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Doctoral Thesis
DOI
https://doi.org/10.11606/T.47.2017.tde-13122017-093536
Document
Author
Full name
Adsson Roberto Magalhães Araujo
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2017
Supervisor
Committee
Costa, Marcelo Fernandes da (President)
Costa, Thiago Leiros
Dias, Alvaro Machado
Fraguas Junior, Renerio
Rios, Mino Correia
Zachi, Elaine Cristina
Title in Portuguese
Três estudos usando a Escala centiMax de Borg® (Escala CR de Borg®, CR 100, cM) para o escalonamento de sintomas depressivos
Keywords in Portuguese
BDI
Depressao
Escalas de Borg
Escalonamento
Psicofisica
Abstract in Portuguese
Pensando nas milhoes de pessoas que sao afetadas mundialmente pelos transtornos depressivos (322 milhoes, sendo mais de 11 milhoes no Brasil e quase 450 mil na Suecia), tentamos criar um instrumento para avaliar depressao de forma mais eficaz. Em geral, os transtornos depressivos sao caracterizados por tristeza, perda de interesse/prazer, sentimentos de culpa ou baixa autoestima, disturbios no sono e apetite, sentimentos de cansaco, e baixa concentracao. Alem dos criterios diagnosticos, diversos instrumentos avaliam quadros depressivos. Utilizamos o Inventario de Depressao de Beck para validar a Escala CR100 de BorgR para o escalonamento de sintomas depressivos. As Escalas de Borg comecaram a ser desenvolvidas na decada de 60 para avaliacao do esforco percebido. A CR100 e uma escala de 0 a 100, com categorias verbais posicionadas de acordo com uma escala numerica gerando dados de razao. Esse tipo de escala tem diversas vantagens, como permitir a comparacao entre e dentre sujeitos e grupos, criacao de perfis de sintomas, analise de sintomas individualmente e a razao de intensidade entre eles. Essa tese consta de tres artigos usando a CR100. O Estudo I investigou as propriedades da CR100 comparada ao BDI. Cinquenta estudantes de Psicologia suecos responderam a um questionario online e os resultados mostraram uma alta correlacao entre as duas escalas (r = 0.754, p < 0.001), demonstrando que a Escala de BorgR avalia depressao tao bem quanto o BDI, entretanto fornece mais resultados. O perfil de sintomas gerado e muito mais detalhado do que o BDI, alem dos dados serem mais precisos e nao serem tao sensiveis as transformacoes matematicas. O Estudo II trata-se da validacao da CR100 para o portugues brasileiro e tal qual o Estudo I, da aplicacao em 50 estudantes brasileiros. Os resultados tambem apontam a alta correlacao entre as escalas (r = 0.824, p<0,001) com todas as caracteristicas se mantendo em ambas as nacionalidades A primeira analise de confiabilidade revelou um alto valor de alfa (entre 0.952 e 0.947) e R2 (entre 0.778 e 0.976), maiores que o BDI. O Estudo III teve como principal objetivo investigar propriedades psicometricas da CR100 em participantes depressivos (N=25) e - 10 - saudaveis (N=25), e encontrar pontos de corte para depressao leve, media e severa. A analise de confiabilidade da Escala revelou um indice alpha de 0.954 e por meio de uma reducao fatorial, os 32 itens foram agrupados em sete componentes. Tambem foi possivel construir um perfil de sintomas entre as duas populacoes corroborando a sensibilidade da CR100 em diferenciar populacao saudavel e com depressao em um intervalo de confianca de 95%. Um indice da razao entre pacientes e sujeitos saudaveis pode ser criado, gerando uma mini escala com oito itens, com um valor alpha de 0.80, e correlacao com a escala completa de r = 0.915 (p <0.001) e com o BDI de r = 0.820 (p<0,001). Os tres estudos revelaram resultados satisfatorios que vao ao encontro do que ja foi corroborado pelas pesquisas com as Escalas de BorgR. Demonstrou-se tambem ser possivel fazer o uso da CR100 para avaliar sintomas depressivos com mais informacoes e cujos dados sao mais precisos do que os instrumentos analisados
Title in English
Three studies using The Borg centiMax Scale® (Borg CR Scale®, CR100, cM) for scaling depressive symptoms
Keywords in English
BDI
Borg Scales
Depression
Psychophysics
Scaling
Abstract in English
Thinking about the millions of people who are affected worldwide by depressive disorders (322 million, more than 11 million in Brazil and almost 450.000 in Sweden), we tried to create an instrument to assess depression more effectively. In general, depressive disorders are characterized by sadness, loss of interest/pleasure, feelings of guilt or low self-esteem, changes in sleep and appetite, tiredness, and low concentration. In addition to the diagnostic criteria, several instruments evaluate depressive disorders. We used the Beck Depression Inventory to validate the Borg CR100 ScaleR for scaling depressive symptoms. The Borg ScalesR were developed in the 60's for the evaluation of perceived exertion. The CR100 is a scale from 0 to 100, with verbal categories placed in agreement with the numerical scale so as to obtain ratio data. This type of scale has several advantages, such as allowing comparison between and within subjects and groups, creating symptoms profile, analyzing individual symptoms and the intensity ratio between them. This thesis consists of three papers using the CR100. Study #1 investigated the properties of CR100 compared to BDI. Fifty Swedish students of Psychology answered an online questionnaire and the results pointed a high correlation between the two scales (r = 0.754, p <0.001), demonstrating that the Borg Scale evaluates depression as well as the BDI, providing more results though. The symptom profile generated was much more detailed than the BDI, in addition, the data was more accurate and not that sensitive to mathematical transformations. Study #2 looked after the validation of CR100 for Brazilian Portuguese and, like #1, the application in 50 Brazilian students. The results also pointed to the high correlation between the scales (r = 0.824, p <0.001) with all characteristics preserved in both nationalities. The first reliability analysis revealed a high alpha value (between 0.952 and 0.947) and R2 (between 0.778 and 0.976), higher than the BDI. The aim of Study #3 was to investigate the psychometric properties of CR100 in depressive (N = 25) and healthy participants (N = 25), and to find cutoff points for light, medium and severe depression. The reliability analysis of the Scale revealed an alpha of 0.954 and by running a factorial reduction, - 12 - the 32 items were grouped into seven components. It was also possible to construct a profile of symptoms between the two populations verifying the sensitivity of CR100 to differentiate healthy from depressive population, in a 95% confidence interval. An index of the ratio between patients and healthy subjects could be created, generating a mini scale with eight items with an alpha value of 0.80 and correlation with the full scale of r = 0.915 (p <0.001) and with the BDI of r = 0.820 (p <0.001). The three studies have shown satisfactory results that match with what has already been demonstrated by researches with the Borg ScalesR. It has also been presented the possibility of using the CR100 to assess depressive symptoms with more information and which data are more accurate than the instruments analyzed
 
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Publishing Date
2017-12-15
 
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