Estudo psicológico longitudinal na distrofia miotônica

Wigg, Cristina Maria Duarte; Duro, Luiz Antonio Alves

doi:10.1590/s0004-282x1995000500006

Cited by 2 publications

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“…In our initial psychological studies, we disclosed intellectual capacity alterations and severe visuo-spatial deficiencies in patients with MyD [15][16][17] , since the results were unsatisfactory in the majority of the cases. For this reason, we decided to magnify the sample of cases and detail the patients' performance on Kohs' blocks test 18 , not only through quantitative but also qualitative studies.…”

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The Kohs' blocks test as an important instrument to investigate the visuo-spatial impairments in myotonic dystrophy: part I. Quantitative and qualitative analysis

Wigg

Duro²

1999

Arq. Neuro-Psiquiatr.

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-This study presents the performance of 39 cases of myotonic dystrophy on Kohs' blocks test (21 females and 18 males, age range from 9 to 70 years). On this test, the patients have to reproduce figures from models previously showed to them. Some of the patients had some kind of professional activity, while others had never exerted a professional occupation. The patients denoted considerable difficulty to perform the test. Some cases constructed entirely different figures in comparison to the presented drawings, translating visuo-spatial and constructional disabilities. The performance was insufficient in 71.4 % of the cases. These cases solved less than 50% of the test. The levels of analysis and synthesis were severely impaired. A total of 18 cases got less than 10 points, not reaching 20% of the test. The results showed the sensitivity of this test in detecting visuo-spatial impairment in myotonic dystrophy.KEY WORDS: myotonic dystrophy, psychological tests, Kohs' blocks.O teste dos cubos de Kohs como importante instrumento para investigar as alterações visuo-espaciais da distrofia miotônica: I. Análise quantitativa e qualitativa RESUMO -Foram avaliados 39 casos de distrofia miotônica a partir do desempenho no teste dos cubos de Kohs. Havia 21 casos femininos e 18 masculinos, idade variando de 9 a 70 anos e diferentes níveis educacionais (do primário ao superior). Alguns encontravam-se ativos profissionalmente, enquanto outros nunca exerceram uma ocupação profissional. Os pacientes denotaram considerável dificuldade na execução deste teste que é instrumento que se apresenta fundamentalmente por reprodução de figuras. Houve casos que construíram figuras com formas bem diferentes dos desenhos apresentados. O desempenho foi insuficiente em 71,4 % dos casos, os quais não conseguiram resolver 50% do teste. Muitas das reproduções fugiram ao padrão correto, traduzindo comprometimento visuo-espacial pela grave distorção em comparação com a figura modelo. Os níveis de análise e síntese estavam comprometidos de forma importante. Dentre os pacientes, 18 casos não alcançaram os 10 pontos, dos 133 possíveis, não realizando sequer 20% do teste. Os resultados comprovaram a sensibilidade deste teste em detectar comprometimento visuo-espacial na distrofia miotônica. PALAVRAS-CHAVES: distrofia miotônica, testes psicológicos, cubos de Kohs, alterações visuo-espaciais.

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The Kohs' blocks test as an important instrument to investigate the visuo-spatial impairments in myotonic dystrophy: part I. Quantitative and qualitative analysis

Wigg

Duro²

1999

Arq. Neuro-Psiquiatr.

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“…Assim, segundo Pichot (1965), os Cubos de Kohs servem para medir configurações tridimensionais relacionadas ao fator espacial. De forma semelhante, Vernon (1952) cita a forte correlação dos Cubos com o fator espacial, enquanto pesquisas com distrofia miotônica (Wigg e Duro, 1995a, 1995b …”

Section: Constructos Teóricos Medidos Pelos Cubos De Kohsunclassified

Parâmetros psicométricos dos cubos de Kohs na avaliação neuropsicológica das funções executivas

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Figure and the Maze WISC-III subtest. The results for the scoring system pointed out a relationship between the total score of the test and the executive functions, which was not observed in relation to the extra movements. For this reason, was chosen the scores of the items considering the presence of correct responses were dichotomized. The analysis of time execution of the items indicated the need to increase their time limits. It was established that the best criteria for interruption of the test was after four consecutive errors. For the items discrimination, it was obtained D index between 11.1 and 90.7, and point bisserial correlations ranging between 0.30 and 0.75, indicating that items were sufficiently discriminative. The construct validity was investigated by factor analysis (main components method, promax rotation). The results indicated a unidimensional structure for the Kohs Cubes. The factor found presented eigenvalue of 7.42 and explained 44% of the total variance of the items, with Cronbach's Alpha of 0.92. The load factors ranged from 0.35 to 0.78 (70% over 0.60), indicating that the items are good behavioral representatives of the construct assessed by the test. The criterion validity for the executive function of the planning was investigated using two instruments. Thereby, a comparison among participants with different magnitudes of planning (analyzed by the copy of the Rey Figure) indicated a significant difference in the scores of the Cubes (t=3.9; gl=165; p<0.001). Moreover, it was observed a correlation between the punctuation in the Cubes and in the Rey Figure ( r=0.50; p<0.001). Similarly, it was found a correlation between the Kohs Block Test and the Mazes WISC-III subtest (r=0.48; p=0.004). Both findings suggested adequate simultaneous validity coefficients to the instrument. The reliability coefficient obtained split half method (Pearson correlation with Spearman-Brown correction), was 0.88 (p<0.001). There were no differences between genres (t=1.22; p=0.22). However, a significant difference was verified between children from municipal public schools and other schools (F =24.75; p<0.001), as well as between right-handed and left-handed (t=2.03; p=0.04). In conclusion, normative tables were developed considering the differences found between the ages (F=23.26; p<0,001).

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Estudo psicológico longitudinal na distrofia miotônica

Cited by 2 publications

References 18 publications

The Kohs' blocks test as an important instrument to investigate the visuo-spatial impairments in myotonic dystrophy: part I. Quantitative and qualitative analysis

The Kohs' blocks test as an important instrument to investigate the visuo-spatial impairments in myotonic dystrophy: part I. Quantitative and qualitative analysis

Parâmetros psicométricos dos cubos de Kohs na avaliação neuropsicológica das funções executivas

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