Condições Clínicas e Processos de Regulação Emocional em Doentes com Condições Neurodegenerativas: desenvolvimento de um modelo preliminar explicativo do stresse
Bibliographic record
Abstract
Introdução: As doenças com condições neurodegenerativas (DcCNs) são crónicas, progressivas e potencialmente incapacitantes, afetando milhões de pessoas no mundo. Características clínicas destas patologias e impacto a curto e/ou a longo-prazo na vida dos doentes, facilitam a coocorrência com o stresse, potenciando a progressão de DcCNs. No entanto, é escasso o conhecimento sobre o efeito conjunto de condições clínicas associadas à neurodegeneração e de processos de regulação emocional na explicação do stresse em pessoas com DcCNs. Objetivos: Este estudo visou desenvolver e testar um modelo preliminar dos sintomas de stresse em pessoas com DcCNs, considerando como variáveis explicativa dor neuropática, fadiga, incapacidade global (condições clínicas decorrentes da neurodegeneração), alexitimia, supressão do pensamento, mindfulness (processos de regulação emocional). Método: Estudo transversal com duas amostras independentes de conveniência, equiparadas em idade, escolaridade e sexo biológico. A amostra clínica com DcCNs incluiu 167 participantes diagnosticados com DcCNs e sem outras doenças neurológicas. A amostra da comunidade sem doenças neurológicas integrou 179 participantes sem doenças neurológicas, recrutados na comunidade. Utilizaram-se os seguintes instrumentos de autorresposta: Six Item Cognitive Impairment Test, um Questionário Sociodemográfico e Clínico, Escala Analógica Visual do Pain Detect Questionnaire, Subescala de Stresse da Depression, Anxiety and Stress Scales-21, Escala Analógica Visual da Fadiga, Toronto Alexithymia Scale-20, World Health Organization Disability Assessment Schedule-12 itens, Subescala de Mindfulness da Self-Compassion Scale, White Bear Suppression Inventory. Resultados: Os sintomas de stresse e potenciais variáveis explicativas diferenciaram-se estatisticamente entre ambas as amostras, exceto a alexitimia, com um valor próximo do limite de significância, bem como o mindfulness. Estas variáveis também se correlacionaram com a sintomatologia de stresse e explicaram-na em regressões lineares simples na amostra clínica com DcCNs, tendo sido selecionadas como covariáveis do modelo de regressão linear múltipla. O modelo final explicou 42.7% da variância dos sintomas de stresse nos participantes com DcCNs; dor neuropática, fadiga e alexitimia revelaram-se regressores significativos, com coeficientes de regressão estandardizados positivos (β) que indicaram uma associação entre o aumento destas variáveis e o aumento da sintomatologia de stresse. Discussão: Os resultados forneceram evidências preliminares sobre a relevância combinada de condições clínicas decorrentes da neurodegeneração e de processos de regulação emocional na explicação do stresse em pessoas com DcCNs. Dor neuropática, fadiga e alexitimia destacaram-se como variáveis relevantes, a considerar na investigação e na prática clínica (avaliação e intervenção) multidisciplinar dirigidas à referida população. | Introduction: Neurodegenerative diseases (NCDs) are chronic, progressive, and potentially disabling, affecting millions of people worldwide. The clinical characteristics of these pathologies and their short- and/or long-term impact on patients' lives facilitate their co-occurrence with stress, potentiating the progression of NCDs. However, knowledge about the combined effect of clinical conditions associated with neurodegeneration and emotion regulation processes in explaining stress in people with NCDs is scarce. Objectives: This study aimed to develop and test a preliminary model of stress symptoms in people with NCDs, considering as explanatory variables neuropathic pain, fatigue, global disability (clinical conditions resulting from neurodegeneration), alexithymia, thought suppression, and mindfulness (emotion regulation processes). Method: This was a cross-sectional study with two independent convenience samples, matched for age, education, and biological sex. The clinical sample with NCSD included 167 participants diagnosed with NCDs and without other neurological diseases. The community sample without neurological diseases included 179 participants without neurological diseases, recruited from the community. The following self-report instruments were used: Six-Item Cognitive Impairment Test, a Sociodemographic and Clinical Questionnaire, Visual Analog Scale of the Pain Detect Questionnaire, Stress Subscale of the Depression, Anxiety and Stress Scales-21, Visual Analog Scale of Fatigue, Toronto Alexithymia Scale-20, World Health Organization Disability Assessment Schedule-12 items, Mindfulness Subscale of the Self-Compassion Scale, and White Bear Suppression Inventory. Results: Stress symptoms and potential explanatory variables differed statistically between the two samples, except for difficulty identifying feelings (alexithymia), with a value close to the significance threshold, as well as mindfulness. These variables also correlated with stress symptoms and explained them in simple linear regressions in the clinical sample with NCDs, having been selected as covariates in the multiple linear regression model. The final model explained 42.7% of the variance in stress symptoms in participants with NCDs; neuropathic pain, fatigue, and alexithymia were significant regressors, with positive standardized regression coefficients (β) indicating an association between increased scores in these variables and increased stress symptoms. Discussion: The results provided preliminary evidence on the combined relevance of clinical conditions resulting from neurodegeneration and emotion regulation processes in explaining stress in people with NCDs. Neuropathic pain, fatigue, and alexithymia stood out as relevant variables to consider in multidisciplinary research and clinical practice (evaluation and intervention) aimed at this population.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.003 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.002 | 0.000 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; both teacher heads agree on what is shown here.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".