HERMANO TAVARES
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Psiquiatria, Faculdade de Medicina - Docente
LIM/23 - Laboratório de Psicopatologia e Terapêutica Psiquiátrica, Hospital das Clínicas, Faculdade de Medicina
LIM/23 - Laboratório de Psicopatologia e Terapêutica Psiquiátrica, Hospital das Clínicas, Faculdade de Medicina
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- Pathological jealousy and pathological love: Apples to apples or apples to oranges?(2018) STRAVOGIANNIS, Andrea Lorena da C.; KIM, Hyoun S.; SOPHIA, Eglacy C.; SANCHES, Cintia; ZILBERMAN, Monica L.; TAVARES, HermanoPathological jealousy evokes emotions, thoughts, and behaviors that cause damage to social and interpersonal relationships. On the other hand, pathological love is the uncontrollable behavior of caring for a partner that results in neglecting the needs of the self. The aim of the present research was to assess the similarities and differences between the two psychopathologies of love. To this end, thirty-two individuals with pathological jealousy and 33 individuals with pathological love were compared on demographics, aspects of romantic relationship (jealousy, satisfaction, love style), psychiatric co-morbidities, personality and psychological characteristics (e.g., impulsivity). In a univariate analysis individuals with pathological jealousy were more likely to be in a current relationship and reported greater satisfaction. The avoidant attachment and the ludus love style were associated with pathological jealousy whereas the secure attachment and agape love style was associated with pathological love. Almost three-quarters (72.3%) of the sample met criteria for a current psychiatric disorder, however no differences emerged between the pathological jealousy and pathological love groups. In a binary logistic regression, relationship status and impairments in parenting significantly differentiated the groups. While both pathological jealousy and pathological love share similarities, they also present with unique differences, which may have important treatment implications.
- Compulsive sexual behavior and psychopathology among treatment-seeking men in Sao Paulo, Brazil(2013) SCANAVINO, Marco de Tubino; VENTUNEAC, Ana; ABDO, Carmita Helena Najjar; TAVARES, Hermano; AMARAL, Maria Luiza Sant'Ana do; MESSINA, Bruna; REIS, Sirlene Caramello dos; MATTINS, Joao Paulo Lian Branco; PARSONS, Jeffrey T.This study examined compulsive sexual behavior (CSB) and psychopathology in a treatment-seeking sample of men in Sao Paulo, Brazil. Eighty-six men (26% gay, 17% bisexual, 57% heterosexual) who met diagnostic criteria for excessive sexual drive and sexual addiction completed assessments consisting of the Mini International Neuropsychiatric Interview, a structured clinical interview for DSM-IV Axis I Disorders Clinical Version (segment for Impulse Control Disorder), Sexual Compulsivity Scale (SCS), and questions about problematic CSB. The average SCS score for our sample was above the cut-off score reported in other studies, and 72% of the sample presented at least one Axis I psychiatric diagnosis. There were no differences among gay, bisexual, and heterosexual men on SCS scores and psychiatric conditions, but gay and bisexual men were more likely than heterosexual men to report casual sex and sex with multiple casual partners as problematic behaviors. SCS scores were associated with psychiatric co-morbidities, mood disorder, and suicide risk, but diagnosis of a mood disorder predicted higher SCS scores in a regression analysis. The study provides important data on the mental health needs of men with CSB in Sao Paulo, Brazil.
- Gambling onset and progression in a sample of at-risk gamblers from the general population(2014) CARNEIRO, Elizabeth; TAVARES, Hermano; SANCHES, Marcos; PINSKY, Ilana; CAETANO, Raul; ZALESKI, Marcos; LARANJEIRA, RonaldoThe goal of this study was to investigate gambling-related behavior, onset and progression in a sample of at-risk gamblers from the community. A national household survey was conducted in Brazil, covering individuals 14 years old or older. Subjects were screened for at-risk gambling, those testing positive answered a questionnaire about gambling progression, preferred games and DSM-IV pathological gambling criteria. Out of 3007 respondents, 118 were considered at-risk gamblers according to the Lie/Bet Questionnaire. According to the DSM-IV, 32.7% and 24.9% of those were considered problem and pathological gamblers, respectively. Early at-risk gamblers (onset prior to 20 years of age), were more likely to be male, to prefer non-commercially structured games, and to chase losses while gambling. Young pathological gamblers (under 35 years of age) progressed faster from regular to problem gambling (roughly 2 years) than mature pathological gamblers (12 years). Such findings had not been described before because previous reports focused mostly on clinical samples that lack young, male, early-onset gamblers. Gambling programs have not satisfactorily covered this segment of gamblers. Outreach strategies and early interventions should be provided to prevent these individuals from rapidly evolving into pathological gambling.
- Major depressive disorder and depressive symptoms in intermittent explosive disorder(2018) MEDEIROS, Gustavo C.; SEGER, Liliana; GRANT, Jon E.; TAVARES, HermanIt is estimated that between 1.7 and 2.6 million people have had intermittent explosive disorder (IED) during their life in the United States alone. Co-occurring psychiatric disorders are very common in IED, being major depressive disorder arguably the most common. The objective of this study was to examine the clinical correlates of IED and depressive manifestations in 74 treatment-seeking subjects. After controlling for confounders, there were associations between major depressive disorder and severity of depressive symptoms, and (a) higher assault scores, (b) more severe hostile behavior and (c) worse social adjustment. Management of depressive symptoms may be an important for IED treatment.
- Kleptomania and Co-morbid addictive disorders(2017) KIM, Hyoun S.; CHRISTIANINI, Aparecida Rangon; BERTONI, Daniela; OLIVEIRA, Maria do Carmo Medeiros de; HODGINS, David C.; TAVARES, HermanoWe examined the association between kleptomania and addictive disorders, including behavioral addictions. Fifty-three individuals with a diagnosis of kleptomania completed measures of kleptomania severity, semi structured clinical interviews to assess co-morbid diagnosis of addictive disorders, and the Shorter PROMIS Questionnaire (SPQ) assessing an array of addictive behaviors. 20.75% of the sample met criteria for an addictive disorder; four for a substance use disorder and four for a behavioral addiction. Kleptomania severity was significantly associated with compulsive work and shopping measured by the SPQ. The results suggest the need to assess a wide array of addictive behaviors in individuals with kleptomania.
- A naturalistic study of recovering gamblers: What gets better and when they get better(2015) ROSSINI-DIB, Danielle; FUENTES, Daniel; TAVARES, HermanoGambling recovery has typically been assessed through the lens of gambling behavior and its consequences. Little attention has been given to less obvious features of gambling disorder, such as negative affectivity, gambling cognitive distortions, impulsivity, cognitive flexibility, planning, inhibitory control, and decision-making. The current study investigates how gambling treatment affected these variables and if any are related to gambling recovery. One hundred and thirteen patients were assigned to psycho-education and psychiatric treatment. A subset of 48 patients was additionally assigned to cognitive behavioral therapy (CBT). Seventy-two patients were reassessed 6 months after treatment onset. Recovered and non-recovered gamblers did not differ in pre-treatment demographic, gambling, and psychiatric profiles. Three outcome variables were strongly related with gambling recovery: negative affectivity, cognitive distortions and decision-making. Logistic regression identified reduction of gambling cognitive distortions and better performance on decision-making as the best predictors of gambling recovery, regardless of the type of treatment received. Beyond the standard outcome measures for gambling treatment, increased sensitivity to loss and decreased positive expectancies towards gambling are key targets to promote recovery in gambling treatment.
- Electronic gaming machines and gambling disorder: A cross-cultural comparison between treatment-seeking subjects from Brazil and the United States(2015) MEDEIROS, Gustavo C.; LEPPINK, Eric W.; YAEMI, Ana; MARIANI, Mirella; TAVARES, Hermano; GRANT, Jon E.Aims: The objective of this paper is to perform a cross-cultural comparison of gambling disorder (GD) due to electronic gaming machines (EGM), a form of gambling that may have a high addictive potential. Our goal is to investigate two treatment-seeking samples of adults collected in Brazil and the United States, countries with different socio-cultural backgrounds. This comparison may lead to a better understanding of cultural influences on GD. Methods: The total studied sample involved 733 treatment-seeking subjects: 353 men and 380 women (average age=45.80, standard deviation +/- 10.9). The Brazilian sample had 517 individuals and the American sample 216. Subjects were recruited by analogous strategies. Results: We found that the Brazilian sample was younger, predominantly male, less likely to be Caucasian, more likely to be partnered, tended to have a faster progression from recreational gambling to GD, and were more likely to endorse chasing losses. Conclusion: This study demonstrated that there are significant differences between treatment-seeking samples of adults presenting GD due to EGM in Brazil and in the United States. These findings suggest that cultural aspects may have a relevant role in GD due to EGM.
- Obsessive-compulsive or addiction? Categorical diagnostic analysis of excoriation disorder compared to obsessive-compulsive disorder and gambling disorder(2019) OLIVEIRRA, Elen Cristina Batista; FITZPATRICK, Chelsea L.; KIM, Hyoun S.; GULASSA, Daniel Carr Ribeiro; AMARAL, Roberta Souza; CRISTIANA, Nicoli de Mattos; HAYASHIUCHI, Ana Yaemi; MCGRATH, Daniel S.; TAVARES, HermanoExcoriation disorder (ED) is currently classified in the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders' Obsessive compulsive and Related Disorders section (OCRD). However, there remain debates regarding whether ED is related to obsessive compulsive disorder (OCD) or whether it is better conceptualized as a behavioral addiction. The present research compared the diagnostic overlap and psychiatric comorbidities of 121 individuals seeking treatment for ED (n = 40), OCD (n = 41) and gambling disorder (GD) (n = 40). ED was more likely to overlap with OCD (n = 14) than GD (n = 3). Compared to OCD, ED had similar frequencies of other body focused repetitive behaviors (BFRBs), but higher frequency of addictive behaviors (Odds Ratio OR = 11.82). In comparison to GD, ED had similar frequencies of addictive behaviors, but higher frequency of BFRBs (OR =19.67). The results support the recent classification of ED as an OCRD. However, ED presents an association with behavioral addictions that suggests a mixed impulsive-compulsive nature. A limitation of the present research was the use of a non-validated semi-structured clinical interview to diagnose impulse control disorders. Future research should examine other characteristics (e.g., epidemiology, neurobiology, genetics, treatment response) to further investigate whether ED should remain classified as an OCRD.
- Development and validation of the compulsive-buying follow-up scale: A measure to assess treatment improvements in compulsive buying disorder(2019) MATTOS, Cristiana Nicoli de; KIM, Hyoun S.; FILOMENSKY, Tatiana Zambrano; TAVARES, HermanoThe aim of the present research was to develop a scale to assess treatment improvements for compulsive buying disorder (CBD), adapted from the Gambling Follow-up Scale Self-Report Version. The Compulsive Buying Follow-up Scale (CBFS) contains six self-report multiple-choice items assessing different aspects of compulsive buying in the past four weeks. Forty-eight treatment-seeking patients with CBD were evaluated, with 39 patients completing the 12-week follow-up. The scale's global alpha was high as well as the item-total correlations per item. The estimations of alpha if-item-deleted were all under the global alpha value, indicating that all items provided relevant contribution within the scale. The CBFS demonstrated significant correlations with previously developed scales of CBD and other measures of psychopathology, with the exception of a non-significant association with the Beck Depression Inventory at pre-treatment. The CBFS correlated significantly with all reference scales at post-treatment. The CBFS also demonstrated strong sensitivity to change and recovery status. The cutoff for the CBFS that provided the greatest sensitivity (0.93) and specificity (0.82) was 22. The results provide support that CBFS is a reliable and valid instrument to measure treatment outcomes over time for CBD.
- Gambling disorder and comorbid behavioral addictions: Demographic, clinical, and personality correlates(2020) TANG, Karen T. Y.; KIM, Hyoun S.; HODGINS, David C.; MCGRATH, Daniel S.; TAVARES, HermanoGambling disorder (GD) frequently co-occurs with substance use disorders. However, the extent to which GD co-occurs with behavioral addictions (BAs) and the demographic, clinical, and personality correlates of comorbid GD and BA is largely unknown. The aims of the present research were to address this gap among people seeking treatment for GD (N = 458) in Sao Paulo, Brazil. Structured clinical interviews diagnosed individuals with GD and other psychiatric disorders. The Shorter PROMIS questionnaire was used to identify BAs (work, exercise, food bingeing, sex, and shopping). Questionnaires assessed demographic characteristics, gambling behavior, and personality. Of the total sample, 206 (45.0%) participants met the criteria of having at least one behavioral addiction (GD+BA). The most common comorbid BA was food bingeing (8.1%) with the least common being exercise (3.6%). In a multivariate logistic regression, individuals with GD + BA tended to be younger, and had greater rates of comorbid post-traumatic stress disorder and bulimia nervosa compared to participants who did not present with a comorbid BA. Taken together, individuals with GD + BA present with increased psychopathology. These results may have important implications for the assessment and treatment of individuals with GD and comorbid BAs.