No description available.

The National Institute of Mental Health (NIMH) has provided a framework for studying psychopathology known as the Research Domain Criteria (RDoC), which conceptualizes depression and other mental disorders on a continuum of levels of analysis, ranging from molecular dysfunction to impairment in cognitive systems indexed by behavioral paradigms. Within the RDoC, these units of analysis and their corresponding normal-to-abnormal functioning can be placed within six domains: (1) negative valence systems; (2) positive valence systems; (3) cognitive systems; (4) social processes; (5) arousal and regulatory systems; and (6) sensorimotor systems. Given the recent emphasis on identifying further mechanisms associated with positive valence systems dysfunction, the present study aimed to assess the relationship between various behavioral paradigms (indexing perception, attention, affective working memory updating, and effort expenditure) and various conceptualizations of anhedonia, a heterogeneous, transdiagnostic symptom implicated as a core component within this domain. Participants (N = 101) with a range of depressive symptoms were recruited for a longitudinal study and completed six weekly in-person sessions, as well as a follow-up session that occurred approximately six weeks after the last session. Findings suggest there were no robust associations between these behavioral paradigms and various self-report measures of anhedonia, contrasting with previous empirical findings. As such, future studies are warranted to continue assessing these possible mechanisms of positive valence systems disturbance.

Background: Approximately 7% of clinically referred youth exhibit profound impairment in the ability to regulate their affect, behavior, and cognition. This phenotype – often referred to as dysregulation – has been associated with a multitude of negative outcomes. Symptom overlap between dysregulation and other psychological disorders has generated debate regarding whether DP constitutes a distinct syndrome characterized by intense, persistent irritability or is merely the combination of symptoms from disruptive or mood disorders. In order to elucidate this question, the current study examined the transdiagnostic continuities and discontinuities in three RDoC constructs (frustrative non-reward, acute threat, and cognitive control) proposed to be mechanisms of irritability Method: Participants were 294 children ages 7-17 (M=10.94; 67% male). Emotional and behavioral symptoms were measured using the Child Behavior Checklist and the Kiddie Schedule for Affective Disorders and Schizophrenia. Frustrative non-reward was measured using a frustration-induction Go/No-Go paradigm during which heart rate variability was indexed by respiratory sinus arrhythmia (RSA) and pre-ejection period (PEP). Acute threat was measured using an Emotional Faces computer paradigm in conjunction with an eyetracker/pupilometer. Cognitive control was assessed with the Behavioral Rating Inventory of Executive Function (BRIEF), Delis-Kaplan Executive Function System (D-KEFS) and Stop Signal Task (SST). Results: Symptoms of dysregulation and non-episodic irritability were strongly, positively related. Due to a lack of demonstrated construct validity for the hypothesized RDoC constructs of frustrative non-reward, acute threat, and cognitive control, two alternative mechanisms—SNS response and cognitive dyscontrol of emotion—were derived from the data. Results showed that blunted sympathetic responsivity and poor executive control in response to emotion were predictive of more severe irritability symptoms. Finally, moderation analyses showed that among highly dysregulated children, low levels of sympathetic responsiveness were associated with more severe irritability symptoms. Conclusions: Despite phenotypic overlap with other forms of developmental psychopathology, dysregulated children can be distinguished based on the severity of their irritability symptoms. This supports the conceptualization of dysregulation as a unique syndrome characterized by intense and persistent irritability and lends credence to the novel diagnosis of DMDD. Furthermore, cognitive, behavioral and physiological patterns identified in this study suggest that difficulties with processing negative emotion—as opposed to frustration or threat specifically—may constitute a vulnerability for irritability.

This study examined the clinical utility of the recently released National Institute of Mental Health's (NIMH) research domain criteria (RDoC) by replicating and extending earlier work by using a demographically novel sample. Information retrieval and natural language processing of archival clinical records was used to achieve two main objectives: (1) estimate how well the RDoC domains match language used by clinicians by creating domain scores and (2) examine the differences between the DSM's and RDoC's ability to predict treatment outcome using these domain scores and DSM diagnoses. The social systems RDoC category was found to be the strongest predictor of treatment outcome across all diagnostic measures.

No description available.

The ability to monitor client change in psychotherapy over time is vital to quality assurance in psychotherapy as well as the continuing improvement of psychotherapy research. Currently there is not a free and comprehensive outcome measure for psychotherapy that meets current research and treatment goals. This study took further steps to validate a suite of measures to aid in treatment and research, theoretically based in the research domain criteria (RDoC) and the phase model of change frameworks. Items previously tested in a community sample were further tested in a clinical population in psychotherapy training clinics and a community clinical sample Data was analyzed using bi-factor confirmatory factor analysis and multidimensional item response theory. Additional exploratory analyses were conducted to explore differential item functioning in these samples.

O desenvolvimento de novas tecnologias vem contribuindo para um conhecimento mais aprofundado da fisiopatologia dos transtornos psiquiátricos, mas os resultados ainda são controversos e não parecem ser específicos para cada diagnóstico. As altas taxas de comorbidade também questionam as características principais de um diagnóstico específico. Em 2009, o Instituto Nacional de Saúde Mental dos EUA iniciou um projeto chamado Research Domain Criteria (RDoC) com o objetivo de desenvolver novas classificações para a pesquisa baseadas em dimensões de comportamentos observáveis associadas a medidas neurobiológicas. Para o estudo da fisiopatologia da comorbidade entre duas doenças mentais, esta proposta sugere que se execute o estudo de sintomas compartilhados e não partir de dois grupos diagnósticos distintos. Na psiquiatria infantil, as altas taxas de comorbidade entre o transtorno do humor bipolar (THB) e o transtorno de déficit de atenção e hiperatividade (TDAH) são um tema controverso. O prejuízo na atenção é um forte candidato para um estudo com a metodologia proposta pelo RDoC visto que os poucos estudos que avaliaram concomitantemente a atenção em jovens com THB e TDAH apresentaram resultados contraditórios. Um dos testes mais utilizados para o estudo da atenção em THB e TDAH é o Continuous Performance Test (CPT). Nossos objetivos foram: 1.Verificar qual é o melhor agrupamento dos sujeitos através dos resultados do Conner\'s Continuous Performance Test (CPT II) independentemente do grupo de origem (THB, TDAH, THB+TDAH, controles); 2. Construir um classificador baseado nos resultados do CPT II; 3com THB+TDAH e 18 controles com idades entre 12 e 17 anos. A melhor divisão dos sujeitos, baseada nos resultados do CPT II, foi em dois novos subgrupos. Grupo A com 35 sujeitos composto de: 30% THB, 52,2% TDAH, 51,5% THB+TDAH, e 16,7% controles. Grupo B com 49 sujeitos: 70% THB, 47,8% TDAH, 48,5% THB+TDAH, e 83,3% controles. O grupo A comparado com o B apresentou um prejuízo funcional maior evidenciado por médias significativamente mais altas no CPT II, com uma diferença significativa em oito das 12 variáveis do CPT II: omissão (p=0,0003), comissão (p=0,00000002), erro padrão (EP) do tempo de reação (TR) (p=1,7x10-20), variabilidade do EP (p=4,3x10-22), detectabilidade (p=0,000008), perseveração (p=0,0000001), TR por intervalo interestímulo (IIE) (p=4,7x10-10) e TR(EP)IIE (p= 1,5x10 -13). Foi possível construir um classificador baseado nas doze variáveis do CPT II, sendo sua acurácia de 98,8% em relação a nossa amostra e 95,2% em relação à validação cruzada confirmando a consistência desses novos grupos. As principais variáveis do CPT II usadas na função discriminante desses novos agrupamentos foram: variabilidade do erro padrão, erro padrão de TR e erro padrão de TR por intervalo interestímulo. Não houve diferença estatística em nenhuma das variáveis do CPT II quando realizamos a comparação tradicional entre THB, TDAH, THB+TDAH, e controles; e a acurácia do classificador para esses grupos foi mais baixa, de 40,5% na nossa amostra e 23,8% na validação cruzada. Discussão: Esses resultados evidenciam a heterogeneidade encontrada nas respostas do CPT II pelos grupos THB, TDAH, THB+TDAH, e controles. As três medidas que mais influenciaram a diferenciação entre os novos agrupamentos A e B foram as que medem a variação no tempo de resposta, que é um dos prejuízos mais replicados no TDAH e também está associada com THB. Essa variabilidade de resposta aumentada é sugerida como um marcador endofenotípico inespecífico de psicopatologia. Conclusão: Nossos achados refletem a heterogeneidade encontrada em pacientes classificados através de categorias diagnósticas vigentes e sugerem que a abordagem da metodologia do RDoC pode ser de grande valia para a melhor compreensão dos transtornos psiquiátricos que acometem crianças e adolescentes. Essa metodologia pode identificar subgrupos com diferenças relevantes do ponto de visto neurobiológico contribuindo para a melhor compreensão da fisiopatologia dos transtornos e promovendo caminhos nos quais a pesquisa pode trazer benefícios para decisões clínicas / The better understanding of psychiatric disorders\' pathophysiology is undeniable. Yet, the results are still replete of controversy and are not diagnostic specific. Categorical approach analysis implicitly involves the notion of a unitary entity, not taking into account the acknowledged heterogeneity present in clinical diagnoses. High comorbidity rates also raises questions about the core features of a specific diagnosis. For this purpose, the National Institute of Mental Health has initiated the Research Domain Criteria (RDoC) project. Instead of using disorders categories as the basis for grouping individuals, RDoC suggests to find relevant dimensions that can cut across traditional disorders. The starting point suggested to study comorbid disorders should be shared symptoms and behaviors, instead of two distinct diagnostic groups. One of the strongest controversies in child psychiatry is the high comorbidity rate between bipolar disorder (BD) and attention-deficit/hyperactivity disorder (ADHD). Distractibility, one of the most common symptoms in BD and ADHD could be a good candidate for an RDoC unit of analysis. Our aim was first to study the patterns of attention based on the Conners\' Continuous Performance Test (CPTII) results in youth with BD, ADHD, BD+ADHD and controls; followed by developing a classifier to compare the classification accuracy of this new formed groups and the original diagnostic ones. Results: 18 healthy controls, 23 patients with ADHD, 33 BD+ADHD and 10 BD were assessed. Using cluster analysis, the entire sample was best clustered in two new groups, A and B, based on the twelve CPT II variables performance, independently of the original diagnoses. 35 subjects in group A: 30% BD, 52.2% ADHD, 51.5% BD+ADHD and 16.7% controls. 49 individuals in group B: 70% BD, 47.8% ADHD, 48.5% BD+ADHD and 83.3% controls. Group A presented a greater impairment exhibited by higher means in all CPTII variables, SNAP-IV means, and lower CGAS means. When we compared the CPT II variables performance between the new clustered groups A and B we found eight out of the twelve CPT II measures that were statistically significant: omission (p=0.0003), commission (p=0.00000002), standard error (SE) of hit reaction time (RT) (p=1.7x10-20), variability of SE (p=4.3x10 -22), detectability (p=0.000008), perseveration (p=0.0000001), hit RT by interstimulus interval (ISI) (p=4.7x10 - 10) and hit RT SE ISI. We found high cross-validated classification accuracy for A and B groups: 95.2%. The stronger CPT II variables in the discriminative pattern were: variability of standard error ranking first, followed by hit RT SE, hit RT SE ISI. There were no statistically significant differences in any of the CPT II measures when comparing the four original groups (BD, ADHD, BD+ADHD, controls). The cross-validated classification accuracy based on the CPT II measures performance in order to classify subjects in the original four groups was much lower (23.8%). Discussion: These results highlight the heterogeneity of CPT II responses among each of the four original groups: BD, ADHD, BD+ADHD and controls. The three variables that most influenced the new clustered groups were the ones that measure and adolescents may share this attentional trait marker. Conclusion: In summary, our findings highlighted the heterogeneity of patients clustered by categorical diagnostic classification. In addition, our classificatory exercise supports the concept behind new approaches like the RDoC framework for child and adolescent psychiatry. It can define meaningful clinical subgroups for the purpose of pathophysiological studies and treatment selection, and provide a pathway by which research findings can be translated into changes in clinical decision making

O desenvolvimento de novas tecnologias vem contribuindo para um conhecimento mais aprofundado da fisiopatologia dos transtornos psiquiátricos, mas os resultados ainda são controversos e não parecem ser específicos para cada diagnóstico. As altas taxas de comorbidade também questionam as características principais de um diagnóstico específico. Em 2009, o Instituto Nacional de Saúde Mental dos EUA iniciou um projeto chamado Research Domain Criteria (RDoC) com o objetivo de desenvolver novas classificações para a pesquisa baseadas em dimensões de comportamentos observáveis associadas a medidas neurobiológicas. Para o estudo da fisiopatologia da comorbidade entre duas doenças mentais, esta proposta sugere que se execute o estudo de sintomas compartilhados e não partir de dois grupos diagnósticos distintos. Na psiquiatria infantil, as altas taxas de comorbidade entre o transtorno do humor bipolar (THB) e o transtorno de déficit de atenção e hiperatividade (TDAH) são um tema controverso. O prejuízo na atenção é um forte candidato para um estudo com a metodologia proposta pelo RDoC visto que os poucos estudos que avaliaram concomitantemente a atenção em jovens com THB e TDAH apresentaram resultados contraditórios. Um dos testes mais utilizados para o estudo da atenção em THB e TDAH é o Continuous Performance Test (CPT). Nossos objetivos foram: 1.Verificar qual é o melhor agrupamento dos sujeitos através dos resultados do Conner\'s Continuous Performance Test (CPT II) independentemente do grupo de origem (THB, TDAH, THB+TDAH, controles); 2. Construir um classificador baseado nos resultados do CPT II; 3com THB+TDAH e 18 controles com idades entre 12 e 17 anos. A melhor divisão dos sujeitos, baseada nos resultados do CPT II, foi em dois novos subgrupos. Grupo A com 35 sujeitos composto de: 30% THB, 52,2% TDAH, 51,5% THB+TDAH, e 16,7% controles. Grupo B com 49 sujeitos: 70% THB, 47,8% TDAH, 48,5% THB+TDAH, e 83,3% controles. O grupo A comparado com o B apresentou um prejuízo funcional maior evidenciado por médias significativamente mais altas no CPT II, com uma diferença significativa em oito das 12 variáveis do CPT II: omissão (p=0,0003), comissão (p=0,00000002), erro padrão (EP) do tempo de reação (TR) (p=1,7x10-20), variabilidade do EP (p=4,3x10-22), detectabilidade (p=0,000008), perseveração (p=0,0000001), TR por intervalo interestímulo (IIE) (p=4,7x10-10) e TR(EP)IIE (p= 1,5x10 -13). Foi possível construir um classificador baseado nas doze variáveis do CPT II, sendo sua acurácia de 98,8% em relação a nossa amostra e 95,2% em relação à validação cruzada confirmando a consistência desses novos grupos. As principais variáveis do CPT II usadas na função discriminante desses novos agrupamentos foram: variabilidade do erro padrão, erro padrão de TR e erro padrão de TR por intervalo interestímulo. Não houve diferença estatística em nenhuma das variáveis do CPT II quando realizamos a comparação tradicional entre THB, TDAH, THB+TDAH, e controles; e a acurácia do classificador para esses grupos foi mais baixa, de 40,5% na nossa amostra e 23,8% na validação cruzada. Discussão: Esses resultados evidenciam a heterogeneidade encontrada nas respostas do CPT II pelos grupos THB, TDAH, THB+TDAH, e controles. As três medidas que mais influenciaram a diferenciação entre os novos agrupamentos A e B foram as que medem a variação no tempo de resposta, que é um dos prejuízos mais replicados no TDAH e também está associada com THB. Essa variabilidade de resposta aumentada é sugerida como um marcador endofenotípico inespecífico de psicopatologia. Conclusão: Nossos achados refletem a heterogeneidade encontrada em pacientes classificados através de categorias diagnósticas vigentes e sugerem que a abordagem da metodologia do RDoC pode ser de grande valia para a melhor compreensão dos transtornos psiquiátricos que acometem crianças e adolescentes. Essa metodologia pode identificar subgrupos com diferenças relevantes do ponto de visto neurobiológico contribuindo para a melhor compreensão da fisiopatologia dos transtornos e promovendo caminhos nos quais a pesquisa pode trazer benefícios para decisões clínicas / The better understanding of psychiatric disorders\' pathophysiology is undeniable. Yet, the results are still replete of controversy and are not diagnostic specific. Categorical approach analysis implicitly involves the notion of a unitary entity, not taking into account the acknowledged heterogeneity present in clinical diagnoses. High comorbidity rates also raises questions about the core features of a specific diagnosis. For this purpose, the National Institute of Mental Health has initiated the Research Domain Criteria (RDoC) project. Instead of using disorders categories as the basis for grouping individuals, RDoC suggests to find relevant dimensions that can cut across traditional disorders. The starting point suggested to study comorbid disorders should be shared symptoms and behaviors, instead of two distinct diagnostic groups. One of the strongest controversies in child psychiatry is the high comorbidity rate between bipolar disorder (BD) and attention-deficit/hyperactivity disorder (ADHD). Distractibility, one of the most common symptoms in BD and ADHD could be a good candidate for an RDoC unit of analysis. Our aim was first to study the patterns of attention based on the Conners\' Continuous Performance Test (CPTII) results in youth with BD, ADHD, BD+ADHD and controls; followed by developing a classifier to compare the classification accuracy of this new formed groups and the original diagnostic ones. Results: 18 healthy controls, 23 patients with ADHD, 33 BD+ADHD and 10 BD were assessed. Using cluster analysis, the entire sample was best clustered in two new groups, A and B, based on the twelve CPT II variables performance, independently of the original diagnoses. 35 subjects in group A: 30% BD, 52.2% ADHD, 51.5% BD+ADHD and 16.7% controls. 49 individuals in group B: 70% BD, 47.8% ADHD, 48.5% BD+ADHD and 83.3% controls. Group A presented a greater impairment exhibited by higher means in all CPTII variables, SNAP-IV means, and lower CGAS means. When we compared the CPT II variables performance between the new clustered groups A and B we found eight out of the twelve CPT II measures that were statistically significant: omission (p=0.0003), commission (p=0.00000002), standard error (SE) of hit reaction time (RT) (p=1.7x10-20), variability of SE (p=4.3x10 -22), detectability (p=0.000008), perseveration (p=0.0000001), hit RT by interstimulus interval (ISI) (p=4.7x10 - 10) and hit RT SE ISI. We found high cross-validated classification accuracy for A and B groups: 95.2%. The stronger CPT II variables in the discriminative pattern were: variability of standard error ranking first, followed by hit RT SE, hit RT SE ISI. There were no statistically significant differences in any of the CPT II measures when comparing the four original groups (BD, ADHD, BD+ADHD, controls). The cross-validated classification accuracy based on the CPT II measures performance in order to classify subjects in the original four groups was much lower (23.8%). Discussion: These results highlight the heterogeneity of CPT II responses among each of the four original groups: BD, ADHD, BD+ADHD and controls. The three variables that most influenced the new clustered groups were the ones that measure and adolescents may share this attentional trait marker. Conclusion: In summary, our findings highlighted the heterogeneity of patients clustered by categorical diagnostic classification. In addition, our classificatory exercise supports the concept behind new approaches like the RDoC framework for child and adolescent psychiatry. It can define meaningful clinical subgroups for the purpose of pathophysiological studies and treatment selection, and provide a pathway by which research findings can be translated into changes in clinical decision making

This is a habilitation thesis submitted to and accepted by the council of the faculty of life sciences at the Humboldt-Universität zu Berlin, Berlin, Germany. The thesis is written in English, but some formal parts (e.g., on the title page) and acknowledgements are written in German language. / Die Research-Domain-Criteria-Initiative und andere haben vorgeschlagen, zur Konzeption psychischer Störungen dimensionale psychologische Konstrukte zu verwenden. Die vorliegende Arbeit beschreibt mehrere Experimente, in denen mit Augenbewegungsaufgaben das Konstrukt der kognitiven Kontrolle evaluiert wurde. Die Studien sollten klären, welche kognitiven und neuronalen Mechanismen zu den bei Menschen mit Schizophrenie oder Zwangsstörung erhöhten Latenzen volitionaler Sakkaden beitragen. In drei Studien wurden Anforderungen der Antisakkadenaufgabe isoliert und funktionelle Magnetresonanztomographie angewendet. Die Ergebnisse legen nahe, dass die verlangsamte volitionale Sakkadengenerierung bei Schizophrenie durch eine dysfunktionale Aktivierung des lateralen präfrontalen Cortex und der supplementären Augenfelder vermittelt wird, was mit Defiziten in der proaktiven Handlungskontrolle verbunden sein könnte. Fünf weitere Experimente sollten Teilprozesse aufklären und haben gezeigt, dass die Defizite möglicherweise aus einer Beeinträchtigung der volitionalen Loslösung der Fixation und der motorischen Vorbereitung resultieren. Zwei weitere Studien legen nahe, dass auch die Zwangsstörung mit erhöhten Latenzen volitionaler Sakkaden assoziiert ist. Effekte experimenteller Variation haben jedoch gezeigt, dass diesen Defiziten wahrscheinlich eine Verlangsamung der Reaktionsauswahl zugrundeliegt. Die bei beiden Patientengruppen vermutlich betroffenen Mechanismen dienen zielgerichteten Verhaltensweisen. Man kann vermuten, dass die Defizite eine Störung auf der Ebene eines allgemeinen Faktors exekutiver Funktionen widerspiegeln. Die experimentellen Ergebnisse weisen jedoch auch auf störungsspezifische Funktionsbeeinträchtigungen hin. Zukünftige Forschung muss den Zusammenhang zwischen diesen Beeinträchtigungen und Symptomen besser aufzuklären, wenn Konzepte psychischer Störungen, die auf experimentell definierten psychologischen Konstrukten basieren, am Ende erfolgreich sein sollen. / The research domain criteria initiative and others have suggested to conzeptualize mental disorders on the basis of dimensional psychological constructs. The present work describes several experiments using eye movement tasks to evaluate the construct of cognitive control. The studies aimed at uncovering cognitive and neural mechanisms involved in increased latencies of volitional saccades as found in individuals with schizophrenia or obsessive-compulsive disorder. Three studies used functional magnetic resonance imaging and isolated different demands of the antisaccade task. The results suggest that slowed volitional saccade generation in schizophrenia is mediated by dysfunctional activation of the lateral prefrontal cortex and the supplementary eye fields, which may relate to deficits in proactive control of action. Five additional behavioral experiments aimed at specifying sub-processes and showed that the deficits might result from impairments in volitional fixation disengagement and motor preparation. Two studies in individuals with obsessive-compulsive disorder suggest that this disorder is also associated with increased latencies of volitional saccades. However, experimental variation revealed that these deficits may reflect a slowing in response selection. The mechanisms affected in both groups are serving goal-directed behaviors and may reflect a disturbance on the level of a common executive functions factor. However, the experimental results also suggest disorder specific functional impairment. Future research will have to improve our understanding of the relationship between these impairments and symptoms if concepts based on experimentally defined psychological constructs shall be successful in the end.

A Ruminação tem sido um importante campo de investigação para estudar os mecanismos cognitivos e alteração dos estados emocionais associados ao processo do desenvolvimento de condições de saúde mental. A presente dissertação, cujo relatório de pesquisa deriva nessa produção, busca elucidar as relações entre ruminação e disforia de gênero. Dessa forma, a dissertação apresentará dois estudos de delineamento transversal que, no entanto, sofrem adaptações na disposição dos indivíduos da amostra para testar hipóteses específicas. Em ambos os estudos foram recrutadas 39 mulheres transexuais, no período de 2014 a 2015, que atenderam aos critérios do DSM 5 para diagnóstico de Disforia de Gênero (DG). O primeiro estudo teve como objetivo analisar os níveis de ruminação em pacientes com disforia de gênero antes e depois da Cirurgia de Redesignação Sexual (CRS), o que contribui com a literatura que investiga marcadores de desfecho positivo para CRS. O primeiro subgrupo (T0) foi constituído por participantes com diagnósticos confirmados para DG e com, no máximo, um ano de acompanhamento em grupoterapia. O T1, por pacientes que atenderam os pré-requisitos em relação à frequência aos atendimentos dos grupos psicoterapêuticos de, no mínimo, um ano, e no máximo dois anos, sem contra-indicação para realização da CRS. E o T2, constituído por pacientes pós-cirúrgicos em um período superior a seis meses. O segundo estudo teve como objetivo tanto analisar a relação entre abuso emocional na infância e ruminação em mulheres transexuais quanto identificar, entre os indivíduos da amostra, quais ruminam em nível p[baixo] = (33) ≤18 e p[alto] = (67) ≥23. Essa classificação entre dois subtipos do pensamento ruminativo pode elucidar diferenças entre os fatores protetivos e os desfechos nocivos na saúde mental e física dessa população. No primeiro estudo, a ruminação diminuiu entre os pacientes no T2 e os escores em ruminação foram ainda gradualmente menores a cada procedimento realizado nas características sexuais secundárias por pacientes deste grupo. Esse achado contribui para pesquisas do paradigma Research Domain Criteria (RDoC), que almeja demonstrar marcadores psicológicos para condições de saúde mental. Nesse caso, a ruminação parece se mostrar como um marcador importante para o desfecho positivo em pacientes com disforia de gênero pós-CRS. No segundo estudo, nosso principal achado reside na prevalência em até 15 vezes (IC95%: 2,25-99,63) de maior chance para engajamento em ruminação elevada ou comportamento disfórico entre os indivíduos que foram expostos ao abuso emocional, sobretudo, entre aqueles que o vivenciaram no intervalo da tipologia que variou de moderado – grave a grave – extremo se comparado aos indivíduos com gravidade entre mínimo a moderado na escala Childhood Trauma Questionnaire (CTQ). O abuso emocional está relacionado com engajamento em ruminação, sobretudo, ao subtipo elevada, o que contribui para aumento em comportamentos disfóricos, e ao estar associado à desregulação da emoção, que contribui para os desfechos nocivos na saúde física e mental desta população. / The Rumination has recently become an important field of study to better understand cognitive mechanisms and emotional status associated to the development of mental health conditions. The current work aims to shine a light upon the relation between rumination and gender dysphoria (GD). In this sense, this work presents two cross-sectional studies, each testing two specific hypotheses. Therefore, they have suffered adaptations in the disposition of the sample. In both studies, 39 transexual women, who fulfilled the DSM 5 diagnostic criteria for GD, were recruited within the years of 2014 and 2015. The first study aimed to analyse how much GD patients have rumination processes before and after sex reassignment surgery (SRS), which contributes to the body of literature seeking for positive outcome markers for SRS. The first group (T0) was made of participants who had a confirmed DG diagnostic and participated of group therapy for up to one year (between 0 and 12 months). The second group (T1) was composed by participants who had a confirmed DG diagnostic and attended from one up to two years of group therapy and had no contraindications for SRS. The third group (T2) was comprised of patients who have gone through SRS surgery at least six months prior to the data collection. The second study aimed to analyse the relation between emotional abuse during childhood and rumination in transexual women and to identify, amongst sample individuals, those who ruminate at a low or high levels. This classification into two subsets of ruminative thinking might clarify diferences between protective factors and poor mental and physical health outcomes in this specific population. In the first study, patients of the T2 group ruminate significantly less than their counterparts; moreover, scores of the ruminative thinking process seems to fall gradually with each alteration in the secondary sex characteristics. This finding contributes to the researches of the Research Domain Criteria (RDoC) paradigm, which seeks to find physiological markers for mental health conditions. In this case, rumination seems to be an important marker for positive outcomes in post-SRS GD patients. In the second study, the main result is the higher (up to 15 fold) prevalence for likeliness to engane in high level of ruminative thinking or dysphoric behaviour amongst the individuals who were exposed to emotional abuse. Above all, the engagement in ruminative thinking process is even higher amongst those who lived through emotional abuse in the moderated - severe and the severe - extreme categories of the Childhood Trauma Questionnaire (CTQ) scale than those in the light - moderate category. Emotional abuse is related to ruminative engagement, specially to the high level subtype of rumination. This contributes to the increase in dysphoric behaviours and to the bad health and mental outcomes in this population, probably associated with emotional dysregulation.