Submitted by Fabio Sobreira Campos da Costa (fabio.sobreira@ufpe.br) on 2016-08-26T14:35:32Z No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Tese (VERSÃO FINAL) Josiane em PDF.pdf: 2742658 bytes, checksum: 600d697767f82f73dd7ae1b6dcfb94eb (MD5) / Made available in DSpace on 2016-08-26T14:35:32Z (GMT). No. of bitstreams: 2 license_rdf: 1232 bytes, checksum: 66e71c371cc565284e70f40736c94386 (MD5) Tese (VERSÃO FINAL) Josiane em PDF.pdf: 2742658 bytes, checksum: 600d697767f82f73dd7ae1b6dcfb94eb (MD5) Previous issue date: 2016-02-26 / FACEPE / O Transtorno de Déficit de Atenção e Hiperatividade tem sido, atualmente, um dos diagnósticos psiquiátricos mais comuns na infância. Trata-se de um transtorno neurocomportamental, com um quadro clínico, de início precoce, que se caracteriza por sintomas de desatenção, hiperatividade e impulsividade exageradas acarretando grandes prejuízos em várias esferas da vida, mas sobretudo na vida social e acadêmica. Além das dificuldades comportamentais, são percebidas as dificuldades nas interações sociais, pois a falta de controle das atitudes e reações dificultam a participação em atividades de grupo, ou que envolvam relações, denotando uma inabilidade de compreender e aceitar as questões do outro. Essa inabilidade, por sua vez, implica na Teoria da Mente, que é o processo cognitivo responsável pela capacidade de compreender, interpretar e atribuir estados mentais para si e para o outro, que viabilizam um melhor desenvolvimento social. Uma criança com TDAH, além do déficit da atenção e impulsividade, apresenta um prejuízo do controle inibitório, que está relacionado com as funções executivas. Um prejuízo nessas funções pode ser observado no desempenho acadêmico, como no comportamento, à medida que a criança apresenta dificuldades de planejar, inibir respostas, sustentar a atenção, participar de jogos e interação com pares, gerando desconforto e conflitos a sua volta. Objetivo: investigar a relação entre teoria da mente, funções executivas e competência social em crianças em risco para o Transtorno de Déficit de Atenção e Hiperatividade. Método: estudo de investigação correlacional, quantitativo, transversal e analítico. Participaram 230 alunos de escolas particulares de Recife, com idades entre 7,0; 10 e 11anos (idade média 8,5), ambos os sexos, divididos em dois grupos, um com crianças que apresentassem ao menos 7 sintomas para TDAH, segundo critérios do DSM-IV, consideradas “em risco”, e outro com crianças com desenvolvimento típico. Os dados foram coletados através de questionário sociodemográfico, questionário SNAP-IV, Matrizes Progressivas de RAVEN, Torre de Londres, Stroop palavra-cores, Tarefas de Teoria da Mente de crença falsa de primeira e segunda ordem e o Inventário Multimídia de Habilidades Sociais para Crianças. Resultados: teoria da mente de 2ª ordem mostrou correlação positiva em crianças com risco para TDAH, assim como, estas apresentaram grande prejuízo na execução das tarefas que avaliaram as funções executivas e competência social, diferindo significativamente do grupo de crianças com desenvolvimento típico. A correlação entre as variáveis, teoria da mente de 2ª ordem, funções executivas e competência social mostraram ser preditoras do TDAH, denotando que quanto maior o risco para o TDAH em crianças, maior o prejuízo da teoria da mente de 2ª ordem, das funções executivas e menos competentes socialmente estas se apresentam. / Attention Deficit Hyperactivity Disorder has been lately, one of the most common psychiatric diagnoses in the childhood. It is a neurobehavioral disorder presenting its clinical conditions at a premature life stage. The symptoms are characterized as exaggerated absence of mind, hyperactivity, and impulsiveness leading to great losses in several areas of the patient’s life, but mainly over his social and academic life. Apart from behavioral difficulties, problems on social interactions are perceived, for the lack of control of the attitudes and reactions, hinder participation on group activities, or activities that involve relations, denoting a disability to comprehend and accept the issues of the other. This disability, on the other hand, implicates on the theory of mind, which is the cognitive process responsible by the capacity to comprehend, interpret and assign mental states for himself and others, which enables better social development. A child with ADHD, in addition to the attention deficit and impulsiveness, presents loss of the inhibitory control, which is related with the executive functions. A damage to these functions can be observed over the academic performance, as on behavior, as the child presents difficulties to plan, inhibit responses, maintain attention, participate of games and interact with pairs, generating discomfort and conflicts around himself. Objective: to investigate the relation between the theory of mind, executive functions and social competence on children at risk to the Attention Deficit Hyperactivity Disorder. Methods: correlation inquiry study, quantitative, transversal and analytical. 230 students from private schools of Recife participated, aged between 7,0 and 10,11 years old (mean age 8,5), both genders, divided into two groups, one with children presenting at least 7 symptoms to ADHD, according to DSM-IV criteria, considered “at risk”, and another containing children with typical development. Data were collected through a sociodemographic questionnaire, SNAP-IV questionnaire, Raven Progressive Dies, London Tower, Stroop word-colors, Theory of Mind tasks of false belief from both first and second orders and the Multimedia Inventory of Social Abilities for Children. Results: theory of mind 2ª order showed positive correlation in children at risk for ADHD, and these showed great impairment in executive functions tasks and social competence, differing significantly from the group of children with typical development. The correlation between the variables theory of mind from 2ª order, executive functions and social competence shown to be predictors of ADHD, indicating that the higher the risk for ADHD in children, the greater the loss of the theory of mind from 2ª order, executive functions and less social competence they present themselves.

The aim of this doctoral thesis is to – from a child perspective and with children as informants – describe and analyze childhood conditions for children whose parents suffer from severe mental illness. The method used is qualitative – 28 children, 10 boys and 18 girls, 7–18 years old, were interviewed about their parents’ mental disorder; the family situation and their own personal life – in school and during free time. The analyses are based on Sociology of Childhood and Family Sociology. Previous studies have, to a great extent, focused on the risk the children run of developing mental health- and social problems and what helps them to grow up healthy. The increased risk of mental health- and social problems has been well confirmed, but also that preventive interventions can contribute to resilience in the children. Although some studies have explored children’s experiences of their parents’ mental illness and the challenges they meet, research from a childhood perspective, has so far been scarce. The results of this study reveal different degrees of emotional, physical and social exposure for the children. Their childhood conditions were related to gender, relations, communication, problem load and social situation of the family. If the parent with a mental illness was a woman, the situation for the child was often more exposed than if it was the father – most likely due to parental roles and expectations on men and women in the Swedish society at that time. Girls seemed more emotionally involved in the parents’ problems than boys, especially if the parent with a mental illness was a father. Most of the parents were divorced or had never lived together. Parental conflicts complicated the life of the children, who were expected to have maintained relationships to both parents. Lack of communication about the parent’s mental disorder in - and outside the family - was common. The children were often uninformed about the parent’s problems.  If hindered to pass information between and outside their two homes, they were left to handle difficult, sometimes dangerous, situations with the mentally ill parent, alone. The home was not always the safe place for rest and recovery, as homes are expected to be. The heavier the total problem load of the family, the more exposed was the child. Most exposed were children whose both parents had severe problems – mental illness or addiction. They were often placed in out of home care, for longer or shorter periods. The kind and degree of exposure the children experienced varied. Four kinds of childhood sceneries could be recognized: (1) the well organized childhood, where the parent’s mental health problem was mainly an emotional burden for the children; (2) the complicated childhood, where the parents conflicts and inability to protect the child made the child either too involved or too lonely in handling the problems that the parent’s mental illness caused them; (3) the problematic childhood where the parent’s mental illness was not the only problem in the family, but factors like the other parent’s drinking, siblings’ problems, social and economical difficulties added to the burden and (4) the exposed childhood where none of the parents was able to take care of the child. Knowledge and openness, about the parents’ problems, seemed to increase competence and decrease feelings of guilt and responsibility for the parent. All of the children stood forward, not as passive victims, but as competent agents in their own lives – although often more or less powerless because of their dependence of their parents and other adults around them. It was clear, though, that there is a need for professionals in adult psychiatry, social services, school and preschool, to pay attention to the children of parents with mental health problems and see to that they get the information and support they need. Keywords: Children, childhood conditions, children as agents, parental mental illness/mental disorders, mental health knowledge, exposed life situations, competence.