Psychopathy is not a diagnostic category, however theories of psychopathy have been discussed throughout psychological history. While the construct of psychopathy is associated with important psychological outcomes, there are inconsistencies in the literature with regard to correlates, etiology and treatment. These inconsistencies suggest that there may be several subtypes of psychopathy. This paper discusses the heterogeneity of psychopathy and considers the existence of psychopathic traits in nonclinical populations. Measures of etiology (Behavioral Activation System and Behavioral Inhibition System; Gray, 1985), psychopathy (Levenson's psychopathy measure; Levenson, Keihl, & Fitzpatrick, 1995) and anxiety (State Trait Anxiety Inventory; Speilberger, Gorsuch & Lushene, 1970) were used in Model based cluster analysis to investigate the existence of subtypes analogous to primary and secondary psychopathy in college students. Four clusters emerged with cluster profiles differing in theoretically coherent ways. Two of the clusters were representative of subclinical primary and secondary psychopathy and the other two represented non-psychopathic groups. Research (Buss, 1961, Dodge, 1991) regarding aggression discriminates between two types of aggression: instrumental and hostile. The current study considered whether the subjects in clusters created by psychopathy data differ in terms of the types of aggression used. As expected, the Psychopathic Traits groups used more aggression than the Non-psychopathic Traits groups, and the Primary Psychopathic Traits group used more instrumental aggression than the Secondary Psychopathic Traits group. Overall, these results support the existence of subclinical subtypes of psychopathy that resemble, in meaningful ways, hypothetical clinical variants. The results also suggest that subtyping may have clinical and forensic utility in risk assessment.

Made available in DSpace on 2015-04-20T12:31:42Z (GMT). No. of bitstreams: 1 PRE-TEXTUAL.pdf: 394027 bytes, checksum: d5e64d94f3ade196d4079ab1173940e8 (MD5) Previous issue date: 2009-06-30 / Fundação de Amparo à Pesquisa do Estado do Amazonas / The global epidemic of AIDS began in 1981, the United States, and after the introduction of antiretroviral drugs to patients infected with HIV / AIDS have been given a higher survival emerged a new challenge, co-infection with the hepatitis C virus (HCV), which is already the leading cause of death in these individuals. The HCV was discovered in 1989 and its main route of transmission, parenteral, is common to HIV, thus increasing the prevalence of co-infection HIV / HCV and are currently more than 30% of those infected by HIV also infected by HCV. There are few studies on co-infection HIV / HCV in the Amazon and this study provides an opportunity to evaluate the association of these viruses. The work is a description of a number of cases and is intended to study the clinical implications and immunobiologicals of co-infection HIV / HCV in a population of patients in the Tropical Medicine Foundation of Amazonas (FMTAM), in the period 2000 to 2007. This study found a prevalence of patients co-infected HIV / HCV of 4.42% (n = 70), with an average annual growth of 3.6%. Of these 72.9% were male, 47.1% were aged 30 | - 40. Of these 80% had completed the first grade, 50% received up to a minimum wage and 55.7% were natural in the city of Manaus where 94.3% from the capital too. Of the patients studied, 68.6% were heterosexuals and 84.3% of patients there was sexual promiscuity as a risk factor. During the study period 34.3% of the patients died. Co-infected individuals, only 25.7% (n = 18/70) to attend the clinic for viral hepatitis FMTAM for collection of biological material. In these patients (n = 18) the mean AST was 61.5 ± 61 U / L, ALT of 62.2 ± 37 U / L and the AST / ALT was 0.88 ± 0.33 U / L. As for lipids 38.9% had total cholesterol> 200mg/dl, 83.3% had HDL ≤ 40 mg / dL, 77.8% had triglycerides> 150 mg / dL and 33.3% had glucose> 110 mg / dL . Included 83.3% of patients used HAART scheme whereby 100% of these were using the protease inhibitor regimen. In applying the FIB-4 score in predicting fibrosis found that 77.8% with a cutoff point was <1.45 and 22.2% with a cutoff> 3.25. As for CD4 + T cells 72.2% had <500 cls/mm3 with a median of 271 cls/mm3, on the T CD8 + 88.9% had ≥ 215 cls/mm3 with a median of 794.5 cls/mm3. The ratio CD4 + / CD8 + was 0.32 cls/mm3. As the viral load of HIV and HCV there was a median of 16,911 copies / mL and 543,209 copies / mL, respectively. In this population 88.9% had the genotype 1 of HCV and 94.4% had a sub-type B HIV. Of these, 83.3% had Child-Pugh A and 61.1% who had normal liver on ultrasound. When the dose cytokines IL4, IL6, IL8, IL10, IL12 and IFN-γ in these patients found that only the IL6 (p = <0.001) showed statistical significance especially when correlated to the logarithm of the HCV viral load (0.031). The results found in this study, despite the low prevalence, have annual growth of co-infection due to improvement in the research of hepatitis C in patients with HIV. These results contribute to a better understanding of the clinical, epidemiological and immunological profile of patients co-infected in the north, because these data may lead to greater understanding of the interaction of these two viruses resulted in early diagnosis and consequent reduction of deaths. / A epidemia mundial da AIDS teve início em 1981, nos Estados Unidos, e pós a introdução dos anti-retrovirais os pacientes infectados com HIV/AIDS passaram a ter uma sobrevida maior surgindo um novo desafio, a co-infecção com o vírus da hepatite C (HCV), a qual já é a principal causa de morte nestes indivíduos. O HCV foi descoberto em 1989 e sua principal via de transmissão, a parenteral, é comum ao HIV, com isso aumentando a prevalência da co-infecção HIV/HCV e estando atualmente, mais de 30% dos infectados pelo HIV também infectados pelo HCV. Existem poucos estudos sobre co-infecção HIV/HCV no Amazonas e o presente estudo oferece uma oportunidade de avaliar a associação destes vírus. O trabalho é do tipo descritivo de uma série de casos e tem o objetivo de estudar as implicações clínicas e imunobiológicas da co-infecção HIV/HCV em uma população de pacientes atendidos na Fundação de Medicina Tropical do Amazonas (FMTAM), no período de 2000 a 2007. Este estudo encontrou uma freqüência de pacientes co-infectados HIV/HCV de 4,4% (n=70), com uma média de crescimento anual de 3,6% dos casos. Destes 72,9% eram do sexo masculino, 47,1% tinham entre 30|- 40 anos. Destes 80% possuíam o primeiro grau completo, 50% recebiam até um salário mínimo e 55,7% eram naturais da cidade de Manaus sendo que 94,3% também procedentes da capital. Dos pacientes estudados, 68,6% eram heterossexuais e em 84,3% dos pacientes encontrou-se a promiscuidade sexual como fator de risco. No período do estudo 34,3% dos pacientes foram à óbito. Dos indivíduos co-infectados, apenas 25,7% (n=18/70) comparecerem ao ambulatório de hepatites virais da FMTAM para coleta de material biológico. Nestes pacientes (n=18) a média da AST foi 61,5±61 U/L, da ALT 62,2±37 U/L e a relação AST/ALT foi 0,88±0,33 U/L. Quanto aos lipídeos 38,9% apresentaram colesterol total >200mg/dL, 83,3% apresentaram HDL ≤ 40 mg/dL, 77,8% tinham triglicerídeos >150 mg/dL e 33,3% tinham glicemia >110 mg/dL. Dos pacientes incluídos 83,3% usavam esquema HAART sendo que 100% destes faziam uso de inibidor da protease no esquema. Ao aplicar o escore FIB-4 para predizer fibrose verificou-se que 77,8% ficou com ponto de corte <1,45 e 22,2% com ponto de corte >3,25. Quanto às células T CD4+ 72,2% tinham <500 cls/mm3 com uma mediana de 271 cls/mm3, quanto ao T CD8+ 88,9% tinham ≥215 cls/mm3 com uma mediana de 794,5 cls/mm3. A razão CD4+ /CD8+ foi 0,32 cls/mm3. Quanto à carga viral do HIV e do HCV verificou-se uma mediana de 16.911 cópias /mL e de 543.209 cópias/mL, respectivamente. Nesta população 88,9% apresentaram o genótipo 1 do HCV e 94,4% apresentaram o sub-tipo B do HIV. Destes, 83,3% apresentavam Child-Pugh A sendo que 61,1% apresentavam fígado normal na ultra-sonografia. Ao dosar as citocinas IL4, IL6, IL8, IL10, IL12 e IFN-γ nestes pacientes verificou-se que apenas a IL6 (p= <0,001) apresentou significância estatística principalmente quando correlacionada ao logaritmo da carga viral do HCV (0,031). Os resultados encontrados neste estudo, apesar da baixa prevalência, apresentam crescimento anual da co-infecção provavelmente devido à melhora na investigação da hepatite C nos pacientes com HIV. Estes resultados contribuem para um melhor conhecimento sobre os dados clínicos, epidemiológicos, bem como perfil imunológico dos pacientes co-infectados da região Norte, uma vez que estes dados podem levar à uma maior compreensão da interação destes dois vírus resultando em diagnóstico precoce, e conseqüente redução dos óbitos.