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Previous issue date: 2016-03-04 / Conselho Nacional de Pesquisa e Desenvolvimento Cient?fico e Tecnol?gico - CNPq / The occurrence of maltreatment in childhood is a phenomenon with high prevalence around the world and is associated to a series of neurobiological, emotional and cognitive impairments in victims. A body of evidence already exists regarding its consequences for adolescent and adult samples, suggesting deleterious medium and long-term impacts; however, impairments in childhood have not been sufficiently studied. Thus, the aim of this study is to assess the impact of maltreatment on cognition during childhood, as well as the presence of associated clinical symptoms. This thesis is composed of three papers: one theoretical and two empirical. The theoretical article entitled "Cognitive, neurobiological and psychopathological alterations associated with child maltreatment: a review of systematic reviews" aims to review the association between maltreatment and neurobiological, cognitive and lifetime comorbid psychiatric alterations. Important neurobiological alterations were found to be associated with maltreatment, as changes in levels of cortisol, dopamine, norepinephrine and serotonin. Structural impairments were found in regions such as the frontal cortex and hippocampus in adult victims of childhood maltreatment. The most consistent finding was the association between childhood maltreatment and presence of psychiatric conditions in adulthood. Regarding the impact of maltreatment on cognition, there are few studies to date and they report contrasting results. A need for further studies with child samples was evidenced through the literature review, in order to assess the immediate or short-term impact of maltreatment in cognition, as well as the presence of clinical symptoms. Thus, the first empirical article entitled "Cognitive Performance and Clinical Symptoms in Maltreatment Victims: Intellectual Impairment Evidence in a Child Sample in Brazil" aims to assess global cognitive profile and the prevalence of intellectual impairment of a sample of child victims of maltreatment between 6 and 12 years of age. A further objective is to assess the presence of internalizing and externalizing symptoms and their relation to the cognitive profile of the sample. Group differences were found across all assessed functions, with the presence of important intellectual impairment in the maltreatment group. More clinical symptoms, especially externalizing symptoms, were found in the maltreatment group. Few associations were found between clinical symptoms and cognitive profile. The second empirical article, "Executive Function and clinical symptoms in children exposed to maltreatment", sought to assess in a more specific manner the executive functioning of a group of child victims of maltreatment aged 8 to 12 years. Furthermore, clinical symptoms were more broadly investigated in the sample, through the assessment of depression, anxiety and post-traumatic stress symptoms. Evidence of an important executive impairment was found in the maltreatment group. Inhibitory control remained impaired even when controlling for intelligence. More clinical symptoms were found in the maltreatment group, with no association between most of the cognitive and clinical measures. Lastly, final considerations about the work are drawn. In view of the findings of a high prevalence of intellectual impairments in the maltreatment group and the dissociation between cognitive impairments and clinical profile, the discussion revolves around preventive and cognitive stimulation interventions for victims. / A ocorr?ncia de maus-tratos na inf?ncia ? um fen?meno com alta preval?ncia ao redor do mundo e est? associado a uma s?rie de preju?zos neurobiol?gicos, emocionais e cognitivos nas v?timas. Ainda que j? exista um corpo de evid?ncias sobre as suas sequelas em amostras de adolescentes e adultos, sugerindo um impacto delet?rio a m?dio e longo prazo, os preju?zos na inf?ncia ainda n?o foram suficientemente estudados. Dessa forma, o objetivo geral deste trabalho foi avaliar o impacto dos maus-tratos na cogni??o durante a inf?ncia, bem como a presen?a de sintomatologia cl?nica associada. A presente tese ? composta de 3 artigos, sendo um artigo te?rico e dois artigos emp?ricos. O primeiro artigo te?rico denominado ?Cognitive, neurobiological and psychopathological alterations associated with child maltreatment: a review of systematic reviews? teve como objetivo revisar a associa??o entre maus-tratos e altera??es neurobiol?gicas, cognitivas e comorbidades psiqui?tricas ao longo da vida. Foram encontradas importantes altera??es neurobiol?gicas associadas aos maus-tratos com modifica??es nos n?veis de cortisol, dopamina, noradrenalina e serotonina. Em n?vel estrutural foram encontradas diminui??es em regi?es como c?rtex frontal e hipocampo em adultos v?timas de maus-tratos na inf?ncia. O achado mais consistente foi a associa??o entre maus-tratos na inf?ncia e presen?a de quadros psiqui?tricos na vida adulta. Em rela??o ao impacto dos maus-tratos na cogni??o, existem poucos estudos at? o momento e estes encontraram resultados contrastantes. A partir da revis?o da literatura evidenciou-se a necessidade de mais estudos com amostras de crian?as, para avaliar o impacto imediato, ou de curto prazo, dos maus-tratos na cogni??o, bem como a presen?a de sintomatologia cl?nica. Dessa forma, o primeiro artigo emp?rico denominado ?Desempenho Cognitivo e Sintomas Cl?nicos em V?timas de Maus-tratos: Evid?ncias de Preju?zo Intelectual em uma Amostra de Crian?as no Brasil? teve como objetivo avaliar o perfil cognitivo global, bem como a preval?ncia de preju?zo intelectual de uma amostra de crian?as v?timas de maus-tratos de 6 a 12 anos. Teve como objetivo ainda avaliar a presen?a de sintomas internalizantes e externalizantes na amostra e sua rela??o com o perfil cognitivo. Foram encontradas diferen?as entre os grupos em todas as fun??es avaliadas, com a presen?a de importante preju?zo intelectual no grupo maus-tratos. Foi encontrada, ainda, maior sintomatologia cl?nica, sobretudo de sintomas externalizantes, no grupo maus-tratos. Foram encontradas poucas associa??es entre a sintomatologia cl?nica e o perfil cognitivo encontrado. O segundo artigo emp?rico, ?Fun??es Executivas e sintomatologia cl?nica em crian?as expostas a maus-tratos?, buscou avaliar de uma forma mais espec?fica as fun??es executivas de um grupo de crian?as de 8 a 12 anos v?timas de maus-tratos bem como investigar de forma mais ampla a sintomatologia cl?nica na amostra, avaliando sintomas de depress?o, ansiedade e sintomatologia de estresse p?s-traum?tico. Foram encontradas evid?ncias de importante preju?zo executivo no grupo maus-tratos. O controle inibit?rio manteve-se prejudicado, mesmo quando a intelig?ncia foi controlada. Houve maior presen?a de sintomatologia cl?nica no grupo maus-tratos, sem associa??o entre a maior parte das medidas cognitivas e cl?nicas. Por ?ltimo, foram tra?adas considera??es finais sobre o trabalho. Tendo em vista os achados de alta preval?ncia de preju?zos intelectuais no grupo maus-tratos e dissocia??o entre os preju?zos cognitivos e o perfil cl?nico, foram discutidas, a partir da literatura, interven??es preventivas e de estimula??o cognitiva para as v?timas.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/6564 |
| Date | 04 March 2016 |
| Creators | N??ez Carvalho, Jana?na Castro |
| Contributors | Kristensen, Christian Haag |
| Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Psicologia, PUCRS, Brasil, Faculdade de Psicologia |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 2588426296948062698, 600, 600, 600, 600, 2599381623216554467, 3411867255817377423, -2555911436985713659 |
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