,77; DP2=0,63 t =6,12, p < 0,001) e também entre os grupos de deprimidos e não deprimidos (média3=3,14; DP3=0,69; média4=3,72; DP4=0,61 t = 7,25 p <0,001). O instrumento demonstrou boa validade convergente, através de correlações significativas (p < 0,001) entre o EUROHIS-QOL 8-ITEM e todos os domínidos do WHOQOL- BREF (QV Geral r = 0,47; Saúde Geral r= 0,54; Físico r = 0,69; Psicológico r = 0,62; Relações Sociais r = 0,55; Meio Ambiente r = 0,55) e entre o EUROHIS-QOL 8-ITEM e os domínios do SF-36 (QV Geral r = 0,36; Capacidade Funcional r =0,49; Limitação Física r = 0,45; Dor r = 0,43; Saúde Geral r = 0,52; Vitalidade r = 0,21; Aspectos Sociais r = 0,45; Aspectos Emocionais r = 0,38 e Saúde Mental r = 0,17), com exceção do domínio social (p = 0,38). Na análise de Rasch, as medidas de ajuste geral do modelo apresentaram adequado desempenho estatístico e foi considerado um bom ajuste logo na primeira avaliação (Ajuste de resíduo Interação Item pessoa: M= 0,01 e DP= 1,51; ajuste de resíduo de pessoa: M = -0,38 e DP= 1,19 e Item traço: Item total X²=69,60 p=0,00. Personal Separation Index = 0,82), ou seja, os resíduos foram aceitáveis, não foi preciso excluir itens. O EUROHIS-QOL 8-ITEM, apresentou bom ajuste aos dados na análise fatorial confirmatória (X²= 18,46; DF= 15; CFI= 0,99; RMSEA= 0,03; GFI = 0,99; RMR=0,03; P = p,24). Conclusão: O EURHIS-QOL 8-ITEM, validado em amostras europeias apresentou adequadas propriedades psicométricas neste estudo, mostrando-se uma medida confiável de QV para ser usada em amostras brasileiras. / In the 70s, quality of life began to be considered a health outcome. With the growing importance of this assessment in different areas of medicine, there were no instruments developed in the cross-cultural perspective for international use. In this context, quality of life assessement outcome measures were developed by the WHOQOL group from WHO. With the need of shorter instruments which demanded less time to be filled in, the EUROHIS-QOL 8 ITEM was developed, originated from WHOQOL-BREF items. Objectives: Test the psychometric properties of EUROHIS-QOL 8-ITEM in a Brazilian sample. Methods: The sample consisted of 325 individuals. They were divided in to two groups, 151 subjects constituted the group of patients from the Hospital de Clinicas de Porto Alegre, RS, and 174 subjects the group of healthy controls. Some analyses were performed for the assessment of the psychometric properties of EUROHIS-QOL 8-ITEM index. Internal consistency was measured by using Cronbach’s alpha. Discriminant validity was assessed by comparing the group of patients and healthy controls and also the depressed and nondepressed. Analysis of convergent validity was through the correlation of EUROHIS-QOL 8-ITEM with different quality of life measures already validated and recognized as the SF-36 and WHOQO-BREF. Factor analysis was assessed using structural equation model (SEM). Unidimensionality was assessed using the properties of the Rasch model. Results: The Cronbach's alpha showed good internal consistency (with a value of 0.81). The measure also showed good discriminative ability between the groups of patients and healthy controls (mean1=3.32; SD1=0.70; mean2=3.77; SD2=0.63 t =6.12, p = 0,00) and between the depressed and nondepressed groups (mean3=3.14; SD3=0.69; mean4=3.72; SD4=0.61 t = 7.25 p =0.00). The instrument showed good convergent validity through significant correlations ( p < 0.001 ) between the EUROHIS–QOL 8-ITEM and all domains of WHOQOL-BREF (QV Overall r = 0.47; General Health r= 0.54; Physical Health r = 0.69; Psychological Health r = 0.62; Social Relationship r = 0.55; Meio Environment r = 0.55) and between EUROHIS-QOL 8-ITEM and the domains of the SF-36 (QV Overall r = 0.36; Functioning Physical r =0.49; Role Physical r = 0.45; Bodily Pain r = 0.43; General Health r = 0.52; Vitality r = 0.21; Social Functioning r = 0.45; Role Emotional r = 0.38 and Mental Health r = 0.17) , except for the social domain ( p = 0.38). In the Rasch analysis, general fit measures of the model had adequate statistical performance and were considered a good fit at the first assessment (residual fit Item-person Interaction: M = 0.01, SD = 1.51; person residual fit: M = -0.38, SD = 1.19 and Item-trait: Total Item X² = 69.60 p = 0.00. Personal Separation Index = 0.82), that is, the residuals were acceptable, it was not necessary to exclude items. The EUROHIS-QOL 8-ITEM showed a good fit to the data in the confirmatory factor analysis (X² = 18.46, DF = 15; CFI = 0.99; RMSEA = 0.03; GFI = 0.99; RMR = 0.03; P = 24). Conclusion: EUROHIS-QOL 8-ITEM, validated in European samples, showed adequate psychometric properties in this study showing to be a reliable quality of life measure to be used in Brazilian samples.

Efficient allocation of public resources requires identification, measurement and quantification of costs and benefits of alternative programs. Patient reported outcomes (PROs) are routinely incorporated into economic evaluations of health technologies, but patient experience is often overlooked. This thesis aims to develop a descriptive system for patient experience that can be valued and used to inform economic evaluation. The generation and selection of items is key in the development of any PRO measure. The thesis provides a contemporary overview of recommended methods and those actually used by instrument developers. Frequently a staged approach is used to establish dimensions first, using exploratory factor analysis, followed by item selection using item response theory (IRT), Rasch or structural equation modelling (SEM). I demonstrate the use of different methods for item selection and its underlying mechanics, followed by comparison of the methods. An existing patient dataset, the Inpatient survey (2014) that collected information on nearly 70 aspects of healthcare delivery from NHS users was used. Logistic regression analyses were applied with respondents' rating of overall patient experience specified as dependent variable. Advanced statistical analyses focussed mostly on patients who had an operation or procedure. Latent construct or dimensions were derived and measurement model was confirmed using confirmatory factor analysis. IRT and factor analysis were employed in each one-factor model for item selection. Regression analyses identified many significant variables but most overlapped conceptually. An 11 and 8 factor model for patients with A&E and planned admissions respectively was determined. A generalised partial credit model and a factor analysis model identified different items to include in each dimension. Broadly the items identified by different methods related to respect, comfort and clear communication to patients. This thesis presents descriptive systems for patient experience that is amenable to valuation. It also demonstrates that different patient experience instruments are generated based on patient population used and item selection technique adopted.

Background: Patient evaluation of primary health care (PHC) as a recognised means of obtaining important information for quality improvement can be enhanced with the availability and use of acceptable, reliable and valid questionnaires. This research reports the development and validation of the patients' evaluation scale (PES) for assessment of the quality of primary health care in Nigeria. Methods: Mixed methods design was used to develop and validate items, response scale and domains in the Patients' Evaluation Scale. Items were derived from literature review and content analysis of interviews with patients. Face and content validity were established with primary health care experts and patients while quantitative pilots were conducted to determine questionnaire's acceptability across groups and appropriate response format. The conduct of a large multi-centre psychometric validation survey was used to determine the internal structure (exploratory factor analysis), reliability (internal consistency), construct, criterion and discriminative validities (Pearson's correlation coefficient, structural equation modelling using regression equation method) and acceptability (scale and item response pattern) of the questionnaire. The discriminatory properties were assessed by questionnaire's ability to differentiate population groups' scores in line with 'a priori' hypotheses. Results: The development resulted in the long and shortened forms of PES containing 27 and 18-items respectively. Both showed good indices for validity and acceptability among various population groups in Nigeria. PES-SF resulted from the deletion of items in PES that didn't meet recommended Eigen value < 1, factor loading < 0.5, item-total, item-domain correlation < 0.4 and item-item correlation within domains of < 0.2. PES-SF has Cronbach's alpha of 0.87 for entire questionnaire and 0.78, 0.79 and 0.81 respectively for the three domains (codenamed 'facility', 'organisation', and 'health care'). The three components solution from the Scree plot explained 56.6% of the total variance of perceived quality. Items correlated significantly higher with domain identified through factor analysis than with other domains. In line with 'a priori' hypothesis, scale and domains scores of PES-SF could differentiate population groups based on patients' clinical and socio-demographic characteristics. PES-SF scores also showed significant correlation with patient general satisfaction and likelihood of returning or recommending others to the PHC centres. Conclusion: The patient evaluation scale designed for exit assessment of patients' experiences with PHC in Nigeria shows good measurement properties. It will be useful to clinicians, researchers and policy makers for patient-focused quality improvement activities in Nigeria. Further research will involve translation to major Nigerian languages and to assess PES validity against observed quality criteria.

Why is it that some athletes are able to withstand the pressures of competitive sport and attain peak performances, whereas others succumb to the demands and under-perform? It is the study of psychological resilience that aims to address this question. To significantly advance psychologists' knowledge and understanding of this area, there exists an urgent need to develop a sport-specific measure of resilience (Fletcher & Sarkar, 2012; Galli & Vealey, 2008; Gucciardi, Jackson, Coulter, & Mallett, 2011). The purpose of this thesis, therefore, is to investigate the assessment of psychological resilience in sport performers. To this end, the thesis is split into five chapters. Chapter one reviews and critiques the various definitions, concepts, and theories of resilience, and provides an overview of the research that has specifically examined psychological resilience in sport performers. Chapter two reviews psychometric issues in resilience research and its implications for sport psychology (part one), and discusses psychological resilience in sport performers via a review of the stressors athletes encounter and the protective factors that help them withstand these demands (part two). Drawing on these reviews of resilience in sport, Chapter three (studies one-three) describes the development and validation of the Sport Resilience Scale (SRS). More specifically, Study 1 explores the content validity of a pool of items designed to reflect psychological resilience in athletes, Study 2 examines the factorial structure of the SRS using exploratory factor analysis, and Study 3 tests the factorial structure of the SRS via confirmatory factor analysis, investigates whether the components of the measurement model are invariant across different groups, and examines the relationship between the SRS and other relevant concepts. Using the SRS, and based on Fletcher and Sarkar's (2012) grounded theory of psychological resilience, Chapter four (studies 4 and 5) investigates resilience in sport performers via an examination of moderation and mediation hypotheses. Specifically, Study 4 tests whether the association between the stressors athletes encounter and athletes' positive adaptation is moderated by the protective factors that athletes possess and Study 5 tests whether the association between the stressors athletes encounter and athletes' positive adaptation is mediated by their cognitive appraisal processes. Lastly, Chapter five offers a summary, discussion, and conclusion of the thesis. Overall, the research reported in this thesis has developed the first valid and reliable measure of psychological resilience in sport performers and has provided quantitative support for Fletcher and Sarkar's (2012) theoretical model of sport resilience by illustrating the moderating role of protective factors and the mediating role of cognitive appraisal.

Existem evidências de que as manifestações psicóticas não são vivenciadas apenas por pessoas diagnosticadas com transtornos mentais, mas também por pessoas saudáveis da população geral, as denominadas experiências tipo-psicóticas. A Escala de Avaliação das Experiências Psíquicas na Comunidade (CAPE) é um instrumento usado em pesquisas epidemiológicas e foi desenvolvido especificamente para a detecção e avaliação da frequência de experiências tipo-psicóticas na população geral. A CAPE, em sua apresentação original é composta por 42 itens, distribuídos em três dimensões: positiva, negativa e depressiva. O objetivo deste estudo foi verificar as evidências de fidedignidade e validade da CAPE em uma amostra brasileira e investigar a associação de traumas na infância e uso de cannabis com a ocorrência de experiências tipo-psicóticas em indivíduos da população geral. A amostra foi composta por 217 pacientes em primeiro episódio psicótico, 104 irmãos de pacientes psicóticos e 319 controles de base populacional, todos residentes na área de cobertura do Departamento Regional de Saúde do Estado de São Paulo (DRS XIII). Os participantes responderam a instrumentos de avaliação e diagnósticos, incluindo a Entrevista Clínica Estruturada para o DSM IV (SCID), o Questionário sobre Traumas na Infância (CTQ), Questionário de Experiências com Maconha (CEQ), além da CAPE. Os dados clínicos foram analisados por meio do pacote estatístico SPSS e as evidências psicométricas por meio do software AMOS. Após a retirada de nove itens, a CAPE, com 33 itens, mostrou bons índices de ajustamento [CFI = 0,895; GFI = 0,822; PGFI = 0,761; RMSEA = 0,055 p (rmsea <= 0,05) = 0,04] e boa consistência interna (> 0,70) em todos as suas dimensões. Nas análises realizadas apenas com a amostra de base populacional, não foram encontradas diferenças significativas entre as pontuações totais da CAPE-33 e das suas três dimensões quanto a intervalos de idade, estado civil e escolaridade. Mulheres apresentaram pontuações significativamente mais elevadas do que os homens no escore total (p<0,001) e nas dimensões negativa (p < 0,001) e depressiva (p < 0,001). A vivência de traumas na infância (abuso emocional, abuso físico, abuso sexual, negligência emocional, negligência física) associou-se com pontuações mais elevadas no escore total da CAPE (p <0,001) e nas suas três dimensões (positiva p = 0.001, negativa p = 0,004, depressiva p < 0,001). Indivíduos que relataram uso de cannabis alguma vez na vida apresentaram maiores pontuações na dimensão positiva da CAPE-33, em comparação às pessoas que nunca usaram a substância (p = 0,016). A CAPE adaptada para o Brasil (CAPE-33) mostrou bons índices de ajustamento e consistência interna, como encontrado em outras culturas. Presença de trauma precoce e uso de cannabis associaram-se à ocorrência de experiências tipo-psicóticas, à semelhança do que os estudos epidemiológicos mostram para a esquizofrenia. Nossos dados corroboram a abordagem dimensional das psicoses, com frequência e gravidade das manifestações se distribuindo num continnum na população geral. / There is evidence that psychotic manifestation is not experienced only by people diagnosed with mental disorders but also by healthy people in the general population, known as psychotic-like experiences. The Community Assessment Psychic Experiences (CAPE) is an instrument used in epidemiological research and was developed specifically for the detection and evaluation of the frequency of psychotic-like experiences in the general population. The CAPE, in its original submission, is composed of 42 items, distributed in three dimensions: positive, negative and depressive. The objective of this study was to verify the evidence of reliability and validity the CAPE in a brazilian sample and to investigate the association of childhood traumas and cannabis use with the occurrence of psychotic-like experiences in individuals of the general population. The sample consisted of 217 patients in the first psychotic episode, 104 siblings of psychotic patients and 319 population-based controls, all residents in the coverage area of the São Paulo Regional Health Department (DRS XIII). Participants responded to assessment and diagnostic tools, including the Structured Clinical Interview for DSM IV (SCID), the Childhood Trauma Questionnaire (CTQ), the Cannabis Experience Questionnaire (CEQ), and CAPE. Clinical data were analyzed using SPSS statistical package and the psychometric evidence using AMOS software. After the removal of nine items, CAPE, with 33 items, showed good adjustment indices [CFI = 0.895; GFI = 0.822; PGFI = 0.761; RMSEA = 0.055 p (rmsea <= 0.05) = 0.04] and good internal consistency (> 0.70) in all its dimensions. In the analyzes performed only with the population-based sample, no significant differences were found between the CAPE-33 total scores and its three dimensions regarding age, marital status and schooling intervals. Women presented scores significantly higher than men in the total score (p <0.001) and in the negative (p <0.001) and depressive (p <0.001) dimensions. The experience of childhood traumas (emotional abuse, physical abuse, sexual abuse, emotional neglect, physical neglect) was associated with higher scores in the CAPE total score (p <0.001) and its three dimensions (positive p = 0.001, negative p = 0.004, depressive p <0.001). Individuals who reported cannabis use in their lifetime had higher scores in the positive dimension of the CAPE-33 compared to people who had never used the substance (p = 0.016). The CAPE adapted to Brazil (CAPE-33) showed good adjustment indices and internal consistency, as found in other cultures. Presence of early trauma and use of cannabis were associated with the occurrence of psychotic-like experiences, in accordance with what epidemiological studies show for schizophrenia. Our data corroborate the dimensional approach of the psychoses, with frequency and severity of the manifestations being distributed in a continnum in the general population.

Speech audiometry is the aspect of audiology that provides critical information on how individuals hear one of the most important sounds of daily life: speech. The speech recognition threshold (SRT) is a measure of speech audiometry that is widely used to provide information on an individual's capacity to hear speech. Over time, researchers and clinicians have worked to improve the SRT by developing and modifying a variety of word lists to be used during testing. Eventually, spondaic words were selected as the best stimuli for the SRT. The spondaic words had to meet four criteria: familiarity, phonetic dissimilarity, normal sampling of English sounds, and homogeneity with respect to audibility. This study examined the aspect of homogeneity with regard to slope of the psychometric function. Specifically, whether slope of the psychometric function had an effect on the number of words used to obtain the SRT, and thus reduce test time, as well as whether slope had an effect on the relationship between the SRT and the pure-tone average (PTA). It was hypothesized that words with a steep slope would significantly reduce test time and yield a close SRT-PTA agreement. Three word lists (steep, medium, and shallow sloping words), all recorded by a male talker, were used to obtain the SRT on 40 participants (ages 18-30 years). Statistical analysis showed significant differences in the number of words to obtain the SRT and the SRT-PTA agreement. However, when the differences were examined from a clinical perspective, the results were negligible. When compared with words with medium and steep slopes, words with shallow slope required an average of four extra words to obtain the SRT, which does not result in a meaningful reduction in test time. For clinical purposes, it appears that the slope of the psychometric function does not need to be taken into consideration for the SRT. Clinicians may use a variety of words as long as they meet the original four criteria for selection of spondees.