Alunos com perturbação de hiperatividade e défice de atenção : intervenção educativa

A PHDA Perturbação de Hiperatividade e Défice de Atenção é uma problemática cada vez mais comum na infância e afeta 3 a 7,5% das crianças em idade escolar. Existem três subtipos de PHDA, dependendo da combinação de sintomas que a criança apresenta. Algumas crianças são predominantemente hiperativas ou impulsivas, enquanto outras apresentam significativas dificuldades de atenção ou ainda outras que tem ambas as combinações. Esta problemática pode manifesta-se de maneiras distintas, mas com mais incidência em dificuldades de aprendizagens e em perturbações do comportamento. Ao longo dos primeiros capítulos é apresentada uma revisão da literatura científica sobre a Perturbação de Hiperatividade e Défice de Atenção (PHDA), tal como aparece definida no DSM-IV-TR (2002): De seguida, aborda-se questões relacionadas com a sua etiologia, diagnóstico e avaliação. Esta revisão de literatura visa recolher informação que permita clarificar quais os instrumentos e estratégias a utilizar pelos professores e pais, para melhorar o processo de ensino aprendizagem do aluno com PHDA, e por sua vez, torná-lo mais positivo, nas vertentes, cognitiva, social e emocional. Para além da parte teórica, esta investigação integra, também, uma componente empírica, a qual visa descrever como é desenvolvida a intervenção educativa junto de uma aluna com Hiperatividade e Défice de Atenção. Com este trabalho espera-se contribuir para um melhor conhecimento da realidade da problemática, bem como, as estratégias e metodologias a utilizar em contexto da sala de aula e em contexto familiar.

O impacto das Tecnologias de Informação e Comunicação em crianças com perturbação de hiperatividade e défice de atenção

A Perturbação de Hiperatividade e Défice de Atenção (PHDA) é uma das perturbações mais frequentes na infância, sendo detetada com maior frequência em contexto escolar, dada as exigências impostas ao nível das regras sociais e académicas. Este estudo apresenta uma revisão da literatura sobre a PHDA, evidenciando aspetos importantes sobre a problemática, como as suas caraterísticas, os problemas associados, a etiologia, o diagnóstico, a intervenção, entre outros. São apresentadas estratégias de intervenção a nível pedagógico, de forma a auxiliar os agentes educativos a lidar eficazmente com a PHDA. É descrito o impacto das Tecnologias de Informação e Comunicação (TIC) em contexto educativo, evidenciando a influência que as mesmas podem ter em crianças com PHDA especificamente na sua capacidade de atenção, no seu desempenho escolar e na sua inclusão. O objetivo deste trabalho é reunir informações úteis sobre a PHDA e as TIC, de forma a apresentar estratégias diversificadas que possam auxiliar os agentes educativos a intervir de forma responsável e eficaz com alunos com PHDA. Ambiciona-se que este estudo, leve os docentes a compreender que as TIC podem funcionar como uma excelente ferramenta de trabalho a explorar com alunos com PHDA.

Estratégias de Intervenção devem ter os docentes para a Inclusão de Alunos com Perturbação Hiperactividade e Défice de Atenção

Este estudo centra-se em aprofundar o conhecimento sobre a Perturbação de hiperactividade com défice de atenção na infância, os problemas associados e a pertinência da intervenção em contexto de sala de aula. Sabe-se que a PHDA afecta um elevado número de crianças e jovens condicionando o seu rendimento escolar e colocando as instituições escolares, os professores e os pais em constante desafio. Problemática qualificada por impulsividade, hiperactividade, e falta de atenção. Neste contexto, é expectável que a escola dinamize acções que permitam uma igualdade de oportunidades, um ensino de qualidade, de transmissão de saberes e desenvolvimento de competências individualizadas, implementando estratégias educativas e pedagógicas centradas na diversidade dos alunos a fim de impulsionar o sucesso escolar. Assim, este trabalho pretende averiguar qual o conhecimento dos professores, do 1º e 2º. Ciclo sobre a PHDA e que práticas educativas empregam. A metodologia utilizada á recolha de dados através de inquérito por questionário. Os resultados demonstram que grande parte dos professores têm conhecimento sobre PHDA, alguns dos quais já tiveram alunos com esta problemática e consideram importante ter formação especializada, dado ser difícil de gerir. Em geral os professores julgam que a PHDA não desaparece e as escolas ainda têm falta de recursos no acompanhamento. No entanto, de uma forma geral os professores consideram importante ter estratégias para aperfeiçoar o desempenho escolar.

Memorias en movimiento: testimonios corporales sobre marcas inscritas por el diagnóstico del “trastorno bipolar”

Los diagnósticos clínicos de “trastornos mentales” son categorías que aparecen dentro de un contexto particular, por lo que están cargados de significados y atravesado por una economía política del deseo. De tal manera, el diagnóstico puede marcar a las personas que los portan. Con esta premisa y desde un enfoque de los Estudios de la Cultura, esta investigación busca analizar las formas en que los sujetos diagnosticados con trastorno mental experimentan dicha marca y las narrativas que emergen de tal experiencia. En este estudio se presentan tres narraciones de personas diagnosticadas con trastorno bipolar, considerando que esta última es una categoría problemática, conectada con el ámbito social, médico, familiar, farmacológico y demás. Más que un trastorno, el estado bipolar expresa la complejidad humana, que ha sido marcada psiquiátricamente como una falencia. De ahí la importancia de registrar la manera en que estas experiencias se inscriben en la memoria de las participantes, a partir de su bitácora testimonial oral y corporal/ visual/emocional, que incorpora movimientos dancísticos para el registro visual.

A double-Gerdien instrument for simultaneous bipolar air conductivity measurements on balloon platforms

A bipolar air conductivity instrument is described for use with a standard disposable meteorological radiosonde package. It is intended to provide electrical measurements at cloud boundaries, where the ratio of the bipolar air conductivities is affected by the presence of charged particles. The sensors are two identical Gerdien-type electrodes, which, through a voltage decay method, measure positive and negative air conductivities simultaneously. Voltage decay provides a thermally stable approach and a novel low current leakage electrometer switch is described which initiates the decay sequence. The radiosonde supplies power and telemetry, as well as measuring simultaneous meteorological data. A test flight using a tethered balloon determined positive (σ+) and negative (σ−) conductivities of σ+ = 2.77±0.2 fS m−1 and σ− = 2.82±0.2 fS m−1, respectively, at 400 m aloft, with σ+/σ− = 0.98±0.04.

Neural response to emotional prosody in schizophrenia and in bipolar affective disorder

Background Evidence suggests a reversal of the normal left-lateralised response to speech in schizophrenia. Aims To test the brain's response to emotional prosody in schizophrenia and bipolar disorder. Method BOLD contrast functional magnetic resonance imaging of subjects while they passively listened or attended to sentences that differed in emotional prosody Results Patients with schizophrenia exhibited normal right-lateralisation of the passive response to 'pure' emotional prosody and relative left-lateralisation of the response to unfiltered emotional prosody When attending to emotional prosody, patients with schizophrenia activated the left insula more than healthy controls. When listening passively, patients with bipolar disorder demonstrated less activation of the bilateral superior temporal gyri in response to pure emotional prosody, and greater activation of the left superior temporal gyrus in response to unfiltered emotional prosody In both passive experiments, the patient groups activated different lateral temporal lobe regions. Conclusions Patients with schizophrenia and bipolar disorder may display some left-lateralisation of the normal right-lateralised temporal lobe response to emotional prosody. Declaration of interest R.M. received a studentship from Neuraxis,, and funding from the Neuroscience and Psychiatry Unit, University of Manchester.

Expression of the Rap1 guanine nucleotide exchange factor, MR-GEF, is altered in individuals with bipolar disorder

In the rodent forebrain GABAergic neurons are generated from progenitor cells that express the transcription factors Dlx1 and Dlx2. The Rap-1 guanine nucleotide exchange factor, MR-GEF, is turned on by many of these developing GABAergic neurons. Expression of both Dlx1/2 and MR-GEF is retained in both adult mouse and human forebrain where, in human, decreased Dlx1 expression has been associated with psychosis. Using in situ hybridization studies we show that MR-GEF expression is significantly down-regulated in the forebrain of Dlx1/2 double mutant mice suggesting that MR-GEF and Dlx1/2 form part of a common signalling pathway during GABAergic neuronal development. We therefore compared MR-GEF expression by in situ hybridization in individuals with major psychiatric disorders (schizophrenia, bipolar disorder, major depression) and control individuals. We observed a significant positive correlation between layers II and IV of the dorso-lateral prefrontal cortex (DLPFC) in the percentage of MR-GEF expressing neurons in individuals with bipolar disorder, but not in individuals with schizophrenia, major depressive disorder or in controls. Since MR-GEF encodes a Rap1 GEF able to activate G-protein signalling, we suggest that changes in MR-GEF expression could potentially influence neurotransmission.

Rod bipolar cells in the retina of the capuchin monkey (Cebus apella): Characterization and distribution

Rod bipolar cells in Cebus apella monkey retina were identified by an antibody against the alpha isoform of protein kinase C (PKC alpha). which has been shown to selectively identify rod bipolars in two other primates and various mammals. Vertical sections were used to confirm the identity of these cells by their characteristic morphology of dendrites and axons. Their topographic distribution was assessed in horizontal sections; counts taken along the dorsal, ventral, nasal, and temporal quadrants. The density of rod bipolar cells increased from 500 to 2900 cells/mm(2) at 1 mm from the fovea to reach a peak of 10,000-12,000 cellss/mm(2) at 4 mm, approximately 5 deg of eccentricity, and then gradually decreased toward retinal periphery to values of 5000 cells/mm(2) or less. Rod to rod bipolar density ratio remained between 10 and 20 across most of the retinal extension. The number of rod bipolar cells per retina was 6,360,000 +/- 387,433 (mean +/- S.D., n = 6). The anti-PKC alpha antibody has shown to be a good marker of rod bipolar cells of Cebus, and the cell distribution is similar to that described for other primates. In spite of the difference in the central retina, the density variation of rod bipolar cells in the Cebus and Macaca as well as the convergence from rod to rod bipolar cells are Generally similar, suggesting that both retinae stabilize similar sensitivity (as measured by rod density) and convergence.

Clinical significance of lifetime panic disorder in the course of bipolar disorder type I

Objectives: The aim of the study was to analyze the impact of lifetime panic disorder (PD) diagnosis in a sample of patients with bipolar disorder type I (BPI), evaluating clinical and demographic variables. Methods: Ninety-five outpatients from the Bipolar Disorder Research Program at the Institute of Psychiatry of the University of Sao Paulo Medical School were enrolled. Twenty-seven BPI patients with PD were compared to 68 BPI patients without any anxiety disorders regarding clinical and demographic variables. Results: Compared to BPI patients without any anxiety disorders, patients with BPI + PD presented significantly higher number of mood episodes (18.9 +/- 13.8 vs 8.5 +/- 7.8; P < .001), depressive episodes (10.8 +/- 8.2 vs 4.6 +/- 4,8; P = .001), and manic episodes (7.4 +/- 7.3 vs 3.6 +/- 3.6; P = .008). Patients with BPI + PD had more frequently a depressive episode as their first one compared to BPI patients without anxiety disorders (94.1% vs 57.5%; P = .011). Patients with BPI + PD had more comorbidity with lifetime diagnosis of drug abuse or dependence (33.3% vs 8.8%; P = .010) and eating disorders (29.6% vs 6.0%; P = .004). Conclusions: The higher number of mood episodes in general presented by patients with BPI + PD when compared with BPI patients without any anxiety disorders, along with the higher frequencies of drug misuse and eating disorders, indicates that PD comorbidity is associated with a poorer Course and outcome of BPI. The higher frequency of depression as the onset mood episode and the higher number of manic episodes in the group with PD may have important treatment implications and should be further investigated. (C) 2009 Elsevier Inc. All rights reserved.

Functional and Structural Connectivity Between the Perigenual Anterior Cingulate and Amygdala in Bipolar Disorder

Objective: Abnormalities in the morphology and function of two gray matter structures central to emotional processing, the perigenual anterior cingulate cortex (pACC) and amygdala, have consistently been reported in bipolar disorder (BD). Evidence implicates abnormalities in their connectivity in BD. This study investigates the potential disruptions in pACC-amygdala functional connectivity and associated abnormalities in white matter that provides structural connections between the two brain regions in BD. Methods: Thirty-three individuals with BD and 31 healthy comparison subjects (HC) participated in a scanning session during which functional magnetic resonance imaging (fMRI) during processing of face stimuli and diffusion tensor imaging (DTI) were performed. The strength of pACC-amygdala functional connections was compared between BD and HC groups, and associations between these functional connectivity measures from the fMRI scans and regional fractional anisotropy (FA) from the DTI scans were assessed. Results: Functional connectivity was decreased between the pACC and amygdala in the BD group compared with HC group, during the processing of fearful and happy faces (p < .005). Moreover, a significant positive association between pACC-amygdala functional coupling and FA in ventrofrontal white matter, including the region of the uncinate fasciculus, was identified (p < .005). Conclusion: This study provides evidence for abnormalities in pACC-amygdala functional connectivity during emotional processing in BD. The significant association between pACC-amygdala functional connectivity and the structural integrity of white matter that contains pACC-amygdala connections suggest that disruptions in white matter connectivity may contribute to disturbances in the coordinated responses of the pACC and amygdala during emotional processing in BD.

Abnormal Corpus Callosum Integrity in Bipolar Disorder: A Diffusion Tensor Imaging Study

Objective: Abnormalities in the anterior interhemispheric connections provided by the corpus callosum (CC) have long been implicated in bipolar disorder (BID). In this study, we used complementary diffusion tensor imaging methods to study the structural integrity of the CC and localization of potential abnormalities in BD. Methods: Subjects included 33 participants with BID and 40 healthy comparison participants. Fractional anisotropy (FA) measures were compared between groups with region of interest (ROD methods to investigate the anterior, middle, and posterior CC and voxel-based methods to further localize abnormalities. Results: In ROI-based analyses, FA was significantly decreased in the anterior and middle CC in the BID group (p <.05). Voxel-based analyses similarly localized group differences to the genu, rostral body, and anterior midbody of CC (p <.05, corrected). Conclusion: The findings demonstrate abnormalities in the structural integrity of the anterior CC in BID that might contribute to altered interhemispheric connectivity in this disorder.

Abnormal anterior cingulum integrity in bipolar disorder determined through diffusion tensor imaging

Background Convergent evidence implicates white matter abnormalities in bipolar disorder. The cingulum is an important candidate structure for study in bipolar disorder as it provides substantial white matter connections within the corticolimbic neural system that subserves emotional regulation involved in the disorder. Aims To test the hypothesis that bipolar disorder is associated with abnormal white matter integrity in the cingulum. Method Fractional anisotropy in the anterior and posterior cingulum was compared between 42 participants with bipolar disorder and 42 healthy participants using diffusion tensor imaging. Results Fractional anisotropy was significantly decreased in the anterior cingulum in the bipolar disorder group compared with the healthy group (P=0.003); however, fractional anisotropy in the posterior cingulum did not differ significantly between groups. Conclusions Our findings demonstrate abnormalities in the structural integrity of the anterior cingulum in bipolar disorder. They extend evidence that supports involvement of the neural system comprising the anterior cingulate cortex and its corticolimbic gray matter connection sites in bipolar disorder to implicate abnormalities in the white matter connections within the system provided by the cingulum.