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Cross-cultural adaptation of the Inventory of Callous-Unemotional Traits for evaluation of callous-unemotional traits in Brazilian adolescents

ABSTRACT

Objective

To perform the cross-cultural adaptation of the Inventory of Callous-Unemotional Traits (ICU) for Brazilian Portuguese to evaluate callous-unemotional traits in Brazilian adolescents.

Method

A methodological study involving the stages of translation, back-translation, expert committee review and assessment of the clarity of the pre-final version of the ICU, tested by 40 adolescents aged 10-17 years, of both sexes, attending a public school.

Results

The pre-final version of the ICU was approved by the expert committee and by the original developer of the questionnaire. The assessment of clarity showed good understanding of questionnaire items. Ten items found to be the least clear were modified according to the suggestions of the respondents.

Conclusion

The final Brazilian Portuguese version of the ICU proved to be similar to the original instrument regarding semantic, experiential and conceptual equivalence. Further studies are warranted to evaluate the psychometric properties of the adapted Brazilian Portuguese version of the ICU.

Adolescent; Evaluation studies; Schools

RESUMO

Objetivo

Realizar a adaptação transcultural para o português brasileiro do instrumento Inventory of Callous-Unemotional Traits (ICU) para avaliação de traços de insensibilidade e afetividade restrita de adolescentes.

Método

Estudo metodológico que envolveu as etapas de tradução, retradução, avaliação por comitê de especialistas e de clareza da versão pré-final do ICU, avaliado por 40 adolescentes, entre 10 e 17 anos, de ambos os sexos, de uma escola pública.

Resultados

A versão pré-final do ICU foi aprovada pelo comitê de especialistas e pelo autor do instrumento. A avaliação da clareza revelou uma boa compreensão dos itens. Os 10 itens com menor clareza foram modificados conforme as sugestões.

Conclusão

A versão final do ICU para o português brasileiro mostrou ser similar ao instrumento original no que se refere à equivalência semântica, operacional e conceitual. Recomenda-se a realização de estudos que evidenciem a validade psicométrica do ICU adaptado para o português brasileiro.

Adolescente; Estudos de avaliação; Escolas

RESUMEN

Objetivo

Realizar la adaptación transcultural para el portugués brasileño del instrumento Inventory of Callous-Unemotional Traits (ICU) para evaluación de trazos de insensibilidad y afectividad restricta de adolescentes.

Método

Estudio metodológico que abarcó las etapas de traducción, re-traducción, evaluación por comité de expertos y de claridad de la versión pre-final del ICU, evaluado por 40 adolescentes, entre 10 y 17 años, de ambos los sexos, de una escuela pública.

Resultados

La versión pre-final del ICU ha sido aprobada por el comité de expertos y por el autor del instrumento. La evaluación mostró claramente una buena comprensión de los ítems. Sin embargo, 10 ítems con menos claridad se modificaron como sugerencias.

Conclusión

La versión final del ICU para el portugués brasileño resultó ser similar a la del instrumento original en lo relativo a la semántica, operacional, así como la equivalencia conceptual. Se recomiendan estudios que revelen la validez psicométrica del ICU adaptado para el portugués brasileño.

Adolescente; Estudios de evaluación; Escuelas

INTRODUCTION

Antisocial behavior is a common reason for referring adolescents to mental health care(11. White SF, Frick PJ. Callous-Unemotional Traits. In: Levesque RJR (editor). Encyclopedia of Adolescence. New York: Springer Science+Business Media; 2011. p. 369-75.). In addition, antisocial behavior in adolescence is a strong predictor of antisocial personality disorder in adulthood, especially when accompanied by callous traits – lack of concern for the feelings or problems of others; lack of guilt or remorse – and unemotional traits – little reaction to emotionally arousing situations, constricted emotional experience and expression, indifference, and aloofness in normatively engaging situations(22. Frick PJ, White SF. Research review: the importance of callous-unemotional traits for developmental models of aggressive and antisocial behavior. J Child Psychol Psychiatry. 2008;49(4):359-75.). Given the importance of the presence of callous-unemotional (CU) traits for understanding the development of young people with antisocial behavior, it is necessary to have an instrument that can reliably and efficiently measure these traits in this population.

In this respect, the Inventory of Callous-Unemotional Traits (ICU) was developed with the purpose of measuring CU traits in samples of American adolescents(33. Kimonis ER, Frick PJ, Skeem JL, Marsee MA, Cruise K, Munoz LC, et al. Assessing callous-unemotional traits in adolescent offenders: validation of the Inventory of Callous-Unemotional Traits. Int J Law Psychiatry. 2008;31(3):241-52.). The ICU consists of 24 items, half of which are reverse scored. Respondents rate each statement on a four-point Likert scale: 0 = “not at all true”; 1 = “somewhat true”; 2 = “very true”; 3 = “definitely true”. The total score ranges from 0 to 72, with higher scores indicating stronger CU traits(33. Kimonis ER, Frick PJ, Skeem JL, Marsee MA, Cruise K, Munoz LC, et al. Assessing callous-unemotional traits in adolescent offenders: validation of the Inventory of Callous-Unemotional Traits. Int J Law Psychiatry. 2008;31(3):241-52.).

However, the ICU has not yet been translated and adapted to Brazilian Portuguese. The process of cross-cultural adaptation involves the linguistic translation of the content of the instrument, considering cultural aspects and the context in which they are embedded, aiming to maximize the attainment of semantic and conceptual equivalence between the source and target versions of the instrument(44. Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Recommendations for the Cross-Cultural Adaptation of Health Status Measures. Toronto: Institute for Work & Health; 2007 [cited 2015 Aug 10]. Available from: http://www.dash.iwh.on.ca/sites/dash/files/downloads/cross_cultural_adaptation_2007.pdf.
http://www.dash.iwh.on.ca/sites/dash/fil...
-55. Borsa JC, Damásio BF, Bandeira DR. Adaptação e validação de instrumentos psicológicos entre culturas: algumas considerações. Paidéia. 2012;22(53):423-32.). After the cross-cultural adaptation process, it is necessary to follow specific steps related to the evaluation of the psychometric properties of the adapted measure(66. Pacico LC, Hutz CS. Validade. In: Hutz CS, Bandeira DR, Trentini CM (organizadores). Psicometria. Porto Alegre: Artmed; 2015. p. 71-84.).

The ICU has already been adapted in other countries. For example, in a community sample of 1,143 German adolescents(77. Essau CA, Sasagawa S, Frick PJ. Callous-unemotional traits in a community sample of adolescents. Assessment. 2006;13(4):454-69.) and in a sample of 347 Greek adolescents aged 12 to 18 years(88. Fanti KA, Frick PJ, Georgiou S. Linking Callous-Unemotional Traits to instrumental and non-instrumental forms of aggression. J Psychopathol Behav Assess. 2009;31(4):285-98.). In both studies, validation of psychometric properties was considered satisfactory(77. Essau CA, Sasagawa S, Frick PJ. Callous-unemotional traits in a community sample of adolescents. Assessment. 2006;13(4):454-69.-88. Fanti KA, Frick PJ, Georgiou S. Linking Callous-Unemotional Traits to instrumental and non-instrumental forms of aggression. J Psychopathol Behav Assess. 2009;31(4):285-98.). A cross-culturally adapted instrument is known to provide greater precision in assessing and, consequently, indicating interventions with a biopsychosocial focus, since the latest version of the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) points out that a dimensional assessment of psychopathology can supplement the traditional categorical diagnoses(99. American Psychiatric Association (US). Manual diagnóstico e estatístico de transtornos mentais: DSM-5. 5. ed. Porto Alegre: Artmed; 2014.).

In fact, CU traits are strongly associated with an underlying emotional dysfunction, an essential feature of psychopathy(1010. Feilhauer J, Cima M, Arntz A. Assessing Callous-Unemotional traits across different groups of youths: further cross-cultural validation of the Inventory of Callous-Unemotional traits. Int J Law Psychiatry. 2012;35(4):251-62.). These traits, however, are relatively stable throughout childhood and into adolescence compared to other personality attributes and psychopathologies in this age group(11. White SF, Frick PJ. Callous-Unemotional Traits. In: Levesque RJR (editor). Encyclopedia of Adolescence. New York: Springer Science+Business Media; 2011. p. 369-75.). Nevertheless, the stability of CU traits over time does not mean that they cannot be modified(99. American Psychiatric Association (US). Manual diagnóstico e estatístico de transtornos mentais: DSM-5. 5. ed. Porto Alegre: Artmed; 2014.).

The aim of the present study was to perform the cross-cultural adaptation of the original U.S. version of the ICU for Brazilian Portuguese to evaluate CU traits in Brazilian adolescents.

METHODS

This methodological study was conducted as part of the first author’s dissertation(1111. Rigatti R. Adaptação transcultural e evidências de validação psicométricas do Inventory of Callous-Unemotional traits (ICU) para avaliação de traços de insensibilidade e afetividade restrita de adolescentes no Brasil [dissertação]. Porto Alegre (RS): Escola de Enfermagem, Universidade Federal do Rio Grande do Sul, Porto Alegre, 2016.) and designed to cross-culturally adapt the ICU for use in Brazil following standardized steps(44. Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Recommendations for the Cross-Cultural Adaptation of Health Status Measures. Toronto: Institute for Work & Health; 2007 [cited 2015 Aug 10]. Available from: http://www.dash.iwh.on.ca/sites/dash/files/downloads/cross_cultural_adaptation_2007.pdf.
http://www.dash.iwh.on.ca/sites/dash/fil...
). First, two bilingual translators whose mother tongue is Portuguese (target language) and who are fluent in English (source language) produced two independent translations of the instrument to minimize misinterpretation. The two translators then discussed their Portuguese-language versions of the instrument until a consensus was reached on the translation. This was followed by the back-translation stage, which involved translating the synthesis of the two forward translations back into the source language (English). Two independent back-translations were produced by two bilingual translators with the source language (English) as their mother tongue. The two translators then met and developed a consensus back-translation(44. Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Recommendations for the Cross-Cultural Adaptation of Health Status Measures. Toronto: Institute for Work & Health; 2007 [cited 2015 Aug 10]. Available from: http://www.dash.iwh.on.ca/sites/dash/files/downloads/cross_cultural_adaptation_2007.pdf.
http://www.dash.iwh.on.ca/sites/dash/fil...
).

A committee of experts met to consolidate all the versions of the ICU and developed the prefinal version of the instrument for field testing. The material at the disposal of the committee included the original questionnaire and all translations. The expert committee comprised a researcher with experience in cross-cultural adaptation of instruments, two psychologists and two nurses with experience in child and adolescent psychiatry. The result of this stage was the prefinal version of the instrument both in Portuguese and in English. This English version was sent to the original developer of the questionnaire for appraisal.

The next stage was the field test of the prefinal version of the questionnaire for textual clarity, which measured the understanding of questionnaire items by adolescents. A sample of 30 to 40 persons is considered sufficient to evaluate the items(44. Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Recommendations for the Cross-Cultural Adaptation of Health Status Measures. Toronto: Institute for Work & Health; 2007 [cited 2015 Aug 10]. Available from: http://www.dash.iwh.on.ca/sites/dash/files/downloads/cross_cultural_adaptation_2007.pdf.
http://www.dash.iwh.on.ca/sites/dash/fil...
). The sample consisted of students aged 10 to 17 years, of both sexes, regularly enrolled in one of the public schools in the city of Porto Alegre, state of Rio Grande do Sul, participating in the project. Data were collected between October and December 2014. All eligible students present in the classrooms on the day of the field test were invited to examine the items of the prefinal version of the ICU for clarity. Students were allowed to decline participation at any time during data collection.

The clarity of the 24 items was assessed by asking students to rate their understanding of each item on a three-point Likert scale: 0 = “did not understand”, 1 = “somewhat understood”, and 2 = “fully understood”. The leading question was as follows: “To what extent do you understand the question?. Upon completion of the evaluation, students were asked to report the items that were least understood and suggest how they could be made clearer.

This study is part of the research project entitled “Anti-bullying program in school: epidemiology, etiology and interventions evaluated in a cluster randomized trial,” approved by the Research Ethics Committee at the Federal University of Rio Grande do Sul (CAEE No. 19651113.5.3001.5347). The author of the original version of the ICU, Paul J. Frick, from the University of New Orleans, United States, granted permission for translation and validation of the ICU for Brazilian Portuguese. Written informed consent was obtained from all parents or legal guardians authorizing their children to participate in the study. All students who agreed to participate signed an assent form at the time of questionnaire administration.

RESULTS

The consensus versions of all translations and back-translations were reviewed and approved by the expert committee (Table 1).

Table 1
– Consensus versions of the translation into Portuguese and back-translation into English of the ICU. Porto Alegre, Brazil

The back-translated version, in English, was sent to the author of the original version of the ICU and, after his approval, the prefinal version of the ICU, in Portuguese, was assessed for clarity. A total of 40 students from one of the participating schools were included at this stage, of whom 21 (52%) were boys, with a mean (SD) age of 13.3 (1.15) years.

The results of the field test of the prefinal version of the ICU for textual clarity are shown in Table 2. The overall mean (SD) clarity score was 1.72 (0.71). Considering that values close to 2 correspond to “fully understood”, overall the items were well understood by the adolescents.

Table 2
– Evaluation of the prefinal version of the ICU for clarity (n=40). Porto Alegre, Brazil

The students suggested changes to improve the clarity of the items that they found to be more difficult to understand. The suggestions made by the students were evaluated, resulting in the following changes: Item 4 – the originally translated statement “Eu não me importo com quem eu tenho que machucar (who I hurt) para conseguir o que eu quero” was changed to “Eu não me importo em machucar alguém (hurting someone) para conseguir o que quero”; item 8 – the originally translated statement “Eu me preocupo (I am concerned) com os sentimentos dos outros” was changed to “Eu me importo (I care) com os sentimentos dos outros”; item 9 – the originally translated statement “Eu não me importo se eu me meto em encrencas (I do not care if I get into trouble)” was changed to “Eu não me importo de me meter em confusão (I do not mind getting into trouble)”; item 12 – the originally translated statement “Eu pareço muito frio(a) (very cold) e insensível com os outros” was changed to “Eu pareço indiferente (indifferent) e insensível com os outros”; and item 13 – the originally translated statement “Eu admito facilmente quando estou (I easily admit to being) errado(a)” was changed to “Para mim, é fácil admitir que estou (For me, it is easy to admit that I am) errado(a)”.

Other difficulties encountered by the students were related to words such as “remorseful” and “expressive”, which were considered sophisticated words in their opinion. This evaluation resulted in changes in items 18 and 19: Item 18 – the originally translated statement “Eu não sinto remorso (remorseful) quando faço alguma coisa errada” was changed to “Eu não me sinto culpado(a) (guilty) quando faço alguma coisa errada” and item 19 – the originally translated statement “Eu sou muito expressivo(a) e emotivo(a) (I am very expressive and emotional)” was changed to “Eu demonstro meus sentimentos e sou muito emotivo(a) (I show my feelings and am very emotional)”.

The students also reported difficulty understanding the expression “doing things well” in item 20. In addition, the expression was part of a negative statement. Thus, in item 20, the originally translated statement “Eu não gosto de gastar muito tempo para fazer as coisas bem-feitas (I do not like to put the time into doing things well)” was changed to “Para mim, fazer as coisas bem-feitas é perda de tempo (In my opinion, doing things well is a waste of time)”. Finally, the word “hard”, used in item 23, had a sexual connotation for the students, leading to laughter and joking among them. Therefore, in item 23, the originally translated statement “Eu trabalho duro em (I work hard on) tudo o que eu faço” was changed to “Eu me dedico muito a (I put a lot of myself into) tudo o que eu faço”.

After adjusting the items according to the evaluation of clarity by the students, we obtained the final version of the ICU in Brazilian Portuguese (Appendix).

DISCUSSION

After the translation and semantic adaptation of the ICU, the items of the final version of the instrument were considered clear enough to be understood by the adolescents. The final Brazilian Portuguese version of the ICU proved to be similar to the original instrument regarding semantic, experiential and conceptual equivalence.

The findings of the present study are consistent, for example, with those of a study of cross-cultural adaptation involving the evaluation of semantic, idiomatic and conceptual equivalence between the source and target versions of the instrument Vécu et Santé Perçue de l’Adolescent (VSP-A), a questionnaire developed in France to assess health-related quality of life in adolescents. The Portuguese version of the VSP-A, tested in a sample of adolescents from a public school in the state of Rio de Janeiro, was semantically equivalent to the original instrument, although some items had to be modified to facilitate its use in Brazil(1212. Aires MT, Werneck GL. Equivalências semântica e de itens da edição em português do Vécu et Santé Perçue de l’Adolescent: questionário de avaliação da qualidade de vida do adolescente. Cad Saude Pública. 2012;28(10):1993-2001.).

In the present study, 10 items of the ICU were considered somewhat unclear by the adolescents. In items 4 and 9, for example, the sentence begins with negative elements, but replacement with a synonymous term was sufficient to improve understanding. In item 20, however, which is also a negative statement, the negation hindered proper understanding of the content; therefore, this item was converted into an affirmative sentence. In items 8 and 13, the verbs were considered “formal” by most students, and were therefore replaced, respectively, with a colloquial synonymous variant and with a more readily understandable verbal form. The findings are consistent with the process of cross-cultural adaptation of other instruments in which some items had to be modified to facilitate their use in Brazil(1212. Aires MT, Werneck GL. Equivalências semântica e de itens da edição em português do Vécu et Santé Perçue de l’Adolescent: questionário de avaliação da qualidade de vida do adolescente. Cad Saude Pública. 2012;28(10):1993-2001.).

In items 12 and 18, the adjectives were replaced with more common synonyms to improve understanding, since the ones previously used were considered “formal words” by the students. Items 19 and 20, respectively, were rephrased to clarify the content and to remove a term with sexual connotation, as understood by the students, in the first version of the questionnaire. This situation may be related to the transition from childhood to adolescence, considering that, at this stage, there are numerous physical, physiological, cognitive and social changes that may affect children’s and adolescents’ self-perceived competence(1313. Borsa JC, Bandeira DR. Uso de instrumentos psicológicos de avaliação do comportamento agressivo infantil: análise da produção científica brasileira. Aval Psicol. 2011;10(2):193-203.-1414. Roehrs H, Maftum MA, Zagonel, IPS. Adolescência na percepção de professores do ensino fundamental. Rev Esc Enferm USP. 2010;44(2):421-8.).

The adapted Brazilian Portuguese version of the ICU is a reliable tool that can be used for early assessment of CU traits not only by health professionals specializing in behavioral psychology but also by those working in different settings, such as schools and primary care(1414. Roehrs H, Maftum MA, Zagonel, IPS. Adolescência na percepção de professores do ensino fundamental. Rev Esc Enferm USP. 2010;44(2):421-8.-1515. Nobréga JF, Nitschke RG, Silva FP, Carraro CAG, Alves C. A careful look to postmodern tribes: caring for adolescent health in the context of their everyday lives. Rev Gaúcha Enferm. 2013;34(3):201-5.). It may be particularly useful for nurses of the Family Health Strategy, in which part of their duties is to identify the demands of the schools, plan actions and, together with the primary care team, implement health promotion interventions(1414. Roehrs H, Maftum MA, Zagonel, IPS. Adolescência na percepção de professores do ensino fundamental. Rev Esc Enferm USP. 2010;44(2):421-8.,1616. Mendes CS. Prevenção da violência escolar: avaliação de um programa de intervenção. Rev Esc Enferm USP. 2011;45(3):581-8.). Thus, based on the early identification of problems, the adapted ICU may also be used to evaluate the results of interventions focused on maladaptive behaviors that target adolescents(11. White SF, Frick PJ. Callous-Unemotional Traits. In: Levesque RJR (editor). Encyclopedia of Adolescence. New York: Springer Science+Business Media; 2011. p. 369-75.).

CONCLUSIONS

The present methodological study cross-culturally adapted the original U.S. version of the ICU to Brazilian Portuguese in order to evaluate CU traits in Brazilian adolescents. The cross-cultural adaptation process followed the recommendations established in the literature, involving the participation of an expert committee and pretesting of the instrument in the target population for evaluation of clarity. This field test allowed us to rephrase ambiguous or confusing statements, reaching equivalence between the source and target versions of the ICU while adapting it to the Brazilian reality to enable its application in clinical practice, education and research.

The validated instrument fills a gap in the Brazilian context for evaluation of CU traits in school-aged adolescents, since these traits can trigger mental health problems that have an impact on their quality of life. A limitation of this study is the lack of national studies on the subject in this field of research, thereby hindering a proper comparison of the results. In addition, it is essential that instruments validated for use in Brazil according to standardized procedures be available in order to reliably design intervention programs.

Future studies should be conducted to further investigate the psychometric properties of the final version of the ICU, such as internal consistency and factor analysis. This instrument may be useful for monitoring behavioral changes and evaluating interventions with a biopsychosocial focus that target adolescents with CU traits.

APPENDIX

Inventory of Callous-Unemotional Traits – ICU, Brazilian Portuguese version

Instruções: Leia cada afirmação e decida o quanto cada uma delas descreve você. Marque sua resposta circulando o número mais apropriado. Por favor, não deixe nenhuma afirmação sem resposta.

Não é verdade É um pouco verdade É muito verdade Definitivamente é verdade 1 Eu mostro meus sentimentos abertamente. ◻ ◻ ◻ ◻ 2 O que eu acho ser certo e errado é diferente do que outras pessoas acham. ◻ ◻ ◻ ◻ 3 Eu me importo se estou indo bem na escola ou no trabalho. ◻ ◻ ◻ ◻ 4 Eu não me importo em machucar alguém para conseguir o que quero. ◻ ◻ ◻ ◻ 5 Eu me sinto mal ou culpado(a) quando faço algo errado. ◻ ◻ ◻ ◻ 6 Eu não monstro minhas emoções para as outras pessoas. ◻ ◻ ◻ ◻ 7 Eu não me importo de chegar atrasado. ◻ ◻ ◻ ◻ 8 Eu me importo com o sentimento dos outros. ◻ ◻ ◻ ◻ 9 Eu não me importo de me meter em confusão. ◻ ◻ ◻ ◻ 10 Eu não deixo os meus sentimentos me controlarem. ◻ ◻ ◻ ◻ 11 Eu não me importo em fazer as coisas bem-feitas. ◻ ◻ ◻ ◻ 12 Eu pareço indiferente e insensível com os outros. ◻ ◻ ◻ ◻ 13 Para mim, é fácil admitir quando estou errado(a). ◻ ◻ ◻ ◻ 14 É fácil para os outros perceberem como eu estou me sentindo. ◻ ◻ ◻ ◻ 15 Eu sempre tento fazer o melhor que eu posso. ◻ ◻ ◻ ◻ 16 Eu peço desculpas (digo “eu sinto muito”) para pessoas que eu machuco. ◻ ◻ ◻ ◻ 17 Eu tento não ferir os sentimentos dos outros. ◻ ◻ ◻ ◻ 18 Eu não me sinto culpado(a) quando faço alguma coisa errada ◻ ◻ ◻ ◻ 19 Eu demonstro meus sentimentos e sou muito emotivo(a). ◻ ◻ ◻ ◻ 20 Para mim, fazer as coisas bem-feitas é perda de tempo ◻ ◻ ◻ ◻ 21 Os sentimentos dos outros não são importantes para mim. ◻ ◻ ◻ ◻ 22 Eu escondo os meus sentimentos dos outros. ◻ ◻ ◻ ◻ 23 Eu me dedico muito a tudo o que eu faço. ◻ ◻ ◻ ◻ 24 Eu faço coisas para que os outros se sintam bem. ◻ ◻ ◻ ◻

REFERÊNCIAS

  • 1
    White SF, Frick PJ. Callous-Unemotional Traits. In: Levesque RJR (editor). Encyclopedia of Adolescence. New York: Springer Science+Business Media; 2011. p. 369-75.
  • 2
    Frick PJ, White SF. Research review: the importance of callous-unemotional traits for developmental models of aggressive and antisocial behavior. J Child Psychol Psychiatry. 2008;49(4):359-75.
  • 3
    Kimonis ER, Frick PJ, Skeem JL, Marsee MA, Cruise K, Munoz LC, et al. Assessing callous-unemotional traits in adolescent offenders: validation of the Inventory of Callous-Unemotional Traits. Int J Law Psychiatry. 2008;31(3):241-52.
  • 4
    Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Recommendations for the Cross-Cultural Adaptation of Health Status Measures. Toronto: Institute for Work & Health; 2007 [cited 2015 Aug 10]. Available from: http://www.dash.iwh.on.ca/sites/dash/files/downloads/cross_cultural_adaptation_2007.pdf
    » http://www.dash.iwh.on.ca/sites/dash/files/downloads/cross_cultural_adaptation_2007.pdf
  • 5
    Borsa JC, Damásio BF, Bandeira DR. Adaptação e validação de instrumentos psicológicos entre culturas: algumas considerações. Paidéia. 2012;22(53):423-32.
  • 6
    Pacico LC, Hutz CS. Validade. In: Hutz CS, Bandeira DR, Trentini CM (organizadores). Psicometria. Porto Alegre: Artmed; 2015. p. 71-84.
  • 7
    Essau CA, Sasagawa S, Frick PJ. Callous-unemotional traits in a community sample of adolescents. Assessment. 2006;13(4):454-69.
  • 8
    Fanti KA, Frick PJ, Georgiou S. Linking Callous-Unemotional Traits to instrumental and non-instrumental forms of aggression. J Psychopathol Behav Assess. 2009;31(4):285-98.
  • 9
    American Psychiatric Association (US). Manual diagnóstico e estatístico de transtornos mentais: DSM-5. 5. ed. Porto Alegre: Artmed; 2014.
  • 10
    Feilhauer J, Cima M, Arntz A. Assessing Callous-Unemotional traits across different groups of youths: further cross-cultural validation of the Inventory of Callous-Unemotional traits. Int J Law Psychiatry. 2012;35(4):251-62.
  • 11
    Rigatti R. Adaptação transcultural e evidências de validação psicométricas do Inventory of Callous-Unemotional traits (ICU) para avaliação de traços de insensibilidade e afetividade restrita de adolescentes no Brasil [dissertação]. Porto Alegre (RS): Escola de Enfermagem, Universidade Federal do Rio Grande do Sul, Porto Alegre, 2016.
  • 12
    Aires MT, Werneck GL. Equivalências semântica e de itens da edição em português do Vécu et Santé Perçue de l’Adolescent: questionário de avaliação da qualidade de vida do adolescente. Cad Saude Pública. 2012;28(10):1993-2001.
  • 13
    Borsa JC, Bandeira DR. Uso de instrumentos psicológicos de avaliação do comportamento agressivo infantil: análise da produção científica brasileira. Aval Psicol. 2011;10(2):193-203.
  • 14
    Roehrs H, Maftum MA, Zagonel, IPS. Adolescência na percepção de professores do ensino fundamental. Rev Esc Enferm USP. 2010;44(2):421-8.
  • 15
    Nobréga JF, Nitschke RG, Silva FP, Carraro CAG, Alves C. A careful look to postmodern tribes: caring for adolescent health in the context of their everyday lives. Rev Gaúcha Enferm. 2013;34(3):201-5.
  • 16
    Mendes CS. Prevenção da violência escolar: avaliação de um programa de intervenção. Rev Esc Enferm USP. 2011;45(3):581-8.

Publication Dates

  • Publication in this collection
    2017

History

  • Received
    16 May 2016
  • Accepted
    24 May 2017
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