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Previous issue date: 2012-03-06 / The BD with the onset in childhood and adolescence causes considerably serious damages to the emotional growth and development of these individuals. Stressful life events (SLE) have been associated to the appearance of psychopathologies, mainly affective ones, by worsening its prognosis and aggravating the illness course. Although there is scientific relevance in the theme, the studies on juvenile bipolar disorder and life events are scarce in the literature. SLE occurred during childhood and adolescence may be classified as an exposure to a unique or to different situations that cause stress to the organism and exceed the child s or adolescent s capacity to understand and handle such event. For aproximately 40 years, the researches on life events have been focusing their interest in etiological issues about psychiatric morbidity in general, through the understanding of genetic and environmental interactions. However, while verifying the studies from these decades of scientific production, a considerable gap can be noticed, regarding the instruments and assessing measures referring to such events. Studies demonstrate a positive association between the presence of a toxic environment and the neuropsychophysiological vulnerability. Even though many of studies propose to verify the adverse events occurred during life, it is noticed the lack of a consensual instrument in the literature for this measure. The beginning of this work had the purpose to translate and adapt to the Portuguese language an instrument denominate Stressful Life Events Schedule (SLES), that investigates the SLE occurred in adolescents in the last 12 months, in order to strongly implement and support with a greater robustness the studies of this theme. The instrument showed as an useful 9 tool, in an general manner, the items had a good equivalence among the versions. The appreciation of conceptual equivalence and of items enabled linguistic adjustments and terminological adaptations of some terms. Further study is required to evaluate the other psychometric properties of the SLES in our culture. The second article indicated association between the humor symptomatology and global functioning to the SLE occurred in the last year in 23 adolescents with BD and 20 healthy controls without psychopathology. To evaluate the life events it was used the SLES-Adolescents, through having a face to face interview, that is accompanied with a scale having 79 SLE. To verify the severity of impact of these SLE, each item had a four point scale (not at all, a little, somewhat and a lot). This data revealed a frequency of SLE significantly higher in bipolar adolescents than in the healthy controls. Besides that, a positive association between the number of SLE and the seriousness of maniac depressive symptoms, as well as a reduction of the global functioning of individuals with humor disorder was detected. The occurrence of SLE appears associated with maniac and depressive symptoms as well as the reduction of the overall functioning of the individual assailed by bipolar disorder. Finally, this dissertation has the purpose of contributing to an acknowledgment of the psychosocial vulnerability factors associated with bipolar disorder in adolescence. / O transtorno bipolar com in?cio na inf?ncia e adolesc?ncia (TBIA) prejudica o crescimento emocional e o desenvolvimento desses indiv?duos de forma consider?vel. Eventos de vida estressantes (EVE) t?m sido associados ao desencadeamento de psicopatologias, piorando seu progn?stico e agravando ainda mais o intercurso da doen?a. Embora o tema tenha relev?ncia cient?fica, na literatura ainda s?o escassos os estudos sobre TBIA e eventos de vida. Os EVE ocorridos durante a inf?ncia e adolesc?ncia podem ser classificados como uma exposi??o a uma ?nica ou a diferentes situa??es que causam estresse no organismo e que excedem a capacidade da crian?a ou adolescente de compreender e lidar com este evento. H? aproximadamente 40 anos, as pesquisas sobre eventos de vida, v?m focando seu interesse nas quest?es etiol?gicas de morbidades psiqui?tricas em geral, atrav?s do entendimento das intera??es gen?ticas e ambientais. Ao verificar os estudos dessas d?cadas de produ??o cient?fica percebe-se uma lacuna quanto aos instrumentos e medidas de avalia??o desses eventos. Os estudos demonstram uma associa??o positiva entre a presen?a de um ambiente t?xico e a vulnerabilidade neuropsicofisiol?gica. O in?cio desse trabalho teve por objetivo traduzir e adaptar para a l?ngua portuguesa um instrumento denominado Stressful Life Events Schedule (SLES) que investiga os EVE ocorridos em adolescentes nos ?ltimos 12 meses, a fim de implementar e embasar com maior robustez os estudos desta tem?tica. O instrumento mostrou-se uma ferramenta ?til, de modo geral, e os itens obtiveram boa equival?ncia entre as vers?es. A aprecia??o da equival?ncia conceitual e de itens propiciou ajustes ling??sticos e adapta??es terminol?gicas de alguns termos. Futuros estudos s?o necess?rios para avaliar as demais 7 propriedades psicom?tricas do SLES na nossa cultura. O segundo artigo emp?rico indica a associa??o entre a sintomatologia de humor e o funcionamento global aos EVE ocorridos no ?ltimo ano em 23 adolescentes bipolares e 20 controles sem psicopatologia. Para avalia??o dos eventos de vida utilizou-se o SLES-Adolescentes (SLES-A) sendo uma entrevista face a face, que ? acompanhada por uma escala contendo 79 EVE. Para verificar a intensidade do impacto desses EVE, cada item acompanhava uma escala de quatro pontos (nem um pouco, um pouco, bastante e muito). Os resultados apontaram uma alta correla??o entre o n?mero de EVE, os preju?zos funcionais e a sintomatologia do humor do transtorno bipolar. Quanto mais EVE relatados, maior n?mero de sintomas depressivos e man?acos e pior funcionamento global do indiv?duo com TB. Os EVE dependentes nesses jovens bipolares (M= 6.82;DP=4.19) apresentaram-se tr?s vezes maiores do que na amostra controle (M=2.25;DP=2.53) (p=0.000). Os EVE de alto impacto ocorreram numa propor??o de quatro vezes mais nos adolescentes com TB (M=8.78;DP=7,32) do que nos controles (M=2.20;DP=4.00) (p=0.000). Por fim, n?o se trata de pensar em uma rela??o de causalidade, mas sim na rela??o entre o funcionamento psicossocial adverso associado ao curso da doen?a. Esta disserta??o tem como finalidade a contribui??o para um reconhecimento dos fatores de vulnerabilidade psicossocial associados ao TB na adolesc?ncia.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/784 |
| Date | 06 March 2012 |
| Creators | Coelho, Roberta Paula Schell |
| Contributors | Grassi-oliveira, Rodrigo |
| Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Psicologia, PUCRS, BR, Faculdade de Psicologia |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| 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, 500, 600, 2599381623216554467 |
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