Clarice Gorenstein

• University of São Paulo

Purpose Suicide is a leading cause of death among 15-29-year-olds. Effective prevention strategies are urgent, particularly for university students, where knowledge gaps regarding suicide-related factors hinders preventative efforts. The present study aimed to identify subgroups within Brazilian college students to examine the relationship of ident...

The Beck Depression Inventory-II (BDI-II) is a widely used tool for rating the severity of depressive symptoms. Studies on the factor structure of the BDI-II in adolescents have yielded controversial findings. Most studies have reported an oblique two-factor model that describes the ‘cognitive’ and ‘somatic-affective’ dimensions. However, there is...

The Beck Depression Inventory-II (BDI-II) is a tool widely used to rate the severity of depressive symptoms. Regarding the factor validity of the BDI-II in adolescents, the two-factor solution describing “cognitive” and “somatic-affective” dimensions has been shown to be the most reported. Recently, bifactor model analysis has become popular to des...

Background Although observational studies have already shown promising results of flourishing, a broader concept of health based on positive psychology, there is still a gap in the literature regarding studies that combine different topics of flourishing in a single intervention. Objectives To develop a comprehensive and integrate intervention bas...

Background: Suicide is one of the leading causes of death among youth and its occurrence among college students is a matter of great concern. Challenges of transitional adulting and mental illness increase the likelihood of suicidal cognition in students. The objective of present study was to investigate the prevalence of suicide ideation and asso...

Background: Suicide is one of the leading causes of death among youth and its occurrence among college students is a matter of great concern. Challenges of transitional adulting and mental illness increase the likelihood of suicidal cognition in students. The objective of present study was to investigate the prevalence of suicide ideation and assoc...

Background: Several instruments that measure spirituality present overlaps with positive emotions, impacting the interpretation of their findings. In order to minimize these problems, we aimed to develop, assess the reliability and validate a new scale to evaluate spirituality. Methods: The instrument was designed using a theoretical framework mini...

Depression is a common psychiatric disorder and is associated with severe impairment in the patient’s lives. Even so, depressive conditions remain underdiagnosed and its assessment is made mainly by clinical judgment, which brings an unavoidable decrease in diagnostic reliability. There are several instruments widely used in research, which aim to...

The Beck depression inventory (BDI) is among the most used self-rating scales for measuring depression worldwide. Since the test construction in 1961, the BDI has been employed in more than 14,000 empirical studies. This chapter discusses the utility of the BDI based on previous studies on its psychometric properties. We only consider those studies...

The present chapter summarizes aspects of depression among college students, who experience higher rates of depression than those found in general population. Depression in students is often associated with some risk behaviors, such as suicidal thoughts and attempts, non-suicidal self-injury, and substance abuse. Although universal screening of dep...

Background: Self-reported depressive complaints among college students might indicate different degrees of severity of depressive states. Through the framework of item response theory, we aim to describe the pattern of responses to items of the Beck Depression Inventory-II (BDI-II), in terms of endorsement probability and discrimination along the c...

Background: It is unclear if individuals with Major Depressive Disorder (MDD) present different nonverbal behavior (NVB) compared with healthy individuals, and also if depression treatments affect NVB. In this study, we compared the NVB of MDD subjects and healthy controls. We also verified how MDD subjects' NVB is affected by depression severity...

Traumatic memories are particularly persistent, which probably underlies the significant rates of treatment failure observed in Posttraumatic Stress Disorder (PTSD). We explored whether interventions for PTSD that also interfere with the reconsolidation of aversive memories, namely, Prolonged Exposure (PE) and Electroconvulsive Therapy (ECT), could...

Background: This study examines the response pattern of depressive symptoms in a nationwide student sample, through item analyses of a rating scale by both classical test theory (CTT) and item response theory (IRT). Methods: The 21-item Beck Depression Inventory-II (BDI-II) was administered to 12,711 college students. First, the psychometric pro...

Introduction: Subjects with Posttraumatic Stress Disorder (PTSD) seem to have extinction deficits supposed to underlie both the physiopathology and the significant rates of treatment refractoriness observed. Interventions that block the reconsolidation of the traumatic memory could compensate for this deficit. Electroconvulsive Therapy (ECT) has sh...

Nonverbal behaviors exhibited by patients with depression in their interactions with others may reflect social maladjustment and depression maintenance. Investigations of associations between unipolar depression and both patients’ and interviewers’ behaviors have been scarce and restricted to European samples. This study examined whether nonverbal...

Background Major depressive disorder (MDD) is associated with impairments in nonverbal behaviors (NVBs) and vagal activity. The polyvagal theory proposes that vagal activity regulates heart rate and NVBs by modulating a common anatomically and neurophysiologically discrete social engagement system. However, the association between these putative e...

Objective: The aim of this study was to investigate whether cognitive variables proposed by the protection motivation theory (PMT) were predictive of occasional and frequent intention to drive after drinking in medical students. Methods: One hundred fifty-five students attending preclinical years at a Medical School in São Paulo, Brazil, partici...

Presents the preliminary results of a study that accessed the effects of applying two sessions of standard prolonged exposure therapy to patients with PTSD either after retrieving their index traumatic event or a neutral event

Background: Clinical assessment of depression is an important part of pre-surgical assessment among individuals with morbid obesity. However, there is no agreed-upon instrument to identify mood psychopathology in this population. We examined the reliability and criterion validity of the clinician-administered Montgomery-Åsberg Depression Rating Sc...

This study aimed to investigate the impact of child-focused pediatric OCD treatment on parental anxiety, family accommodation and family environment. Forty-three parents (72.1% female, mean age±SD=43.1±5.6 years) were evaluated at baseline and after their children's (n=33, 54.5% female, mean age±SD=12.9±2.7 years) randomized treatment with Group Co...

Few studies have investigated gender difference and associated disability among workers. Comprehensive investigations concerning the occurrence and consequences of depression in workplace are scarce. The study aims to evaluate how workers perceive depression in workplace, as well as to examine depression-related disabilities by gender. This is a cr...

The aim of this study was to investigate the influence of demethylation rate on the outcome of obsessive-compulsive disorder patients treated with clomipramine. Eighteen patients meeting the DSM-IV criteria for obsessive-compulsive disorder received 150-300 mg of clomipramine daily in a single-blind design for 12 weeks. The patients were evaluated...

Various functional magnetic resonance imaging studies addressed the effects of antidepressant drugs on brain functioning in healthy subjects; however, none specifically investigated positive mood changes to antidepressant drug. Sixteen subjects with no personal or family history of psychiatric disorders were selected from an ongoing 4-week open tri...

The relationship between psychopathy and traits of temperament and character in a specific population of criminals, such as murderers, has not been sufficiently investigated. This study assesses the relationship between psychopathy and temperament and character traits in murderers. The sample consisted of 118 men divided into three groups: psychopa...

Information concerning the occurrence and consequences of depression in the workplace is scarce. This study estimates how workers perceive depression, to investigate depression-related disabilities, and management of depression in the workplace. This investigation is based on a cross-sectional web-based survey of 1,000 workers recruited from online...

Background : In medial temporal lobe epilepsy (MTLE), previous studies addressing the hemispheric laterality of epileptogenic focus and its relationship with learning and memory processes have reported controversial findings. Objective : To compare the performance of MTLE patients according to the location of the epileptogenic focus on the left (M...

Objective: To review the psychometric properties of the Beck Depression Inventory-II (BDI-II) as a self-report measure of depression in a variety of settings and populations. Methods: Relevant studies of the BDI-II were retrieved through a search of electronic databases, a hand search, and contact with authors. Retained studies (k = 118) were al...

To perform a systematic review of the utility of the Beck Depression Inventory for detecting depression in medical settings, this article focuses on the revised version of the scale (Beck Depression Inventory-II), which was reformulated according to the DSM-IV criteria for major depression. We examined relevant investigations with the Beck Depressi...

Background: The purpose of this study was to investigate demographic and clinical factors associated with the long-term outcome of obsessive-compulsive disorder (OCD). Methods: A hundred ninety-six previously untreated patients with DSM-IV criteria OCD completed a 12-week randomized open trial of group cognitive-behavioral therapy (GCBT) or fluo...

The aim of this study was to compare impulsivity among patients with bipolar disorder, their siblings, and healthy controls in order to examine whether impulsivity in bipolar disorder is related to genetic liability for the illness. Using the Barratt Impulsiveness Scale, we assessed 204 subjects: 67 euthymic outpatients with bipolar disorder type I...

BACKGROUND: Evaluations of clinical depression are traditionally based on verbal information. Nonverbal expressive behavior, however, being associated with a person's reflexive responses, may reveal negative emotional or social processes that are not under complete control of the patients. However, investigations of nonverbal behavior in the evalua...

The Beck Depression Inventory (BDI) is used worldwide for detecting depressive symptoms. This questionnaire has been revised (1996) to match the DSM-IV criteria for a major depressive episode. We assessed the reliability and the validity of the Brazilian Portuguese version of the BDI-II for non-clinical adults. The questionnaire was applied to 60 c...

The efficacy of estrogen replacement therapy (ERT) for mood disturbances associated with menopause has yet to be firmly established. The objective of this study was to investigate the efficacy of ERT for improving mood and anxiety of non-depressive postmenopausal women. This double-blind, randomized, placebo-controlled study involved two treatment...

The aim of this study was to compare temperament and character traits among patients with bipolar disorder (BD), their siblings, and healthy controls (HCs) in order to examine whether personality traits are related to the genetic vulnerability to develop BD. Using the Temperament and Character Inventory, we assessed 204 subjects: 67 euthymic outpat...

This study aimed to evaluate the effect of estrogen replacement therapy on verbal cognitive performance of middle-aged postmenopausal women. Middle-aged (40 to 59 years) hysterectomized, oligosymptomatic women receiving 0.625 mg/day of conjugated equine estrogens (N = 27) or placebo (N = 32) in a double-blind parallel group design were compared acc...

The aim of this study was to translate the Structured Clinical Interview for Mood Spectrum into Brazilian Portuguese, measuring its reliability, validity, and defining scores for bipolar disorders. Questionnaire was translated (into Brazilian Portuguese) and back-translated into English. Sample consisted of 47 subjects with bipolar disorder, 47 wit...

BACKGROUND: Several methodologies were developed to validate psychometric instruments. However, there are, in the scientific literature, a lack of instruments to evaluate romantic relationship. OBJECTIVE: The present work aims at validating into Portuguese the content of the self-report Love Attitudes Scale (Escala de Atitudes do Amor – Hendrick et...

Despite the relevance of irritability emotions to the treatment, prognosis and classification of psychiatric disorders, the neurobiological basis of this emotional state has been rarely investigated to date. We assessed the brain circuitry underlying personal script-driven irritability in healthy subjects (n = 11) using functional magnetic resonanc...

The Prospective and Retrospective Memory Questionnaire (PRMQ) has been shown to have acceptable reliability and factorial, predictive, and concurrent validity. However, the PRMQ has never been administered to a probability sample survey representative of all ages in adulthood, nor have previous studies controlled for factors that are known to influ...

Academic examinations are an important source of stress for students. This study is intended to assess senior high school students' mood changes during the preparation for a very important academic examination, the Brazilian university admission examination. Positive and Negative Affect Schedule - Expanded Form was used to assess the students three...

In recent years, there has been increasing evidence that antidepressants are effective even in doses that are lower than those suggested for their chief indications (depressive and anxiety disorders). Besides being effective, low doses are associated with lesser side effects than standard dosage. In addition, low doses of antidepressants may produc...

Objective: Wives of pathological gamblers tend to endure long marriages despite financial and emotional burden. Difficulties in social adjustment, personality disorders, and comorbidity with psychiatric disorders are pointed as reasons for remaining on such overwhelming relationships. The goal was to examine the social adjustment, personality and n...

Wives of pathological gamblers tend to endure long marriages despite financial and emotional burden. Difficulties in social adjustment, personality psychopathology, and comorbidity with psychiatric disorders are pointed as reasons for remaining on such overwhelming relationships. The goal was to examine the social adjustment, personality and negati...

To compare the emotional response and level of anxiety of psychopathic murderers, non-psychopathic murderers, and nonpsychopathic non-criminals. 110 male individuals aged over 18 years were divided into three groups: psychopathic murderers (n = 38); non-psychopathic murderers (n = 37) serving sentences for murder convictions in Maximum Security Pri...

Objective: To compare the emotional response and level of anxiety of psychopathic murderers, non-psychopathic murderers, and non-psychopathic non-criminals. Method: 110 male individuals aged over 18 years were divided into three groups: psychopathic murderers (n = 38); non-psychopathic murderers (n = 37) serving sentences for murder convictions in...

Pathological love (PL)--behavior characterized by providing repetitive and uncontrolled care and attention to the partner in a romantic relationship--is a rarely studied condition, despite not being rare and causing suffering. This study aims at investigating impulsivity, personality, and characteristics related to the romantic relationship in this...

Previous functional magnetic resonance imaging (fMRI) studies examined neural activity responses to emotive stimuli in healthy individuals after acute/subacute administration of antidepressants. We now report the effects of repeated use of the antidepressant clomipramine on fMRI data acquired during presentation of emotion-provoking and neutral sti...

Nocturnal melatonin pineal output is triggered by sympathetic outflow. Antidepressants that block norepinephrine neuronal uptake should increase pineal function. This can be monitored by measuring 6-sulfatoximelatonin (aMT6s), the main melatonin metabolite, in the urine. In this study, we compared the excretion of aMT6s before (baseline), one, and...

Anxiety related to dental treatment is a fairly common phenomenon. Some studies have shown that there is an association between dental anxiety and general fears and anxiety, neuroticism and general psychological distress. This study was designed to examine the relationship between dental anxiety and trait anxiety. The sample consisted of 1,030 indi...

Happy emotional states have not been extensively explored in functional magnetic resonance imaging studies using autobiographic recall paradigms. We investigated the brain circuitry engaged during induction of happiness by standardized script-driven autobiographical recall in 11 healthy subjects (6 males), aged 32.4 +/- 7.2 years, without physical...

Fear of heights, or acrophobia, is one of the most frequent subtypes of specific phobia frequently associated to depression and other anxiety disorders. Previous evidence suggests a correlation between acrophobia and abnormalities in balance control, particularly involving the use of visual information to keep postural stability. This study investi...

Depression symptomatology was assessed with the Beck Depression Inventory (BDI) in a sample of Jewish adolescents, in order to compare the frequency and severity of depression with non-Jewish adolescents as well as examine gender difference of the expression of depressive symptomatology. Subjects comprised 475 students from Jewish private schools,...

The purpose of the present study was to assess the social skills of euthymic patients with bipolar disorder. A group of 25 outpatients with bipolar disorder type I were evaluated in comparison with a group of 31 healthy volunteers who were matched in terms of level of education, age, sex and intelligence. Both groups were assessed using a self-repo...

Antidepressants increase melatonin levels, but it is still unclear whether this effect is related to the improvement of depressive symptoms or to unrelated pharmacological action of antidepressants. To answer this question, the effect of antidepressants on 6-sulphatoxymelatonin (aMT6s), the main melatonin urinary metabolite, was examined in drug-fr...

To study the executive functioning in euthymic bipolar patients in comparison to healthy controls and to examine the relationship between neuropsychological deficits and clinical variables. Twenty-five euthymic bipolar patients and 31 controls underwent a battery of executive tasks including mental flexibility, inhibitory control and verbal fluency...

To test a reliable and easily administered frustration-induction procedure for experimental research. One hundred volunteers (81 women, mean age +/- SD 34.2 +/- 8 years) physically and psychiatrically healthy submitted to the frustration induction procedure were prevented from reaching reward level scores. Subjective aggressiveness feelings related...

The present study evaluated, through self-reports of positive affects, of negative affects and of life satisfaction, the therapeutic effects of anodal Transcranial Direct Current Stimulation (TDCS) on depressed patients. Thirty one patients with major depression participated on this study. They were distributed in two groups: Active Group (n=21) tr...

Long-term treatment with clomipramine (CMI), a tricyclic antidepressant, induces food craving and body weight gain in patients. The present study investigated the effects of chronic treatment with CMI on total food intake, macronutrient selection, and body weight gain in rats. Male Wistar rats were maintained on a dietary self-selection regime with...

Premenstrual syndrome and premenstrual dysphoric disorder (PMDD) seem to form a severity continuum with no clear-cut boundary. However, since the American Psychiatric Association proposed the research criteria for PMDD in 1994, there has been no agreement about the symptomatic constellation that constitutes this syndrome. The objective of the prese...

The present study evaluated, through self-reports of positive affects, of negative affects and of life satisfaction, the therapeutic effects of anodal Transcranial Direct Current Stimulation

This study explores the psychometric properties of the Portuguese version of Corah's Dental Anxiety Scale (DAS), an instrument designed to assess the manifestations of dental anxiety. The DAS has been translated into several languages, but no adaptation and reliability analysis of the Portuguese version of the scale has yet been carried out. A tota...

Nos dias de hoje, o uso de técnicas de neuroimagem funcional permite investigações detalhadas dos circuitos cerebrais engajados durante o desempenho de paradigmas de estimulação que envolvem diferentes aspectos do processamento emocional em seres humanos saudáveis. Este artigo discute os princípios básicos dos métodos mais comumente usados em estud...

Pathological Gambling is an impulse control disorder. Impulsivity has been investigated separately by neuropsychological tests and self-report scales. Although some studies have tried to correlate these approaches, their interaction has not been sufficiently explored among pathological gamblers (PG). In this study, we have compared 214 PG (162 with...

The secretion of melatonin has been shown as abnormal in some depressed patients, but most such studies were conducted in the northern hemisphere and with severely depressed inpatients. The aim of this study was to evaluate melatonin excretion profiles in major depressive outpatients from São Paulo, Brazil, individually matched to well-screened hea...

Depressive disorders are conditions that often require continuous treatment, and it is therefore important to evaluate the consequences of prolonged administration. There are few studies assessing cognitive functions of depressed patients after long-term use of antidepressants. This study evaluated the cognitive performance of depressed patients tr...

Nowadays, the use of functional imaging techniques allows detailed investigations of the brain circuits engaged during the performance of stimulation paradigms that involve different aspects of emotional processing in the healthy human brain. This article discusses the basic principles of the methods most often employed in functional neuroimaging s...

The objective of the present study was to investigate the psychometric properties and cross-cultural validity of the Beck Depression Inventory (BDI) among ethnic Chinese living in the city of São Paulo, Brazil. The study was conducted on 208 community individuals. Reliability and discriminant analysis were used to test the psychometric properties a...

This study aimed to detect the prevalence of depressive symptomatology and its expression in a nonclinical Brazilian adolescent student sample. A sample of students from private and public schools (n = 1555, aged 13 to 17 years) answered the Beck Depression Inventory (BDI). We performed factor analysis of the BDI as an indicator of the expression o...

The present study aims to assess the factor structure of the DSM-IV Premenstrual Dysphoric Disorder (PMDD) symptoms and its relationship with depressive symptoms. We evaluated retrospectively PMDD symptoms in 513 female college students, through a self-reporting questionnaire based on DSM-IV criteria, in addition to the Beck Depression Inventory (B...

Common mental disorders (CMD) are critical issues in community studies. The 12-item version Chinese Health Questionnaire (CHQ-12) has not been sufficiently explored for use in Chinese communities around the world. This paper evaluates CMD among ethnic Chinese living in Brazil, by examining its psychometric properties and factorial structure of CHQ-...

This article describes the most useful instruments and methods that measure general and specific psychopathological features of the eating disorders. Thirteen self-report measures and two interviewer-based instruments are reviewed. The authors present, for each instrument, a brief description of its structure, their preferential utilization and the...

Este artigo descreve os principais instrumentos e métodos utilizados para mensurar os aspectos psicopatológicos gerais e específicos dos transtornos alimentares. São revistos treze instrumentos auto-aplicáveis e duas entrevistas clínicas semi-estruturadas. Os autores apresentam para cada instrumento de avaliação uma breve descrição de sua estrutura...

This study investigated the chronic use (6.3 +/- 0.5 years; mean +/- SEM) of therapeutic doses of clomipramine (57.0 +/- 8.0 mg/day) by outpatients with panic disorder/agoraphobia who were currently in remission to assess impairment of memory and psychomotor functions. In addition, the association between test performance and serum levels of clomip...

Social dysfunction is often associated with depressive disorders and its evaluation is an important measure of treatment outcome. The aim of this study was to assess the effect of two treatments, venlafaxine and amitriptyline, on the social functioning of depressed patients. Twenty-eight outpatients, meeting criteria for recurrent or single major d...

Social dysfunction is reported in several psychiatric diseases and its evaluation is becoming an important measure of treatment outcome. The aim of this study was to obtain normative data, to test the validity and the ability of the Portuguese version of the Self-Report Social Adjustment Scale (SAS-SR) to detect different clinical conditions. The P...

Little is known about the intracellular mechanisms involved in the pathophysiology of panic disorder (PD). Abnormalities in the cyclic AMP system have been described in several psychiatric disorders but there are no studies in panic patients. We evaluated not only the levels of platelet cyclic AMP, but also cyclic GMP and nitric oxide synthase (NOS...

Eighty-one panic disorder patients with or without agoraphobia were treated with flexible doses of clomipramine under single-blind conditions. Fifty-seven (70.3%) reached operational criteria for full remission in 16.2 +/- 6.5 weeks, with a mean dose of 89.1 +/- 8.2 mg/day. Fifty-four (81%) of them received a continuous post-remission maintenance t...

The psychometric properties of the Portuguese version of the trait form of the State-Trait Anxiety Inventory (STAI-T) and its relation to the Beck Depression Inventory (BDI) were evaluated in a large Brazilian college student sample containing 845 women and 235 men. STAI-T scores tended to be higher for women, singles, those who work, and subjects...

In order to study the effect of estrogen replacement therapy on mood test scale (Beck Depression Inventory) in postmenopausal women, we developed a double-blind, randomized, placebo-controlled study, by replacing the hormone with conjugated estrogen 0.625mg per day or placebo, during six months, in 66 hysterectomized, healthy, and assymptomatic wom...

Nos últimos anos muitos esforços têm sido empregados para elucidar os mecanismos envolvidos na regulação da transcrição gênica. Moléculas que participam desses processos regulatórios, como os fatores de transcrição, têm recebido atenção especial. A participação desses fatores em diversas funções neurais enfatiza sua importância para a compreensão d...

The psychometric properties of the Portuguese version of the Beck Depression Inventory were studied on a large Brazilian college student sample (N= 1,080; 845 women, 235 men). The BDI scores according to sociodemographic characteristics and mean individual item scores for total sample and by gender were compared. BDI scores tend to be higher for wo...

Since the beginning of the history of modern psychopharmacology on the 40's, many advances were obtained on the understanding of the mechanism of action of psychotropic drugs. This article gives an overview of such advances, since the introduction of the early techniques, such as the measurement of amines by fluorescence and the receptor-binding st...

Desde o início da história da psicofarmacologia moderna, na década de 40, vários avanços foram obtidos na elucidação do mecanismo de ação dos compostos psicoativos. O artigo aborda tais avanços enfocando as principais técnicas utilizadas, desde o desenvolvimento das técnicas de mensuração de aminas por emissão de fluorescência e da técnica de ligaç...

Several placebo-controlled trials have shown the efficacy of clomipramine (CMI) in panic disorder. However, none has investigated the relationship between CMI, and desmethylclomipramine (DCMI) plasma levels, and outcome. In this trial, 41 patients meeting the DSM-III-R criteria for panic disorder with/without agoraphobia received 50-200 mg of CMI d...