Maus-tratos na infância e sintomas de ansiedade e depressão em adolescentes escolares: efeito do treinamento cognitivo processual em grupo (TCP-G)

Abstract

INTRODUCTION: Between 10 and 20% of children and adolescents have mental disorders, resulting in impaired socio-occupational functioning and integral health. Presence of abuse increases the risks of developing symptoms of anxiety and depression. OBJECTIVE: The first objective of this thesis was to analyze the effectiveness of trial-based cognitive training in group (TBCT-G) applied universally in reducing anxiety and depression symptoms in school adolescents. The second objective was to investigate the association between abuse and the occurrence of anxious and depressive symptoms. METHODS: At a military school located in Salvador, Bahia, 684 adolescents, divided in 28 classes, were evaluated for the presence of maltreatment, anxious symptoms, depressive symptoms, quality of life and risk behaviors. These classes were then randomized to either the TBCT-G group or the control group (without intervention). The active group lasted 18 weeks, in which adolescents were trained to develop cognitive and behavioral skills to reduce psychological symptoms. Twelve months after the end of the intervention, follow-up evaluation was performed. Primary measures were the revised Anxiety and Depression Scale for Children (RCADS) and the Child Trauma Inventory (QUESI). Secondary measures were the multidimensional student life satisfaction scale (MSLSS), socio-demographic inventories and questions about the practice or suffering of bullying, use of alcohol, cannabis and other drugs, and self-harm behaviors. RESULTS: After the intervention period, there was no statistically different reduction between groups in baseline RCADS data. The results also did not indicate improvement in MSLSS scores in any of the domains. In line with previous studies, data have shown that universal interventions have limitations for reducing internalizing symptoms in school adolescents. The thesis also identified that most of the maltreatment suffered is emotional abuse, physical abuse and emotional neglect. Having suffered such maltreatment was both associated with the presence of higher levels of anxious and depressive symptoms and increased probability of these symptoms occurring. CONCLUSION: The study showed that TBCT-G training was not effective in reducing anxiety and depression symptoms, probably because of its universal application and probably because of the time limitation in the training application. Also, childhood maltreatment is frequent and produces anxious and depressive symptoms, increasing the risk of developing mental disorders.