As fases da pré-adolescência e adolescência são complexas porque englobam diversas mudanças nos indivíduos, se passa por rápido crescimento físico, alteração hormonal, mudanças no ambiente social e nas exigências. Estas fases são caracterizadas por comportamentos de risco por falta de controle inibitório, que está relacionado ao córtex pré- frontal, última área a se desenvolver do sistema nervoso. Há também a experimentação de álcool e drogas durante a adolescência e puberdade. Este trabalho realizou três estudos que abrangeram a temática do controle inibitório na pré-adolescência e adolescência. O primeiro foi uma revisão sistemática a respeito da avaliação do controle inibitório na adolescência e uso de neuroimagem. O segundo investigou a relação do consumo de álcool na adolescência com uso excessivo de bebidas alcóolicas dos pais. E o terceiro objetivou avaliar a impulsividade, controle inibitório e consumo de álcool em indivíduos de 10 a 16 anos. Os três artigos sugeriram um padrão de maior controle inibitório ao longo do desenvolvimento na fase da adolescência. Ainda foi possível observar que as bebidas alcóolicas têm sido consumidas cada vez mais precocemente e em maiores quantidades. Além disso, o consumo excessivo de álcool dos pais de adolescentes pode influenciar no consumo dos filhos nesta fase. / Stages of pre-adolescence and adolescence are complex because they involve several changes in individuals, they pass through a fast physical growth, hormonal changes, changes in the social environment and the requirements. These phases are characterized by risk behavior for lack of inhibitory control, which is related to the prefrontal cortex, the last area to develop the nervous system. There are also experimenting with alcohol and drugs during adolescence and puberty. This work conducted three studies which approached the inhibitory control in preadolescence and adolescence. The first was a systematic review regarding the inhibitory control assessment in adolescence and use of neuroimaging. The second investigated the relationship of alcohol consumption in adolescence with excessive use of alcohol from parents. And the third was aimed at evaluating impulsivity, inhibitory control and alcohol consumption in individuals 10-16 years. The three articles suggested a pattern of greater inhibitory control over development in adolescence. Although it was observed that the alcoholic beverages have been consumed ever earlier and in larger quantities. In addition, excessive alcohol consumption of parents of teenagers can influence the consumption of children at this stage.

This thesis focuses on specific work of primary school teachers that is related to children with the symptoms of ADHD. The theoretical part describes primary school system, young school age children from the perspective of development psychology, further it deals with ADHD in terms of terminology, occurrence, origins of this disorder and description of symptoms ADHD. The practical part of this thesis contains interviews with teachers which encountered children with ADHD during their working experience.It analyses ways of pedagogic work with this disorder in primary schools.

A seleção genética de comportamentos relacionados a um componente emocional do tipo ansiedade, associada ao estudo das possíveis influências desse traço sobre outros componentes emocionais como o medo, impulsividade e tarefas de aprendizagem aversiva, podem contribuir para o entendimento da ansiedade, bem como, fornecer uma base sólida para investigações neurofisiológicas, bioquímicas e moleculares da mesma. Assim, o presente trabalho selecionou duas linhagens de ratos da linhagem Wistar: uma com característica de alta exploração dos braços abertos do labirinto em cruz-elevado (Filô-HE) e outra com baixa exploração desses braços (Filô-LE), e comparou os efeitos da seleção dessas duas linhagens sobre comportamentos associados à ansiedade, medo, impulsividade e aprendizagem aversiva. Para isso, um lote de animais fornecidos pelo Biotério Central da USP-RP foram distribuídos em dois grupos distintos: (1) os que apresentavam maior exploração dos braços abertos do Labirinto em Cruz Elevado (LCE) - (Filô-HE) e (2) os com menor exploração desses braços (Filô-LE) ao longo de doze gerações (de S1 a S12, sem contar o grupo inicial do qual derivam as gerações). Na sexta, nona e décima segunda gerações, os animais foram submetidos aos seguintes testes comportamentais: LCE, Campo Aberto (somente na décima segunda), esquiva passiva, labirinto aquático de Morris (somente na décima segunda), sobressalto (que avalia a resposta de medo), e gradiente de aversão elevado (desenvolvido em nosso laboratório para medir impulsividade). Os dados indicaram a seleção de duas linhagens de ratos Wistar com características distintas para a exploração dos braços abertos do LCE. De um lado, foi selecionada a linhagem Filô-HE, que possui como principal característica, altos índices de exploração de ambientes que geralmente são evitados por outros animais. De outro, foi selecionada (até a oitava geração), a linhagem Filô-LE, que explorava muito pouco ambientes potencialmente aversivos. Tais resultados podem ser interpretados, respectivamente, como (a) baixa e alta frequência de comportamentos associados à ansiedade e medo, (b) baixa e alta frequência de comportamentos associados à impulsividade, (c) altos e baixos níveis de dificuldade na aprendizagem relacionada a memórias emocionais, ou (d) até mesmo o efeito conjunto de todas essas características comportamentais. Porém, para um conhecimento mais confiável, é necessário que os estudos supracitados passem a explorar aspectos neurofisiológicos, psicofarmacológicos, bioquímicos e genéticos, ampliando a investigação dos componentes emocionais selecionados. Bem como, promovendo um controle mais rígido dos traços selecionados e de suas relações com outros componentes que possam interferir na seleção / The genetic selection of behaviors related to an anxiety-like emotional component, associated to the study of the possible influences of this trait over other emotional components like fear, impulsivity and aversive learning, can contribute to the understanding of anxiety as well as supply a solid basis for its neurophysiological, biochemical and molecular investigation. Thus, the present work selected two strains of Wistar rats: one characterized by a high exploration of the open arms of an elevated plus-maze (Filô-HE) and another with a low exploration of these arms (Filô-LE), and compared the effects of such a selection on behaviors associated with anxiety, fear, impulsivity and aversive learning. For this, a batch of animals supplied by the animal house of the USP at Ribeirão Preto were distributed into two distinct groups: (1) one presenting more exploration of the open arms of an elevated plus-maze (EPM) Filô-HE and (2) one with less open arm exploration Filô-LE along twelve generations (from S1 to S12, not counting the initial group from which all generations derived). On the sixth, ninth and twelfth generations the animals were submitted to the following behavioral tests: LCE, open-field (only in the twelfth generation), passive avoidance, Morris aquatic maze (only in the twelfth generation), startle (which evaluates a fear response), and elevated aversion gradient (developed in our laboratory to measure impulsivity). The data indicated a selection of two Wistar rats strains with distinct characteristics concerning the exploration of the open arms of and EPM. On the one hand, the strain Filô-HE was selected exhibiting as the main characteristic high measures of exploration of environments which are usually avoided by other animals. On the other hand, the strain Filô-LE was selected (up to the eighth generation) exhibiting very little exploration of potentially dangerous environments. These results may be interpreted as, respectively, (a) low and high frequency of behaviors associated to anxiety and fear, (b) low and high frequency of behaviors associated to impulsivity, (c) high and low levels of difficulty in learning related to emotional memories, or (d) even the joint effect of all these behavioral characteristics. However, for a more reliable knowledge it is necessary that the studies above begin to explore neurophysiological, psychopharmacological, biochemical and genetic aspects, broadening the investigation ot hte selected emotional components, as well as promoting a more strict control of the selected traits and of its relations with other components that may interfere in the selection

Fatores como o tempo de espera ou o risco a ser enfrentado por uma recompensa maior têm um efeito importante e, por vezes, paradoxal no processo de tomada de decisão. O Capítulo I apresenta uma discussão teórica sobre a tomada de decisão mediada por esses dois fatores, bem como sua interligação com o conceito de impulsividade e o Transtorno de Déficit de Atenção e Hiperatividade (TDAH). O Capítulo II oferece uma aplicação desses conceitos em um modelo animal do espectro da Síndrome Alcoólica Fetal, condição que apresenta algumas características semelhantes ao TDAH. Utilizando ratos expostos ao álcool no período pré-natal, duas tarefas de tomada de decisão mediada por tempo ou probabilidade foram usadas para testar se esses animais apresentam diferenças em seus padrões de escolha. Não foram encontradas diferenças significativas entre grupos controle e experimentais. Futuros estudos com outros protocolos, espécies e/ou linhagens são desejáveis. / Factors such as the time to wait, or the risk to be faced for a bigger reward have an important and, sometimes, paradoxical effect on the decision making process. Chapter I presents a theoretical discussion about decision making mediated by these two factors, as well as how they relate to the concept of impulsivity and the Attention-Deficit Hyperactivity Disorder (ADHD). Chapter II offers a practical application of these concepts in an animal model of the spectrum of Fetal Alcohol Syndrome, a condition that presents some similar characterstics in comparison to ADHD. Using rats prenatally exposed to ethanol, two decision making tasks, mediated by time or probability, were used to test if these animals show any difference in their patterns of choice. No significant differences were found between control and experimental groups. Future studies with other protocols, species and/or strains are desirable.

As fases da pré-adolescência e adolescência são complexas porque englobam diversas mudanças nos indivíduos, se passa por rápido crescimento físico, alteração hormonal, mudanças no ambiente social e nas exigências. Estas fases são caracterizadas por comportamentos de risco por falta de controle inibitório, que está relacionado ao córtex pré- frontal, última área a se desenvolver do sistema nervoso. Há também a experimentação de álcool e drogas durante a adolescência e puberdade. Este trabalho realizou três estudos que abrangeram a temática do controle inibitório na pré-adolescência e adolescência. O primeiro foi uma revisão sistemática a respeito da avaliação do controle inibitório na adolescência e uso de neuroimagem. O segundo investigou a relação do consumo de álcool na adolescência com uso excessivo de bebidas alcóolicas dos pais. E o terceiro objetivou avaliar a impulsividade, controle inibitório e consumo de álcool em indivíduos de 10 a 16 anos. Os três artigos sugeriram um padrão de maior controle inibitório ao longo do desenvolvimento na fase da adolescência. Ainda foi possível observar que as bebidas alcóolicas têm sido consumidas cada vez mais precocemente e em maiores quantidades. Além disso, o consumo excessivo de álcool dos pais de adolescentes pode influenciar no consumo dos filhos nesta fase. / Stages of pre-adolescence and adolescence are complex because they involve several changes in individuals, they pass through a fast physical growth, hormonal changes, changes in the social environment and the requirements. These phases are characterized by risk behavior for lack of inhibitory control, which is related to the prefrontal cortex, the last area to develop the nervous system. There are also experimenting with alcohol and drugs during adolescence and puberty. This work conducted three studies which approached the inhibitory control in preadolescence and adolescence. The first was a systematic review regarding the inhibitory control assessment in adolescence and use of neuroimaging. The second investigated the relationship of alcohol consumption in adolescence with excessive use of alcohol from parents. And the third was aimed at evaluating impulsivity, inhibitory control and alcohol consumption in individuals 10-16 years. The three articles suggested a pattern of greater inhibitory control over development in adolescence. Although it was observed that the alcoholic beverages have been consumed ever earlier and in larger quantities. In addition, excessive alcohol consumption of parents of teenagers can influence the consumption of children at this stage.

Fatores como o tempo de espera ou o risco a ser enfrentado por uma recompensa maior têm um efeito importante e, por vezes, paradoxal no processo de tomada de decisão. O Capítulo I apresenta uma discussão teórica sobre a tomada de decisão mediada por esses dois fatores, bem como sua interligação com o conceito de impulsividade e o Transtorno de Déficit de Atenção e Hiperatividade (TDAH). O Capítulo II oferece uma aplicação desses conceitos em um modelo animal do espectro da Síndrome Alcoólica Fetal, condição que apresenta algumas características semelhantes ao TDAH. Utilizando ratos expostos ao álcool no período pré-natal, duas tarefas de tomada de decisão mediada por tempo ou probabilidade foram usadas para testar se esses animais apresentam diferenças em seus padrões de escolha. Não foram encontradas diferenças significativas entre grupos controle e experimentais. Futuros estudos com outros protocolos, espécies e/ou linhagens são desejáveis. / Factors such as the time to wait, or the risk to be faced for a bigger reward have an important and, sometimes, paradoxical effect on the decision making process. Chapter I presents a theoretical discussion about decision making mediated by these two factors, as well as how they relate to the concept of impulsivity and the Attention-Deficit Hyperactivity Disorder (ADHD). Chapter II offers a practical application of these concepts in an animal model of the spectrum of Fetal Alcohol Syndrome, a condition that presents some similar characterstics in comparison to ADHD. Using rats prenatally exposed to ethanol, two decision making tasks, mediated by time or probability, were used to test if these animals show any difference in their patterns of choice. No significant differences were found between control and experimental groups. Future studies with other protocols, species and/or strains are desirable.

Avaliou-se como o tratamento de jogadores patológicos (JP) impacta processos mentais através de medidas neuropsicológicas associadas à impulsividade (tarefas tradicionais, computadorizadas e comportamentais) e a relação destas com variáveis tradicionais de tratamento (fissura, distorções cognitivas e comportamento de jogo). Compararam-se os resultados pré e pós-tratamento de 72 JP (56% homens) em tratamento ambulatorial. Observaram-se melhoras significativas em medidas neuropsicológicas de amplitude atencional, controle inibitório e adiamento de gratificação, bem como em medidas de auto-relato de comportamento de jogo, fissura, distorções cognitivas, afetividade negativa e impulsividade. Estas variáveis foram introduzidas em um modelo de análise de componentes principais (ACP) e os três fatores obtidos foram comparados entre respondedores e não respondedores a tratamento. Mostraram-se capazes de distinguí-los os fatores Distorções Cognitivas/Afetos Negativos e Fissura/Controle Inibitório, mas não o fator Inquietação Motora; indicando quais medidas clínicas e aspectos neuropsicológicos podem contribuir para avaliação da eficácia terapêutica, auxiliando na distinção entre JP recuperados e não recuperados. Descritores: neuropsicologia/métodos, jogo de azar/psicologia, impulso/psicologia, questionários, resultado de tratamento / It was assessed how pathological gamblers (PG) treatment impact mental processes investigated by neuropsychological measures associated to impulsivity (traditional, computer and behavioral tasks) and their relation with traditional treatment variables (craving, cognitive distortions and gambling behaviour). The data of 72 PG (56% of man) undergoing outpatient treatment were analyzed. Statistically significative differences were observed in neuropsychological measures as attentional span, inhibitory control and reward delay, as well in self report scores as craving, cognitive distortions, negative affect and impulsivity, indicating positive changes. The variance of all data that varied significantly along gambling treatment were introduced to a principal component analysis (PCA). The three factors obtained were compared between recovered and non recovered gamblers. Recovered and non-recovered differed by the Cognitive Distortions/Negative Affect and Craving/Inhibitory Control, but not by Motor Restlessness factor; indicating that clinical measures and neuropsychological aspects could contribute to the assessment of therapeutic efficacy, helping to distinguish between recovered and non recovered PG

One of the key features of bipolar disorder (BD) is risky and impulsive decision-making, behaviours theorised to arise from dysregulation in a biobehavioural system governing approach of rewards. However the neural mechanisms of this conceptual model have not been well specified, and there remains a gap between this model and key clinical phenomena such as mixed episodes. This thesis takes a neuroeconomics and reinforcement learning approach to characterise the neural mechanisms of motivational decision-making in BD. A review of the neurobiological evidence for reward dysregulation in BD (Chapter 1) arrives at a model in which striatal hypersensitivity is exacerbated by reduced dorsolateral prefrontal cortical (dlPFC) control. This model is tested by four studies using electrophysiology, source analysis and functional neuroimaging. Chapters 3 and 4 employ EEG to explore how hypomanic traits modulate motivational processing in contexts requiring learning and trade-offs between risk and between immediate and delayed reward. In Chapter 3, high trait hypomania was associated with impaired loss learning and a neural evaluation of rewards and losses more favourably, relative to low hypomania. This “rose-tinted” bias may reinforce risky behaviours that pay off and reduce learning from aversive repercussions. Chapter 4 reports an attentional bias towards immediate reward which may drive a steeper delay discounting trajectory and an inability to delay gratification. In Chapters 5 and 6 simultaneous electrophysiological and functional neuroimaging was utilised to characterise spatial and temporal perturbations to the mesocorticolimbic reward network in a clinical sample of BD. Patients showed a poorer ventromedial prefrontal cortical representation of the objective value of outcomes as well as a heightened striatal reward response. The latter finding was related to decreased dlPFC activation, which also interacted with residual manic symptoms. This is interpreted in terms of reduced top-down executive control that is exacerbated by residual manic symptoms, suggesting a potential mechanism underlying relapse and extremely high levels of reward-seeking seen during mania. EEG source imaging localised differences during reward outcome evaluation to early sensory-attentional (N1), reward evaluation (FRN) and cognitive (P300) stages of processing. For rewards, patients exhibited greater activity in precuneus, frontal eye fields (N1) and ventral anterior cingulate (FRN), consistent with an attentional bias to reward that drives hyperactivity in reward circuitry. Collectively the results provide evidence of reward dysfunction from behavioural measures and two neuroimaging modalities. The results support a model in which a core hypersensitivity to reward and a “rose-tinted” evaluation bias act to 1) potentiate the impact of rewarding outcomes and 2) attenuate aversive ones maintains a distorted representation of objective likelihood and value associated with actions. This is exacerbated by reduced prefrontal control – which may be particularly associated with mania – highlighting a potential target for novel pharmacological and psychological interventions.

Objective: The efficacy of bariatric surgery has been proven; however, a subset of patients fails to achieve expected long-term weight loss postoperatively. As differences in surgery outcome may be influenced by heterogeneous psychological profiles in pre-bariatric patients, previous subtyping models differentiated patients based on temperament traits. The objective of the present study was to expand these models by additionally considering emotion dysregulation and disinhibited eating behaviors for subtyping, as these factors were associated with maladaptive eating behaviors and poor post-bariatric weight loss outcome. Methods: Within a prospective multicenter registry, N = 370 pre-bariatric patients were examined using interview and self-report questionnaires. A latent profile analysis was performed to identify subtypes based on temperament traits, emotion dysregulation, and disinhibited eating behaviors. Results: Five pre-bariatric subtypes were identified with specific profiles regarding self control, emotion dysregulation, and disinhibited eating behaviors. Subtypes were associated with different levels of eating disorder psychopathology, depression, and quality of life. The expanded model increased variance explanation compared to temperament-based models. Conclusion: By adding emotion dysregulation and disinhibited eating behaviors to previous subtyping models, specific pre-bariatric subtypes emerged with distinct psychological deficit patterns. Future investigations should test the predictive value of these subtypes for post bariatric weight loss and health-related outcomes.

Exekutivfunktionen sind die Grundlage der Aufmerksamkeitssteuerung, Handlungsplanung, Impulskontrolle, und notwendig für zielgerichtetes Handeln. Impulskontrolle bedeutet dabei die Fähigkeit, behaviorale Impulse und Gedanken zu unterdrücken (Evenden, 1999). Erkrankungen, wie die Borderline Persönlichkeitsstörung (BPS) oder die Aufmerksamkeitsdefizit-/ Hyperaktivitätsstörung (ADHS), die sich durch Einschränkungen der Impulskontrolle auszeichnen, gehören zu den häufigsten psychiatrischen Erkrankungen unserer Zeit und sind schwer zu behandeln. Klinische Beobachtungen (Linehan, 1996) wie auch aktuelle Forschungsergebnisse (Silbersweig et al., 2007) zur BPS lassen einen engen Zusammenhang der affektiven und impulsiven Symptomatik vermuten. Ziel der Studie war zum einen, die gestörte Impulskontrolle bei BPS mit Hilfe psychometrischer und neuropsychologischer Verfahren zu bestätigen und zum anderen die komplexe Interaktion affektiver und inhibitorischer Netzwerke mit Hilfe funktioneller Magnetresonanztomographie zu untersuchen. Dazu wurde ein fMRI-Paradigma entwickelt, dass Emotionsinduktion (Ärger, Freude, Neutral) mit einer Impulskontrollaufgabe (Go/NoGo) verband. Neben dem Vergleich mit einer gesunden Kontrollgruppe wurden zur störungsspezifischen Abgrenzung auch Frauen mit ADHS untersucht. Patientinnen mit BPS gaben dabei in Selbstbeurteilungsmaßen höhere Impulsivitätswerte als gesunde Kontrollen und ähnlich hohe Werte wie Patientinnen mit ADHS an, waren aber in den Aufgaben behavioraler Impulskontrolle nicht beeinträchtigt. In allen drei Versuchsgruppen ergab sich eine emotionale Modulation durch die vorher induzierten Emotionen. Während aber gesunde Kontrollen für erfolgreiche Inhibition v. a. den inferioren Präfrontalkortex verstärkt rekrutieren, war sowohl in der BPS- als auch in der ADHS eine Modulation im Nucleus subthalamicus zu beobachten. Während Patienten mit BPS entsprechend früherer Befunde mit verstärkter Amygdalaaktivierung auf die Emotion Ärger reagierten, zeigten die Patientinnen mit ADHS veränderte Aktivierungen des affektiven Netzwerkes bei der Emotion Freude. Emotionsunabhängig zeigten sich in der ADHS-Gruppe Hypoaktivierungen im mittleren Cingulum und dorsolateralen Präfrontalkortex. Zusammengefasst entsprechen die Ergebnisse der Annahme eines hyperaktivierten limbischen affektiven Systems und eines hypoaktivierten präfrontalen Kontrollsystems bei Borderline Persönlichkeitsstörung (Depue & Lenzenweger, 2005; Dinn et al., 2004; Posner et al., 2003). Eine emotionale Modulation scheint zu einer kompensatorischen Aktivierung von Hirnregionen des Hemmungsnetzwerkes zu führen. Eine generell beeinträchtige neutrale Impulskontrollfähigkeit scheint in Abgrenzung zur ADHS jedoch nicht vorzuliegen.