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- ItemAcesso aberto (Open Access)Adiamento de recompensa e a autorregulação emocional em crianças com transtorno de déficit de atenção/hiperatividade(Universidade Federal de São Paulo (UNIFESP), 2015-09-16) Utsumi, Daniel Augusto [UNIFESP]; Muszkat, Mauro [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Current research in neuropsychology show the importance of investigating the hot executive processes in Attention-Deficit/Hyperactivity Disorder (ADHD) as the reward delay and emotional self-regulation. Temporal Discounting (TD) paradigm has been used for the assessment of reward delay and impulsivity in ADHD and reflects the trend of devaluation of a given reward as the time of delivery is delayed. This study aimed to analyse the performance of children with and without ADHD into three types of TD tasks, correlating the results with emotional self-regulation measures of Behavior Rating Inventory of Executive Functions (BRIEF) and Child Behavior Checklist (CBCL) scales. The study included 49 children aged 8-12 years, divided into two groups: 25 children with ADHD and 24 controls. For the evaluation of TD were developed three types of tasks: 1) hypothetical - in which the reward was not delivered and the time intervals have not been expected, 2) hypothetical with temporal expectation - in which the reward was not delivered, but the time intervals could be expected and 3) real - in which the reward was delivered and the time intervals could be expected. We used material reward (toys), one of which was given to the participant at the end of the real task in view of the ecological analysis of reinforcement aspects on the choice of the participants. Difference was observed between the groups in the hypothetical with temporal expectation task, in which the ADHD group showed a higher rate of depreciation of the favorite toy. A strong correlation between levels of emotional self-regulation proposed by the BRIEF and CBCL scales was observed. The hypothetical with temporal expectation task correlated significantly and negatively with behavioral regulation index and inhibition scale of BRIEF, suggesting associations between impulsivity and low emotional self-regulation. However, no TD task correlated with the CBCL. It was concluded that tasks involving toys can be used to evaluate the TD construct, especially the hypothetical with temporal expectation task, which was sensitive to evaluate the reward delay concept. It can also be used in future research for the differenciation of clinical groups and as a complementary tool for the assessment of emotional self-regulation.
- ItemSomente MetadadadosAssociação entre variáveis sociodemográficas, clinicas e neuropsicológicas com resposta ao tratamento farmacológico em pacientes com transtorno do déficit de atenção e hiperatividade (TDAH)(Universidade Federal de São Paulo (UNIFESP), 2015-06-30) Rodrigues, Raphael Suwwan [UNIFESP]; Rosario, Maria Conceicao Do Rosario [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Attention Deficit Hyperactivity Disorder (ADHD) is associated with a significant negative impact on the lives of patients and their families. Drug treatment with methylphenidate (MPH), while reducing the losses associated with the disorder, it is not universally effective. The main objective of this study is to investigate associations between clinical, neuropsychological and sociodemographic factors with response to methylphenidate treatment in children and adolescents with ADHD after 25 weeks of intervention. 40 patients between age 6-18 were evaluated in the ADHD Unit of Child and Adolescent Psychiatry (UPIA), Federal University of São Paulo (UNIFESP). Significant associations were found between the number, severity of ADHD symptoms and performance on tasks of visuospatial working memory and response to treatment.
- ItemAcesso aberto (Open Access)Follow-up de crianças diagnosticadas com tdah e tratamento medicamentoso(Universidade Federal de São Paulo (UNIFESP), 2014-09-24) Muzzi, Maria do Carmo [UNIFESP]; Muszkat, Mauro [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common disorders in childhood and adolescence. It is characterized by a persistent pattern of inattention and / or hyperactivity / impulsivity. The precise causes of ADHD are still unknown, despite the large number of previous studies. The influence of genetic and environmental factors in their development is widely accepted in the literature. The symptoms of inattention, hyperactivity and impulsivity, consequently bring a great impact on academic development, as well as in the neurodevelopmental and psychosocial interaction areas. Also it reflects consistently in adaptive functioning and emotional self-regulation. The therapeutic intervention of ADHD involves a multimodal approach, including psychosocial and pharmacological interventions. The literature shows stimulants as first-choice medications, including methylphenidate, showing efficacy. Treatment with stimulants for ADHD leads to an improvement of symptoms throughout the day. The clinical goal of treatment is not limited only to improve the symptoms, but also to promote optimal functionality in emotional, behavioral, academic and social domains. The aim of this study was to seek correlations between results related to cognition, emotion and behavior in a sample of children and adolescents diagnosed with ADHD. We used for this purpose a few instruments including the Continuous Performance Test (CPT), computerized visual task. In addition, questionnaires completed by parents and school that contained behavioral and emotional information were employed. These procedures were performed before and after use of the medicine methylphenidate. The total sample for this study consisted of 12 male children and 1 female, aged between 6 and 14 years. After assessment, they received medicine treatment with methylphenidate, and after a period of 6 months were subjected to reassessment. After reassessment, the results indicated that there was a reduction in mean and median for all domains, only the index related to depression did not show a statistically significant difference. The data obtained from these results indicate a reduction of clinical, cognitive, emotional and behavioral symptomatology whose indices obtained effect size of large magnitude.