OBJETIVO: Realizar um breve percurso sobre o desenvolvimento conceitual de um dos construtos psicológicos de maior evidência nos dias atuais, a saber: o transtorno de personalidade antissocial (TPAS). Especificamente, esse percurso se realiza no sistema categórico proposto pela Associação Americana de Psiquiatria (APA), o Manual Diagnóstico e Estatístico de Distúrbios Mentais (DSM). MÉTODO: Utilizou-se a revisão literária sobre a evolução e a avaliação do construto associada a pesquisas empíricas consultadas nos principais livros e periódicos de reconhecimento internacional na área, tais como: Personality and Individual Differences, Psychological Medicine, Annual Review of Clinical Psychology, Psychological Bulletin, Journal of Abnormal Psychology, Journal of Personality Assessment, International Journal of Offender Therapy and Comparative Criminology, Aggression and Violent Behavior, Handbook of Psychopathy, entre outros. RESULTADO: Observa-se que o diagnóstico do TPAS é baseado nos critérios categóricos e não dimensionais. Isso significa que o sistema não consegue predizer a priori a variabilidade (intensidade) dos traços desse transtorno por ser o DSM desenvolvido no reconhecimento de sintomas e síndromes. CONCLUSÃO: Apesar de o TPAS ter passado por diversas revisões e de apresentar insuficiência taxonômica, ele ainda é amplamente utilizado no diagnóstico e no prognóstico clínico de condições relacionadas ao comportamento social desviante.

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OBJECTIVE: This present work does a brief developmental route about one of the most evidence contemporary construct: the antisocial personality disorder (APD). Specifically, this guide is realized in accordance to categorical system raised by American Psychiatry Association (APA), the Diagnosis Statistical of Mental Disorders (DSM). METHOD: This article uses a literature revision about the evolution and assessment of the construct associate to empirical studies counseled in main books and journals worldwide recognized in the area as: Personality and Individual Differences, Psychological Medicine, Annual Review of Clinical Psychology, Psychological Bulletin, Journal of Abnormal Psychology, Journal of Personality Assessment, International Journal of Offender Therapy and Comparative Criminology, Aggression and Violent Behavior, Handbook of Psychopathy, among others. RESULT: It observes that diagnosis of APD is based in categorical criteria not dimensionally. It means that system doesn't predict to prior the traits variability (intensity) of that disorder because the DSM it was development to recognize symptoms and syndromes. CONCLUSION: Despite the APD has gone for different revisions and still presents taxonomic deficient it remains widely used in clinical diagnoses and prognoses related to social deviant behavior.

OBJETIVO: Realizar um breve percurso sobre o desenvolvimento conceitual de um dos construtos psicológicos de maior evidência nos dias atuais, a saber: o transtorno de personalidade antissocial (TPAS). Especificamente, esse percurso se realiza no sistema categórico proposto pela Associação Americana de Psiquiatria (APA), o Manual Diagnóstico e Estatístico de Distúrbios Mentais (DSM). MÉTODO: Utilizou-se a revisão literária sobre a evolução e a avaliação do construto associada a pesquisas empíricas consultadas nos principais livros e periódicos de reconhecimento internacional na área, tais como: Personality and Individual Differences, Psychological Medicine, Annual Review of Clinical Psychology, Psychological Bulletin, Journal of Abnormal Psychology, Journal of Personality Assessment, International Journal of Offender Therapy and Comparative Criminology, Aggression and Violent Behavior, Handbook of Psychopathy, entre outros. RESULTADO: Observa-se que o diagnóstico do TPAS é baseado nos critérios categóricos e não dimensionais. Isso significa que o sistema não consegue predizer a priori a variabilidade (intensidade) dos traços desse transtorno por ser o DSM desenvolvido no reconhecimento de sintomas e síndromes. CONCLUSÃO: Apesar de o TPAS ter passado por diversas revisões e de apresentar insuficiência taxonômica, ele ainda é amplamente utilizado no diagnóstico e no prognóstico clínico de condições relacionadas ao comportamento social desviante.

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OBJECTIVE: This present work does a brief developmental route about one of the most evidence contemporary construct: the antisocial personality disorder (APD). Specifically, this guide is realized in accordance to categorical system raised by American Psychiatry Association (APA), the Diagnosis Statistical of Mental Disorders (DSM). METHOD: This article uses a literature revision about the evolution and assessment of the construct associate to empirical studies counseled in main books and journals worldwide recognized in the area as: Personality and Individual Differences, Psychological Medicine, Annual Review of Clinical Psychology, Psychological Bulletin, Journal of Abnormal Psychology, Journal of Personality Assessment, International Journal of Offender Therapy and Comparative Criminology, Aggression and Violent Behavior, Handbook of Psychopathy, among others. RESULT: It observes that diagnosis of APD is based in categorical criteria not dimensionally. It means that system doesn't predict to prior the traits variability (intensity) of that disorder because the DSM it was development to recognize symptoms and syndromes. CONCLUSION: Despite the APD has gone for different revisions and still presents taxonomic deficient it remains widely used in clinical diagnoses and prognoses related to social deviant behavior.

OBJETIVO: Realizar um breve percurso sobre o desenvolvimento conceitual de um dos construtos psicológicos de maior evidência nos dias atuais, a saber: o transtorno de personalidade antissocial (TPAS). Especificamente, esse percurso se realiza no sistema categórico proposto pela Associação Americana de Psiquiatria (APA), o Manual Diagnóstico e Estatístico de Distúrbios Mentais (DSM). MÉTODO: Utilizou-se a revisão literária sobre a evolução e a avaliação do construto associada a pesquisas empíricas consultadas nos principais livros e periódicos de reconhecimento internacional na área, tais como: Personality and Individual Differences, Psychological Medicine, Annual Review of Clinical Psychology, Psychological Bulletin, Journal of Abnormal Psychology, Journal of Personality Assessment, International Journal of Offender Therapy and Comparative Criminology, Aggression and Violent Behavior, Handbook of Psychopathy, entre outros. RESULTADO: Observa-se que o diagnóstico do TPAS é baseado nos critérios categóricos e não dimensionais. Isso significa que o sistema não consegue predizer a priori a variabilidade (intensidade) dos traços desse transtorno por ser o DSM desenvolvido no reconhecimento de sintomas e síndromes. CONCLUSÃO: Apesar de o TPAS ter passado por diversas revisões e de apresentar insuficiência taxonômica, ele ainda é amplamente utilizado no diagnóstico e no prognóstico clínico de condições relacionadas ao comportamento social desviante.

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OBJECTIVE: This present work does a brief developmental route about one of the most evidence contemporary construct: the antisocial personality disorder (APD). Specifically, this guide is realized in accordance to categorical system raised by American Psychiatry Association (APA), the Diagnosis Statistical of Mental Disorders (DSM). METHOD: This article uses a literature revision about the evolution and assessment of the construct associate to empirical studies counseled in main books and journals worldwide recognized in the area as: Personality and Individual Differences, Psychological Medicine, Annual Review of Clinical Psychology, Psychological Bulletin, Journal of Abnormal Psychology, Journal of Personality Assessment, International Journal of Offender Therapy and Comparative Criminology, Aggression and Violent Behavior, Handbook of Psychopathy, among others. RESULT: It observes that diagnosis of APD is based in categorical criteria not dimensionally. It means that system doesn't predict to prior the traits variability (intensity) of that disorder because the DSM it was development to recognize symptoms and syndromes. CONCLUSION: Despite the APD has gone for different revisions and still presents taxonomic deficient it remains widely used in clinical diagnoses and prognoses related to social deviant behavior.

OBJETIVO: Descrever o perfil das tentativas de suicídio e mortalidade por suicídio no município de Santa Maria de Jetibá, interior do Espírito Santo, no período de 2001 a 2007. MÉTODO: Estudo descritivo, observacional e de abordagem quantitativa. A identificação dos casos de tentativas de suicídio e suicídios ocorreu por meio dos Boletins de Ocorrência Policial da Polícia Militar do Município, onde foram selecionados todos os casos. Para análise dos dados, foram utilizadas tabelas de frequência e os testes de hipótese t Student e Qui-quadrado. RESULTADOS: O coeficiente médio de mortalidade por suicídio foi de 12,9/100.000. Verificou-se que as mulheres realizam mais tentativas de suicídio, enquanto os homens foram mais eficientes, cometendo mais suicídio (p = 0,008). A média de idade para as vítimas de tentativas de suicídio foi de 30 ± 10,1 anos e de suicídio 42 ± 14,9 anos (p = 0,001). Os meios mais utilizados para os casos de suicídio foi o enforcamento (57,1%), enquanto para as tentativas foi o envenenamento por agrotóxico (42,5%). CONCLUSÃO: Verificou-se que o perfil dos suicidas se diferencia dos que tentam, especialmente segundo o sexo, a idade e os meios utilizados, enfatizando a necessidade de se desencadear discussões acerca de programas, tratamento e prevenção para os grupos mais vulneráveis.

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OBJECTIVE: To describe the profile of suicide attempts and suicide mortality in the municipality of Santa Maria de Jetibá, inside Espírito Santo, from 2001 to 2007. METHOD: A descriptive, observational and quantitative study. The identification of cases of suicide attempts and suicides occurred through the police records from the Military Police of the city, where we selected all cases. Frequency tables were used and tests of hypotheses Student t and Chi-square in the data analysis. RESULTS: The average mortality rate from suicide was 12.9/100,000. It was found that women carry out more suicide attempts, while men were more efficient, more committing suicide (p = 0.008). The average age for victims of suicide attempts was 30 ± 10.1 years and suicide 42 ± 14.9 years (p = 0.001). The most frequently used methods for cases of suicide was hanging (57.1%), while for attempts was pesticide poisoning (42.5%). CONCLUSION: It was found that the profile of suicidal person differs from the one who try, especially by gender, age and media used, emphasizing the need to initiate discussions about programs, treatment and prevention for vulnerable groups.

INTRODUÇÃO: Estudo realizado em clínicas cirúrgicas de dois hospitais de Belo Horizonte com 100 pacientes adultos de ambos os sexos, distribuídos em dois grupos: Grupo 1 - 22 pacientes sem experiência com cirurgia; Grupo 2 - 78 pacientes submetidos previamente a outras operações de médio e grande porte. OBJETIVO: Avaliar o impacto do estresse psíquico em pacientes submetidos a operações de grande porte sob anestesia geral, relacionando suas reações físicas e psíquicas com as diferentes fases do estresse. MÉTODO: Para investigação do estresse, utilizou-se o Inventário de Sintomas de Stress para Adultos, desenvolvido por Lipp, um dia antes e dois dias e sete dias após a operação. A comparação dos grupos quanto às variáveis "sexo", "dor" e "percentual de estresse" foi realizada pelo teste do qui ao quadrado e para a variável idade foi utilizado o teste t de Student. As diferenças foram consideradas significativas para p < 0,05. RESULTADOS: Os grupos não foram homogêneos quanto ao percentual geral de estresse nas três mensurações. O Grupo 1 diminuiu e o Grupo 2 aumentou o estresse no pós-operatório. Prevaleceram sintomas psíquicos do estresse em ambos os grupos. CONCLUSÃO: O fato de ter sido operado previamente reduziu a tensão pré-operatória, porém não interferiu nos distúrbios emocionais pós-operatórios.

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INTRODUCTION: One hundred adult patients hospitalized in the surgical wards of two hospitals of Belo Horizonte city, Brazil, were separated into two groups: group 1, 22 patients who had no previous experience with surgeries; and group 2, 78 patients who had been previously submitted to major surgical procedures. OBJECTIVE: To evaluate the impact of psychical stress on patients submitted to major operations under general anesthesia and to correlate physical and psychological reactions to different stages of stress. METHOD: The Stress Symptoms Inventory for Adults was used one day before and two and seven days after the operation. The groups were compared with regard to sex, level of pain and stress percentage with the chi-square test and for age with the Student t test. The level of significance was set at p < 0.05. RESULTS: The groups were not homogeneous regarding the general percentage of stress on the occasion of the three measurements. The level of stress was decreased in Group 1 and increased in Group 2. Psychic stress symptoms prevailed in both groups. CONCLUSION: Previous experience with surgery under general anesthesia reduces preoperative stress, but does not affect postoperative stress.

Context  Overlapping neurobiological pathways between obesity and addiction disorders are currently in discussion. Whereas the hypothalamic regulation of energy homeostasis by endocrine feedback signals has been widely investigated, its interplay with mesolimbic reward-associated pathways represents a rich field of future research.

Objective  To assess changes in regional brain activation in response to food-related cues in association with body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) and the plasma concentration of the appetite-regulating peptide leptin.

Design  Case-control study.

Setting  Academic addiction and brain imaging center, Central Institute of Mental Health, Mannheim, Germany.

Participants  Twenty-one obese subjects (BMI >30) and 23 age- and sex-matched nonobese control subjects (BMI 18.5-24.0) recruited by advertisements.

Main Outcome Measures  Regional brain activation (blood oxygen level–dependent response) in response to visual cue presentation and association of the brain activation with BMI and plasma leptin concentration.

Results  Significant positive relationships were observed for food cue–induced brain activations in the ventral striatum in association with the plasma concentration of leptin (r = 0.27; P = .04) and with BMI (r = 0.47; P = .001).

Conclusions  Data suggest a physiological role of satiety factors in modulating the responsivity of mesolimbic circuits to food cues. Moreover, an altered homeostatic feedback regulation of reward pathways might explain addictionlike behavior and the inability of obese patients to adapt food intake to physiological needs.

Context  Purpose in life is associated with a substantially reduced risk of Alzheimer disease (AD), but the neurobiologic basis of this protective effect remains unknown.

Objective  To test the hypothesis that purpose in life reduces the deleterious effects of AD pathologic changes on cognition in advanced age.

Design  A longitudinal, epidemiologic, clinicopathologic study of aging was conducted that included detailed annual clinical evaluations and brain autopsy.

Participants  Two hundred forty-six community-based older persons from the Rush Memory and Aging Project participated.

Main Outcome Measures  Purpose in life was assessed via structured interview, and cognitive function was evaluated annually and proximate to death. On postmortem examination, 3 indexes of AD pathologic features were quantified: global AD pathologic changes, amyloid, and tangles. The associations of disease pathologic changes and purpose in life with cognition were examined using linear regression and mixed models.

Results  Purpose in life modified the association between the global measure of AD pathologic changes and cognition (mean [SE] parameter estimate, 0.532 [0.211]; P = .01), such that participants who reported higher levels of purpose in life exhibited better cognitive function despite the burden of the disease. Purpose in life also reduced the association of tangles with cognition (parameter estimate, 0.042 [0.019]; P = .03), and the protective effect of purpose in life persisted even after controlling for several potentially confounding variables. Furthermore, in analyses examining whether purpose in life modified the association between AD pathologic effects and the rate of cognitive decline, we found that higher levels of purpose in life reduced the effect of AD pathologic changes on cognitive decline (parameter estimate, 0.085 [0.039]; P = .03).

Conclusion  Higher levels of purpose in life reduce the deleterious effects of AD pathologic changes on cognition in advanced age.

Context  Depression and dementia are common in older adults and often co-occur, but it is unclear whether depression is an etiologic risk factor for dementia.

Objective  To clarify the timing and nature of the association between depression and dementia.

Design  We examined depressive symptoms assessed in midlife (1964-1973) and late life (1994-2000) and the risks of dementia, Alzheimer disease (AD), and vascular dementia (VaD) (2003-2009) in a retrospective cohort study. Depressive symptoms were categorized as none, midlife only, late life only, or both. Cox proportional hazards models (age as timescale) adjusted for demographics and medical comorbidities were used to examine depressive symptom category and risk of dementia, AD, or VaD.

Setting  Kaiser Permanente Medical Care Program of Northern California.

Participants  Thirteen thousand five hundred thirty-five long-term Kaiser Permanente members.

Main Outcome Measure  Any medical record diagnosis of dementia or neurology clinic diagnosis of AD or VaD.

Results  Subjects had a mean (SD) age of 81.1 (4.5) years in 2003, 57.9% were women, and 24.2% were nonwhite. Depressive symptoms were present in 14.1% of subjects in midlife only, 9.2% in late life only, and 4.2% in both. During 6 years of follow-up, 22.5% were diagnosed with dementia (5.5% with AD and 2.3% with VaD). The adjusted hazard of dementia was increased by approximately 20% for midlife depressive symptoms only (hazard ratio, 1.19 [95% CI, 1.07-1.32]), 70% for late-life symptoms only (1.72 [1.54-1.92]), and 80% for both (1.77 [1.52-2.06]). When we examined AD and VaD separately, subjects with late-life depressive symptoms only had a 2-fold increase in AD risk (hazard ratio, 2.06 [95% CI, 1.67-2.55]), whereas subjects with midlife and late-life symptoms had more than a 3-fold increase in VaD risk (3.51 [2.44-5.05]).

Conclusions  Depressive symptoms in midlife or in late life are associated with an increased risk of developing dementia. Depression that begins in late life may be part of the AD prodrome, while recurrent depression may be etiologically associated with increased risk of VaD.

This week, Savvy Psychologist Dr. Ellen Hendriksen answers, “What is mindfulness?” Plus, 3 starter exercises to try

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New findings underscore the challenge of balancing psychiatric needs and potential negative consequences for newborns 

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At long last, introverts are having their day. Over the last few years, being quiet and inner-directed has become not only acceptable, but downright trendy.  But introversion often gets mistaken...

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Europe is experiencing the largest movement of people since the Second World War. Researchers struggle to help the migrants cope with the trauma of displacement

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Shaking and numbness and sweat, oh my! What do we call it when what we fear is fear itself? None other than the little-known, but hugely important concept of anxiety sensitivity. This week, Savvy...

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Famed Goldwater Rule adopted by the American Psychiatric Association is said to deprive the public of expert analysis about the mental health of elected leaders 

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The largest study of its kind suggests long-term physical inactivity and character traits may be linked 

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Genes and pregnancy problems combine to increase significantly the likelihood of developing schizophrenia

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More of us are getting at least a dozen good, happy years after 65

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The term “separation anxiety” usually conjures the image of a tearful toddler, or worse, a whimpering dog, but millions of grown-ups live with separation anxiety, too

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Context  Overlapping neurobiological pathways between obesity and addiction disorders are currently in discussion. Whereas the hypothalamic regulation of energy homeostasis by endocrine feedback signals has been widely investigated, its interplay with mesolimbic reward-associated pathways represents a rich field of future research.

Objective  To assess changes in regional brain activation in response to food-related cues in association with body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) and the plasma concentration of the appetite-regulating peptide leptin.

Design  Case-control study.

Setting  Academic addiction and brain imaging center, Central Institute of Mental Health, Mannheim, Germany.

Participants  Twenty-one obese subjects (BMI >30) and 23 age- and sex-matched nonobese control subjects (BMI 18.5-24.0) recruited by advertisements.

Main Outcome Measures  Regional brain activation (blood oxygen level–dependent response) in response to visual cue presentation and association of the brain activation with BMI and plasma leptin concentration.

Results  Significant positive relationships were observed for food cue–induced brain activations in the ventral striatum in association with the plasma concentration of leptin (r = 0.27; P = .04) and with BMI (r = 0.47; P = .001).

Conclusions  Data suggest a physiological role of satiety factors in modulating the responsivity of mesolimbic circuits to food cues. Moreover, an altered homeostatic feedback regulation of reward pathways might explain addictionlike behavior and the inability of obese patients to adapt food intake to physiological needs.

Context  Purpose in life is associated with a substantially reduced risk of Alzheimer disease (AD), but the neurobiologic basis of this protective effect remains unknown.

Objective  To test the hypothesis that purpose in life reduces the deleterious effects of AD pathologic changes on cognition in advanced age.

Design  A longitudinal, epidemiologic, clinicopathologic study of aging was conducted that included detailed annual clinical evaluations and brain autopsy.

Participants  Two hundred forty-six community-based older persons from the Rush Memory and Aging Project participated.

Main Outcome Measures  Purpose in life was assessed via structured interview, and cognitive function was evaluated annually and proximate to death. On postmortem examination, 3 indexes of AD pathologic features were quantified: global AD pathologic changes, amyloid, and tangles. The associations of disease pathologic changes and purpose in life with cognition were examined using linear regression and mixed models.

Results  Purpose in life modified the association between the global measure of AD pathologic changes and cognition (mean [SE] parameter estimate, 0.532 [0.211]; P = .01), such that participants who reported higher levels of purpose in life exhibited better cognitive function despite the burden of the disease. Purpose in life also reduced the association of tangles with cognition (parameter estimate, 0.042 [0.019]; P = .03), and the protective effect of purpose in life persisted even after controlling for several potentially confounding variables. Furthermore, in analyses examining whether purpose in life modified the association between AD pathologic effects and the rate of cognitive decline, we found that higher levels of purpose in life reduced the effect of AD pathologic changes on cognitive decline (parameter estimate, 0.085 [0.039]; P = .03).

Conclusion  Higher levels of purpose in life reduce the deleterious effects of AD pathologic changes on cognition in advanced age.

Context  Depression and dementia are common in older adults and often co-occur, but it is unclear whether depression is an etiologic risk factor for dementia.

Objective  To clarify the timing and nature of the association between depression and dementia.

Design  We examined depressive symptoms assessed in midlife (1964-1973) and late life (1994-2000) and the risks of dementia, Alzheimer disease (AD), and vascular dementia (VaD) (2003-2009) in a retrospective cohort study. Depressive symptoms were categorized as none, midlife only, late life only, or both. Cox proportional hazards models (age as timescale) adjusted for demographics and medical comorbidities were used to examine depressive symptom category and risk of dementia, AD, or VaD.

Setting  Kaiser Permanente Medical Care Program of Northern California.

Participants  Thirteen thousand five hundred thirty-five long-term Kaiser Permanente members.

Main Outcome Measure  Any medical record diagnosis of dementia or neurology clinic diagnosis of AD or VaD.

Results  Subjects had a mean (SD) age of 81.1 (4.5) years in 2003, 57.9% were women, and 24.2% were nonwhite. Depressive symptoms were present in 14.1% of subjects in midlife only, 9.2% in late life only, and 4.2% in both. During 6 years of follow-up, 22.5% were diagnosed with dementia (5.5% with AD and 2.3% with VaD). The adjusted hazard of dementia was increased by approximately 20% for midlife depressive symptoms only (hazard ratio, 1.19 [95% CI, 1.07-1.32]), 70% for late-life symptoms only (1.72 [1.54-1.92]), and 80% for both (1.77 [1.52-2.06]). When we examined AD and VaD separately, subjects with late-life depressive symptoms only had a 2-fold increase in AD risk (hazard ratio, 2.06 [95% CI, 1.67-2.55]), whereas subjects with midlife and late-life symptoms had more than a 3-fold increase in VaD risk (3.51 [2.44-5.05]).

Conclusions  Depressive symptoms in midlife or in late life are associated with an increased risk of developing dementia. Depression that begins in late life may be part of the AD prodrome, while recurrent depression may be etiologically associated with increased risk of VaD.

This week, Savvy Psychologist Dr. Ellen Hendriksen reveals three toxic thinking habits that keep you feeling insecure, plus offers three ways to feel more confident.

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Before, on and after Christmas suicide rates are lowest of the year—but New Year’s Day sees a spike

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New findings underscore the challenge of balancing psychiatric needs and potential negative consequences for newborns 

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A research-based way to improve life and reduce depression among people caring for loved ones with dementia 

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Therapies that focus on changing behaviors are just as effective as those that modify thoughts in managing the debilitating mood disorder

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The ethical threat posed by Adderall and other drugs that improve motivation

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The ethical threat posed by Adderall and other drugs that improve motivation

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Peer counselors are playing a growing role in guiding newcomers to mental health care

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Alice B. Toklas truly stirred the pot when she included a recipe for hashish fudge in her memoir-cum-cookbook. She published The Alice B. Toklas Cookbook in 1954, following the death of her lifelong...

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Alice B. Toklas truly stirred the pot when she included a recipe for hashish fudge in her memoir-cum-cookbook. She published The Alice B. Toklas Cookbook in 1954, following the death of her lifelong...

-- Read more on ScientificAmerican.com