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Doctoral Thesis
DOI
https://doi.org/10.11606/T.47.2022.tde-06092022-080115
Document
Author
Full name
Andreza Carla de Souza Lopes
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2022
Supervisor
Committee
Cordas, Taki Athanassios (President)
Costa, Marcelo Fernandes da
Dunker, Karin Louise Lenz
Kachani, Adriana Trejger
Luz, Felipe Quinto da
Title in Portuguese
Prejuízos de funções executivas e coerência central na anorexia: meta-análise e protocolos de avaliação e remediação cognitiva
Keywords in Portuguese
Anorexia Nervosa
Coerência Central
Funções Executivas
Neuropsicologia
Terapia de Remediação Cognitiva
Abstract in Portuguese
Apesar do entendimento sobre a neuropsicologia dos transtornos alimentares ter aumentado consideravelmente nas últimas décadas, ainda existem algumas lacunas de conhecimento importantes relacionadas a avaliação e reabilitação neuropsicológica de pessoas com anorexia nervosa, bem como sua implementação de forma adequada à população brasileira. O objetivo desta tese foi investigar dados atuais das principais alterações cognitivas de pessoas com AN Anorexia Nervosa, através do uso de instrumentos adequados para a avaliação neuropsicológica, bem como subsidiar o uso de técnicas adaptadas para a população brasileira para a intervenção cognitiva. Foram realizados três estudos para atender esse objetivo, investigando (1) diretrizes, baseadas em evidências científicas, de instrumentos que permitissem a construção de protocolos e procedimentos baseados na prática clínica, para a avaliação neuropsicológica de pessoas com anorexia nervosa; (2) uma revisão sistemática com metanálise sobre o funcionamento executivo e coerência central em pacientes diagnosticados com AN, para identificar a existência de comprometimentos da FE Funções Executivas, em pacientes com AN, comparados com controles saudáveis, a partir de testes padronizados que avaliam flexibilidade cognitiva (Teste de Trilhas, Parte B TMT-B e Wisconsin Card Sorting Test - WCST), tomada de decisão (Iowa Gambling Task -IGT), planejamento visuoespacial e coerência central (Teste de Figuras Complexas de Rey). O último estudo desta tese foi (3) a tradução e adaptação cultural, para o contexto brasileiro, do manual da Terapia de Remediação Cognitiva (TRC). As bases para a condução destes estudos e os seus principais achados foram discutidos ao longo desta tese
Title in English
Impairments of executive functions and central coherence in anorexia: meta-analysis and cognitive assessment and remediation protocols
Keywords in English
Anorexia Nervosa
Central Coherence
Cognitive Remediation Therapy
Executive Functions
Neuropsychology
Abstract in English
Although our understanding of the neuropsychology of eating disorders has increased considerably in recent decades, there are still some critical knowledge gaps related to the assessment and rehabilitation of people with anorexia nervosa and its implementation in an acceptable way for the Brazilian population. The objective of this thesis was to investigate current data on the main cognitive alterations of people with Anorexia Nervosa - AN through the use of adequate instruments for neuropsychological assessment and to subsidize the use of techniques adapted for the Brazilian population for cognitive intervention. We carried out three studies to meet this objective, investigating (1) guidelines based on scientific evidence of instruments that allow the construction of protocols and procedures based on clinical practice for the assessment of people with anorexia nervosa; (2) a systematic review with meta-analysis on executive functioning and central coherence in patients diagnosed with AN, to identify the existence of Executive Functions - EF impairments in patients with AN, compared with healthy controls, from standardized tests that assess cognitive flexibility (Test of Trails, Part B - TMT-B and Wisconsin Card Sorting Test - WCST), decision making (Iowa Gambling Task -IGT), visuospatial ability and central coherence (Rey's Complex Figures Test). The last study of this thesis was (3) the translation and cultural adaptation, for the Brazilian context, of the Cognitive Remediation Therapy (CRT) manual. The bases for conducting these studies and their main findings have been discussed throughout this thesis
 
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lopes_corrigida.pdf (5.16 Mbytes)
Publishing Date
2022-09-09
 
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