CLARICE GORENSTEIN
Projetos de Pesquisa
Unidades Organizacionais
BMF, ICB - Docente
LIM/23 - Laboratório de Psicopatologia e Terapêutica Psiquiátrica, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/23 - Laboratório de Psicopatologia e Terapêutica Psiquiátrica, Hospital das Clínicas, Faculdade de Medicina - Líder
41 resultados
Resultados de Busca
Agora exibindo 1 - 10 de 41
- RELIABILITY AND DIMENSIONAL VALIDITY OF THE BECK DEPRESSION INVENTORY-II (BDI-II) AMONG BRAZILIAN ADOLESCENTS(2018) FERREIRA-MAIA, Ana Paula; BORONAT, Alexandre Canon; GORENSTEIN, Clarice; WANG, Yuan-Pang
- What is the nonverbal communication of depression? Assessing expressive differences between depressive patients and healthy volunteers during clinical interviews(2018) FIQUER, Juliana Teixeira; MORENO, Ricardo Alberto; BRUNONI, Andre R.; BARROS, Vivian Boschesi; FERNANDES, Fernando; GORENSTEIN, ClariceBackground: It is unclear if individuals with Major Depressive Disorder (MDD) present different nonverbal behavior (NVB) compared with healthy individuals, and also if depression treatments affect NVB. In this study, we compared the NVB of MDD subjects and healthy controls. We also verified how MDD subjects' NVB is affected by depression severity and acute treatments. Methods: We evaluated 100 MDD outpatients and 83 controls. We used a 21-category ethogram to assess the frequency of positive and negative NVB at baseline. MDD subjects were also assessed after eight weeks of treatment (pharmacotherapy or neuromodulation). We used the Wilcoxon signed-rank test to compare the NVB of MDD subjects and controls; beta regression models to verify associations between MDD severity and NVB; the Shapiro-Wilk test to verify changes in NVB after treatment; and logistic regression models to verify NVB associated with treatment response according to the Hamilton depression rating scale. Results: Compared with controls, MDD subjects presented higher levels of six negative NVB (shrug, head and lips down, adaptive hand gestures, frown and cry) and lower levels of two positive NVB (eye contact and smile). MDD subjects' NVB was not associated with depression severity, and did not significantly change after depression treatment. Treatment responders showed more interpersonal proximity at baseline than non-responders. Limitations: Our ethogram had no measure of behavior duration, and we had a short follow-up period. Conclusions: MDD subjects have more negative and less positive social NVB than controls. Their nonverbal behavior remained stable after clinical response to acute depression treatments.
bookPart Instrumentos de mensuração em psiquiatria(2021) WANG, Yuan-Pang; HENNA, Elaine; JúNIOR, Antonio Reis de Sá; GORENSTEIN, Clarice- Child-focused treatment of pediatric OCD affects parental behavior and family environment(2015) GORENSTEIN, Gabriela; GORENSTEIN, Clarice; OLIVEIRA, Melaine Cristina de; ASBAHR, Fernando Ramos; SHAVITT, Roseli GedankeThis study aimed to investigate the impact of child-focused pediatric OCD treatment on parental anxiety, family accommodation and family environment. Forty-three parents (72.1% female, mean age +/- SD=43.1 +/- 5.6 years) were evaluated at baseline and after their children's (n=33, 54.5% female, mean age +/-SD=12.9 +/- 2.7 years) randomized treatment with Group Cognitive-Behavioral Therapy or fluoxetine for 14 weeks. Validated instruments were administered by trained clinicians. Parents were assessed with the State-Trait Anxiety Inventory (STAI), the Family Accommodation Scale (FAS) and the Family Environment Scale (FES). The Yale-Brown Obsessive-Compulsive Scale was administered to children. Significant findings after the children's treatment include decreased family accommodation levels (participation, modification and distress/consequences domains); increased cohesion and active-recreational components of the family environment. In addition, changes in the FAS distress/consequences and the FES cohesion subscores were correlated with the children's clinical improvement. These results suggest that child-focused OCD treatment may have a positive impact on family accommodation and family environment. Future studies should further clarify the reciprocal influences of pediatric OCD treatment and family factors.
- The Beck depression inventory: Uses and applications(2021) WANG, Y. P.; GORENSTEIN, C.The Beck depression inventory (BDI) is among the most used self-rating scales for measuring depression worldwide. Since the test construction in 1961, the BDI has been employed in more than 14,000 empirical studies. This chapter discusses the utility of the BDI based on previous studies on its psychometric properties. We only consider those studies that are primarily concerned with the validity of the psychometric properties. The advantages of the BDI are its good internal consistency, sensitivity to change, broad construct validity, flexible criterion validity in differentiating between depressed and nondepressed subjects, and international propagation. The main limitations of the tool are the lack of representative norms, doubtful objectivity of interpretation, and controversial factorial validity. Agreements and contradictions between the various studies, as well as potential factors (sampling issues, statistical procedures, sensitivity to change) accounting for the variance in their results, are discussed. © 2021 Elsevier Inc. All rights reserved.
article 4 Citação(ões) na Scopus Validation of scales for pathological love assessment(2011) BERTI, Marina Perito; ZILBERMAN, Monica Levit; SOPHIA, Eglacy Cristina; GORENSTEIN, Clarice; PEREIRA, Ana Paula; LORENA, Andrea; MELLO, Cidalia; CORDAS, Taki Athanassios; TAVARES, HermanoBackground: Several methodologies were developed to validate psychometric instruments. However, there are, in the scientific literature, a lack of instruments to evaluate romantic relationship. Objective: The present work aims at validating into Portuguese the content of the self-report Love Attitudes Scale (Escala de Atitudes do Amor - Hendrick et al., 1998), the Relationship Assessment Scale (Escala de Avaliacao do Relacionamento - Hendrick, 1988), and the Adult Attachment Types (Tipos de Apego do Adulto - Hazan et al., 1987), taking the Brazilian cultural context into consideration, thus rendering the study of pathological love in the Brazilian population feasible. Methods: Such process involved four stages: (1) translation into Portuguese, (2) back translation, (3) presentation of the translated version to mental health professionals and university students, and (4) application of the final version in a sample of the target population using a rating scale. Results: The scales were easily understood and significantly discriminated individuals with pathological love and healthy volunteers. Discussion: Our results show that the Brazilian version of these instruments is valid and may be used in investigations involving romantic relationships.- Response pattern of depressive symptoms among college students: What lies behind items of the Beck Depression Inventory-II ?(2018) SA JUNIOR, Antonio Reis de; ANDRADE, Arthur Guerra de; ANDRADE, Laura Helena; GORENSTEIN, Clarice; WANG, Yuan-PangBackground: This study examines the response pattern of depressive symptoms in a nationwide student sample, through item analyses of a rating scale by both classical test theory (CTT) and item response theory (IRT). Methods: The 21-item Beck Depression Inventory-II (BDI-II) was administered to 12,711 college students. First, the psychometric properties of the scale were described. Thereafter, the endorsement probability of depressive symptom in each scale item was analyzed through CTT and IRT. Graphical plots depicted the endorsement probability of scale items and intensity of depression. Three items of different difficulty level were compared through CTT and IRT approach. Results: Four in five students reported the presence of depressive symptoms. The BDI-II items presented good reliability and were distributed along the symptomatic continuum of depression. Similarly, in both CTT and IRT approaches, the item 'changes in sleep' was easily endorsed, 'loss of interest' moderately and 'suicidal thoughts' hardly. Graphical representation of BDI-II of both methods showed much equivalence in terms of item discrimination and item difficulty. The item characteristic curve of the IRT method provided informative evaluation of item performance. Limitation: The inventory was applied only in college students. Conclusion: Depressive symptoms were frequent psychopathological manifestations among college students. The performance of the BDI-II items indicated convergent results from both methods of analysis. While the CTT was easy to understand and to apply, the IRT was more complex to understand and to implement. Comprehensive assessment of the functioning of each BDI-II item might be helpful in efficient detection of depressive conditions in college students.
- Clinical utility of the Montgomery-Asberg Depression Rating Scale for the detection of depression among bariatric surgery candidates(2016) DUARTE-GUERRA, Leorides Severo; GORENSTEIN, Clarice; PAIVA-MEDEIROS, Paula Francinelle; SANTO, Marco Aurelio; NETO, Francisco Lotufo; WANG, Yuan-PangBackground: Clinical assessment of depression is an important part of pre-surgical assessment among individuals with morbid obesity. However, there is no agreed-upon instrument to identify mood psychopathology in this population. We examined the reliability and criterion validity of the clinician-administered Montgomery-Asberg Depression Rating Sca (MADRS) and the utility of a short version for bariatric surgery candidates. Methods: The sample was 374 patients with obesity, consecutively recruited from the waiting list of a bariatric surgery clinic of University Hospital, Brazil: women 80 %, mean BMI 47 kg/m(2), mean age 43.0 years. The 10-item MADRS was analyzed against the SCID-I. Items that showed small relevance to sample's characteristics and contribution to data variability were removed to develop the short 5-item version of scale. We calculated the sensitivity and specificity of cutoff points of both versions MADRS, and values were plotted as a receiver operating characteristic curve. Results: For the 10-item MADRS, the Cronbach's alpha coefficient was 0.93. When compared against SCID-I, the best cut-off threshold was 13/14, yielding sensitivity of 0.81 and specificity 0.85. Following items were removed: reduced appetite, reduced sleep, concentration difficulties, suicide thought and lassitude. The 5-item version showed an alpha coefficient of 0.94 and a best cut-off threshold of 10/11, yielding sensitivity of 0.81 and specificity 0.87. Similar overall ability to discriminate depression of almost 90 % was found for both 10-item and 5-item MADRS. Conclusion: The MADRS is a reliable and valid instrument to assess depressive symptoms among treatment-seeking bariatric patients. Systematic application of the abbreviated version of the MADRS can be recommended for enhancing the clinical detection of depression during perioperative period.
- A Sib-Pair analysis of impulsivity in bipolar disorder type I(2013) ALMEIDA, Karla Mathias de; NERY, Fabiano Goncalves; MORENO, Ricardo Alberto; GORENSTEIN, Clarice; LAFER, BenyObjective: The aim of this study was to compare impulsivity among patients with bipolar disorder, their siblings, and healthy controls in order to examine whether impulsivity in bipolar disorder is related to genetic liability for the illness. Methods: Using the Barratt Impulsiveness Scale, we assessed 204 subjects: 67 euthymic outpatients with bipolar disorder type I, 67 siblings without bipolar disorder, and 70 healthy controls. Results: Impulsivity scores were higher among patients with bipolar disorder than among healthy controls. Siblings showed higher motor impulsivity scores than did healthy controls. Conclusions: Our results suggest that motor impulsivity may be a vulnerability marker for bipolar disorder. Our data may contribute to further improve preventive strategies in subjects at high risk for bipolar disorder.
- Can Gender and Age Impact on Response Pattern of Depressive Symptoms Among College Students? A Differential Item Functioning Analysis(2019) SA JUNIOR, Antonio Reis de; LIEBEL, Graziela; ANDRADE, Arthur Guerra de; ANDRADE, Laura Helena; GORENSTEIN, Clarice; WANG, Yuan-PangBackground: Self-reported depressive complaints among college students might indicate different degrees of severity of depressive states. Through the framework of item response theory, we aim to describe the pattern of responses to items of the Beck Depression Inventory-II (BDI-II), in terms of endorsement probability and discrimination along the continuum of depression. Potential differential item functioning of the scale items of the BDI-11 is investigated, by gender and age, to compare across sub-groups of students. Methods: The 21-item BDI-II was cross-sectionally administered to a representative sample of 12,677 Brazilian college students. Reliability was evaluated based on Cronbach's alpha coefficient. Severity (b,) and discrimination (a) parameters of each BDI-II items were calculated through the graded response model. The influence of gender and age were tested for differential item functioning (DIF) within the item response theory-based approach. Results: The BDI-II presented good reliability (alpha = 0.91). Women and younger students significantly presented a higher likelihood of depression (cut-off > 13) than men and older counterparts. In general, participants endorsed more easily cognitive-somatic items than affective items of the scale. ""Guilty feelings,"" ""suicidal thoughts,"" and ""loss of interest in sex"" were the items that most likely indicated depression severity (b >= 3.60). However, all BDI-ll items showed moderate-to-high discrimination (a >= 1.32) for depressive state. While two items were flagged for DIF, ""crying"" and ""loss of interest in sex,"" respectively for gender and age, the global weight of these items on the total score was negligible. Conclusions: Although respondents' gender and age might present influence on response pattern of depressive symptoms, the measures of self-reported symptoms have not inflated severity scores. These findings provide further support to the validity of using BDI-II for assessing depression in academic contexts and highlight the value of considering gender- and age-related common symptoms of depression.