I den här uppsatsen har tre kvinnor med högfungerande autism intervjuats, två representanter från intresseorganisationer inriktade på autism och neuropsykiatriska funktionsvariationer samt en föredetta arbetskonsulent på Arbetsförmedlingen. Syftet med studien var att öka förståelsen för intervjupersonernas upplevda hinder och förbättringsmöjligheter för kvinnor med autism att etablera sig på arbetsmarknaden. Forskningsfrågorna handlade om hinder och förbättringar och besvarades genom semistrukturerade kvalitativa intervjuer. Resultatet och svaret på intervjupersonernas upplevda hinder mynnade ut i ett antal teman som rör sig om hur kvinnor får sina diagnoser för sent, okunskap i omgivningen och strukturella svårigheter inom arbetslivet. Förbättringsåtgärder som presenterades var förebyggande stöd, ökad kunskap hos myndigheter, skola, vård och arbetsgivare samt kollektiv organisering i syfte att stärka den gemensamma identiteten. Resultatet analyserades och bearbetades utifrån studiens teoretiska ramverk som utgjordes av stigma-teorin av Erwing Goffman och Empowerment. / In this essay, three women with high-functioning autism were interviewed, two representatives from interest-groups focused on autism and neuropsychiatric disabilities, and a former work consultant atthe Swedish Public Employment Service. The purpose of the study was to increase the understanding of the interviewees' perceived obstacles and opportunities for improvement for women with autism to establish themselves on the labor market. The research questions focused on obstacles and improvements and were answered through semi-structured qualitative interviews. The response to the interviewees' perceived obstacles has resulted in a number of themes: i) how women receive their diagnoses too late, ii) ignorance of the environment and iii) structural obstacles on the labor market. Improvements that were presented were i) preventive support, ii) increased knowledge in authorities, schools, healthcare and employers and iii) collective organization in order to strengthen the common identity. The results were analyzed and processed based on the study's theoretical framework, which consisted of the stigma theory of Erwing Goffman and the concept of Empowerment.

The aim of this study was to investigate and understand how west African immigrant mothers of children with neuropsychiatric disability are been supported by the Lss service provider. Method: Qualitative semi- structured interviews were conducted with seven participants , therein four were west African mothers of children with neuropsychiatric disability, and three were Lss service workers.  The interviews were transcribed and then later thematically analysed. The Result shows that there are challenges for the mothers to understand the supportive information avaliable because of language barriers, therefore making it difficult for the Lss to know whom to provide structural services to, thus there are no health promotional interventions mapped out for the mothers.  A total of five main themes and ten subthemes emerged . Conclusion: The findings from this study showed that west African immigrant mothers of children with neuropsychiatric disability in Sweden have a cultural perception that disability is outlawed and prohibited,  and their insufficient knowledge on the importance of health literacy affects the Lss from providing sustainable rehabilitation  and structural services.

Los centros de salud han cambiado de manera drástica en función, forma y organización. Este cambio se ha dado desde el campo religioso hasta uno altamente sofisticado y técnico. Es por ello que, para iniciar la investigación, se realizó un estudio de la tipología arquitectónica para entender su función y evolución. Se concluyó que se debía atender la rama de salud mental debido a que, según el Ministerio de Salud, son las enfermedades mentales las que causan una mayor pérdida de años de vida en el Perú. Luego, se buscó cuál era la situación actual de los centros de salud especializados en psiquiatría, además de qué zonas eran las más indicadas para realizar una intervención. Se determinó que el lugar ideal para implementar un proyecto que cubra las necesidades de calidad y calidez en los servicios de salud sería Lima Este. Esto debido a un análisis que prioriza el nivel de impacto en la población y busca atender el principal foco de demanda en el país. A continuación se decidió Intervenir el Hospital Hermilio Valdizán debido a su importancia sobre los demás hospitales psiquiátricos nacionales por factores de ubicación y cobertura. Asimismo, en el sector en donde se ubica, se identifican los mayores índices de pobreza y pobreza extrema, los cuales tienen relación directa con las enfermedades neuro-psiquiátricas. Para finalizar, se realizó un listado de criterios de diseño. Para ello, se utilizó el énfasis de la Fenomenología de la percepción, ya que es considerado como un potenciador de la tipología. / Health centers have changed significantly in terms of function, form, and organization. This change has gone from a religious field to a highly sophisticated and technical one. Therefore, to start the research, there was a study of the architectural typology to understand their function and evolution. The decision was to focus the investigation on the mental health branch, because mental illnesses cause the greatest loss of life years in Peru, according to the Health Ministry of Peru (MINSA).  Subsequently, there was an investigation into the current situation of specialized health centers, and which areas would be most suitable for intervention. The conclusion was that the ideal place to implement a project that meets the needs of quality and warmth in healthcare services would be East Lima, based on an analysis that prioritizes the impact level on the population and seeks to meet the main focus of demand in the country. The next step was to go to the Hermilio Valdizán Hospital because of its importance over other psychiatric hospitals in terms of location and coverage in East Lima. Its location is in Santa Anita’s district, where the highest rates of poverty and extreme poverty exist. These rates are directly related to neuropsychiatric diseases. Finally, a design criteria list was created using the emphasis on the Phenomenology of Perception, as this is considered a typology enhancer. / Tesis

Through practical experiences in social work we have found that siblings of children with neuropsychiatric disability are being left behind in family treatment. We have also identified  a knowledge gap through previous research in how siblings experience their role and relationships within the family. The purpose of this study is to establish an understanding of how neuropsychiatric disability affects the siblings in the family. The siblings referred to in this qualitative study, who we got in touch with through social media, have been interviewed through six semi-structured interviews. Furthermore, the answers have been analyzed through systems theory. The results show that the siblings have taken great responsibility for their sibling and taken a step back as the sibling with neuropsychiatric disability had extensive needs that required a lot of attention and care from their parents.

Syftet med detta arbete är att undersöka hur lärare inom särskolan jobbar och reflekterar över praxisnära arbete som berör elevdemokrati och elevinflytande. Studien har genomförts i form av gruppintervjuer där totalt sju verksamma lärare på en grundsärskola i mellersta Sverige har deltagit. Den aktuella grundsärskolan valdes ut sedan det på skolan under läsåret 2021/2022 bedrevs ett förändringsarbete med syfte att öka elevinflytandet och elevdemokratin. Denna studie utgår från hypotesen att ett sådant förbättringsarbete på sikt resulterar i att lärare och elever får ökade kunskaper genom en ökad och mer konkret förståelse för elevinflytande och elevdemokrati som arbetsområden i skolan. Studien visar att lärarna upplever sig ha fått större kunskap om och att lärarna i större utsträckning reflekterar över demokratiska värden, och detta oftare än vad eleverna gör. Lärarna lyfter fram att det är svårt att veta om eleverna i sin tur ha fått en större kunskap om och förståelse för demokratiska värden i ett sådant riktat arbetsområde som är fallet i denna studie. Detta kan ses mot bakgrund av elevernas dagsform och tidsuppfattning, vilket är två parametrar som återkommer. Samtliga deltagande lärare menar att det demokratiska uppdraget är stort och svårt att genomföra i praktiken, och att lärarens utgångspunkt av den anledningen behöver utgå från elevernas förutsättningar och en förståelse för elevernas världsuppfattning och intresse. Utöver dagsform och tidsuppfattning framgår av resultatet att även elevernas förmåga att kommunicera med sin omgivning är en viktig påverkande faktor. Detta resulterar i att lärares planering, och även projektets målsättning, snabbt kan behövas förändras. Lärarna i studien lyfter dock att det är viktigt att jobba med dessa frågor och förmågor, så eleverna blir förberedda för det kommande samhällslivet. Verksamma lärare har en förhoppning när det arbetas med demokratiska värden, att eleverna ska utveckla förståelse för deras rättigheter i samhället och att de även förstår att deras åsikter spelar roll i samhället. Även om lärarna lyfter fram att det arbete som de har gjort med detta tema genom det aktuella förändringsarbetet är bra, belyser samtliga deltagare att detta är något som behöver utvecklas ännu mer. Detta gör att särskolans demokratiska arbetssätt behöver hitta former och arbetssätt som passar varje elevgrupp eftersom det finns en stor mångfald av elever och att deras förutsättning ser väldigt olika ut – något som gör att den enskilda läraren har olika förutsättningar och möjligheter att jobba med demokratiska värden. / The aim of this essay is to investigate how teachers within the special school work and reflect over close-to-practise work regarding questions regarding student democracy and student influence. The study has been conducted in the form of group interviews where a total of seven working teachers at a special school in the middle of Sweden have participated. The special school in question was chosen because the school was part of a change process with the aim of increasing the student democracy and influence during the school year of 2021/2022. This study is based on the hypothesis that such a change process eventually results in increased knowledge through an improved and more concrete understanding of student influence and student democracy as a subject area in school for both teachers and students.The study shows that the teachers feel like they have gained a deeper knowledge and to a greater extent reflects over democratic values, and furthermore shows that the teachers do so more often than the students. The teachers emphasize that it is difficult to know if the students in their turn have gained a deeper knowledge about and understanding of democratic values in such a directed work area as in the case of interest in this study. This can be seen in the light of the daily form and sense of time of the students, which are two parameters that are recurring. All of the participating teachers suggest that the democratic mission is massive and difficult to implement in practice, and that the teachers’ starting point for that reason needs to be based on the students’ prerequisites and an understanding of the students' worldview and interest. In addition to daily form and time perception, the results show that the students' ability to communicate with their surroundings is also an important influencing factor. As a result, teachers' planning, and also the project's objectives, may need to be changed quickly. However, the teachers in the study emphasize that it is important to work with these issues and abilities, so that the students are prepared for the coming social life. Working teachers have a hope when working with democratic values, that students will develop an understanding of their rights in society and that they will also understand that their opinions play a role in society. Although the teachers emphasize that the work they have done on this theme through the current change process is good, all participants highlight that this is something that needs to be developed even more. This means that the special school's democratic work methods need to find forms and methods that suit each group of students because there is a large diversity of students and that their prerequisites look very different - something that means that the individual teacher has different conditions and opportunities to work with democratic values.

The study examines in what way social workers who handle financial assistance experience the impact of theoretical knowledge and practical knowledge in treatment of clients with neuropsychiatric disabilities. Furthermore, the study aims to investigate what opportunities and limitations there are for acquiring this knowledge. The study is based on an inductive approach where nine social workers were interviewed through qualitative semi-structured interviews. Qualitative content analysis has been applied as the analysis method of the study where two main categories were identified: Theoretical knowledge and practical knowledge are significant for a more favorable treatment of clients with neuropsychiatric disabilities and Theoretical and practical knowledge becomes personal. Furthermore, the results have been analyzed on the basis of previous research combined with the study's theoretical starting point: theoretical knowledge and practical knowledge, with inspiration from the theory of knowledge. The results of the study show that theoretical knowledge and practical knowledge can enable a more favorable treatment of clients with neuropsychiatric disabilities. The results also indicate that the practical knowledge is attributed to greater significance than what the theoretical knowledge is emphasized to do. Furthermore, the study results demonstrate that the social workers’ knowledge acquisition will be limited based on whether the organization provides education, methods, guidance or the opportunity to read at the workplace. The social workers’ opportunities for acquiring knowledge thus become dependent on the professional's own interest and experiences, and the knowledge can thus be thought to be personal. / Studien undersöker hur socialsekreterare som handlägger ekonomiskt bistånd upplever att teoretisk respektive praktisk kunskap kan ha för betydelse vid bemötandet av klienter med neuropsykiatriska funktionsnedsättningar (NPF). Vidare syftar studien till att undersöka vilka möjligheter och begränsningar det finns för att inhämta denna kunskap. Studien utgår ifrån en induktiv ansats där nio socialsekreterare intervjuades genom kvalitativa semistrukturerade intervjuer. I studien har kvalitativ innehållsanalys applicerats som analysmetod där två huvudkategorier har identifierats: Teoretisk kunskap samt praktisk kunskap har betydelse för ett mer fördelaktigt bemötande av klienter med NPF och Teoretisk kunskap samt praktisk kunskap blir personbunden. Vidare har resultatet analyserats utifrån tidigare forskning förenat med studiens teoretiska utgångspunkt: teoretisk kunskap och praktisk kunskap, med inspiration från kunskapsteorin. Studiens resultat påvisar att teoretisk kunskap samt praktisk kunskap kan möjliggöra för ett mer fördelaktigt bemötande gentemot klienter med NPF, däremot tillskrivs den praktiska kunskapen större betydelse än vad den teoretiska kunskapen framhålls göra. Vidare indikerar studiens resultat på att socialsekreterarnas kunskapsinhämtning blir begränsad utifrån om organisationen tillhandahåller utbildning, metoder, handledning eller möjlighet till lästid på arbetsplatsen. Socialsekreterarnas möjligheter för kunskapsinhämtning blir därmed beroende av den professionellas eget intresse och egna erfarenheter, och kunskapen kan därmed tänkas bli personbunden.

L’identification de biomarqueurs des maladies mentales telles que l’autisme, la schizophrénie ou la maladie d’Alzheimer, est d’une importance capitale non seulement pour établir un diagnostic objectif, mais aussi pour suivre l’effet des traitements. La création et le maintien de fonctions neuronales sub-cellulaires, telle que la plasticité synaptique, sont fortement dépendants du transport intraneuronal, essentiel pour acheminer d’importants composants à des positions spécifiques. Un transport actif défaillant semble être partiellement responsable d’anomalies de la plasticité synaptique et de la morphologie neuronale présentes dans de nombreuses maladies neuropsychiatriques. Cette thèse décrit (i) la mise au point d’une méthode de quantification du transport intraneuronal reposant sur le suivi de nanoparticules de diamants fluorescents (fNDs); (ii) l’application de cette technique simple et faiblement invasive à l’analyse fonctionnelle de variants génétiques associés à des maladies neuropsychiatriques. Ce manuscrit comporte quatre chapitres. Le premier détaille l’architecture polygénique complexe des maladies mentales et démontre la pertinence d’étudier le transport intraneuronal. Les deuxième et troisième chapitres sont dédiés à la méthode et détaillent les stratégies d’internalisation des fNDs, les outils de quantification du transport intraneuronal et la validation de la technique. La forte brillance, la photo-stabilité parfaite et l’absence de toxicité cellulaire font des fNDs un outil de choix pour étudier la dynamique du transport intraneuronal sur une durée d’observation de plusieurs heures avec une haute résolution spatiotemporelle et une bonne puissance statistique. Enfin, dans le quatrième chapitre, nous appliquons cette nouvelle méthode d’analyse fonctionnelle pour étudier l’effet de variants génétiques associés à l’autisme et à la schizophrénie. Pour cela, nous utilisons des lignées de souris transgéniques ayant une faible surexpression des gènes MARK1 et SLC25A12, ainsi que des AAV-shRNA pour induire une haplo-insuffisance du gène AUTS2. Notre méthode de diagnostic moléculaire s’avère suffisamment sensible pour déceler des variations fines de la dynamique du transport intraneuronal, ouvrant la voie à de futurs développements en nanomédecine translationnelle. / The identification of molecular biomarkers of brain diseases as diverse as autism, schizophrenia and Alzheimer’s disease, is of crucial importance not only for an objective diagnosis but also to monitor response to treatments. The establishment and maintenance of sub-cellular neuronal functions, such as synaptic plasticity, are highly dependent on intracellular transport, which is essential to deliver important materials to specific locations. Abnormalities in such active transport are thought to be partly responsible for synaptic plasticity and neuronal morphology impairment found in many neuropsychiatric and neurodegenerative diseases. This thesis reports (i) the development of a quantification technic of intraneuronal transport based on fluorescent nanodiamonds (fNDs) tracking; (ii) the application of this simple and minimally invasive approach to the functional analysis of neuropsychiatric disease-related genetic variants.This manuscript falls into four chapters. The first one details the complex polygenic architecture of mental disorders and demonstrates the disease relevance of monitoring the intraneuronal transport. The second and the third chapters are dedicated to the nanodiamond-tracking assay and describe the fNDs internalisation strategies, the spatiotemporal quantitative readouts and the validation of the technic. The high brightness, the perfect photostability and the absence of cytotoxicity make fNDs a tool of choice to perform high throughput long-term bioimaging at high spatiotemporal resolution. Finally, in the fourth chapter, we apply this new functional analysis method to study the effect of genetic variants associated to autism and schizophrenia. We established transgenic mouse lines in which MARK1 and SLC25A12 genes were slightly overexpressed, and AAV-shRNA to induce AUTS2 gene haploinsufficiency. Our molecular diagnosis assay proves sufficiently sensitive to detect fine changes in intraneuronal transport dynamic, paving the way for future development in translational nanomedicine.

Au-delà des symptômes moteurs classiques de la maladie de Parkinson, d’autres troubles neuropsychiatriques, émotionnels ou cognitifs sont fréquemment observés chez le patient parkinsonien. L’apathie, définie comme une importante diminution des comportements motivés dirigés vers un but, est l’un des troubles neuropsychiatriques le plus souvent rapporté en clinique. Si ce symptôme est relativement bien maitrisé par les traitements dopaminergiques, l’application de la stimulation haute fréquence du noyau subthalamique (SHF-NST), traitement neurochirurgical de référence, entraîne sa résurgence chez environ 50 % des patients stimulés. De nombreuses données suggèrent que cette résurgence est liée à la diminution du traitement dopaminergique, permise grâce aux effets spectaculaires de la SHF-NST sur les symptômes moteurs. Au contraire, d’autres études proposent un rôle délétère direct de la SHF-NST sur les comportements motivés. Malheureusement, chez le patient, il n’est pas possible de dissocier l’effet des différents traitements. Ainsi, afin de comprendre les bases neurobiologiques de l’apathie dans la maladie de parkinson, notre laboratoire a récemment développé un modèle animal chez le rat, basé sur des approches de lésions sélectives, partielles et bilatérales des neurones dopaminergiques du mésencéphale, reproduisant un déficit motivationnel pouvant s’apparenter à l’apathie parkinsonienne.L’objectif de ce travail doctoral a été d’étudier l’effet de la SHF-NST sur les comportements motivés chez le rat sain et dans ce modèle animal, et d’en comprendre les mécanismes neurobiologiques. Pour cela, nous avons utilisé un nouveau système de stimulation portatif chez le rat, permettant d’appliquer une SHF-NST chronique et ininterrompue chez l’animal libre de ses mouvements. Dans un premier temps, nous avons évalué l’effet motivationnel de la SHF-NST chez le rat sain et parkinsonien à l’aide de tests de référence. Nous avons ainsi pu montrer que la SHF-NST induisait un déficit motivationnel sévère chez le rat sain, ou exacerbait le déficit présent chez le rat lésé. Dans un deuxième temps, compte tenu de l’efficacité chez le patient des agonistes des récepteurs dopaminergiques D2 et D3 (RD2 et RD3) sur l’apathie pré ou post opératoire, nous avons voulu corriger ce trouble induit par la SHF-NST avec un tel traitement. Cette étude pharmacologique nous a amené à montrer que le pramipexole, un agoniste D2 D3, permet de traiter complétement le déficit induit par la SHF-NST. Enfin, compte tenu de ces résultats pharmacologiques, nous avons voulu vérifier si les effets délétères de la SHF-NST ou thérapeutiques du pramipexole, étaient sous-tendus par une modification d’expression des récepteurs D2 et D3. Pour cela nous avons utilisé une nouvelle technique d’hybridation in situ pour quantifier les transcrits D2 et D3. Si la SHF-NST ne semble pas impacter l’expression de ces récepteurs, l’effet thérapeutique du pramipexole pourrait être sous tendu par une baisse d’expression du RD3 au sein du noyau accumbens.Les données obtenues au cours de ce travail doctoral suggèrent donc fortement que la SHF-NST pourrait en elle-même induire de l’apathie post opératoire. De plus, malgré l’apport thérapeutique de l’activation des RD2 et RD3 sur ce symptôme, son origine serait sous tendue par un autre mécanisme qui reste à être élucider. / Apart from the classical motor symptoms of Parkinson’s disease, neuropsychiatric, emotional or cognitive impairments are also commonly observed in parkinsonian patients. Apathy, defined as a decrease in goal directed motivated behaviours, is one of the most frequently reported neuropsychiatric symptom in PD. This impairment is relatively well alleviated by dopaminergic treatment, but subthalamic nucleus high frequency stimulation (STN-HFS), the gold standard neurosurgical treatment, leads to the resurgence of this symptom in 50% of patients. Clinical evidence suggests that this is due to the reduction of the dopaminergic treatment, made possible by the great effect of STN-HFS on motor symptoms. However, some studies propose a direct deleterious action of STN-HFS on motivated behaviors. Unfortunately, it is impossible to dissociate the effect of the different treatments in patients. Thus, in order to better understand the neurobiological basis of apathy in Parkinson’s disease, our laboratory recently developed a rodent model, based on selective, partial and bilateral lesion of mesencephalic dopaminergic neurons, reproducing a motivational deficit reminiscent of parkinsonian apathy.The aim of this thesis project is to assess the effect of STN-HFS on motivated behaviours in normal and parkinsonian rats, and to unravel the essential mechanisms. We have used a new micro-stimulation system, allowing chronic STN-HFS in freely moving animals. First, we evaluated the motivational effect of STN-HFS in healthy and lesioned rats, using appropriate behavioural tests. We showed that STN-HFS induces a motivational impairment in healthy rats, and exacerbates the deficit observed in parkinsonian rats. Then, considering their therapeutic effect on apathy before or after STN-HFS in patients, we used D2 and D3 dopaminergic receptor agonists to try to manage this deficit in rats. It was thus demonstrated that pramipexole, a D2 D3 agonist, completely alleviated this STN-HFS induced deficit. This result prompted to assess whether the deleterious effect of STN-HFS, or the beneficial effect of pramipexole, depended on modulation of D2 and D3 expression. We therefore applied a new in situ hybridization technique to quantify D2 and D3 mRNAs. We found that STN-HFS alone did not modify their expressions, but the therapeutic effect of pramipexole could be liked to down-regulation of D3 receptors within the nucleus accumbens.Our data strongly suggest that STN-HFS itself may induce post-operative apathy. Moreover, despite the beneficial effect of D2 and D3 agonist on this symptom, its origin could depend on other mechanisms that will need to be deciphered.

Syftet med den här kunskapsöversikten är att få en djupare förståelse om neuropsykiska funktionsnedsättningar hos elever med autism och hur vi som lärare kan anpassa den ordinarie undervisningen, med fokus på SO-undervisning, för att inkludera dessa elever och öka deras förutsättningarna för lärande. Frågeställningen blir därför “Vilka extra anpassningar kan lärare göra inom ramen för ordinarie SO-undervisning för att inkludera elever med autism?”Arbetet görs genom att vi granskar och tolkar vetenskaplig forskning och litteratur, för att sedan besvara frågeställningen för denna kunskapsöversikt. Denna studien har behandlat olika strategier som lärare och pedagoger kan använda i sin undervisning för att underlätta för elever med autism. Dessa strategier är bland annat visuellt stöd, kooperativt lärande mot ett gemensamt mål, rekonstruera olika historiska händelser, exempelvis ett rollspel om vikingatiden, bildstöd, tydlighet och rutiner där man strävar mot strukturerade SO-lektioner. En strukturerad dag med tydliga instruktioner och rutiner ger elever med autism ökad förståelse av vad som finns omkring dem vilket ökar deras medvetenhet. Detta resulterar i att eleverna upplever mer kontroll och känner mer säkerhet både i skolmiljön men även i vardagen.

[pt] A falta de consciência da doença, também denominada anosognosia, é um sintoma comum da Doença de Alzheimer (DA). Sua estrutura funcional e seus mecanismos subjacentes, contudo, não são inteiramente compreendidos. O nível de consciência possui grande relevância para o sucesso do tratamento e para o fardo do cuidador. Outro fator de considerável impacto nas relações interpessoais e, portanto, no bem-estar dos pacientes e cuidadores, é o processamento emocional. A presente tese explora esses tópicos através de quatro artigos. No Artigo 1, utiliza-se a modelagem de equações estruturais (SEM, do inglês structural equation modeling) em uma grande amostra de pessoas com DA para investigar a natureza da relação entre função cognitiva, estado de humor e funcionalidade na previsão do nível de consciência da condição. Os resultados demonstraram que uma menor funcionalidade cognitiva e um maior nível de estado depressivo de humor influenciaram negativamente a capacidade dos pacientes de realizar atividades da vida cotidiana, o que, por sua vez, se mostrou associada a uma maior consciência da doença. O Artigo 2 investigou as origens executivas e mnemônicas da anosognosia na DA, utilizando uma tarefa de tempo de reação e medindo a consciência a respeito da performance na tarefa. Os dados demonstraram que o monitoramento online dos pacientes estava preservado, enquanto o monitoramento a médio e longo prazo esteve comprometido. Tal achado foi corroborado por resultados de dados eletrofisiológicos. Dessa forma, os resultados fortalecem as evidências favoráveis a uma natureza mnemônica, e não executiva, da anosognosia na DA, o que se mostra de acordo com o Cognitive Awareness Model (CAM). O Artigo 3 investigou a reatividade emocional a imagens negativas, auto-relevantes e neutras utilizando medidas de excitação e valência, gravações de expressões faciais e dados eletrofisiológicos. A reatividade emocional dos pacientes de DA foi similar à de jovens adultos, mas as respostas eletrofisiológicas foram elevadas quando comparadas às de idosos saudáveis, o que pode ser explicado por uma falta de mecanismos de controle cognitivo. A apatia esteve associada a menores respostas eletrofisiológicas a figuras negativas, e a consciência de prejuízos sociais se relacionou com maiores níveis de excitação em imagens auto-relevantes. Por sua vez, o Artigo 4 discutiu como a DA afeta as habilidades emocionais através de uma revisão de literatura sobre a empatia desses pacientes. Os aspectos afetivos da empatia deste grupo clínico estiveram relativamente preservados, enquanto foram apresentados déficits nos componentes cognitivos. Os prejuízos relacionados aos componentes afetivos foram principalmente atribuídos a um declínio cognitivo geral. Nossos achados ressaltam que diferentes fatores influenciam a consciência da doença na DA, enfatizando o papel de sintomas neuropsiquiátricos, do funcionamento cognitivo e das atividades da vida diária. Além disso, processos executivos pareceram estar preservados, ao passo que dificuldades em atualizar e consolidar esse conhecimento podem ser uma possível causa de anosognosia na DA. Ademais, sugerimos que as habilidades emocionais são amplamente preservadas em pacientes de DA. Tais resultados são de grande importância para a prática clínica. Pesquisas translacionais são necessárias para implementar os achados de pesquisas em abordagens terapêuticas específicas. / [en] Lack of awareness of condition, also termed anosognosia, is a common symptom in Alzheimer s disease (AD). However, its functional structure and underlying mechanisms are not fully understood. Level of awareness has great relevance for treatment success and caregiver burden. Another factor that has considerable impact on interpersonal relationships and thus on well-being of patients and caregivers is emotional processing. The current thesis explores these topics through four articles. In Article 1, structural equation modeling (SEM) was used in a large sample of people with AD (PwAD) to investigate the nature of the relationship between cognitive function, mood state, and functionality in predicting awareness. Results showed that lower cognitive function and higher level of depressive mood state negatively influenced PwAD s ability to perform daily living activities, which in turn were associated with better awareness. Article 2 investigated executive and mnemonic origins of anosognosia in AD, with a reaction time task being applied to examine awareness of task performance. The findings demonstrated that online monitoring was preserved, while medium- and long-term monitoring were impaired. This was supported by results from electrophysiological data. The results strengthen the evidence for a mnemonic rather than executive nature of anosognosia in PwAD in accordance with the Cognitive Awareness Model (CAM). Article 3 investigated emotional reactivity to negative, self-relevant, and neutral pictures using ratings of arousal and valence, facial expression recordings and electrophysiological data. Emotional reactivity of PwAD was similar to young adults, but electrophysiological responses were elevated compared to healthy older adults, which might be explained by a lack of cognitive control mechanisms. Apathy was associated with reduced electrophysiological responses for negative pictures, and awareness of social impairments was linked to higher arousal ratings of self-relevant pictures. Article 4 discussed how higher emotional abilities are affected by AD, through a review of the literature on empathy in this clinical group. PwAD showed a pattern of relatively preserved affective aspects and impairments in cognitive components of empathy, whereby impairments in affective components can mainly be attributed to a general cognitive decline. Our findings highlight that different factors influence awareness in AD, emphasizing the role of neuropsychiatric symptoms (NPS), cognitive functioning and activities of daily living. Moreover, executive processes seem to be preserved, whereas impairments in updating and consolidation of this knowledge seem to be a possible cause for anosognosia in AD. Furthermore, we suggested that emotional abilities are largely preserved in PwAD. Our results have great significance for clinical practice. Translational research is needed to implement research findings into specific therapeutic approaches.