O Teste Guestáltico Visomotor de Bender é um teste psicológico utilizado em psicodiagnósticos infantis nas áreas clínica e neuropsicológica, embora existam adaptações para adolescentes e adultos. Em crianças seu uso se destina a avaliações da maturidade percepto-motora ou organização visomotora, diagnósticos de lesões cerebrais e perturbações emocionais, podendo também ser utilizado como uma técnica projetiva. Para os adultos é empregado tanto como uma técnica projetiva quanto para a identificação de alguns indicadores psicopatológicos e neuropsicológicos. Desde a sua elaboração em 1938 por Lauretta Bender, diversos sistemas de aplicação e avaliação foram desenvolvidos, sendo um dos mais conhecidos o de Elizabeth Koppitz. A tarefa a ser realizada pelo examinando consiste na reprodução de alguns desenhos, que podem ser somente copiados ou copiados e posteriormente reproduzidos de memória, dependendo do sistema utilizado. A avaliação consiste na análise da forma e precisão com que os desenhos são realizados. Um dos mais novos sistemas de avaliação é o Teste Bender Koppitz-2 proposto por Reynolds, que não é somente uma revisão, mas também uma extensão e um redesenvolvimento do sistema Koppitz original e que foi desenvolvido com o objetivo de avaliar a capacidade de integração visomotora. A principal diferença em relação ao teste original é que são acrescentados novos modelos mais fáceis, para as crianças mais novas, e mais difíceis, para as mais velhas, além dos nove propostos por Bender. Também foi ampliada a faixa etária de utilização, que passou a ser de 5 a 85 anos. Além disso, enquanto na avaliação do teste original são pontuados os erros na reprodução dos desenhos, na versão atual são pontuados os acertos, ou seja, o quanto eles foram bem realizados. O objetivo deste trabalho foi realizar estudos de validade, fidedignidade e normatização do Sistema Koppitiz-2 em crianças de escolas públicas da cidade de São Paulo. A amostra foi composta por 623 crianças, sendo 51,7% do sexo feminino e 48,3% do masculino. As idades variaram entre 6 e 12 anos (média= 9,05 anos e DP=1,86) e a escolaridade entre um e nove anos de estudo. A validade foi investigada em relação ao desenvolvimento e pela relação com outros testes, o Teste de Inteligência Não Verbal - R-2 e as Figuras Complexas de Rey e pela correlação com a versão original do teste. A fidedignidade foi estudada pelos métodos do teste e reteste, precisão entre avaliadores e consistência interna. Os testes foram aplicados individualmente e as crianças que participaram dos diferentes estudos foram incluídas na amostra total. As análises foram conduzidas separadamente para as crianças de 6 e 7 anos e para as de 8 a 12 anos, uma vez que os sistemas de pontuação baseados na qualidade da execução dos desenhos são diferentes em função da idade. Os resultados mostraram correlações entre 0,616 e 0,648 para os mais novos e entre 0,647 e 0,778 para os mais velhos com as Figuras Complexas de Rey. Em relação ao R-2 as correlações variaram entre 0,542 e 0,638 e 0,439 e 0,667 (respectivamente para os mais novos e mais velhos). As correlações com o sistema Koppitz foram de -0,646 para os mais novos e -0,566 para os mais velhos. Quanto à Fidedignidade, as correlações entre o teste e o reteste variaram entre 0,794 e 0,837 para os mais jovens e 0,745 e 0,964 para os mais velhos. Os valores do Alfa de Cronbach variaram entre 0,716 e 0,879 e para a precisão entre avaliadores as correlações foram de 0,966 para os mais novos e 0,972 para os mais velhos. Foram realizadas análises de variância em função da idade, sexo e tipo de escola, cujos resultados indicaram a necessidade de normas em percentil separadas em relação a essas três variáveis, já que as médias dos grupos se diferenciaram estatisticamente em relação a elas, com destaque para as diferenças entre as médias dos mais velhos que tenderam a ser maiores do que as dos mais novos, ainda que não em todos os casos. Os resultados indicaram adequados índices de validade e fidedignidade para o Koppitz-2 que confirmam suas propriedades psicométricas, caracterizando-o como um instrumento que pode ser utilizado nas avaliações da capacidade de integração visomotora de crianças de 6 a 12 anos nos psicodiagnósticos para os mais diversos fins. No entanto ainda serão necessárias algumas revisões nos critérios de avaliação, que em alguns casos, se mostraram pouco definidos / The Bender Gestalt Test is a psychological test used in children diagnosis in clinical and neuropsychological areas, although there are adaptations for adolescents and adults. It is used to the assessments of perceptual-motor maturity or visual-motor organization, diagnosis of brain injuries and emotional disorders of children, and may also be used as a projective technique. For adults it is used both as a projective technique as well as for the identification of some psychopathological and neuropsychological indicators. Since it was published in 1938 by Lauretta Bender, many systems of administration and scoring have been developed, being one of the most known the system of Elizabeth Koppitz. The task to be performed by the examinee is to reproduce some drawings, which can only be copied or be copied and then reproduced by memory, depending on the system used. The evaluation consists in the analysis of the shape and the accuracy in which the drawings are done. One of the newest assessment systems is the Bender Koppitz-2 Test, proposed by Reynolds, which is not only a review, but also an extension and redevelopment of the original Koppitz system that was developed with the purpose of evaluate the visualmotor integration ability. The main difference is that new easier models for youngest children are added in the new test, and more difficult for the older ones, besides the nine, proposed by Bender. It has also been expanded the age range of use, from 5 to 85 years old. Furthermore, while in the evaluation of the original test errors are scored, in the current version the correct reproduction of the drawings are scored instead, meaning how well they were made. The goal of this work was to establish validity, reliability and the standardization of the Koppitiz-2 system to children from public schools in the city of São Paulo. The sample consisted of 623 children, being 51.7% female and 48.3% male. The ages ranged from 6 to 12 years of age (average = 9.05 years, SD = 1.86) and education between one and nine years of study. The validity was investigated in relation to the development and by the relationship with other tests: The Nonverbal Intelligence Test R-2, the Rey Complex Figures and the original version of the test. The reliability was studied by the methods of test and retest, interscorers reliability and internal consistency. The tests were applied individually and children who participated in the different studies were included in the total sample. The analyses were made separately for children of 6 and 7 years old and from 8 to 12 years old since the scoring systems based on the quality of the drawings are different depending on the age. The results showed correlations between 0.616 and 0.648 for the youngest ones and between 0.647 and 0.778 for oldest ones with the Rey Complex Figure. Regarding the R-2, correlations ranged between 0.542 and 0.638 and 0.439 and 0.667 (respectively for the youngest and oldest children). The correlations with the original Koppitz system were -0.646 for the youngest ones and -0.566 for the oldest ones. Reliability coefficients between test and retest varied between 0.794 and 0.837 for youngest and 0.745 and 0.964 for the oldest. The Cronbach\'s alpha ranged between 0.716 and 0.879 and the interscorers reliability correlations were 0.966 for the youngest ones and 0.972 for the oldest ones. Analysis of variance were performed according to age, sex and type of school, since their results indicated the need for standards in separate percentile to these three variables, and the average of the groups differed statistically in relation to them, especially the differences between the means of the oldest, who tended to be higher than of the youngest, but not in all cases. The results indicated adequate validity and reliability indices for the Koppitz-2, that confirm its psychometric properties, characterizing it as a tool that can be used in assessment of visual motor integration ability of children between 6-12 years of age in psychodiagnosis for various purposes. However some revisions will be required in the assessment criteria which, in some cases, proved to be poorly defined

Fundação de Apoio a Pesquisa e à Inovação Tecnológica do Estado de Sergipe - FAPITEC/SE / This dissertation consists of three studies related to the theme of parental stress. In Study 1, described the characteristics of national publications on stress due to parenting and/or parentchild relationship, indexed in two Brazilian electronic bases data (SciELO and PePSIC). The full text of eleven empirical articles were analyzed in terms of their methods (participants and instruments), objectives and main results. In Study 2, we conducted the cross-cultural adaptation and investigation of psychometric properties of the Parental Stress Scale (PSS) for Brazilian-Portuguese. Participants were 304 parents, distributed in the same proportion by gender (mothers and fathers). In Study 3, examined the associations between the level of parental stress and parental socio-educational practices in 135 fathers/mothers of children without chronic disease (control group) and with type 1 diabetes mellitus (T1DM; clinical group). Results from Study 1 provided an overview of the state of the art regarding parental stress in the national literature and highlight the need for further research in the area. Results from Study 2 presented an adapted version of PSS for Brazilian-Portuguese with adequate psychometric properties, as a measure of parental stress in parents of children in general. Results from Study 3 indicated associations between the level of parental stress and parenting practices, and lead to a discussion on the impact of the stressor "child’s chronic disease", specifically T1DM, the stress and parental practices. In the end, the results discussed assist in the creation of intervention strategies for fathers/mothers aimed at minimizing parental stress and child behavior problems and promote health via satisfactory family relationships. / Esta dissertação é composta por três estudos relacionados à temática do estresse parental. No Estudo 1, descreveu-se as características de publicações nacionais sobre o estresse decorrente e/ou da relação pais-filho indexadas em duas bases de dados eletrônicas brasileiras (SciELO e PePSIC). Foram analisados 11 artigos empíricos na íntegra a partir de seus métodos (participantes e instrumentos), objetivos e principais resultados encontrados. No Estudo 2, foi realizada a adaptação e investigação de evidências de validade da Escala de Estresse Parental – EEPa (Parental Stress Scale – PSS) para o português brasileiro. Participaram 304 pais, distribuídos na mesma proporção por sexo (pais/mães). No Estudo 3, examinou-se as associações entre o nível de estresse parental e as práticas socioeducativas parentais em 135 pais/mães de filhos sem doença crônica (grupo controle) e com diabetes mellitus tipo 1 (DM1; grupo clínico). Os resultados do Estudo 1 forneceram um panorama do estado da arte em relação ao tema estresse parental na literatura nacional e evidenciam a necessidade de novos estudos na área. Os resultados do Estudo 2 apresentaram uma versão adaptada e com boas evidências de validade da EEPa em português brasileiro, como uma medida de estresse parental de pais e mães de crianças em geral. Os resultados do Estudo 3 indicaram associações entre o nível de estresse parental as práticas parentais, e levaram a discussões acerca do impacto do estressor “doença crônica do filho”, especificamente o DM1, no estresse e práticas parentais. Ao final, os resultados discutidos auxiliam na criação de estratégias de intervenção para pais/mães que visem minimizar o estresse parental e os problemas de comportamento infantil e promover saúde via relações familiares satisfatórias.

本研究旨在探討「健康、性格、習慣量表(HPH)」的臨床效度。HPH最初是由柯永河教授(民84)編製，後來廣泛使用在國內臨床場域中。發展至今已有中上程度的信效度支持，但過去較缺乏臨床上區辨與構念效度的研究，因此本研究旨在探討HPH區辨不同疾患的能力，以及以臨床疾患為受試時量尺之構念效度。 本研究回顧國內外類似測驗─MMPI、KMHQ、MCMI─的發展軌跡，並參照前人作法來進行HPH的臨床區辨效度研究。初步以臨床場域中常見的精神分裂症、重鬱症、低落型情感疾患、焦慮疾患，共257名患者為受試。先以共變數分析(ANCOVA)探討控制人口與臨床變項後，不同疾患組別在HPH的A、B、D類量尺的影響。再進一步使用羅吉斯迴歸(logistic regression)探討哪些量尺及其組合可以區辨兩兩疾患間的差異。最後，本研究也進行HPH的探索性因素分析(exploratory factor analysis)，以檢驗其臨床上的因素結構。 本研究發現，精神分裂症(A1)、躁症傾向(A2)、憂鬱自殺類(A3、B4、A4)、心理功能與健康(D1、D3、D4、D5、D6)量尺在共變數分析上的差異情形與假設大致相符，後續討論分析也支持強迫症(B5)量尺效度。羅吉斯迴歸中，A1、A3、B4、B5能在兩兩疾患間區辨有顯著預測力。其中A1能在精神分裂症與其他三組疾患的兩兩區辨中預測，A3能在重鬱症與另外兩組(精神分裂症、焦慮症)的兩兩區辨中預測，B4能在低落型情感與精神分裂症的兩兩區辨中預測，B5能在強迫症與其他疾患間的兩兩區辨中預測。但是在重鬱症與低落型情感疾患間，以及低落型情感與焦慮疾患間，沒有量尺能在兩者的區辨中有顯著預測力。而各兩兩疾患間整體區辨效果有中至高度的關聯性，分類正確率也多有七成以上，顯示HPH量表在臨床上的區辨效度獲得支持。 構念效度部分，A、D類量尺因素結構與當初編製的每個量尺構念相近，B類量尺構念雖與原量尺略有不同，但仍不違背原量尺編製架構，因此構念效度亦獲得支持。不過各量尺仍有值得編修之處，討論一節中針對結果提出HPH後續編修之建議。 最後，本研究也將此結果之臨床實務應用於討論一節中詳述，以供後續研究與實務者參考。 / The purpose of this study is to examine the clinical validity of the Health, Personality, and Habit Test (HPH). The HPH was developed by Dr. Yung-Ho Ko in 1995, and has been widely used in clinical settings. The HPH has demonstrated appropriate reliability and validity, but little research has been done on its differential and construct validity in the clinical settings. Therefore, the aim of this study is to explore the HPH’s ability to differentiate between disorders and its construct validity in clinical context. This research reviewed the developments of similar tests, such as MMPI, KMHQ, and MCMI, and examined validity of the HPH with the same methods. Subjects were 257 patients who suffered from common disorders in clinical settings, including schizophrenia, major depression, dysthymia, and anxiety disorders. ANCOVA was first used to explore whether different disorders have an effect on category A, B, and D scales after controlling demographic and clinical variables. Next, logistic regression was used to clarify which scales and combinations can differentiate between two of four disorders. Finally, exploratory factor analysis was conducted to examine the structure of HPH in clinical setting. The results of ANCOVA showed that the differences of schizophrenia scale (A1), manic scale (A2), depression/suicide scales (A3, B4, & A4), obsessive-compulsive disorder (OCD) scale (B5), and psychological function and health scales (D1, D3, D4, D5, D6) were partly consistent with assumptions, supporting the differential validity of HPH. The results of logistic regression analysis also supported the validity of A1, A3, B4, and B5 scales. More specifically, A1 was able to differentiate schizophrenia from any other three disorders, A3 was able to differentiate MDD from schizophrenia and anxiety disorders, B4 was able to differentiate dysthymia from schizophrenia, and B5 was able to differentiate OCD from other disorders. However, none of the scales was able to differentiate MDD from dysthymia, nor were they able to differentiate dysthymia from anxiety disorders. Moreover, each of the logistic regression functions showed moderate to high correlations, and most of them achieved high overall hit rates (above 70%), providing support for the clinical differential validity of the HPH. As for construct validity, these factors in category A and D scales were essentially similar to original scales. Similarly, factors in category B scales were compatible to original scales though difference was found. In sum, these results lent support to the construct validity of the HPH in the clinical settings. However, refining of the scales is needed and suggestions are discussed. Finally, the practical uses of the findings were also discussed.

The Atlanta Inspection and Maintenance program ultimately aims to reduce on-road vehicular emission, a major source of air pollution. The program enforces eligible vehicles to be inspected and repaired, if necessary, before the annual registration renewal. However, various factors can influence the program implementation with respect to the motorists, inspectors, and testing technology. This research explores some of these factors by using empirical data from the Continuous Atlanta Fleet Evaluation project, the inspection transaction records, the Atlanta Household Travel Survey, and the U.S. Census Bureau. The study discusses policy implications of findings from the three essays and offers related recommendations. The first essay examines whether the higher income of a vehicle owner decreases the odds of the vehicle failing the first inspection. Findings show that vehicles owned by low-income households are more likely to fail the first inspection of the annual test cycle. However, after controlling for the vehicle characteristics, the odds of failing the first inspection are similar across households. This suggests that the maintenance behaviors are approximately the same for high- and low-income households. The second essay explains the motorists' decisions in selecting their inspection stations using a random utility model. The study finds that motorists are likely to choose the inspection stations that are located near their houses, charge lower fees, and can serve a large number of customers. Motorists are less likely to choose the stations with a relatively high failure ratio especially in an area of low station density. Moreover, motorists do not travel an extra mile to the stations with lower failure ratio. Understanding choices of vehicle owners can shed some light on the performance of inspection stations. The third essay investigates the validity and reliability of the on-board diagnostic generation II (OBD II) test, a new testing technology required for 1966 and newer model year vehicles. The study compares the inspection results with the observed on-road emission using the remote sensing device (RSD) of the same vehicles. This research finds that the agreement between the RSD measurement and the OBD II test is lower for the relatively older or higher use vehicle fleets

Research Doctorate - Doctor of Philosophy (PhD) / In Chapter 1, I describe social competence, task competence and self-protection in an organisational context. In Chapter 2, I review key self theories and relate them to the self-competence construct. In Chapter 3, I review the research on self-competence to show that there is a need for a construct of social competence and self-protection. I discuss the limitations of three self-competence theories: Bandura’s (1977) self-efficacy theory, Williams and Lillibridge’s (1992) self-competence theory and Tafarodi & Swann’s (1995) self-competence/self-liking theory. In Chapter 4, I present my selfcompetence model. I raise the research questions and specify my hypotheses. In Chapter 5, I describe the construction of Social and Task Competence Scale. I present evidence of the reliability and factor structure of the Social and Task Competence Scale. I concluded that scale revisions were needed. In Chapter 6, I present evidence of the reliability, factor structure and predictive validity of the revised Social and Task Competence Scale and Self-Protection Scale. I describe the results of an experiment that investigated the interaction of task setting, social competence, task competence and selfprotection. I concluded that the measures predicted performance. In Chapter 7, I investigate the factor structure and reliability of the revised Social and Task Competence Scale and revised Self-Protection Scale. I provide evidence of the convergent and discriminant validity of these measures with reliable measures of self-competence, selfesteem, self-monitoring, personality and social desirability. In Chapter 8, I investigate the factor structure and reliability of the Social and Task Competence Scale and Self-Protection Scale after final revisions and show that these measures are acceptable for use in scientific research. I present evidence of their convergent validity with a valid andreliable measure of emotional intelligence, and describe experimental results that supported the hypothesised relationships between perceived task difficulty, social competence, task competence and self-protection and task performance. In Chapter 9, I discuss the implications of my research for self-competence theory, self-regulation and self-esteem and the prediction of social and task performance in organisations.

Background: Patient empowerment is viewed as a priority by policy makers, patients and practitioners worldwide. Although there are a number of measures available, none have been developed specifically for patients in the UK with long-term conditions. It is the aim of this study to report the development and preliminary validation of an empowerment instrument for patients with long-term conditions in primary care.Methods: The study involved three methods. Firstly, a systematic review was conducted to identify existing empowerment instruments, and to describe, compare and appraise their content and quality. The results supported the need for a new instrument. Item content of existing instruments helped support development of the new instrument. Secondly, empowerment was explored in patients with long-term conditions and primary care practitioners using qualitative methods, to explore its meaning and the factors that support or hinder empowerment. This led to the development of a conceptual model to support instrument development. Thirdly, a new instrument for measuring empowerment in patients with long-term conditions in primary care was developed. A cross-sectional survey of patients was conducted to collect preliminary data on acceptability, reliability and validity, using pre-specified hypotheses based on existing theoretical and empirical work. Results: Nine instruments meeting review inclusion criteria were identified. Only one instrument was developed to measure empowerment in long-term conditions in the context of primary care, and that was judged to be insufficient in terms of content and purpose. Five dimensions (‘identity’, ‘knowledge and understanding’, ‘personal control’, personal decision-making’, and ‘enabling other patients’) of empowerment were identified through published literature and the qualitative work and incorporated into a preliminary version of the new instrument. A postal survey achieved 197 responses (response rate 33%). Almost half of the sample reported circulatory, diabetic or musculoskeletal conditions. Exploratory factor analysis suggested a three factor solution (‘identity’, ‘knowledge and understanding’ and ‘enabling’). Two dimensions of empowerment (‘identity’ and ‘enabling’) and total empowerment showed acceptable levels of internal consistency. The measure showed relationships with external measures (including quality of chronic illness care, self-efficacy and educational qualifications) that were generally supportive of its construct validity.Conclusion: Initial analyses suggest that the new measure meets basic psychometric criteria and has potential for the measurement of patient empowerment in long-term conditions in primary care. The scale may have a role in research on quality of care for long-term conditions, and could function as a patient-reported outcome measure. However, further validation is required before more extensive use of the measure.