Programa de Pós-Graduação em Psicologia
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Doctoral Thesis A influência de fatores socioculturais e clínicos sobre o perfil cognitivo de crianças e adolescentes sobreviventes de tumores de fossa posterior(Universidade Federal do Rio Grande do Norte, 2021-12-06) Aragão, Laura Carolina Lemos; Pires, Izabel Augusta Hazin; Garcia, Danielle Ferreira; 06160531425; http://lattes.cnpq.br/5496201609189471; http://lattes.cnpq.br/2483750227081155; Seabra, Alessandra Gotuzo; http://lattes.cnpq.br/7828325860191703; Gomes, Ediana Rosselly de Oliveira; http://lattes.cnpq.br/3846459015672255; Lopes, Fivia de Araújo; http://lattes.cnpq.br/2583445528542625; Maia, Rodrigo da Silva; http://lattes.cnpq.br/1734687878822841Central Nervous System tumors are the most common pediatric solid neoplasms. The posterior fossa, notably the cerebellum, is the region with the highest incidence, where medulloblastomas and pilocytic astrocytomas are more frequent. Medulloblastomas are treated with neurosurgery (NC), systemic chemotherapy (QT) and cranio-spinal radiotherapy (RTX), while most astrocytomas require NC only. The survival range is achieved through sequelae on the development of survivors, especially associated with the neurotoxicity of anti-neoplastic treatment, to which damage to the integrity of the white matter (SB) is attributed. Different factors are added to this complex mosaic, with emphasis on sociocultural aspects, which, independently or superimposed, dialectically structure the development processes. The present work aimed to investigate the influence of sociocultural and clinical aspects on the cognitive profile of children and adolescent survivors of Posterior Fossa Tumors (PFT). The research was subdivided into three studies: 1) Influence of the maternal schooling on intellectual capacity in pediatric PFT survivors; 2) Memory investigation in pediatric PFT survivors; 3) Brain lesions in childhood: a case study of a malignant posterior fossa tumor. Thirty seven subjects aged six to 16 years composed the clinical group and 25 subjects – participants in study 2 only -, the control group, paired 1:1 according to sex, age, type of school, and socioeconomic status of the participants in study 2. The Neuropsychological evaluation performed with the participants and the data analyzed used descriptive and inferential statistical tools. In study 1, we found that the type of treatment was significantly associated nonverbal cognitive functions of intellectual ability, while the maternal schooling variable was associated with impacts on verbal dimensions. In study 2, we found that the clinical group submitted only to NC showed impairments, especially in the verbal working memory, while the broader mnemic impacts were related to the group submitted to antineoplastic therapies. Lower working memory performances were identified in children whose mothers had a lower level of education. In study 3, the neuropsychological profile of the child medulloblastoma survivor revealed relatively mild impairments considering the expected cognitive deficits for subjects treated by antineoplastic therapies. The findings suggest that the sociocultural conditions that permeated the child's development acted as protective factors against the emergence of more serious cognitive sequelae. Thus, the expressive complexity underlying the manifestation of the cognitive profiles presented by this population is highlighted and the central role of the variable maternal education is revealed.Master Thesis Diagnóstico e tratamento do TDA/H: investigação dos critérios utilizados por diferentes categorias profissionais da cidade de Natal-RN(Universidade Federal do Rio Grande do Norte, 2015-06-19) Aragão, Laura Carolina Lemos; Pires, Izabel Augusta Hazin; ; http://lattes.cnpq.br/5496201609189471; ; http://lattes.cnpq.br/2483750227081155; Abreu, José Neander Silva; ; http://lattes.cnpq.br/1020328026365974; Barreto, Maria da Apresentação; ; http://lattes.cnpq.br/0256251497039883TDA/H is usually considered among the most frequent psychological malfunctions in both childhood and adolescence. It covers a complex combination of neurocognitive deficits leading to developmental troubles linked to attention failure, hyperactivity and impulsivity. On the other hand, diagnosis of TDA/H is frequently a hard task, since sociocultural aspects concerning the evaluation of symptoms lead to some etiologic vagueness. Additionally, the large extent of evaluation tools, together with the diversity of therapeutic approaches referred by specialized literature justify the interest of investigating the diverse ways of diagnosing and treating TDA/H by medical doctors, psychologists and psycho-pedagogues developing professional activities in Natal-RN (Brazil) in the assistance of children and teenagers with TDA/H diagnosis hypothesis. A sample of thirty-four professionals participated in this study in a convenience-basis, and submitted to a semi-directed interview. Information from this procedure was analyzed, categorized and submitted to a multidimensional descriptive analysis (cluster analysis procedure), allowing to verify the partition of the sample in two groups: Group 1, basically composed by medical professionals, and Group 2, composed by psychologists and psycho-pedagogues. The categorized variable “Number of sessions” – average time used for arriving to a diagnosis – was the partition-variable showing the larger amount of statistical contribution for the partition, followed by the variables “Professional formation” and “Use of diagnostic tools”. Variables such “Comorbidity”, “TDA/H Definition” and Modalities of Intervention” also showed contribution to the partition obtained, even though their lesser amount of statistical contribution. Despite some similarity between these two groups, data allowed to demonstrate specific association between academic source-formation of the professional concerned and diagnosis and intervention modalities shown by these professionals when dealing with TDA/H. These data confirm relevant heterogeneity in dealing with TDA/H due to professional formation of professionals involved in diagnosis and treatment tasks.