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Master's Dissertation
DOI
https://doi.org/10.11606/D.5.2022.tde-15062022-100750
Document
Author
Full name
Renan Adami Ferraz
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2022
Supervisor
Committee
Brentani, Alexandra Valeria Maria (President)
Gomes, Filumena Maria da Silva
Casella, Erasmo Barbante
Sant'Anna, Maria José Carvalho
Title in Portuguese
Controle inibitório e transtornos psiquiátricos em crianças vivendo longe do pai ou em lares com violência doméstica: estudo transversal utilizando dados de coorte
Keywords in Portuguese
Desenvolvimento infantil
Experiências adversas da infância
Função executiva
Prisões
Privação paterna
Psicopatologia
Psiquiatria infantil
Transtornos do comportamento infantil
Transtornos mentais
Violência doméstica
Abstract in Portuguese
INTRODUÇÃO: O desenvolvimento socioemocional na infância é em grande parte dependente da parentalidade positiva que, por sua vez, está atrelada à presença e estado emocional dos pais. Este estudo buscou avaliar a existência de associação entre fatores prejudiciais à parentalidade positiva, notadamente violência doméstica e ausência ou encarceramento paterno, e as chances de transtornos psiquiátricos e prejuízos ao controle inibitório na primeira infância. MÉTODOS: As crianças nascidas no Hospital Universitário da Universidade de São Paulo entre 2012 e 2014, e suas mães, residentes na região oeste da cidade de São Paulo, foram selecionadas pela Coorte de Nascimentos da Região Oeste. Os dados dessas famílias, obtidos em entrevistas aos três ou quatro anos de idade, foram analisados transversalmente neste estudo. Informações sociodemográficas, bem como de presença e encarceramento paterno, foram fornecidas pelas mães. Já o rastreio de transtornos psiquiátricos e a avaliação do controle inibitório se deram, respectivamente, por meio do Strengths and Difficulties Questionnaire e da escala de controle inibitório do Childrens Behavior Questionnaire, ambos validados e oficialmente traduzidos para o português. RESULTADOS: Duas mil e vinte díades mãe-criança foram incluídas nas análises. Contato inexistente ou pouco frequente com o pai ocorreu para 17,2% das crianças, enquanto o histórico de encarceramento paterno foi positivo para 10,4% delas. A violência doméstica estava presente em 56,8% das famílias, sendo a agressão psicológica a mais prevalente, seguida pela agressão física. Risco elevado para transtornos psiquiátricos foi observado em 17,7% da amostra, sendo mais prevalentes os problemas de conduta (27,7%) e emocionais (21,4%). Não houve associação entre ausência paterna e os desfechos avaliados. Histórico de encarceramento paterno, no entanto, associou-se a maiores chances de transtornos psiquiátricos e pior controle inibitório. A violência doméstica foi associada a problemas de conduta e de relacionamento com colegas, bem como a prejuízo no controle inibitório. Foi, no entanto, relacionada a menores chances de sintomas emocionais. CONCLUSÕES: Violência doméstica e encarceramento paterno associaram-se a maiores chances de transtornos psiquiátricos, principalmente problemas de conduta, e a prejuízo no controle inibitório na primeira infância. Os fatores analisados podem ter representado causas comuns tanto para o desenvolvimento de problemas externalizantes quanto para o déficit de controle inibitório. Estes dados, bem como a análise de causalidade por estudos posteriores, podem contribuir para a formulação de políticas preventivas e mitigadoras de transtornos psiquiátricos na primeira infância
Title in English
Inhibitory control and psychiatric disorders in children enduring father absence or intimate partner violence: cross-sectional study using cohort data
Keywords in English
Adverse childhood experiences
Child behavior disorders
Child development
Child psychiatry
Executive function
Intimate partner violence
Mental disorders
Paternal deprivation
Prisons
Psychopathology
Abstract in English
INTRODUCTION: Socioemotional development in childhood is largely dependent on positive parenting, which, in turn, is linked to the presence and emotional well-being of parents. This study aimed to assess the existence of associations between deleterious impacts in positive parenting, markedly intimate partner violence and father absence or incarceration, and the odds of psychiatric disorders and inhibitory control impairment in early childhood. METHODS: Children born at São Paulos University Hospital between 2012 and 2014 and their mothers, residents of the city of São Paulos western region, were enrolled at the São Paulo Western Region Birth Cohort. Data obtained from these families, at interviews conducted at three or four years of age, were analyzed cross-sectionally in this study. Sociodemographic information, as well as data on paternal presence and incarceration, were provided by the mothers. The screening of psychiatric disorders and assessment of inhibitory control were carried out, respectively, using the Strengths and Difficulties Questionnaire and the Children's Behavior Questionnaires inhibitory control scale, both validated and officially translated into Portuguese. RESULTS: Two thousand and twenty mother-infant dyads were included in the analyses. Absent or limited proximity with the father was found in 17.2% of the children, while history of paternal incarceration was found in 10.4% of them. Intimate partner violence was present in 56.8% of the families, with psychological aggression being the most prevalent, followed by physical aggression. Elevated risk for psychiatric disorders was observed in 17.7% of the sample, being conduct (27.7%) and emotional problems (21.4%) the most prevalent. There was no association between paternal absence and the assessed outcomes. History of paternal incarceration, however, was associated with greater chances of psychiatric disorders and poorer inhibitory control. Intimate partner violence was associated with conduct and peer relationship problems, as well as impaired inhibitory control. It was, however, related to lower odds of emotional symptoms. CONCLUSIONS: Intimate partner violence and paternal incarceration were associated with greater probability of psychiatric disorders, especially conduct problems, and lower inhibitory control in early childhood. The variables analyzed may act as mutual causes both for the development of externalizing problems and impairments in inhibitory control. These data, which might be better clarified by causality analysis in future studies, can contribute to the formulation of policies aiming the prevention or attenuation of psychiatric disorders in early childhood
 
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Publishing Date
2022-06-23
 
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