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PSIQUE | Volume XXII | Issue 1 | 1st January – 30th June 2026
Semiannual Publication. Scientic Journal of the Psychology Research Centre – CIP – from the Universidade Autónoma
de Lisboa – Luís de Camões.
PSIQUE is a scientic journal in Psychology published by the Psychology Research Centre of the
Universidade Autónoma de Lisboa.
Since 2005, PSIQUE has been publishing original papers in the scientic eld of Psychology, in its
several elds of specialization, in open access and free of charge.
From 2018, it is a semi-annual journal publication from 1st January to 30th June and from 1st July to
31st December.
Aims and Scope
It is particularly aimed at psychology researchers, lecturers and students but also at general readers
who are interested in this eld of science.
Psique publishes advances in basic or applied psychological research of relevance for understanding
and improving the human condition in the world. Contributions from all elds of psychology addressing
new developments with innovative approaches are encouraged. Articles that (a) integrate perspectives
from dierent areas within psychology; (b) study the roles of physical, social and cultural domains in
human psychological processes; or (c) include psychological perspectives from dierent regions in the
world are particularly welcomed.
The journal publishes papers in Portuguese, Spanish, French and English.
Directory: Repositório Cientíco de Acesso Aberto de Portugal (RCAAP).
Databases: Repositório Institucional da Universidade Autónoma de Lisboa (Camões).
Indexed by: Academic Search (EBSCO Publishers)
Fuente Academic (EBSCO Publishers).
PSIQUE | Volume XXII | Fascículo 1 | 1 de janeiro – 30 de junho 2026
Publicação semestral. Revista Cientíca do Centro de Investigação em Psicologia – CIP – da Universidade Autónoma
de Lisboa – Luís de Camões.
A Psique é uma revista cientíca em Psicologia, editada pelo Centro de Investigação em Psicologia da
Universidade Autónoma de Lisboa.
Desde 2005 publica artigos originais e comunicações na área cientíca da Psicologia, nos seus vários
domínios de especialização, de acesso livre e gratuito.
É um periódico semestral, a partir de 2018, com data de publicação de 1 de janeiro a 30 de junho e de
1 de julho a 31 de dezembro.
Âmbito e Objetivos
Dirige-se particularmente a investigadores, docentes e estudantes em Psicologia, mas também aos lei-
tores em geral que se interessem pelo conhecimento desta ciência.
A Psique publica avanços na investigação cientíca básica ou aplicada, em Psicologia, com relevância
para compreender e melhorar a condição humana no mundo. A Psique encoraja a submissão de con-
tribuições de todos os campos da Psicologia, produzindo novos desenvolvimentos cientícos, através
de abordagens inovadoras. Particularmente bem-vindos são os artigos que: (a) integram perspetivas de
diferentes áreas da Psicologia; (b) estudam o papel dos domínios físico, social e cultural nos processos
psicológicos humanos; ou (c) integram perspetivas psicológicas de diferentes regiões do mundo.
A revista aceita artigos em Português, Espanhol, Francês e Inglês.
Diretórios: Repositório Cientíco de Acesso Aberto de Portugal (RCAAP).
Base de Dados: Repositório Institucional da Universidade Autónoma de Lisboa (Camões).
Indexação: Academic Search (EBSCO Publishers)
Fuente Academic (EBSCO Publishers).
PSIQUE • e-ISSN 2183-4806 • Volume XXII • Issue Fascículo 1 • 1st january janeiro-30th june junho 2026
PUBLISHING INSTITUTION / INSTITUIÇÃO EDITORA
CIP – Centro de Investigação em Psicologia da Universidade Autónoma de Lisboa (CIP)
Rua de Santa Marta, n.º 47, 3.º, 1169-023 Lisboa
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DOI: https://doi.org/10.26619/2183-4806.XIX.1
e-ISSN: 2183-4806
Title Título: Psique
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Format Suporte: Online
Periodicity: Semiannual Periodicidade: Semestral
Editor in Chief Director: Odete Nunes
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Este trabalho é nanciado por Fundos Nacionais através da FCT – Fundação para a Ciência e a Tecnologia – no âmbito
doprojeto do CIP com a referência UIDB/04345/2020.
This work was funded by national funds through FCT – Fundação para a Ciência e a Tecnologia – as part
the project CIP – Ref.ª: UIDB/04345/2020.
PSIQUE • e-ISSN 2183-4806 • Volume XXII • Issue Fascículo 1 • 1st january janeiro-30th june junho 2026
PSIQUE • e-ISSN 2183-4806 • Volume XXII • Issue Fascículo 1 • 1st january janeiro-30th june junho 2026
EDITOR IN CHIEF DIRECTOR
Odete Nunes Universidade Autónoma de Lisboa, Portugal
ASSOCIATE EDITORS COEDITORES
João Hipólito
José Magalhães
Luísa Ribeiro
Cristina Nunes
Rute Brites
Sandra Figueiredo
Universidade Autónoma de Lisboa, Portugal
Universidade Autónoma de Lisboa, Portugal
Universidade Autónoma de Lisboa, Portugal
Universidade do Algarve, Portugal
Universidade Autónoma de Lisboa, Portugal
Universidade Autónoma de Lisboa, Portugal
EDITORIAL BOARD CONSELHO EDITORIAL
Alexandra Gomes
Ana Antunes
Ana Gomes
Anne-Marie Vonthron
Aristides Ferreira
Carla Moleiro
Célia Oliveira
Daniel Roque Gomes
David Rodrigues
Dulce Pires
Edlia Alves Simões
Filomena Matos
Florence Sordes–Ader
Gina C. Lemos
Inês Ferreira
Isabel Leite
Isabel Mesquita
Isabel Silva
João Viseu
Jorge Gomes
José Eusébio Pacheco
Liliana Faria
Luis Sérgio Vieira
Magda Soa Roberto
Manuel Sommer
Marjorie Poussin
Melanie Vauclair
Miguel Ángel Garcia-Martin
Miguel Pereira Lopes
Monique K. LeBourgeois
Odete Nunes
Patrícia Jardim de Palma
Pedro Armelim Almiro
Pedro Duarte
Ricardo B. Rodrigues
Rosa Novo
Rui Costa Lopes
Saul Neves de Jesus
Sílvia Araújo
Tito Laneiro
Vera Engler Cury
Universidade do Algarve, Portugal
Universidade da Madeira, Portugal
Universidade Autónoma de Lisboa, Portugal
Univerité Paris Ouest-Nanterre, França
ISCTE, Lisboa, Portugal
ISCTE, Lisboa, Portugal
Universidade Lusófona Porto, Portugal
Instituto Politécnico de Coimbra, Portugal
ISCTE, Lisboa, Portugal
I.Criap – Psicologia e Formação Avançada, Portugal
University of Saint Joseph (Macao), Macau
Universidade do Algarve, Portugal
Universidade de Toulouse, França
Instituto Politécnico de Setúbal / Escola Superior de Educação
Universidade Europeia, Portugal
Universidade de Évora, Portugal
Universidade de Évora, Portugal
Universidade de Évora, Portugal
Universidade de Évora, Portugal
ISEG – Universidade Técnica de Lisboa, Portugal
Universidade do Algarve, Portugal
Universidade Europeia, Portugal
Universidade do Algarve, Portugal
Universidade da Beira Interior, Portugal
Universidade Autónoma de Lisboa, Portugal
Universidade de Lyon II, França
Instituto Universitário de Lisboa, Portugal
Universidad de Málaga, Espanha
ISCSP – Universidade de Lisboa, Portugal
University of Colorado Boulder, United States of America
Universidade Autónoma de Lisboa, Portugal
ISCSP – Universidade Técnica de Lisboa, Portugal
Universidade Autónoma de Lisboa, Portugal
Universidad Veracruzana, México
Instituto Universitário de Lisboa, Portugal
Universidade de Lisboa, Portugal
ICS – Universidade de Lisboa, Portugal
Universidade do Algarve, Portugal
Universidade do Minho, Portugal
Universidade Autónoma de Lisboa, Portugal
Pontifícia Universidade Católica de Campinas, Brasil
ASSISTANT EDITORS EDITORES ASSISTENTES
Afonso Herédia
Andreia Bandeira
Filipa Inácio
Francisco Castro
Ana Jarmela
Universidade Autónoma de Lisboa, Portugal
Universidade Autónoma de Lisboa, Portugal
Universidade Autónoma de Lisboa, Portugal
Universidade Autónoma de Lisboa, Portugal
Universidade Autónoma de Lisboa, Portugal
TRANSLATION TRADUÇÃO
Carolina Peralta Universidade Autónoma de Lisboa, Portugal
DESIGN COMPOSIÇÃO GRÁFICA
Undo
WEBSITE SITE
Undo
IT DEVELOPMENT DESENVOLVIMENTO INFORMÁTICO
Anselmo Silveira Universidade Autónoma de Lisboa, Portugal
TABLE OF CONTENTS ÍNDICE
Nota Editorial
Maria Luisa Ribeiro 7
A inuência das funções executivas frias e quentes nos comportamentos adaptativos
de crianças com diagnóstico de perturbação do desenvolvimento intelectual 8
The inuence of cold and hot executive functions on the adaptive behaviours of children
diagnosed with intellectual development disorders 24
Ana Stella Sousa Fagundes, Dina Lúcia Gomes da Silva, Filomena Café Inácio
O Inventário de Avaliação da Personalidade – Adolescentes (PAI-A):
Contributos para a avaliação psicológica de adolescentes 39
The Personality Assessment Inventory – Adolescent (PAI-A):
Contributes to the psychological assessment of adolescents 59
Mariana Moniz, Mauro Paulino, Octávio Moura, Mário R. Simões
Reconquête du soi et quête de sens de vie : Regards sur les processus de reconstruction
psychique chez les survivants du génocide contre les Tutsi en 1994 au Rwanda 78
Reclaiming the Self and the Quest for Meaning in Life: Perspectives on the Processes
of Psychic Reconstruction among Survivors of the Genocide against the Tutsi in Rwanda in 1994 95
Emmanuel Mihigo M., Denis Kazungu, Innocent Kagabo, Turikumwenamungu Jean Bosco
Participação na justiça protetiva e de família: aexperiência da criança 111
Participation in protective and family justice: thechild’sexperience 134
Margarida Leiria, Cristina Nunes
Author Instructions
Instruções aos Autores 156
Reviewers instructions
Instruções aos Revisores 160
PSIQUE • e-ISSN 2183-4806 • Volume XXII • Issue Fascículo 1 • 1st january janeiro-30th june junho 2026
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PSIQUE • e-ISSN 2183-4806 • Volume XXII • Issue Fascículo 1 • 1st january janeiro-30th june junho 2026 • pp. 7
NOTA EDITORIAL
Os Direitos Humanos, e os decorrentes Direitos da Criança, são temas fundamentais na pros-
secução de uma sociedade mais justa, equitativa e saudável. Esta preocupação com a saúde dos
indivíduos é fundamento essencial para os Objetivos de Desenvolvimento Sustentável definidos
pela ONU, a cumprir ativamente até 2030, mais obviamente a Saúde de qualidade (ODS #3). E sem
Saúde de qualidade, dificilmente atingiremos várias outras, como a erradicação da pobreza (ODS
#1) e da fome (ODS #2), a educação de qualidade (ODS #4) ou a Paz e a Justiça eficazes (ODS #16).
Os artigos constantes nesta edição da Psique são trabalhos que se apresentam como claro
contributo para esta ambição coletiva urgente, nomeadamente para grupos particularmente vul-
neráveis: as crianças, os adolescentes, os jovens com dificuldades intelectuais ou psicopatológi-
cas, e os sobreviventes de ações de guerra e genocídio. O olhar sistémico lembra-nos que o que
cada indivíduo faz ou é, em cada momento, não é alheio à sua história pessoal e aos sistemas que
vai integrando. Relembra-nos que muitos indivíduos experimentam traumas e situações de alta
vulnerabilidade desde muito jovens, com efeitos acentuados no seu processo formativo.
O trabalho do Psicólogo necessita deste olhar multifocal, englobando o conhecimento atual
sobre as relações entre as dificuldades intelectuais e relacionais, e a psicopatologia e o contexto
psicossocial. Carece ainda de instrumentos robustos e adaptados às características de cada
população específica (quer em termos de faixa etária, quer em termos de língua e cultura), como
o aqui apresentado.
Além de efetuar avaliações fidedignas, os Psicólogos devem saber como criar as melhores
condições para o restabelecimento da Saúde e da Justiça, com especial cuidado pelos mais vul-
neráveis. Destacamos neste número os menores envolvidos em processos de Justiça e as pessoas
que viveram traumas profundos, e cuja intervenção psicoterapêutica é essencial para a restaura-
ção do seu poder pessoal e esperança no futuro. Contribuir para a melhoria da Saúde Psicológica
dos outros, num paradigma de respeito profundo pelas suas fragilidades, é criar um futuro mais
saudável, seguro, ecológico e satisfatório para todos.
Maria Luisa Ribeiro
(Co-editor)
8
A INFLUÊNCIA DAS FUNÇÕES EXECUTIVAS FRIAS E QUENTES
NOS COMPORTAMENTOS ADAPTATIVOS DE CRIANÇAS COM
DIAGNÓSTICO DE PERTURBAÇÃO DO DESENVOLVIMENTO
INTELECTUAL
THE INFLUENCE OF COLD AND HOT EXECUTIVE FUNCTIONS ON THE
ADAPTIVE BEHAVIOURS OF CHILDREN DIAGNOSED WITH INTELLECTUAL
DEVELOPMENT DISORDERS
Ana Stella Sousa Fagundes1, Dina Lúcia Gomes da Silva2, Filomena Café Inácio3
PSIQUE • EISSN 21834806 • VOLUME XXII • ISSUE FASCÍCULO 1
1ST JANUARY JANEIRO 30TH JUNE JUNHO 2026 • PP. 823
DOI: https://doi.org/10.26619/2183-4806.XXII.1.3
Submited on 20/01/2025 Submetido a 20/01/2025
Accepted on 12/12/2025 Aceite a 12/12/2025
Resumo
A Perturbação do Desenvolvimento Intelectual (PDI) caracteriza-se pela presença de défices
no funcionamento intelectual e nas habilidades adaptativas. Este estudo procurou investigar de
que forma o funcionamento executivo pode estar relacionado com o critério adaptativo da PDI, a
partir de uma amostra de 40 crianças de 8 a 12 anos. Foram utilizadas a Bateria de Avaliação de
Funções Executivas em Crianças (TI-BAFEC) e a Vineland - Escala de Comportamento Adapta-
tivo, para avaliar o desempenho das crianças com PDI e explorar esta relação. Foram encontra-
das correlações positivas entre as pontuações totais de ambos os instrumentos, bem como entre
os seus domínios. A análise de regressão revelou que as Funções Executivas (FEs) frias contri-
buem significativamente para os domínios de Comunicação e Autonomia, enquanto as Funções
Executivas emocionais têm um papel importante no domínio de Socialização. Esses resultados
destacam a importância de avaliar separadamente cada domínio dos Comportamentos Adapta-
tivos (CA) na PDI. Conclui-se que as funções executivas frias e emocionais têm um impacto sig-
nificativo nos comportamentos adaptativos das crianças com PDI, o que pode orientar o desen-
volvimento de intervenções e estratégias de apoio mais eficazes para melhorar o funcionamento
adaptativo dessas crianças.
Palavras-chave: funções executivas frias e quentes, comportamentos adaptativos, perturbação do
desenvolvimento intelectual, neurodesenvolvimento.
1 Mestre em Neurociências Cognitivas e Neuropsicologia, Universidade do Algarve. E-mail: asfagundespsico@hotmail.com
ORCID ID: https://orcid.org/0009-0000-4722-8676
2 Doutora em Ciências Biomédicas, Universidade do Algarve. E-mail: dlsilva@ualg.pt ORCID ID: https://orcid.org/0000-0003-
4437-2765
3 Doutora em Psicologia, Universidade do Algarve. E-mail: fcinacio@ualg.pt ORCID ID: https://orcid.org/0000-0003-4387-
0578
9
PSIQUE • e-ISSN 2183-4806 • Volume XXII • Issue Fascículo 1 • 1st january janeiro-30th june junho 2026 • pp. 8-23
Ana Stella Sousa Fagundes, Dina Lúcia Gomes da Silva, Filomena Café Inácio
9
PSIQUE • e-ISSN 2183-4806 • Volume XXII • Issue Fascículo 1 • 1st january janeiro-30th june junho 2026 • pp. 8-23
Abstract
Intellectual Disability (ID) is characterized by deficits in intellectual functioning and
adaptive skills. This study aimed to investigate how executive functioning may be related to
the adaptive criterion of the ID, based on a sample of 40 children aged 8 to 12 years. The Child
Executive Function Assessment Battery and the Vineland Adaptive Behaviour Scale were used
to assess the performance of children with ID and explore this relationship. Positive correlations
were found between the total scores of both instruments, as well as between their domains.
Regression analysis revealed that cold Executive Functions (EFs) contribute significantly to the
domains of Communication and Autonomy, while hot Executive Functions play an important
role in the Socialization domain. These results highlight the importance of separately assessing
each domain of Adaptive Behaviours (AB) in ID. It is concluded that cold and hot executive
functions have a significant impact on the adaptive behaviours of children with ID, which can
guide the development of more effective interventions and support strategies to improve the
adaptive functioning of these children.
Keywords: cognitive and emotional executive functions, adaptive behaviours, intellectual disability,
neurodevelopmental.
Introdução
Na década de 1980, Lezak definiu as Funções Executivas (FEs) como a capacidade de forma-
ção de objetivos, planeamento, realização do plano direcionado ao objetivo e desempenho efi-
caz. Nos anos seguintes, surgiram várias definições para o conceito de FEs, bem como vários sub-
componentes, definições essas que, apesar das diferenças, são concordantes no que diz respeito
à complexidade e importância do funcionamento executivo para o comportamento humano e a
sua dependência de aspetos socioculturais (Jurado & Rosselli, 2007).
As FEs são um conjunto de habilidades cognitivas superiores que desempenham um papel
essencial no funcionamento diário, que nos permitem controlar o nosso comportamento, ajudan-
do-nos a lidar com demandas complexas e a tomar decisões eficazes (Raver et al., 2013; Ellefson
et al., 2017; Al-Jawahiri e Nielsen, 2021; Kusi-Mensah et al., 2021). O funcionamento executivo
também é responsável pela implementação de estratégias para desempenho e descontinuação
das ações, podendo inibir respostas habituais que podem estar associadas não somente a um pro-
cessamento cognitivo, como também a decisões pessoais e interações sociais, abrangendo aspe-
tos de desejo e motivação (Lezak et al., 2004). No que diz respeito ao quotidiano dos indivíduos,
as FEs desempenham um papel importante no desempenho académico, no sucesso profissional,
nas relações interpessoais e na resolução de problemas diários (Gomes et al., 2018; Fuentes et al.,
2014; Cypel, 2006; Castellanos et al., 2006; Miyake et al., 2000).
Alguns autores sugerem que as FEs podem ser divididas em “Frias” e “Quentes” (Chan et al.,
2008; Séguin, Arseneault, & Tremblay, 2007; cit. In Núñez Carvalho et al., 2012). As FEs frias são
formadas por um conjunto de habilidades que nos permitem planear, organizar, monitorizar,
resolver problemas, controlar e direcionar o nosso comportamento, sendo componentes mais
baseados na lógica (Chan et al. 2008) e são funções evocadas por problemas relativamente abstra-
tos e descontextualizados, que se concentram na capacidade de suprimir processos automáticos
10
PSIQUE • e-ISSN 2183-4806 • Volume XXII • Issue Fascículo 1 • 1st january janeiro-30th june junho 2026 • pp. 8-23
A influência das funções executivas frias e quentes nos comportamentos adaptativos de crianças
com diagnóstico de perturbação do desenvolvimento intelectual
ou respostas impulsivas e manter instruções ou representações de tarefas na memória de tra-
balho (Castellanos et al., 2006). Por outro lado, as FEs quentes envolvem a regulação de compor-
tamentos sociais, resolução de conflitos que necessitam de fatores emocionais e interpessoais,
além dos comportamentos em que os reforços e a punição estão claramente em questão. Elas
desempenham um papel fundamental na gestão e na adaptação das emoções, permitindo uma
resposta emocional adequada às diferentes situações (Chan et al. 2008). Castellanos e colabo-
radores (2006) argumentam que as FEs quentes são necessárias para a resolução de problemas
caracterizados por um alto envolvimento afetivo ou que exigem avaliações flexíveis do valor
afetivo dos estímulos. A figura 1 sumariza os principais componentes das FEs, considerando a
divisão entre as habilidades frias e habilidades quentes.
Esta divisão entre FEs frias e FEs quentes parece ter distinção na atividade neuronal dos
córtices frontais, ou seja, aspetos puramente cognitivos (caracterizados como “frios”) estão
associados às zonas dorso-laterais do córtex pré-frontal; e aspetos mais emocionais (carac-
terizados como “quentes”) estão associados à zona ventro-medial do córtex pré-frontal, que
abrange os córtices medial e órbitofrontal e às estruturas límbicas (Zelazo e Müller, 2002). Os
autores ainda relatam que ao nível de maturação cerebral, as áreas envolvidas nas FEs quen-
tes podem amadurecer mais cedo do que as áreas envolvidas nas FEs frias. Segundo Osório
e colaboradores (2021), embora as FEs frias e quentes possam ser compreendidas como ativi-
dades distintas, trabalham normalmente juntas como parte de uma função adaptativa com o
mundo.
Durante o processamento cognitivo necessário para regular pensamentos, emoções e
ações que pretendem canalizar e direcionar um Comportamento Adaptativo (CA) e social-
mente apropriado, as FEs são recrutadas (Miller & Cohen, 2001; Zelazo et al., 2008; Bertollo e
Yerys, 2019) e assim, favorecem a possibilidade de alterar e adaptar o comportamento a dife-
rentes situações da vida e contribuir para uma integração sociocognitiva, com resultados fun-
cionais bem-sucedidos (Kochanska et al., 2000; Lezak et al., 2004; Corso et al., 2013; Carlson,
2016; Anderson & Beauchamp, 2012; Bertollo e Yerys, 2019). Para Kochanska e colaboradores
(2000) e Carlson (2016), a possibilidade de alterar e adaptar o comportamento em diferentes
situações da vida depende da possibilidade de inibir comportamentos indesejáveis ou inade-
quados. Para Carlson e colaboradores (2002), antes das crianças poderem começar a construir
conceitos mais complexos da vida mental, é preciso que um certo nível de destreza executiva
se desenvolva.
Ao pesquisarem sobre a estabilidade da função executiva e das predições do CA da meia
infância à pré-adolescência, Harms e colaboradores (2014) descobriram que melhores habilida-
des de função executiva podem ser um fator de proteção que reduz o comportamento de risco
em adolescentes. Mais especificamente, certos aspetos da função executiva da infância e da sen-
sibilidade neural à recompensa e punição, previram algumas diferenças individuais na busca de
sensações e CA em crianças que entraram na adolescência.
Pinto e colaboradores (2006) declaram que os comportamentos das crianças assumem níveis
de complexidade cognitiva crescentes através da sua participação em atividades de jogo e apren-
dizagem, ou seja, maiores percentagens de tempo em atividades que são consideradas estimula-
doras para a criatividade e para o pensamento divergente, proporcionam maior probabilidade de
níveis elevados de funcionamento cognitivo e adaptativo. Entender como os CA se desenvolvem
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PSIQUE • e-ISSN 2183-4806 • Volume XXII • Issue Fascículo 1 • 1st january janeiro-30th june junho 2026 • pp. 8-23
Ana Stella Sousa Fagundes, Dina Lúcia Gomes da Silva, Filomena Café Inácio
11
PSIQUE • e-ISSN 2183-4806 • Volume XXII • Issue Fascículo 1 • 1st january janeiro-30th june junho 2026 • pp. 8-23
na infância é essencial para identificar fatores adaptáveis e obstáculos críticos para intervenções
direcionadas às limitações.
O presente estudo foi realizado com uma amostra de crianças com o diagnóstico de PDI,
uma perturbação do neurodesenvolvimento que apresenta início no decorrer do desenvolvi-
mento da criança (do nascimento até os 18 anos) e é caracterizada por um grande espectro
de défices funcionais que se manifestam tanto por uma eficiência intelectual significativa-
mente inferior à norma considerada para idade do indivíduo, como a limitações adaptativas
Controlo da Atenção (atenção
seletiva, atenção dividida e
atenção alternada)
Flexibilidade Cognitiva
(mudanças de estratégias,
transferências de conceitos,
uência verbal e resolução
criativa de problemas)
Memória de Trabalho
(capacidade de
processamento em vários
níveis de complexidade)
FEs Frias
Funções Executivas (FEs)
Pensamento Social (meta-
cognição, teoria da mente e
compreensão da ironia)
Autorregulação
(ajustamento da intensidade
da resposta emocional,
inibição do comportamento,
extinção de respostas
e ajustamento perante
feedback
)
Tomada de Decisão (base em
informações emocionais)
Orientação para Objetivos
(planeamento e inibição de
resposta automática)
FEs Quentes
FIGURA1
Caracterização das FEs, a partir da divisão entre FEs frias e FEs quentes (Zelazo e Carlson, 2012).
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A influência das funções executivas frias e quentes nos comportamentos adaptativos de crianças
com diagnóstico de perturbação do desenvolvimento intelectual
ao funcionamento de atividades do quotidiano, como a comunicação, o autocuidado, a socia-
lização e a aprendizagem escolar (Évora, 2019, Antunes, 2012, Mecca et al., 2015, Santos,
2020, Firmino, 2022). Essas limitações refletem uma incapacidade ou restrição no desempe-
nho funcional esperado, que representam uma desvantagem substancial para o indivíduo e
são influenciadas por variáveis contextuais, podendo ser contidas por meio de intervenções,
apoios ou por meio da redução de barreiras que impedem oportunidades, equidade e inclusão
(Hallberg e Bandeira, 2021).
O interesse do estudo das FEs no âmbito da PDI prende-se não apenas com o seu contributo
para as funções intelectuais, mas também com o entendimento de que disfunções executivas em
idade infantil podem originar défices na autorregulação emocional e autocontrolo comporta-
mental, refletindo diretamente na capacidade de emissão de respostas adequadas às exigências,
o que é basal para o funcionamento adaptativo (Godoy, 2012; Segamarchi et al., 2021).
Almeida e da Silva (2020) realizaram uma revisão integrativa da literatura em torno das
perspetivas atuais sobre o ensino de FEs em crianças com PDI. Os autores confirmaram
que a imaturidade das estruturas frontais do cérebro desta população é uma das principais
características observadas e, ao saber que essas áreas são responsáveis por FEs, justifica-se
o aumento da dificuldade em planear, organizar, executar tarefas, tomar decisões, manter a
atenção, controlar emoções, antecipar consequências e apresentar uma flexibilidade cogni-
tiva e comportamental.
Este estudo aborda a relação entre as FEs frias e quentes e os CA em crianças com diagnós-
tico de PDI provenientes de um contexto familiar de baixos recursos socioeconómicos e com
integração social mais limitada devido a contingências culturais.
O Presente Estudo
Nesta investigação, pretendeu-se avaliar aspetos da aprendizagem e ajustamento da criança
às atividades quotidianas nos contextos doméstico, escolar e pessoal. As FEs frias foram ava-
liadas com base em medidas de flexibilidade cognitiva, memória operatória e orientação para
objetivos, enquanto as FEs quentes basearam-se em medidas de pensamento social, tomada de
decisão e autorregulação.
Foram definidos os seguintes objetivos:
I. Avaliar o desempenho da amostra no que diz respeito às FEs frias e quentes, assim como
nos CA;
II. Verificar se as FEs frias e quentes se relacionam com os CA;
III. Verificar a influência das FEs frias e quentes nos diferentes domínios do CA (Comunica-
ção, Autonomia e Socialização).
Considerando a pesquisa bibliográfica realizada, formularam-se as seguintes hipóteses de
investigação:
H1: As crianças com PDI apresentaram um desempenho geral inferior à média normativa no
instrumento de avaliação dos CA.
H2: Relativamente aos CA, o domínio da Socialização apresenta pontuações superiores em
relação aos outros domínios.
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H3: As crianças com PDI apresentam um desempenho geral inferior à média normativa no
instrumento de avaliação das FEs.
H4: O desempenho nas FEs quentes é superior ao desempenho nas FEs frias.
H5: Existe uma relação positiva entre as FEs (frias e quentes) e os CA.
H6: As FEs frias apresentam correlação positiva com os domínios Comunicação e Autonomia
dos CA.
H7: As FEs quentes apresentam correlação positiva com o domínio Socialização dos CA.
H8: As FEs frias têm influência significativa nos domínios Comunicação e Autonomia dos CA.
H9: As FEs quentes têm influência significativa no domínio Socialização dos CA.
Metodologia
Participantes
Foram selecionadas 40 crianças para participação no estudo com idades compreendidas
entre 8 e os 12 anos (média de idade ± desvio padrão (DP) = 10.03 ± 1.33 anos), escolaridade entre
1.º e 6.º do ensino básico (média de escolaridade ± DP = 3.40 ± 1.21 anos), de ambos os sexos (45%
feminino e 55% masculino), oriundos de contexto socioeconómico inferior.
Os critérios de inclusão dos participantes da amostra do estudo foram: 1) ter diagnóstico de
PDI nos últimos 12 meses; 2) crianças a frequentar o ensino primário; e 3) frequentar com assi-
duidade as sessões multidisciplinares realizadas na instituição clínica. Foram definidos como
critério de exclusão os seguintes aspetos: 1) presença de outras perturbações neurológicas e/ou
psiquiátricas; 2) limitações motoras; 3) baixa acuidade visual e/ou auditiva; 4) percentil maior ou
igual a 15 nas Matrizes Progressivas Coloridas de Raven.
Para avaliar as FEs e os CA das crianças foram selecionados dois instrumentos psicológicos,
sendo eles, respetivamente, a Tartaruga da Ilha - Bateria de Avaliação de Funções Executivas em
Crianças (de Mesquita, 2011) e a Vineland - Escala de Comportamento Adaptativo (Sparrow et al.,
1984; Sparrow & Cicchetti, 1985; Sparrow & Cicchetti, 1989).
Descrição dos instrumentos
Para estimativa das FEs, foi utilizada a Tartaruga da Ilha - Bateria de Avaliação de Funções
Executivas em Crianças (TI-BAFEC) (de Mesquita, 2011), sendo um instrumento destinado à ava-
liação das FEs em crianças dos 6 aos 10 anos, integrando, nos seus objetivos, tanto a vertente das
FEs frias, como as FEs quentes.
O instrumento está organizado em três domínios axiais: o primeiro refere-se às FEs frias e
reúne 8 provas; o segundo diz respeito às FEs quentes e reúne 5 provas; o terceiro analisa a inte-
ração entre as duas áreas anteriores e reúne 2 provas de avaliação da forma como o indivíduo
utiliza em simultâneo as FEs frias e quentes, num total de 15 provas (de Mesquita, 2011).
O cálculo dos Scores FEs totais exige a administração da totalidade dos testes da TI-BAFEC.
Os totais FEs são calculados como médias dos resultados compósitos dos testes. As pontua-
ções podem ser convertidas para percentis, permitindo determinar o nível de funcionamento
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A influência das funções executivas frias e quentes nos comportamentos adaptativos de crianças
com diagnóstico de perturbação do desenvolvimento intelectual
executivo de cada criança dentro das seguintes categorias: “Superior” (92 a 100), “Médio Supe-
rior” (76 a 91), “Médio” (26 a 75), “Médio Inferior” (10 a 25) e “Inferior” (0 a 9).
Para avaliar os CA, foi utilizada a Vineland – Escala de Comportamento Adaptativo (Sparrow
et al., 1984; Sparrow & Cicchetti, 1985; Sparrow & Cicchetti, 1989), uma ferramenta que permite
avaliar a funcionalidade do indivíduo desde o nascimento até à idade adulta (90 anos). Ela con-
siste numa entrevista semiestruturada em formato de questionário com cinco domínios possí-
veis que se dividem em 11 subdomínios. Foram aplicados os três primeiros domínios da escala,
sendo eles a “Comunicação” (Recetiva, Expressiva e Escrita), a “Autonomia” (Pessoal, Doméstica
e Comunitária) e a “Socialização” (Relações Interpessoais, Lazer e Regras Sociais) pois foi com-
provado em vários estudos que são os domínios diretamente relacionados aos CA (Tomaszewski
et al., 2020; Santos, 2007; Perry e Factor, 1989).
A Vineland produz pontuações padrão para os domínios e subdomínios, além de uma pon-
tuação única, o Adaptive Behaviour Composite. Também estão disponíveis pontuações derivadas,
incluindo percentis, níveis adaptativos e equivalência de idade. As normas são tabeladas por
idade de 0 a 18 anos ou mais. Durante o período avaliativo do estudo algumas questões foram
respondidas não somente pelo participante, como também pelo seu responsável legal e pelo seu
terapeuta de referência.
Os resultados da Vineland são interpretados com cinco diferentes níveis adaptativos, sendo
eles, “Alto” (pontuações 131 a 160), “Moderadamente Alto” (116 a 130), “Adequado” (85 a 115),
“Moderadamente Baixo” (70 a 84) e “Baixo” (0 a 69). Contudo, os resultados classificados no nível
“Baixo”, recebem ainda subclassificações como “Baixo com Défice Leve” (51 a 69), “Baixo com
Défice Moderado” (36 a 50), “Baixo com Défice Severo” (21 a 35) e “Baixo com Défice Profundo”
(abaixo de 20).
Procedimentos
Os dados foram recolhidos após obtenção de consentimento informado dos encarregados de
educação, tendo sido assegurado o anonimato e a confidencialidade dos participantes, em con-
formidade com os princípios éticos e procedimentos da investigação em crianças previstos no
Decreto-Lei n.º 67/98, relativo à proteção de dados pessoais.
A aplicação dos instrumentos decorreu entre março e julho de 2022 e foi conduzida por
uma investigadora, formada em psicologia, devidamente treinada e seguindo rigorosamente
os manuais das respetivas escalas. Antes do início da avaliação, a criança era preparada com
uma breve explicação sobre as tarefas, com uma linguagem adequada à idade e ao contexto
social, garantindo a compreensão das instruções. As sessões individuais, com duração aproxi-
mada de 45 minutos cada, ocorreram num ou dois encontros, de forma a prevenir fadiga cogni-
tiva ou emocional. As pausas foram realizadas sempre que necessário. As crianças da amostra
estavam em acompanhamento multidisciplinar (neuropsicologia ou terapia da fala ou terapia
ocupacional).
Os resultados foram registados imediatamente após cada tarefa, seguindo os protocolos dos
instrumentos, e posteriormente codificados e armazenados digitalmente em suportes seguros e
com acesso exclusivo da equipa deinvestigação.
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Análise Estatística
A análise estatística foi conduzida no IBM SPSS Statistics (IBM Corp.). Inicialmente
foramrealizados testes de pressupostos para avaliar a adequação do uso de estatística para-
métrica, incluindo o teste de Shapiro–Wilk, a inspeção de assimetria e curtose e a análise
gráfica das distribuições, para verificação da normalidade. A homogeneidade das variâncias
foi analisada através do teste de Levene. Não foram identificadas violações significativas dos
pressupostos.
Na sequência, procedeu-se à análise descritiva para caracterizar o desempenho da amostra
nos instrumentos de FEs e CA. Para examinar diferenças entre domínios e entre FEs frias e quen-
tes, aplicaram-se testes comparativos adequados às características dos dados.
A investigação das relações entre FEs e CA foi realizada por meio da correlação de Pear-
son, atendendo ao cumprimento dos pressupostos estatísticos. Por fim, análises de regressão
múltipla foram conduzidas com o intuito de identificar os contributos específicos das FEs frias
e quentes na variabilidade dos domínios Comunicação, Autonomia e Socialização dos CA. Esta
sequência analítica foi organizada de modo a responder de forma direta e coerente às hipóteses
deinvestigação.
Resultados
No que diz respeito à pontuação total dos participantes na BAFEC, instrumento de avalia-
ção das FEs, verificou-se um desempenho geral médio de M = 26.02 (DP = 12.08), classificado
como “Médio”. Analisando separadamente as FEs frias e quentes, observou-se que os participan-
tes apresentavam um valor médio de M = 25.41 (DP = 14.19) nas FEs frias, correspondendo a um
nível “Médio Inferior”, e de M = 26.62 (DP = 15.55) nas FEs quentes, classificado como “Médio”.
Acomparação entre as médias das FEs frias e quentes revelou não existirem diferenças estatisti-
camente significativas, t(39) = -0.44, p = .66, d = -0.07.
Relativamente ao desempenho na Vineland, instrumento de avaliação dos CA, os resultados
indicaram um valor total médio de M = 59.97 (DP = 11.44), correspondente a um nível adaptativo
“Baixo com Défice Leve”. Quando analisados os três domínios específicos, verificou-se que os
participantes apresentaram médias de M = 51.65 (DP = 16.86) no domínio Comunicação, M =
68.40 (DP = 15.21) no domínio Autonomia e M = 74.63 (DP = 12.62) no domínio Socialização. Estes
valores correspondem, respetivamente, aos níveis adaptativos “Baixo com Défice Leve”, “Baixo
com Défice Leve” e “Moderadamente Baixo”.
A comparação dos três domínios da Vineland evidenciou diferenças estatisticamente signi-
ficativas, F(2,78) = 47.48, p < .01, η²p = .55, indicando um efeito de grande magnitude. As análi-
ses post hoc, realizadas através do procedimento de Bonferroni, revelaram que as pontuações no
domínio de Socialização foram significativamente superiores às dos restantes domínios, seguin-
do-se as do domínio de Autonomia. Por sua vez, o domínio de Comunicação apresentou pontua-
ções significativamente mais baixas (em todas as comparações p < .01).
A Tabela 1 apresenta os valores das correlações de Pearson entre as FEs (totais, frias e quen-
tes) e os diferentes domínios dos CA (Comunicação, Autonomia e Socialização).
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A influência das funções executivas frias e quentes nos comportamentos adaptativos de crianças
com diagnóstico de perturbação do desenvolvimento intelectual
TABELA1
Correlação de Pearson (r) entre as FEs frias e quentes e os diferentes domínios dos CA (Comunicação,
Autonomia e Socialização), (N = 40).
Funções Executivas
Total (BAFEC)
Funções Executivas
frias (BAFEC)
Funções Executivas
quentes (BAFEC)
Comportamentos Adaptativos Total (Vineland) .52** .51** .34*
Comportamentos Adaptativos Comunicação (Vineland) .45** .42** .31
Comportamentos Adaptativos Autonomia (Vineland) .32* .44** .10
Comportamentos Adaptativos Socialização (Vineland) .50** .38* .43**
Nota: * p < .05; ** p < .01
De forma geral, verificaram-se correlações significativamente positivas entre a pontuação
total das FEs e o total dos domínios do CA (r = .52, p < .001), bem como com as FEs frias (r = .51,
p< .001) e as FEs quentes (r = .34, p = .034). Observou-se igualmente uma associação positiva
significativa entre a pontuação total das FEs e os domínios da Vineland de Comunicação (r = .45,
p=.004), de Autonomia (r = .32, p = .04) e de Socialização (r = .50, p < .001).
No caso das FEs frias, verificaram-se correlações positivas significativas com os domínios de
Comunicação (r = .42, p = .007), de Autonomia (r = .44, p = .004) e de Socialização (r = .38, p = .016).
Já as FEs quentes apresentaram correlação significativa apenas com o domínio de Socialização
(r= .43, p = .005), não se observando correlações estatisticamente significativas com os domínios
de Comunicação (r = .31, p = .050) e de Autonomia (r = .10, p = .55).
Com o intuito de identificar quais as FEs que mais contribuem para explicar a variabilidade
nos níveis adaptativos de Comunicação, Autonomia e Socialização, realizaram-se três análises
de regressão múltipla, considerando as FEs frias e quentes como variáveis preditoras.
No domínio da Comunicação, o modelo de regressão explicou 21.3% da variância, R2 = .21,
F(2, 37) = 4.99, p = .012. Apenas as FEs frias contribuíram significativamente, β = .36, p = .026,
enquanto as FEs quentes não apresentaram contributo significativo, β = .20, p = .21.
Relativamente ao domínio de Autonomia, o modelo de regressão explicou 19.9% da variân-
cia, R2 = .20, F(2, 37) = 4.6, p = .016, verificando-se novamente que apenas as FEs frias tiveram um
contributo significativo, β = .46, p = .005. As FEs quentes, por sua vez, não demonstraram contri-
buto relevante, β = -.05, p = .76.
Por fim, o modelo de regressão relativo ao domínio de Socialização explicou 25.3% da variân-
cia, R2 = .25, F(2, 37) = 6.28, p = .004. Neste caso, as FEs quentes apresentaram um contributo
significativo, β = .35, p = .026), enquanto as FEs frias mostraram uma tendência marginal, β = .27,
p=.08.
Discussão
O presente estudo explorou a relação entre as FEs e os CA em crianças com PDI, conside-
rando os domínios de Comunicação, Autonomia e Socialização. Relativamente ao desempenho
nas FEs, esperava-se que a amostra apresentasse alterações no funcionamento executivo, já que
os estudos prévios evidenciam a imaturidade das estruturas frontais do cérebro nesta população,
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com consequente dificuldade em gerir as FEs (Almeida e Da Silva, 2020). A análise das FEs dos
participantes do presente estudo revelou um desempenho considerado médio. Este resultado
poderá ser justificado à limitada sensibilidade do instrumento utilizado, dificultando o registo
de pequenas progressões destas funções durante a infância (De Mesquita, 2011).
Não foram encontradas diferenças significativas entre as FEs frias e quentes, diferente da
literatura, que sugere um desenvolvimento relativamente superior das áreas cerebrais envolvi-
das nas FEs quentes, já que estas se desenvolvem antes das áreas cerebrais que envolvem as FEs
frias (Hongwanishkul et al., 2016). A limitação do tamanho e da representatividade da amostra,
bem como a inclusão de algumas crianças com idade superior à recomendada para a aplicação
do instrumento, poderão ter influenciado estes resultados. A inclusão destas crianças deveu-se
à possibilidade de alargar a aplicação do instrumento a idades mais elevadas em casos de défice
intelectual, como acontece na PDI.
Deve-se também considerar que o instrumento utilizado poderá não ter sido suficiente para
detetar diferenças sutis entre as habilidades mais frias e mais quentes, possivelmente devido à
pouca correspondência entre as atividades propostas e a realidade ecológica de cada criança. A
avaliação das FEs quentes exigia elevada motivação, devido à duração de algumas tarefas, e a
utilização de reforçadores específicos e de magnitude adequada à realidade dos participantes.
No que diz respeito aos CA, a média geral da amostra situa-se abaixo do nível adaptativo
esperado para crianças neurotípicas da mesma idade, correspondendo a um défice leve. Os domí-
nios de Comunicação e Autonomia apresentaram desempenho inferior, enquanto o domínio da
Socialização se encontra na média, ainda que moderadamente baixa. A maioria das interven-
ções e programas de apoio a crianças com PDI, tal como as crianças do presente estudo, centra-
-se sobretudo no desenvolvimento de competências sociais e na interação, dado que a sociali-
zação desempenha um papel crucial na vida quotidiana das crianças, independentemente das
suas habilidades cognitivas, sendo essencial em contextos escolares, familiares e comunitários.
Simultaneamente, o ambiente em que a criança está inserida pode influenciar estas aprendiza-
gens: a interação social frequente proporciona mais oportunidades de prática e aperfeiçoamento
das habilidades sociais, enquanto as habilidades de autonomia e comunicação tendem a depen-
der mais de contextos familiares ou estruturados (De Mesquita, 2011).
Estes resultados reforçam a importância de analisar cada domínio separadamente ao avaliar
os CA em crianças com PDI. De acordo com Évora (2019), o desempenho aquém do esperado nos
domínios conceptual (Comunicação) e prático (Autonomia) pode ser explicado, possivelmente,
por se tratarem de domínios mais dependentes do funcionamento intelectual. De facto, no pre-
sente estudo, todos os participantes apresentavam um QI abaixo do esperado para a sua idade, o
que sugere que crianças com menor funcionamento intelectual podem apresentar dificuldades
cognitivas que comprometem a aquisição e utilização das habilidades de Comunicação e Auto-
nomia. Estas dificuldades podem incluir problemas na compreensão de instruções, na aquisição
e expressão da linguagem, na memória de trabalho, na organização mental, na capacidade de
generalização e nas habilidades motoras finas, todas fundamentais para o desenvolvimento des-
tes comportamentos adaptativos.
As análises correlacionais do estudo sugerem a existência de uma relação positiva signifi-
cativa entre as FEs e os CA. Resultados semelhantes foram observados por Gligorović e Ðurović
(2014), que avaliaram crianças com PDI leve e encontraram correlações significativas entre deter-
minados aspetos do controlo inibitório e a maioria dos domínios adaptativos. Estudos realizados
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A influência das funções executivas frias e quentes nos comportamentos adaptativos de crianças
com diagnóstico de perturbação do desenvolvimento intelectual
com populações infantis com outros quadros clínicos, como PEA (Gardiner e Iarocci, 2018), Trans-
torno de Conduta e PHDA (Bonilla-Santos et al., 2019), histórico de exposição pré-natal ao álcool
(Ware et al., 2012), Síndrome de Down (Sabat et al., 2020), Síndrome de Muenke (Yarnell et al.,
2015) e Perturbações Mentais (Halvorsen et al., 2019), também apontam para relevância das FEs
como preditoras dos CA.
Através das análises de regressão, pretendeu-se determinar de que modo as FEs frias e quen-
tes influenciam os domínios de Comunicação, Autonomia e Socialização dos CA. Foi possível
observar a influência das FEs frias nos domínios de Comunicação e de Autonomia, enquanto as
FEs quentes possuem influência somente no domínio da Socialização.
Confirmou-se que as FEs frias, ligadas a processos mnésicos, controlo inibitório, defini-
ção e manutenção de objetivos e flexibilidade cognitiva, contribuem de forma significativa
para os CA nos três domínios, demonstrando grande dimensão das FEs frias na regulação do
comportamento. Dificuldades no controlo atencional, na adaptação de estratégias diante de
novas informações, na manutenção e monitorização de elementos relevantes, assim como na
iniciativa do planeamento de ações, refletem limitações nas FEs frias e impactam sobretudo
no domínio conceptual (Comunicação), envolvendo competências académicas, realização de
tarefas diárias e atividades laborais, e o domínio prático (Autonomia), relacionado com cui-
dados e necessidades pessoais, cuidados de saúde, gestão de dinheiro e independência no seu
bem-estar (De Mesquita, 2011)
Relativamente às FEs quentes, elas parecem influenciar exclusivamente a Socialização.
Ahabilidade de compreender e regular o próprio pensamento, tomar decisões e autorregular
emoções e comportamentos prediz competências sociais como empatia, comunicação interpes-
soal, formar amizades e julgamento social.
Embora alguns resultados sejam estatisticamente significativos, eles não são tão robustos,
sendo relevante considerar a reduzida dimensão da amostra. Entende-se que crianças com PDI
apresentam ampla variabilidade nas capacidades frias e quentes, que podem não ter sido total-
mente captada neste estudo, o que dificulta a identificação de padrões consistentes. Fatores como
gravidade do diagnóstico e contexto social devem ser considerados.
Considera-se que estudos futuros deverão contemplar amostras maiores, incluindo crianças
com e sem diagnóstico de PDI, e utilizar instrumentos adicionais de avaliação das FEs frias e
quentes, idealmente com abordagem ecológica, de forma a aumentar o grau de correspondência
entre o desempenho observado em teste e em situações reais da vida diária, dada a natureza
complexa e multifacetada destes construtos.
Conclusões
Os resultados do presente estudo evidenciam que o bom funcionamento executivo contribui
significativamente para o desempenho adaptativo na PDI, o que torna a criança mais capaz de
lidar com as constantes exigências e mudanças do meio envolvente, assumindo um papel mais
ativo no processo de aprendizagem e respondendo de forma adaptativa aos desafios quotidianos,
quer em contexto escolar, quer nos diversos contextos da vida. Almeida e Da Silva (2020) desta-
cam que, mesmo quando as FEs se manifestam de maneira adequada à idade e ao género, estas
podem ser aperfeiçoadas, evidenciando a influência de fatores ambientais no desenvolvimento
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Ana Stella Sousa Fagundes, Dina Lúcia Gomes da Silva, Filomena Café Inácio
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do funcionamento executivo. Assim, é fundamental proporcionar às crianças experiências enri-
quecedoras que favoreçam o desempenho destas competências, visto que as FEs precoces predi-
zem conquistas académicas, saúde, habilidades sociais e bem-estar ao longo da vida (Gomes et
al., 2018; Carlson, 2016; Harms et al., 2014).
Em síntese, compreender o desempenho das FEs e a sua relação com os CA permite uma
avaliação mais precisa das necessidades individuais de crianças com PDI e a implementação de
estratégias de intervenção direcionadas, que promovam o seu desenvolvimento global e autono-
mia funcional, potenciando o sucesso académico, social e pessoal ao longo da vida.
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THE INFLUENCE OF COLD AND HOT EXECUTIVE FUNCTIONS ON
THE ADAPTIVE BEHAVIOURS OF CHILDREN DIAGNOSED WITH
INTELLECTUAL DEVELOPMENT DISORDERS
Ana Stella Sousa Fagundes, Dina Lúcia Gomes da Silva, Filomena Café Inácio
Resumo
A Perturbação do Desenvolvimento Intelectual (PDI) caracteriza-se pela presença de défices no
funcionamento intelectual e nas habilidades adaptativas. Este estudo procurou investigar de que
forma o funcionamento executivo pode estar relacionado com o critério adaptativo da PDI, a partir
de uma amostra de 40 crianças de 8 a 12 anos. Foram utilizadas a Bateria de Avaliação de Funções
Executivas em Crianças (TI-BAFEC) e a Vineland - Escala de Comportamento Adaptativo, para ava-
liar o desempenho das crianças com PDI e explorar esta relação. Foram encontradas correlações
positivas entre as pontuações totais de ambos os instrumentos, bem como entre os seus domínios. A
análise de regressão revelou que as Funções Executivas (FEs) frias contribuem significativamente
para os domínios de Comunicação e Autonomia, enquanto as Funções Executivas emocionais têm
um papel importante no domínio de Socialização. Esses resultados destacam a importância de
avaliar separadamente cada domínio dos Comportamentos Adaptativos (CA) na PDI. Conclui-se
que as funções executivas frias e emocionais têm um impacto significativo nos comportamen-
tos adaptativos das crianças com PDI, o que pode orientar o desenvolvimento de intervenções e
estratégias de apoio mais eficazes para melhorar o funcionamento adaptativo dessas crianças.
Abstract
Intellectual Developmental Disorder (IDD) is characterized by the presence of deficits in
intellectual functioning and adaptive skills. This study aimed to investigate how executive func-
tioning may be related to the adaptive criterion of IDD, based on a sample of 40 children aged 8 to
12 years. The Executive Functions Assessment Battery for Children (TI-BAFEC) and the Vineland
Adaptive Behavior Scale were used to assess the performance of children with IDD and to explore
this relationship. Positive correlations were found between the total scores of both instruments,
as well as between their respective domains. Regression analysis revealed that cold Executive
Functions (EFs) contribute significantly to the Communication and Autonomy domains, whereas
emotional Executive Functions play an important role in the Socialization domain. These results
highlight the importance of assessing each domain of Adaptive Behaviors (AB) in IDD separately.
It is concluded that cold and emotional executive functions have a significant impact on the
adaptive behaviors of children with IDD, which may guide the development of more effective
interventions and support strategies to improve their adaptive functioning.
Keywords: cold and hot executive functions, adaptive behaviors, intellectual developmental disorder,
neurodevelopment.
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THE INFLUENCE OF COLD AND HOT EXECUTIVE FUNCTIONS ON THE ADAPTIVE BEHAVIOURS
OF CHILDREN DIAGNOSED WITH INTELLECTUAL DEVELOPMENT DISORDERS
Ana Stella Sousa Fagundes, Dina Lúcia Gomes da Silva, Filomena Café Inácio
Introduction
In the 1980s, Lezak defined Executive Functions (EFs) as the capacity for goal formation, plan-
ning, execution of goal-directed plans, and effective performance. In subsequent years, multiple
definitions of the EF construct and its subcomponents emerged. Despite their differences, these
definitions converge in recognizing the complexity and importance of executive functioning for
human behavior and its dependence on sociocultural factors (Jurado & Rosselli, 2007).
The EFs comprise a set of higher-order cognitive abilities that play an essential role in daily
functioning, enabling individuals to control their behaviors, manage complex demands, and
make effective decision-making (Raver et al., 2013; Ellefson et al., 2017; Al-Jawahiri e Nielsen,
2021; Kusi-Mensah et al., 2021). Executive functioning is also responsible for implementing per-
formance strategies and discontinuing actions, allowing inhibition of habitual responses that
may be associated not only with cognitive processing but also with personal decisions and social
interactions, encompassing aspects of desire and motivation (Lezak et al., 2004). In everyday life,
EFs play an important role in academic performance, professional success, interpersonal rela-
tionships, and problem solving (Gomes et al., 2018; Fuentes et al., 2014; Cypel, 2006; Castellanos
et al., 2006; Miyake et al., 2000).
Some authors suggest that EFs may be divided into “cold” and “hot” components (Chan et
al., 2008; Séguin, Arseneault, & Tremblay, 2007; cit. In Núñez Carvalho et al., 2012). Cold EFs con-
sist of abilities that enable planning, organization, monitoring, problem solving, and behavioral
control and direction, being more logic-based components (Chan et al., 2008). They are elicited
by relatively abstract and decontextualized problems and focus on suppressing automatic pro-
cesses or impulsive responses and maintaining task instructions or representations in working
memory (Castellanos et al., 2006). Conversely, hot EFs involve the regulation of social behaviors,
resolution of conflicts requiring emotional and interpersonal factors, and situations in which
reinforcement and punishment are salient. They play a fundamental role in emotion manage-
ment and adaptation, enabling appropriate emotional responses to different situations (Chan et
al., 2008). Castellanos and colleagues (2006) argue that hot EFs are necessary for solving problems
characterized by high affective involvement or requiring flexible evaluations of the affective
value of stimuli. Figure 1 summarizes the main components of EFs, considering the distinction
between cold and hot abilities.
This distinction between cold and hot EFs appears to correspond to differences in neuronal
activity within the frontal cortices. Purely cognitive (“cold”) aspects are associated with the dor-
solateral regions of the prefrontal cortex, whereas more emotional (“hot”) aspects are associ-
ated with the ventromedial prefrontal cortex, encompassing the medial and orbitofrontal corti-
ces and limbic structures (Zelazo e Müller, 2002). These authors further report that, in terms of
brain maturation, areas involved in hot EFs may mature earlier than those involved in cold EFs.
According to Osório and colleagues (2021), although cold and hot EFs can be conceptualized as
distinct activities, they typically operate together as part of an adaptive function in interaction
with the world.
During the cognitive processing required to regulate thoughts, emotions, and actions aimed
at directing adaptive and socially appropriate behavior, EFs are recruited (Miller & Cohen, 2001;
Zelazo et al., 2008; Bertollo e Yerys, 2019). They facilitate behavioral modification and adapta-
tion across life situations and contribute to sociocognitive integration with successful functional
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THE INFLUENCE OF COLD AND HOT EXECUTIVE FUNCTIONS ON THE ADAPTIVE BEHAVIOURS
OF CHILDREN DIAGNOSED WITH INTELLECTUAL DEVELOPMENT DISORDERS
Ana Stella Sousa Fagundes, Dina Lúcia Gomes da Silva, Filomena Café Inácio
outcomes (Kochanska et al., 2000; Lezak et al., 2004; Corso et al., 2013; Carlson, 2016; Anderson
& Beauchamp, 2012; Bertollo e Yerys, 2019). Kochanska et al. (2000) and Carlson (2016) argue that
behavioral adaptation depends on the ability to inhibit undesirable or inappropriate behaviors.
Carlson et al. (2002) propose that a certain level of executive proficiency must develop before
children can construct more complex concepts of mental life.
Research on the stability of executive function and predictions of adaptive behavior from
middle childhood to preadolescence showed that stronger executive abilities may act as a
Attentional Control (selective,
divided, and alternating
attention)
Cognitive Flexibility (strategy
switching, concept transfer,
verbal uency, and creative
problemsolving)
Worldng Memory (processing
capacity across multiple levels
of complexity)
Cool EFS
Executive Functions (EFs)
Social Cognition
(metacognition, theory of
mind, and understann of
irony)
Selfregulation (adjustment
ofemotional response
intensity, behavioural
inhibition, response
extinction, and adaptation to
feedback)
Decision-maldng (based on
emotional information)
Goal Orientation (planning
and inhibition of automatic
responses)
Hot EFS
FIGURE1
Characterization of FEs, based on the division between cold FEs and hot FEs (Zelazo and Carlson, 2012).
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THE INFLUENCE OF COLD AND HOT EXECUTIVE FUNCTIONS ON THE ADAPTIVE BEHAVIOURS
OF CHILDREN DIAGNOSED WITH INTELLECTUAL DEVELOPMENT DISORDERS
Ana Stella Sousa Fagundes, Dina Lúcia Gomes da Silva, Filomena Café Inácio
protective factor reducing risk behaviors in adolescence (Harms et al., 2014). Specific aspects of
childhood executive function and neural sensitivity to reward and punishment predicted indi-
vidual differences in sensation seeking and adaptive behavior in children entering adolescence.
Pinto et al. (2006) state that children’s behaviors assume increasing levels of cognitive com-
plexity through participation in play and learning activities. Greater engagement in activities
that stimulate creativity and divergent thinking increases the likelihood of higher levels of cog-
nitive and adaptive functioning. Understanding how adaptive behaviors develop in childhood is
essential for identifying modifiable factors and critical barriers for targeted interventions.
The present study was conducted with a sample of children diagnosed with IDD, a neurode-
velopmental disorder with onset during childhood (from birth to 18 years), characterized by a
broad spectrum of functional deficits manifested as significantly below-average intellectual
efficiency and adaptive limitations in daily functioning, including communication, self-care,
socialization, and academic learning (Évora, 2019, Antunes, 2012, Mecca et al., 2015, Santos, 2020,
Firmino, 2022). These limitations reflect restricted functional performance and represent a sub-
stantial disadvantage influenced by contextual variables, which may be mitigated through inter-
ventions, supports, or the reduction of barriers to opportunity, equity, and inclusion (Hallberg e
Bandeira, 2021).
Interest in studying EFs within IDD stems not only from their contribution to intellectual
functioning but also from evidence that executive dysfunction in childhood may lead to deficits
in emotional self-regulation and behavioral self-control, directly affecting the ability to generate
appropriate responses to environmental demands, which is fundamental for adaptive function-
ing (Godoy, 2012; Segamarchi et al., 2021).
Almeida and da Silva (2020) conducted an integrative literature review on current perspec-
tives regarding the teaching of EFs in children with IDD. They confirmed that immaturity of
frontal brain structures is a key characteristic in this population. Since these regions underlie
EFs, such immaturity explains increased difficulty in planning, organizing, executing tasks,
decision-making, maintaining attention, controlling emotions, anticipating consequences, and
demonstrating cognitive and behavioral flexibility.
This study examines the relationship between cold and hot EFs and adaptive behaviors in
children with IDD from low socioeconomic backgrounds and limited social integration due to
cultural contingencies.
The Present Study
This study aimed to assess aspects of children’s learning and adjustment to everyday activ-
ities in domestic, school, and personal contexts. Cold EFs were assessed based on measures of
cognitive flexibility, working memory, and goal orientation, whereas hot EFs were based on
measures of social thinking, decision-making, and self-regulation.
The following objectives were defined:
I. To assess the performance of the sample regarding cold and hot EFs, as well as adaptive
behaviors (AB);
II. To examine whether cold and hot EFs are related to AB;
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THE INFLUENCE OF COLD AND HOT EXECUTIVE FUNCTIONS ON THE ADAPTIVE BEHAVIOURS
OF CHILDREN DIAGNOSED WITH INTELLECTUAL DEVELOPMENT DISORDERS
Ana Stella Sousa Fagundes, Dina Lúcia Gomes da Silva, Filomena Café Inácio
III. To examine the influence of cold and hot EFs on the different domains of AB (Communi-
cation, Autonomy, and Socialization).
Based on the literature review conducted, the following research hypotheses were formu-
lated:
H1: Children with IDD present overall performance below the normative average on the AB
assessment instrument.
H2: Regarding AB, the Socialization domain presents higher scores compared to the other
domains.
H3: Children with IDD present overall performance below the normative average on the EF
assessment instrument.
H4: Performance in hot EFs is superior to performance in cold EFs.
H5: There is a positive relationship between EFs (cold and hot) and AB.
H6: Cold EFs show a positive correlation with the Communication and Autonomy domains
of AB.
H7: Hot EFs show a positive correlation with the Socialization domain of AB.
H8: Cold EFs significantly influence the Communication and Autonomy domains of AB.
H9: Hot EFs significantly influence the Socialization domain of AB.
Methodology
Participants
Forty children aged between 8 and 12 years were selected to participate in the study (mean
age ± standard deviation [SD] = 10.03 ± 1.33 years), with schooling ranging from the 1st to the 6th
grade of primary education (mean years of schooling ± SD = 3.40 ± 1.21), including both sexes
(45% female and 55% male), and from low socioeconomic backgrounds.
The inclusion criteria were: (1) having a diagnosis of IDD within the previous 12 months; (2)
children attendanding in primary education; and (3) regular participation in multidisciplinary
sessions conducted at the clinical institution. Exclusion criteria were: (1) presence of other neuro-
logical and/or psychiatric disorders; (2) motor limitations; (3) low visual and/or auditory acuity;
and (4) a percentile greater than or equal to 15 on the Raven’s Colored Progressive Matrices.
Two psychological instruments were selected to assess children’s EFs and AB, respectively:
the Tartaruga da Ilha – Executive Functions Assessment Battery for Children (TI-BAFEC) (de
Mesquita, 2011) and the Vineland Adaptive Behavior Scale (Sparrow et al., 1984; Sparrow & Cic-
chetti, 1985; Sparrow & Cicchetti, 1989).
Description of Instruments
To estimate EFs, the Tartaruga da Ilha – Executive Functions Assessment Battery for Children
(TI-BAFEC) (de Mesquita, 2011) was used. This instrument is designed to assess EFs in children
aged 6 to 10 years and includes both cold and hot EF components.
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THE INFLUENCE OF COLD AND HOT EXECUTIVE FUNCTIONS ON THE ADAPTIVE BEHAVIOURS
OF CHILDREN DIAGNOSED WITH INTELLECTUAL DEVELOPMENT DISORDERS
Ana Stella Sousa Fagundes, Dina Lúcia Gomes da Silva, Filomena Café Inácio
The instrument is organized into three main domains: the first concerns cold EFs and com-
prises eight tasks; the second concerns hot EFs and comprises five tasks; and the third examines
the interaction between the two previous areas and includes two tasks assessing the simultane-
ous use of cold and hot EFs, totaling 15 tasks (de Mesquita, 2011).
Calculation of total EF scores requires administration of the complete TI-BAFEC battery.
Total EF scores are calculated as the mean of composite test results. Scores may be converted
into percentiles to determine each child’s executive functioning level within the following cate-
gories: “Superior” (92–100), “High Average” (76–91), “Average” (26–75), “Low Average” (10–25), and
“Inferior” (0–9).
To assess AB, the Vineland Adaptive Behavior Scale (Sparrow et al., 1984; Sparrow & Cic-
chetti, 1985; Sparrow & Cicchetti, 1989) was used. This tool evaluates individual functioning
from birth to adulthood (up to 90 years) and consists of a semi-structured interview in question-
naire format with five possible domains divided into 11 subdomains. The first three domains
were administered: Communication (Receptive, Expressive, and Written), Autonomy (Personal,
Domestic, and Community), and Socialization (Interpersonal Relationships, Leisure, and Social
Rules), as these domains have been shown to be directly related to AB (Tomaszewski et al., 2020;
Santos, 2007; Perry e Factor, 1989).
The Vineland produces standard scores for domains and subdomains, as well as a single
overall score, the Adaptive Behavior Composite. Derived scores are also available, including per-
centiles, adaptive levels, and age equivalence. Norms are age-based from 0 to 18 years or older.
During the assessment period, some questions were answered not only by the participant but
also by their legal guardian and primary therapist.
Vineland results are interpreted across five adaptive levels: “High” (131–160), “Moderately
High” (116–130), “Adequate” (85–115), “Moderately Low” (70–84), and “Low” (0–69). Scores classi-
fied as “Low” are further subdivided into “Low with Mild Deficit” (51–69), “Low with Moderate
Deficit” (36–50), “Low with Severe Deficit” (21–35), and “Low with Profound Deficit” (below 20).
Procedures
Data were collected after obtaining informed consent from legal guardians. Participant ano-
nymity and confidentiality were ensured in accordance with ethical principles and research
procedures involving children as established in Decree-Law No. 67/98 concerning personal data
protection.
Instrument administration occurred between March and July 2022 and was conducted by a
trained psychology researcher following the respective manuals rigorously. Prior to assessment,
children received a brief age-appropriate explanation of the tasks to ensure comprehension of
instructions. Individual sessions lasted approximately 45 minutes and were conducted in one or
two meetings to prevent cognitive or emotional fatigue. Breaks were provided whenever neces-
sary. Children were receiving multidisciplinary follow-up (neuropsychology, speech therapy, or
occupational therapy).
Results were recorded immediately after each task according to instrument protocols and
were subsequently coded and digitally stored in secure systems accessible only to the research
team.
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OF CHILDREN DIAGNOSED WITH INTELLECTUAL DEVELOPMENT DISORDERS
Ana Stella Sousa Fagundes, Dina Lúcia Gomes da Silva, Filomena Café Inácio
Statistical Analysis
Statistical analysis was conducted using IBM SPSS Statistics (IBM Corp.). Assumption testing
for parametric statistics included the Shapiro–Wilk test, inspection of skewness and kurtosis,
and graphical distribution analysis to verify normality. Homogeneity of variances was assessed
using Levene’s test. No significant assumption violations were identified.
Descriptive analyses were then conducted to characterize sample performance on EF and
AB instruments. Comparative tests appropriate to data characteristics were used to examine dif-
ferences between domains and between cold and hot EFs.
Relationships between EFs and AB were investigated using Pearson correlation. Finally, mul-
tiple regression analyses were conducted to identify the specific contributions of cold and hot
EFs to variability in the Communication, Autonomy, and Socialization domains of AB. This ana-
lytical sequence was structured to address the research hypotheses directly and coherently.
Results
Regarding participants’ total scores on the BAFEC, the EF assessment instrument, an overall
mean performance of M = 26.02 (SD = 12.08) was observed, classified as “Average.” When cold
and hot EFs were analyzed separately, participants showed a mean value of M = 25.41 (SD =
14.19) in cold EFs, corresponding to a “Low Average” level, and M = 26.62 (SD = 15.55) in hot EFs,
classified as “Average.” Comparison between the means of cold and hot EFs revealed no statisti-
cally significant differences, t(39) = -0.44, p = .66, d = -0.07.
With respect to performance on the Vineland, the AB assessment instrument, results indi-
cated a total mean value of M = 59.97 (SD = 11.44), corresponding to a “Low with Mild Deficit”
adaptive level. When the three specific domains were analyzed, participants presented means
of M = 51.65 (SD = 16.86) in the Communication domain, M = 68.40 (SD = 15.21) in the Autonomy
domain, and M = 74.63 (SD = 12.62) in the Socialization domain. These values correspond, respec-
tively, to the adaptive levels “Low with Mild Deficit,” “Low with Mild Deficit,” and “Moderately
Low.”
Comparison of the three Vineland domains revealed statistically significant differences,
F(2,78) = 47.48, p < .01, η²p = .55, indicating a large effect size. Post hoc analyses conducted using
the Bonferroni procedure showed that scores in the Socialization domain were significantly
higher than those in the remaining domains, followed by the Autonomy domain. The Communi-
cation domain presented significantly lower scores in all comparisons (p < .01).
Table 1 presents Pearson correlation values between EFs (total, cold, and hot) and the differ-
ent AB domains (Communication, Autonomy, and Socialization).
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THE INFLUENCE OF COLD AND HOT EXECUTIVE FUNCTIONS ON THE ADAPTIVE BEHAVIOURS
OF CHILDREN DIAGNOSED WITH INTELLECTUAL DEVELOPMENT DISORDERS
Ana Stella Sousa Fagundes, Dina Lúcia Gomes da Silva, Filomena Café Inácio
TABLE1.
Pearson correlation (r) between cold and hot EFs and the different AB domains (Communication, Autonomy,
and Socialization), (N = 40).
Total Executive
Functions (BAFEC)
Cold Executive
Functions (BAFEC)
Hot Executive
Functions (BAFEC)
Total Adaptive Behaviors (Vineland) .52** .51** .34*
AB Communication (Vineland) .45** .42** .31
AB Autonomy (Vineland) .32* .44** .10
AB Socialization (Vineland) .50** .38* .43**
Note: p < .05; ** p < .01
Overall, significant positive correlations were found between total EF scores and total AB
scores (r = .52, p < .001), as well as with cold EFs (r = .51, p < .001) and hot EFs (r = .34, p = .034).
A significant positive association was also observed between total EF scores and the Vineland
domains of Communication (r = .45, p = .004), Autonomy (r = .32, p = .04), and Socialization (r =
.50, p < .001).
Cold EFs showed significant positive correlations with the Communication (r = .42, p = .007),
Autonomy (r = .44, p = .004), and Socialization (r = .38, p = .016) domains. In contrast, hot EFs
showed a significant correlation only with the Socialization domain (r = .43, p = .005), with no sta-
tistically significant correlations observed with the Communication (r = .31, p = .050) and Auton-
omy (r = .10, p = .55) domains.
To identify which EF components most contributed to explaining variability in adaptive lev-
els of Communication, Autonomy, and Socialization, three multiple regression analyses were
conducted using cold and hot EFs as predictor variables.
In the Communication domain, the regression model explained 21.3% of the variance, R² =
.21, F(2, 37) = 4.99, p = .012. Only cold EFs contributed significantly, β = .36, p = .026, whereas hot
EFs did not show a significant contribution, β = .20, p = .21.
For the Autonomy domain, the regression model explained 19.9% of the variance, R² = .20,
F(2, 37) = 4.6, p = .016. Again, only cold EFs made a significant contribution, β = .46, p = .005, while
hot EFs showed no relevant contribution, β = -.05, p = .76.
Finally, the regression model for the Socialization domain explained 25.3% of the variance,
R² = .25, F(2, 37) = 6.28, p = .004. In this case, hot EFs made a significant contribution, β = .35, p =
.026, whereas cold EFs showed a marginal trend, β = .27, p = .08.
Discussion
The present study explored the relationship between executive functions (EFs) and adaptive
behaviors (AB) in children with IDD, considering the domains of Communication, Autonomy,
and Socialization. Regarding EF performance, it was expected that the sample would present
alterations in executive functioning, as previous studies indicate immaturity of frontal brain
structures in this population, resulting in difficulties in managing EFs (Almeida e Da Silva, 2020).
Analysis of the participants’ EFs in the present study revealed performance considered to be
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Ana Stella Sousa Fagundes, Dina Lúcia Gomes da Silva, Filomena Café Inácio
average. This finding may be explained by the limited sensitivity of the instrument used, which
may hinder the detection of small developmental progressions in these functions during child-
hood (De Mesquita, 2011).
No significant differences were found between cold and hot EFs, in contrast to the literature
suggesting relatively greater development of brain areas involved in hot EFs, as these tend to
mature earlier than areas associated with cold EFs (Hongwanishkul et al., 2016). The limited size
and representativeness of the sample, as well as the inclusion of some children older than the
recommended age range for the instrument, may have influenced these results. The inclusion of
these children was justified by the possibility of extending the instrument’s use to older ages in
cases of intellectual impairment, as occurs in IDD.
It should also be considered that the instrument used may not have been sufficient to detect
subtle differences between colder and hotter abilities, possibly due to limited ecological corre-
spondence between the proposed activities and each child’s real-life context. Assessment of hot
EFs required high levels of motivation because of the duration of certain tasks and the need for
reinforcement strategies appropriate in magnitude and relevance to participants’ realities.
With regard to AB, the overall sample mean falls below the adaptive level expected for neu-
rotypical children of the same age, corresponding to a mild deficit. The Communication and
Autonomy domains showed lower performance, whereas the Socialization domain was within
the average range, although moderately low. Most interventions and support programs for
children with IDD, including those in the present study, tend to focus primarily on developing
social skills and interaction, given that socialization plays a crucial role in children’s daily lives
regardless of cognitive ability and is essential in school, family, and community contexts. At
the same time, the environment in which the child is embedded may influence these learning
processes: frequent social interaction provides more opportunities to practice and refine social
skills, whereas autonomy and communication skills tend to depend more on family or structured
contexts (De Mesquita, 2011).
These findings reinforce the importance of analyzing each domain separately when assess-
ing AB in children with IDD. According to Évora (2019), below-expected performance in the con-
ceptual (Communication) and practical (Autonomy) domains may be explained by their greater
dependence on intellectual functioning. In the present study, all participants demonstrated IQ
levels below what is expected for their age, suggesting that children with lower intellectual func-
tioning may experience cognitive difficulties that compromise the acquisition and application of
Communication and Autonomy skills. These difficulties may include problems in understanding
instructions, language acquisition and expression, working memory, mental organization, gen-
eralization capacity, and fine motor skills, all of which are essential for the development of these
adaptive behaviors.
Correlational analyses suggest a significant positive relationship between EFs and AB. Sim-
ilar findings were reported by Gligorović e Ðurović (2014), who assessed children with mild
IDD and found significant correlations between aspects of inhibitory control and most adaptive
domains. Studies involving children with other clinical conditions, such as autism spectrum dis-
order (Gardiner e Iarocci, 2018), conduct disorder and ADHD (Bonilla-Santos et al., 2019), prena-
tal alcohol exposure (Ware et al., 2012), Down syndrome (Sabat et al., 2020), Muenke syndrome
(Yarnell et al., 2015), and mental disorders (Halvorsen et al., 2019), also indicate the relevance of
EFs as predictors of AB.
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OF CHILDREN DIAGNOSED WITH INTELLECTUAL DEVELOPMENT DISORDERS
Ana Stella Sousa Fagundes, Dina Lúcia Gomes da Silva, Filomena Café Inácio
Regression analyses were conducted to determine how cold and hot EFs influence the Com-
munication, Autonomy, and Socialization domains of AB. The results showed that cold EFs influ-
ence the Communication and Autonomy domains, whereas hot EFs influence only the Socializa-
tion domain.
Cold EFs—linked to memory processes, inhibitory control, goal setting and maintenance,
and cognitive flexibility—contribute significantly to AB across domains, demonstrating their
central role in behavioral regulation. Difficulties in attentional control, adaptation of strategies
in response to new information, maintenance and monitoring of relevant elements, and initi-
ative in planning actions reflect limitations in cold EFs and particularly affect the conceptual
domain (Communication), which involves academic competencies and daily task performance,
and the practical domain (Autonomy), which relates to personal care, health management, finan-
cial management, and independent well-being (De Mesquita, 2011).
Hot EFs appear to influence exclusively the Socialization domain. The ability to understand
and regulate one’s own thinking, make decisions, and self-regulate emotions and behaviors pre-
dicts social competencies such as empathy, interpersonal communication, friendship formation,
and social judgment.
Although several findings reached statistical significance, they are not highly robust, and the
small sample size must be considered. Children with IDD present considerable variability in cold
and hot abilities that may not have been fully captured in this study, complicating the identifica-
tion of consistent patterns. Factors such as diagnostic severity and social context should also be
taken into account.
Future studies should include larger samples, encompassing children with and without IDD
diagnoses, and employ additional instruments to assess cold and hot EFs, ideally using ecologi-
cally valid approaches to increase correspondence between test performance and real-life func-
tioning, given the complex and multifaceted nature of these constructs.
Conclusions
The present study contributes to a better understanding of the relationship between execu-
tive functions and adaptive behaviors in children with IDD, highlighting the differentiated roles
of cold and hot executive processes in everyday functioning.
The findings suggest that executive functioning is positively associated with adaptive perfor-
mance, reinforcing the importance of considering EFs as a central component in the assessment
and intervention of children with IDD. In particular, cold EFs appear to play a more prominent
role in the development of Communication and Autonomy skills, whereas hot EFs are especially
relevant to Socialization. These results underscore the need for targeted intervention strategies
that address specific executive components in order to promote more effective adaptive func-
tioning.
From a practical perspective, the study emphasizes the importance of integrating execu-
tive function training into educational and clinical programs designed for children with IDD.
Interventions that simultaneously stimulate cognitive regulation, emotional control, and social
decision-making may foster improvements not only in academic performance but also in inde-
pendence and interpersonal relationships.
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Ana Stella Sousa Fagundes, Dina Lúcia Gomes da Silva, Filomena Café Inácio
Despite its contributions, the study presents limitations, particularly the reduced sample size
and the restricted generalizability of the findings. Future research should expand the scope of
investigation by including more diverse and representative samples and by employing multiple
assessment methods with greater ecological validity. Longitudinal designs would also be valu-
able in clarifying how executive and adaptive skills evolve over time and influence each other
throughout development.
In summary, understanding the interaction between executive functions and adaptive
behaviors is essential for designing comprehensive support strategies that enhance the quality
of life and social inclusion of children with IDD.
The results of the present study demonstrate that effective executive functioning contrib-
utes significantly to adaptive performance in IDD, enabling the child to better manage the con-
stant demands and changes of the surrounding environment, assume a more active role in the
learning process, and respond adaptively to daily challenges, both in school settings and across
broader life contexts. Almeida and Da Silva (2020) emphasize that even when EFs manifest in a
manner appropriate to age and gender, they can still be enhanced, highlighting the influence of
environmental factors on the development of executive functioning. Therefore, it is essential to
provide children with enriching experiences that foster the development of these competencies,
given that early EFs predict academic achievement, health outcomes, social skills, and overall
well-being across the lifespan (Gomes et al., 2018; Carlson, 2016; Harms et al., 2014).
In summary, understanding EF performance and its relationship with adaptive behavior
allows for a more precise assessment of the individual needs of children with IDD and supports
the implementation of targeted intervention strategies that promote overall development and
functional autonomy, thereby enhancing academic, social, and personal success throughout life.
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39
O INVENTÁRIO DE AVALIAÇÃO DA PERSONALIDADE
ADOLESCENTES PAIA: CONTRIBUTOS PARA A AVALIAÇÃO
PSICOLÓGICA DE ADOLESCENTES
THE PERSONALITY ASSESSMENT INVENTORY ADOLESCENT PAIA:
CONTRIBUTES TO THE PSYCHOLOGICAL ASSESSMENT OF ADOLESCENTS
Mariana Moniz, Mauro Paulino, Octávio Moura, Mário R. Simões
PSIQUE • EISSN 21834806 • VOLUME XXII • ISSUE FASCÍCULO 1
1ST JANUARY JANEIRO 30TH JUNE JUNHO 2026 • PP. 3958
DOI: https://doi.org/10.26619/2183-4806.XXII.1.1
Submited on 13/11/2024 Submetido a 13/11/2024
Accepted on 27/11/2025 Aceite a 27/11/2025
Resumo
A adolescência é uma fase de desenvolvimento pautada por transformações físicas, sociais
e psicológicas que, quando associadas a fatores de risco individuais, sociais ou ambientais, a
tornam particularmente vulnerável ao desenvolvimento de psicopatologia. A avaliação psicoló-
gica de adolescentes deve considerar estas vulnerabilidades, proporcionando instrumentos de
avaliação que produzam dados objetivos, fiáveis e válidos. No entanto, em Portugal, são raras as
medidas objetivas que permitem avaliar a personalidade e psicopatologia em adolescentes. Em
fase de validação para a população portuguesa, o Inventário de Avaliação da Personalidade –
Adolescentes (PAI-A) é um questionário objetivo de autorresposta que permite obter informação
sobre a personalidade, psicopatologia e contexto psicossocial de adolescentes, complementando
a versão de adultos da qual deriva. O presente artigo procede a uma revisão do processo de
desenvolvimento, estrutura, características psicométricas, administração, cotação e interpreta-
ção do PAI-A. É sublinhada a sua aplicabilidade em contexto clínico, escolar e forense. São men-
cionadas versões disponíveis em outros países e discutida a utilidade da sua adaptação à popu-
lação portuguesa, considerando as características e contributos para a avaliação psicológica de
adolescentes em Portugal.
Palavras-chave: Inventário de Avaliação da Personalidade – Adolescentes; Personalidade; Psicometria;
Validação: Avaliação Psicológica.
Abstract
Adolescence is a developmental stage marked by physical, social, and psychological
transformations that make it particularly susceptible to psychopathology, when confronted
with individual, social, and environmental risk factors. The psychological assessment of
adolescents must take into account these vulnerabilities by providing reliable, valid, and robust
instruments. However, in Portugal, there is still a dearth of objective measures of personality
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Mariana Moniz, Mauro Paulino, Octávio Moura, Mário R. Simões
and psychopathology for adolescents. The Personality Assessment Inventory – Adolescent
(PAI-A) is an objective self-report questionnaire that aims to provide relevant information on
the personality, psychopathology, and psychosocial context of adolescents, and it is a direct
derivation of its adult version. The present study aims to conduct a review on the development,
structure, psychometric properties, administration, scoring, and interpretation steps of the PAI-
A, as well as to present the settings in which it can be applied (clinical, educational, and forensic).
International adaptations of the PAI-A are provided, and the utility of a Portuguese adaptation
is debated, considering its qualities and possible contribution to the field of psychological
assessment of adolescents in Portugal.
Keywords: Personality Assessment Inventory – Adolescent; Personality; Psychometry; Validation.
Introdução
A adolescência é um estádio de desenvolvimento repleto de transformações e desafios físicos
(e.g., início da puberdade, desenvolvimento de características sexuais secundárias, alterações
hormonais), sociais (e.g., separação emocional dos pais, forte identificação com pares, compor-
tamentos exploratórios e de risco, delineamento de planos vocacionais, maior autonomia social,
formação de relações íntimas) e psicológicos (e.g., desenvolvimento cognitivo, consolidação da
identidade e orientação sexual, reavaliação da imagem corporal) (Kar et al., 2015; McIntosh et al.,
2003).
As transformações morfológicas e funcionais que o cérebro enfrenta nesta fase, associadas
a alterações hormonais e biológicas e ao contexto cultural e socioeconómico no qual os adoles-
centes se encontram vão moldar o modo como estes pensam, sentem e se comportam (Spear,
2013). Quando coexistem com fatores de risco (e.g., psicológicos, familiares), estas transforma-
ções levam a que a adolescência seja um estádio suscetível ao desenvolvimento de problemas do
foro psicológico (Shorey et al., 2022).
Por outro lado, certas características pessoais (e.g., temperamento, traços da personalidade),
estratégias de coping maladaptativas (e.g., envolvimento em comportamentos de risco), expe-
riência de perdas significativas (e.g., morte de progenitores ou figuras de referência), perceção
de isolamento social, experiências de discriminação e existência de doença crónica (e.g., doença
oncológica) constituem também fatores de risco ao desenvolvimento de problemas psicológicos
em adolescentes (Ati et al., 2021; Carballo et al., 2020; Lu, 2019). Ademais, a existência de esti-
los parentais desadequados, desequilíbrio nutricional, má higiene do sono, relações conflituosas
com os pares, recurso excessivo a tecnologias e redes sociais, existência de um histórico de pro-
blemas mentais na família e instabilidade familiar constituem importantes fatores de risco ao
desenvolvimento de psicopatologia neste estádio desenvolvimento (Ati et al., 2021; Lu, 2019). A
exposição a experiências de violência está também referenciada como um fator de risco para o
desenvolvimento de psicopatologia na adolescência (Fowler et al., 2009; Wilmshurst, 2015).
De entre os problemas de saúde mental mais prevalentes nesta faixa etária, encontra-se a
depressão e ansiedade (e.g., Shorey et al., 2021; Skrove et al., 2012), comummente associadas a
comportamentos autolesivos (e.g., Gillies et al., 2018; Muehlenkamp et al., 2012); a perturbação de
hiperatividade/défice de atenção (PHDA) (e.g., Polanczyk et al., 2014), assim como as perturbações
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O Inventário de Avaliação da Personalidade – Adolescentes (PAI-A):
Contributos para a avaliação psicológica de adolescentes
da personalidade, sendo a perturbação da personalidade borderline a mais referenciada (e.g.,
Sharp & Fonagy, 2015). A este propósito, ainda que o diagnóstico de perturbação da personali-
dade em menores de 18 anos permaneça foco de debate, devido à potencial rotulagem dos jovens
e à natureza instável e transiente deste estágio de desenvolvimento, um crescente número de
estudos tem demonstrado que este diagnóstico pode, efetivamente, ser estabelecido de forma
fiável, uma vez que perturbações da personalidade tendem a ser estáveis ao longo do ciclo vital
(e.g., Guilé et al., 2018; Sharp, 2017). Não obstante o debate existente, é reconhecido que todos os
problemas supracitados, se não identificados e intervencionados, podem tornar-se persistentes
ao longo da vida adulta (Butcher, 2018).
Os últimos anos registaram uma elevada prevalência de psicopatologia nos adolescentes, a
nível nacional e internacional. A título de exemplo, em 2022, Portugal apresentou a taxa de sui-
cídio mais elevada dos últimos 20 anos (Instituto Nacional de Estatística, 2024) e o programa
nacional de prevenção ao suicídio nas escolas Mais Contigo indicou que, em 2025, cerca de 40%
dos adolescentes portugueses reportou sintomas depressivos e que 12% estão em risco de adotar
comportamentos suicidários (Santos et al., 2025). Ademais, um estudo conduzido pela UNICEF
(2025) revelou que o tema da saúde mental continua a ser a principal preocupação das crianças e
adolescentes portugueses. A nível internacional, a evidência científica aponta para uma preva-
lência de psicopatologia em jovens entre os 10 e os 19 anos de idade na ordem dos 15% (Organi-
zação Mundial de Saúde, 2024).
Estes dados nacionais e internacionais relevam para uma necessidade premente de desen-
volver ou adaptar métodos de avaliação e intervenção adequados e ajustados às necessidades
específicas desta população. Adicionalmente, é importante ter em conta que as últimas décadas
têm assistido a uma transformação substancial das experiências de socialização dos adolescen-
tes. A título de exemplo, o quase ilimitado acesso a redes sociais, que tem um potencial impacto
negativo no funcionamento emocional e social dos jovens (Keles et al., 2020), torna a avaliação do
funcionamento psicológico desta faixa etária relevante na atualidade.
Face à prevalência de psicopatologia em adolescentes, a avaliação psicológica emerge como
uma etapa fundamental para a compreensão do funcionamento dos adolescentes e subsequente
tomada de decisão clínica ou encaminhamento para serviços de saúde mental.
Butcher (2018) enumera um conjunto de motivos pelos quais os adolescentes podem ser enca-
minhados para um processo de avaliação, designadamente: (i) preocupações parentais sobre o
comportamento do adolescente (e.g., isolamento social, absentismo escolar, comportamentos
de oposição), (ii) existência de problemas familiares, (iii) problemas comportamentais e legais
(e.g., condutas qualificadas como crime na lei penal, consumos de substâncias, comportamentos
agressivos), e (iv) contextos de regulação do exercício das responsabilidades parentais e disputa
parental, entre outros.
No entanto, a avaliação psicológica de adolescentes é, muitas vezes, mais complexa do que
a avaliação com adultos, dado que remete para uma fase de rápido desenvolvimento e transfor-
mações, onde o risco de diagnósticos prematuros e a necessidade de diagnósticos diferenciais
constituem alguns desafios a considerar (Neal et al., 2022). Ademais, é necessário equacionar a
possibilidade de o adolescente não compreender o motivo pelo qual está a ser sujeito a avaliação
e, como tal, de se encontrar desmotivado para colaborar no processo avaliativo, pelo que cabe
ao profissional conseguir contornar esta desmotivação, assim como recorrer a uma abordagem
multimétodo, que inclua não só a entrevista com o jovem e seus progenitores, como também
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Mariana Moniz, Mauro Paulino, Octávio Moura, Mário R. Simões
uma avaliação instrumental, recorrendo a instrumentos estandardizados e capazes de identifi-
car desmotivação ou distorção de imagem (e.g., testes de validade de sintomas ou inventários de
personalidade que incluem escalas de avaliação da validade das respostas). Ainda que relevante,
o recurso exclusivo a entrevistas aos jovens ou ao relato de progenitores e professores é insufi-
ciente (Srinath et al., 2019). Uma utilização responsável e crítica de medidas psicológicas, que
recorram a dados normativos, é assim, também, fundamental (Kazdin, 2005).
A administração de instrumentos de avaliação psicológica permite obter informação fiável
e objetiva acerca do funcionamento psicológico de adolescentes e as medidas de autorresposta,
em particular, estão entre as ferramentas mais utilizadas para obter dados sobre o estado psi-
cológico dos sujeitos (Meyer et al., 2015). Dado que os adolescentes, tendencialmente, já detêm
as capacidades desenvolvimentais necessárias para proporcionar informação fiável sobre o seu
estado subjetivo e experiências de vida (Krishnamurthy, 2010), a utilidade de instrumentos de
autorresposta, como é o caso dos inventários é, assim, reforçada.
A anteriormente mencionada complexidade inerente à avaliação de adolescentes traduz-se
também no número escasso de inventários de personalidade especificamente desenvolvidos e
destinados a este período etário (e.g., Archer & Newsom, 2000; Archer et al., 1991; Cashel, 2002).
De entre as medidas de autorresposta especialmente concebidas para atender a popula-
ções adolescentes, encontram-se o Personality Inventory for Youth (PIY; Lachar & Gruber, 1995), o
Inventário Clínico de Millon para Adolescentes (MACI; Millon et al., 1993; adaptação portuguesa:
Cavaco 2004), o Inventário Multifásico de Personalidade de Minnesota – Adolescentes (MMPI-A;
Butcher et al., 1992; adaptação portuguesa: Silva et al., 2006; Carvalho & Novo, 2018) e, mais
recentemente, o Inventário de Avaliação de Personalidade – Adolescentes (PAI-A; Morey, 2007).
Adicionalmente, o Inventário de Avaliação da Saúde Mental de Jovens de Massachusetts – Ver-
são 2 (MAYSI-2; Grisso & Barnum, 2014; adaptação portuguesa: Almiro et al., 2017) e o Youth
Self Report (YSR) – incluído no Sistema de Avaliação Empiricamente Validado (ASEBA) para o
Período Pré-Escolar e Escolar (Achenbach & Rescorla, 2001; adaptação portuguesa: Achenbach et
al., 2014) – surgem como outras importantes ferramentas de autorresposta que procuram avaliar
a psicopatologia e os comportamentos problemáticos em adolescentes.
À data, em Portugal, já existem estudos de validação com alguns destes inventários, nomea-
damente com o MACI (e.g., Ramos et al., 2014) e MMPI-A (e.g., Carvalho et al., 2014; Santos et al.,
2024), mas apenas o MAYSI-2 e YSR – dois instrumentos de psicopatologia, e não de personali-
dade – se encontram comercializados.
Em suma, reconhece-se uma elevada prevalência de psicopatologia e sintomas psicopatoló-
gicos em adolescentes, assim como uma necessidade de recorrer a múltiplos métodos para afe-
rir o seu estado mental. Contudo, a escassez de instrumentos de avaliação da personalidade de
adolescentes em Portugal é evidente, pelo que se torna necessário realizar estudos de adaptação
e validação de medidas robustas e fiáveis, de modo a garantir uma boa prática da avaliação psi-
cológica junto desta população.
Nesta senda, o PAI-A surge como um instrumento objetivo de autorresposta que reúne diver-
sas vantagens relativamente a outros instrumentos de avaliação da personalidade de adoles-
centes (e.g., MMPI-A), graças à sua dimensão comparativamente mais reduzida, à sua estrutura
(organizada em escalas de quatro pontos, que permitem reportar, não só a presença de sintomas,
como a sua severidade) e à sua facilidade de leitura, que exige apenas um nível correspondente
ao 4º ano de escolaridade (ao contrário do MMPI-A, que requer um nível de leitura equivalente
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O Inventário de Avaliação da Personalidade – Adolescentes (PAI-A):
Contributos para a avaliação psicológica de adolescentes
ao 6º ano de escolaridade) (Charles et al., 2021; Morey & Meyer, 2014). Em relação a um outro
instrumento validado para a população portuguesa, o MAYSI-2 (que se encontra exclusivamente
validado para contexto forense), reconhece-se que o PAI-A é mais longo, o que significa um maior
tempo de administração. No entanto, é de reforçar que o PAI-A possui escalas que medem a dis-
torção de imagem (positiva e negativa) e os estudos têm revelado que constitui um instrumento
com superior precisão para detetar agressividade em adolescentes e para identificar comporta-
mentos suicidas e autolesivos neste estádio de desenvolvimento (e.g., Shaffer et al., 2018).
Dadas estas potencialidades e a sua comprovada aplicabilidade em contextos diversifica-
dos, reconhece-se que a adaptação e validação do PAI-A para a população portuguesa permitirá
contribuir para responder ao problema da falta de instrumentos de avaliação de personalidade
disponíveis e validados para a população adolescente portuguesa. O presente estudo tem como
principal objetivo proceder a uma organização e análise compreensiva das características do
PAI-A, possíveis contextos de aplicação e aplicabilidade em diferentes países e culturas, servindo
de ponto de partida para compreender os possíveis contributos desta medida no campo da ava-
liação psicológica de adolescentes em Portugal.
Inventário de Avaliação de Personalidade – Adolescentes (PAI-A)
Desenvolvimento e estrutura do PAI-A
O PAI-A, uma derivação direta do Inventário de Avaliação da Personalidade (PAI; Morey,
1991; Paulino et al., 2023), é um instrumento objetivo de autorresposta que inclui 264 itens que
fornecem dados sobre a personalidade, psicopatologia e ambiente psicossocial de adolescentes
(i.e., 12 aos 18 anos), através de uma versão equiparável à versão adulta, em termos de conteúdo
dos itens e propriedades psicométricas (Morey, 2007; Venta et al., 2018).
De acordo com o autor do instrumento, Leslie Morey, o PAI-A foi construído na sequência de
um crescente “interesse expresso por muitos profissionais que queriam aplicar o PAI a adoles-
centes” (Morey, 2007, p. 1), pelo que o objetivo central da adaptação de uma versão a adolescentes
foi garantir a manutenção da estrutura da versão adulta, ajustando apenas os itens considerados
inadequados para populações mais jovens, de modo a torná-los apropriados a adolescentes entre
os 12 e 18 anos de idade (Morey, 2007).
À semelhança do que se sucedeu no PAI, os construtos clínicos avaliados pelo PAI-A foram
selecionados com base em dois critérios: (i) a sua importância histórica no que remete à nosologia
das perturbações psicológicas; e (ii) a sua relevância para a prática diagnóstica atual (Morey, 2018).
Os itens e escalas do PAI, mais tarde adaptados à sua versão de adolescentes, foram construídos
de modo a proporcionar informação sobre os construtos a medir, no que concerne à diversidade
e severidade de sintomas (Morey & McCredie, 2020). A versão final do PAI-A manteve, assim, uma
estrutura de escalas e subescalas análoga à versão de adultos.
A estandardização original do PAI-A incluiu uma amostra da população geral (n = 707) com
idades compreendidas entre os 12 e 18 anos, estratificada com base no género, raça/etnia e idade,
de acordo com os Censos 2003 dos Estados Unidos da América. O grupo clínico (n = 1160), por
sua vez, incluiu jovens com perturbação do comportamento, perturbação depressiva, ansiedade,
PHDA, entre outras (Morey, 2007).
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Mariana Moniz, Mauro Paulino, Octávio Moura, Mário R. Simões
O PAI-A inclui 22 escalas não sobrepostas, organizadas em quatro escalas de validade,
11escalas clínicas, cinco escalas de contingência clínica e duas escalas de estilos de relaciona-
mento interpessoal, suplementadas por um conjunto de 31 subescalas que refletem áreas clínicas
ou relacionadas com o tratamento (Krishnamurthy, 2010) (ver Tabela 1). Dado o desejo em man-
ter a estrutura do PAI, as escalas da versão de adolescentes mantêm o nome da versão original,
sendo as diferenças associadas ao número de itens por escala e sua formulação.
TABELA1
Estrutura das escalas e subescalas do PAI-A
Escala Descrição Subescala
Escalas de validade
Inconsistência (ICN) Padrões de resposta aleatória
Infrequência (INF) Padrões de resposta atípicos
Imagem negativa (NIM) Tendência para se apresentar de forma exageradamente
negativa
Imagem positiva (PIM) Tendência para se apresentar de forma exageradamente
positiva
Escalas Clínicas
Queixas somáticas (SOM) Preocupações com problemas de saúde ou queixas
somáticas especícas
Conversão (SOM-C)
Somatização (SOM-S)
Hipocondria (SOM-H)
Ansiedade (ANX) Manifestações e sinais observáveis de ansiedade Cognitiva (ANX-C)
Afetiva/Emocional (ANX-A)
Fisiológica (ANX-P)
Perturbações relacionadas
com a ansiedade (ARD)
Sintomas e comportamentos relacionados com
perturbações da personalidade
Obsessivo-Compulsiva (ARD-O)
Fobias (ARD-P)
Stress-Traumático (ARD-T)
Depressão (DEP) Manifestações e sintomas de perturbações depressivas. Cognitiva (DEP-C)
Afetiva/Emocional (DEP-A)
Fisiológica (DEP-P)
Mania (MAN) Sintomas afetivos, cognitivos e comportamentais da
mania e hipomania
Nível de Atividade (MAN-A)
Grandiosidade (MAN-G)
Irritabilidade (MAN-I)
Paranoia (PAR) Sintomas de perturbações paranóides e características
estáveis da personalidade paranóide
Hipervigilância (PAR-H)
Perseguição (PAR-P)
Ressentimento (PAR-R)
Esquizofrenia (SCZ) Sintomas relevantes do espetro de perturbações
esquizofrénicas
Experiências Psicóticas (SCZ-P)
Isolamento Social (SCZ-S)
Perturbação do Pensamento (SCZ-T)
Traços borderline (BOR) Atributos do funcionamento da personalidade Borderline Irritabilidade Afetiva (BOR-A)
Problemas de Identidade (BOR-I)
Relacionamentos Problemáticos (BOR-N)
Autoagressão (BOR-S)
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O Inventário de Avaliação da Personalidade – Adolescentes (PAI-A):
Contributos para a avaliação psicológica de adolescentes
Escala Descrição Subescala
Traços antissociais (ANT) Atributos do funcionamento da personalidade antissocial Comportamentos Antissociais (ANT-A)
Egocentrismo (ANT-E)
Comportamentos de Risco (ANT-S)
Problemas com álcool (ALC) Consequências problemáticas do abuso de álcool e traços
da dependência do álcool
Problemas com drogas (DRG) Consequências problemáticas do abuso de substâncias
estupefacientes e traços da dependência de substâncias
estupefacientes
Escalas de contingência clínica
Agressividade (AGG) Características e atitudes relacionadas com a raiva,
hostilidade e agressão Atitude Agressiva (AGG-A)
Agressão Verbal (AGG-V)
Agressão Física (AGG-P)
Ideação suicida (SUI) Ideação suicida, abordando questões associadas à
ideação e planeamento do suicídio
Stress (STR) Impacto de circunstâncias ou situações stressantes
recentes nas principais áreas da vida
Falta de suporte social (NON) Falta de apoio social percebido em termos de quantidade
e qualidade
Resistência ao tratamento
(RXR)
Atributos e atitudes que indicam uma falta de interesse e
motivação para a intervenção psicológica
Escalas de estilos de relação interpessoal
Dominância (DOM) Grau de controlo e independência nas relações
interpessoais
Amabilidade (WRM) Grau de interesse por relações interpessoais empáticas e
de suporte
Qualidades Psicométricas do PAI-A
Os estudos psicométricos revelam uma consistência interna (alfas de Cronbach: M = .79;
mediana = .80; Min. =.70, na escala de Imagem Positiva; Máx. = .90, na escala de Agressão) e uma
fiabilidade teste-reteste (correlação de Pearson: M = .78; mediana = .79; Min.= .65, na escala de
Imagem Positiva; Máx. = .89, na escala de Somatização) aceitáveis para as 22 escalas do PAI-A, na
amostra de comunidade e clínica (Morey, 2007).
De notar que os alfas de Cronbach das escalas da Inconsistência e da Infrequência não foram
calculados no manual original ou subsequentes adaptações do instrumento (e.g., espanhola, sul-
-coreana, italiana), dado que estas escalas não possuem conteúdo substantivo ou específico, sendo
por isso expectáveis valores muito baixos (e.g., na versão estadunidense de adultos, a escala de
Inconsistência obteve um alfa de .45 e a escala de Infrequência de .52; na versão portuguesa, a
escala de Inconsistência registou um alfa de .08 e a escala de Infrequência de .19) (Morey, 1991;
Morey, 2018; Paulino et al., 2024a).
Administração, Cotação e Interpretação de Resultados
Os itens do PAI-A foram escritos para serem compreendidos por jovens com capacidade de
leitura correspondente ao quarto ano de escolaridade e podem ser respondidos numa escala de
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Mariana Moniz, Mauro Paulino, Octávio Moura, Mário R. Simões
quatro pontos: “Totalmente Falso”, “Ligeiramente Falso”, “Bastante Verdadeiro” e “Totalmente
Verdadeiro”. Esta escala de quatro pontos proporciona informação dimensional acerca dos sinto-
mas e experiências, permitindo, assim, obter informação não só acerca da presença de sintomas,
como acerca da sua gravidade (Morey, 2007).
O manual do PAI-A indica um tempo médio de resposta de 45 minutos, ainda que se reco-
nheça que jovens com dificuldades de concentração ou atrasos psicomotores requeiram mais
tempo para completar o inventário (Morey, 2007, 2018). Os materiais do teste incluem um caderno
de itens e o recurso a métodos de administração manuais (Forma HS-A) ou digitais (Forma SS-A).
Adicionalmente, o manual proporciona formulários de perfis e de itens críticos (Morey, 2007).
A administração do PAI-A requer um nível de qualificação enquadrado na categoria C
(Hogrefe, n.d.; Personality Assessment Resources, n.d.), devendo ser realizada por profissionais
– com formação em Psicologia e na administração, cotação e interpretação de instrumentos de
avaliação psicológica – e que estejam familiarizados com os itens e normas do PAI-A. Ademais,
é exigido ao utilizador um conhecimento nos domínios da psicopatologia e da personalidade
(Morey, 2007).
O PAI-A pode ser aplicado individual ou coletivamente, sendo o único requisito a garantia
da confidencialidade das respostas proporcionadas. Ao examinador cabe a responsabilidade de
garantir a existência de condições de espaço e tempo adequadas para a realização da prova,
assim como de prestar esclarecimentos referentes ao conteúdo dos itens ou significado de pala-
vras e/ou frases (Morey, 2018).
Contextos de aplicação do PAI-A
Contexto Clínico
Porque o PAI-A foi concebido como um instrumento de utilidade clínica, com escalas clínicas
e de contingência clínica, a sua utilização permite obter informação que facilita o processo diag-
nóstico e planificação de intervenção (Krishnamurthy, 2010). A título de exemplo, estudos leva-
dos a cabo por Charles et al. (2021, 2022b) demonstraram que o PAI-A proporciona informação
útil na previsão da adesão a programas de intervenção, assim como no seu abandono, através dos
resultados obtidos em algumas das suas escalas (e.g., Depressão, Traços Antissociais, Agressão,
Traços Borderline, Problemas com Álcool, Falta de Suporte Social, Resistência ao Tratamento e
Dominância).
Outras investigações têm demonstrado que as escalas de Depressão e Ansiedade do PAI-A
são capazes de detetar com precisão a ansiedade e depressão em adolescentes, correlacionando-
-se positiva e fortemente com outras medidas de avaliação destes construtos, nomeadamente o
Inventário de Depressão de Beck (BDI-II; Beck et al., 1996, em fase de edição comercial em Portu-
gal), o Questionário de Comportamentos da Criança (CBCL; Achenbach, 2001; Achenbach et al.,
2014), o Inventário Multifásico de Personalidade de Minnesota – Adolescentes (MMPI-A; Butcher,
1992), entre outros (e.g., Ryszewska et al., 2024; Vanwoerden et al., 2018). Estas e outras esca-
las (e.g., subescala de Autoagressão do PAI-A) estão também relacionadas com comportamentos
autolesivos em adolescentes (Caguana, 2022). A sua capacidade de identificar adolescentes com
ideação suicida e a sua capacidade de diferenciar entre adolescentes com baixo e elevado risco
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O Inventário de Avaliação da Personalidade – Adolescentes (PAI-A):
Contributos para a avaliação psicológica de adolescentes
de suicídio tem sido reforçada pela investigação, que tem recorrido a análises de regressão e de
curvas ROC (e.g., Kim et al., 2021; Spencer, 2021). Adicionalmente, dada a sua relativa brevidade
de administração e baixo nível de leitura exigido, algumas investigações têm apontado para a
sua utilidade junto de populações adolescentes com perturbação do espetro do autismo (e.g.,
Hooks et al., 2021).
Na esfera da avaliação de perturbações da personalidade em adolescentes, a literatura tem
apontado para a utilidade da escala de Traços Borderline, tendo esta revelado boa validade con-
vergente e discriminante com outras medidas desta perturbação (e.g., Borderline Personality Fea-
tures Scale for Children – BPFSC; Crick et al., 2005), ainda que se deva acautelar que a escala não
tem em conta todos os critérios de diagnóstico apontados no Manual de Diagnóstico e Estatística
das Perturbações Mentais (DSM-5-TR; American Psychiatric Association, 2022) (e.g., Chanen et
al., 2020; Glenn et al., 2013; Kalpakci & Sharp, 2018; Sharp et al., 2012; Stokes et al., 2019).
Contexto Forense
O longo historial de estudos realizados com a versão de adultos (i.e., PAI), que atestam a sua
aplicabilidade em contexto forense (e.g., Paulino et al., 2024b), assim como as características da
versão de adolescentes (e.g., reduzido número de itens, rápida administração, reduzido nível de
leitura exigido, presença de escalas de defensividade e de simulação de respostas/sintomas),
comprovam o interesse na aplicação do PAI-A igualmente a amostras de jovens envolvidos no
sistema de justiça, uma vez que se trata de uma população com tendência a um rendimento esco-
lar inferior e com potencial de simulação/dissimulação (Gremmen et al., 2019).
A utilidade do PAI-A a amostras forenses é corroborada, quando consideramos que cerca de
1/3 da amostra clínica contida nos estudos de validação do manual do instrumento foi recrutada
de contextos de justiça juvenil, o que reflete bem a associação entre envolvimento em questões
legais e problemas de saúde mental em adolescentes (Charles et al., 2022a).
O PAI-A possui escalas e subescalas focadas no consumo de álcool (Problemas com Álcool)
e droga (Problemas com Droga), trauma (Stress Traumático), ansiedade (Ansiedade), depressão
(Depressão), ideação suicida (Ideação Suicida), traços de personalidade borderline (Traços Border-
line) e traços antissociais (Traços Antissociais), construtos estes prevalentes em jovens envolvidos
no sistema de justiça (Abram et al., 2015; Farwell, 2011; Shaffer et al., 2018). Adicionalmente, ten-
tativas de exagerar ou minimizar sintomas psicológicos constituem uma preocupação premente
em processos de avaliação psicológica forense, devido às implicações que podem decorrer deste
contexto, e estas são avaliadas pelo PAI-A através das escalas de validade disponibilizadas (e.g.,
Imagem Negativa e Imagem Positiva) (Charles et al., 2022a).
Nesta senda, a capacidade de o PAI-A detetar simulação ou exagero de sintomas em adoles-
centes tem sido objeto de diversos estudos desde a génese do inventário. Com efeito, o manual do
instrumento reforça a utilidade diagnóstica de algumas escalas na deteção de simulação, nomea-
damente da escala de Imagem Negativa, cuja capacidade de deteção regista uma sensibilidade
de 100% e especificidade de 88.4%, quando se utiliza um ponto de corte superior a 2.5 desvios-
-padrão, isto é, uma pontuação de pontuação T = 75 (Morey, 2007). Outro estudo, de Rios e Morey
(2013), demonstrou que os indicadores de validade de perfis do PAI-A, especialmente a Função
Discriminante de Rogers (sensibilidade = 82.2%, especificidade = 75.7%), são indicadores eficazes
na identificação de simulação de respostas.
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Mariana Moniz, Mauro Paulino, Octávio Moura, Mário R. Simões
Apesar de não terem sido desenvolvidos especificamente para o PAI-A (mas para o PAI),
alguns estudos têm sugerido que os índices suplementares da versão de adultos podem ter utili-
dade para a versão de adolescentes. A título de exemplo, os indicadores de distorção de resposta
do PAI de adultos são úteis para a deteção de simulação de sintomas de PHDA em adolescentes,
com particular utilidade atribuída à Função Discriminante de Rogers (RDF; Morey, 1996), sendo
este o indicador mais preciso na identificação de adolescentes que simulam esta perturbação do
neurodesenvolvimento (Diaz de Tuesta, 2012; Rios & Morey, 2013). A Função Discriminante de
Rogers, assim como a escala de Imagem Negativa, parecem ser igualmente eficazes na deteção de
“simulação” e exagero de sintomas de depressão e ansiedade (e.g., Malm et al., 2020). Outros indi-
cadores, tais como a Escala de Distorções Negativas (Mogge et al., 2010), o Índice de Simulação
de Hong (Hong & Kim, 2001) e o Índice de Defensividade de Hong (Hong & Kim, 2001), também
aparentam ter relativa utilidade na identificação de distorção de respostas, quando aplicados a
adolescentes, em contexto comunitário (Meyer et al., 2015).
O PAI-A tem ainda aplicabilidade na predição de comportamentos autolesivos e comporta-
mentos agressivos e delinquentes em amostras de jovens envolvidos no sistema de justiça (Charles
et al., 2021; Floyd et al., 2022; Shaffer et al., 2018), assim como na classificação de diferentes tipos
de jovens agressores (e.g., que cometem ofensas interpessoais, contra a propriedade e de consu-
mos), sendo mais eficaz do que outros instrumentos de avaliação de jovens adolescentes, como é
o caso do MMPI-A (Humenik et al., 2019). Complementarmente, estudos recentes têm reportado
correlações fortes e positivas entre o PAI-A e outras medidas de perturbação do comportamento,
nomeadamente o Proposed Specifiers for Conduct Disorder Scale (PSCD; Salekin, 2016) (Neumann
et al., 2024; Salekin et al., 2022), legitimando a sua aplicabilidade em amostras de agressores.
Contexto Escolar
Dado que grande parte da literatura sobre o PAI-A está focada em contextos clínicos e foren-
ses, a investigação sobre a sua aplicação em contexto escolar ainda se encontra numa fase muito
preliminar. Não obstante, a sua aplicabilidade neste contexto tem um grande potencial. A título
exemplificativo, um estudo levado a cabo por Sandström (2024) demonstrou que algumas das
suas escalas (e.g., Resistência ao Tratamento, Ansiedade, Depressão) são preditoras significativas
de rejeição e abandono escolar. Ademais, o estudo conclui que as escalas de Somatização, Para-
noia, Agressão e Resistência ao Tratamento poderão ser também úteis para melhor compreender
o fenómeno de rejeição e abandono escolar.
Apesar da escassez de estudos em contexto escolar, é certo que o PAI-A proporciona aos
adolescentes uma oportunidade para revelarem eventuais dificuldades e experiências pessoais,
constituindo um meio de comunicação (Krishnamurthy, 2010), a partir do qual os psicólogos esco-
lares podem tomar conhecimento dos principais problemas e áreas de maior vulnerabilidade dos
jovens e, subsequentemente, delimitar planos de intervenção adaptados e individualizados.
Adaptação e Validação do PAI-A noutros países
Ao contrário da versão de adultos, que já foi adaptada e validada para múltiplos países (e.g.,
China, Alemanha, Espanha, Grécia, Itália, México, Argentina, Vietname, Irão, Coreia do Sul,
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O Inventário de Avaliação da Personalidade – Adolescentes (PAI-A):
Contributos para a avaliação psicológica de adolescentes
Canadá, Portugal) (Paulino et al., 2023), são ainda escassos os países que adaptaram e validaram o
PAI-A. Com efeito, apenas a Espanha (Cardenal et al., 2018), Argentina (Iglesia et al., 2018; Stover
et al., 2017), Coreia do Sul (Kim et al., 2015) e Itália (Pezzuti et al., 2021) adaptaram o inventário
para as suas populações, encontrando-se este em processo de validação no Uruguai (Machado
et al., 2022). Não obstante a relativa escassez de adaptações internacionais do instrumento, é
de sublinhar que, à exceção da versão espanhola, as restantes adaptações foram levadas a cabo
nos últimos sete anos. Como tal, é um instrumento com uma recente e crescente disseminação.
Na tabela 2, estão representadas as principais propriedades psicométricas das diversas versões
internacionais do PAI-A.
TABELA2
Propriedades psicométricas do PAI-A: Comparações entre países
Propriedades Psicométricas
N.º
itens
N.º
fatores
Média
Consistência
Interna (α)a
Mediana
Consistência
Interna (α)a
Min. Máx.
Média
Fiabilidade
teste-
reteste
Mediana
Fiabilidade
teste-
reteste
Min. Máx.
Versões
E.U.A. 264 4 .79 .80 .70 .90 .78 .79 .65 .89
Espanha 264 4 .83 .85 .65 .96 .79 .79 .71 .87
Argentina 264 4 .82 .83 .68 .95 — — — —
Coreia do Sul 344 5 .75 .77 .51 .88 .91 .93 .65 .87
Itália 264 4 .72 .74 .52 .88 .72 .77 .45 .85
Nota. a Não foram tidas em linha de conta as escalas de Infrequência e de Inconsistência
A primeira adaptação internacional do PAI-A foi levada a cabo em Espanha por Cardenal e
colaboradores (Morey, 2018). Estes autores adotaram os procedimentos da versão original, cons-
truindo o PAI-A a partir da versão de adultos espanhola. Mantendo uma dimensão de 264 itens,
a versão espanhola demonstra adequada fiabilidade no que respeita à sua consistência interna,
com alfas de Cronbach que variam entre .65 (para a escala de Dominância) e .96 (para a escala de
Ideação Suicida) na amostra da população geral. De igual modo, esta versão do PAI-A revela ade-
quada estabilidade temporal: os coeficientes de correlação teste-reteste variam entre .71 (refe-
rente à escala de Problemas com Drogas) e .87 (referente à escala de Traços Antissociais), para um
período de duas semanas entre administrações (Cardenal et al., 2018).
A versão argentina do PAI-A foi desenvolvida em colaboração com os autores da versão espa-
nhola, tendo recorrido à versão por estes adaptada (Morey, 2018). Assim, esta versão espanhola
foi analisada por um painel de professores de diversos países da América Latina com o objetivo
de averiguar a adequação do PAI-A a adolescentes de um número alargado de países de língua
espanhola. No que remete para as suas propriedades psicométricas, foram encontrados valores
de alfa Cronbach (consistência interna) que variam entre .68 (pertencente à escala de Dominân-
cia) e .95 (pertencente à escala de Ideação Suicida) (Morey, 2018).
A adaptação do PAI-A na Coreia do Sul (Kim et al., 2006) foi realizada a partir da versão
coreana de adultos, mas foi posteriormente re-estandardizada em 2018, por Lim e colaboradores
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Mariana Moniz, Mauro Paulino, Octávio Moura, Mário R. Simões
(2018). Esta versão manteve a estrutura interna original do PAI, isto é, quatro escalas de validade,
11 escalas clínicas, cinco escalas de tratamento e duas escalas interpessoais, contendo 344 itens
(Kim et al., 2006). Já no que remete para a fiabilidade, os alfas de Cronbach (consistência interna)
variaram entre .51 (para a escala de Problemas com Álcool) e .88 (para a escala de Traços Bor-
derline), enquanto os coeficientes de correlação teste-reteste variaram entre .80 e .96 (Lim et al.,
2018).
Finalmente, a adaptação e estandardização italiana do PAI-A, realizada por Pezzuti e colabo-
radores (2021), manteve a sua estrutura interna, nomeadamente, 264 itens divididos em 22 esca-
las e 31 subescalas. Esta versão revelou adequada fiabilidade ao nível da consistência interna
(média α = .72 para a amostra da comunidade e α = .79 para amostra clínica). Para um intervalo
de 11 a 41 dias, a correlação média teste-reteste foi de .72 para uma amostra de 60 adolescentes.
As diversas versões internacionais do PAI-A divergem no que respeita aos critérios de tradu-
ção e adaptação adotados, o que resulta em diferenças acentuadas no seu conteúdo (e.g., alguns
itens da versão original não foram incluídos ou estão consideravelmente alterados na versão
espanhola, ainda que os autores não especifiquem o motivo para estas alterações) e no número
de itens (e.g., 264 itens na versão estadunidense, espanhola, argentina e italiana; 344 itens na
versão sul-coreana). A diferente metodologia empregue nos vários países, que resulta em ver-
sões distintas deste instrumento (i.e., itens e conteúdo diferente), poderá constituir um desafio
à realização de estudos transculturais recorrendo ao PAI-A, podendo levar à inconsistência de
resultados entre países e dificultando a comprovação de invariância desta medida (i.e., do nível
em que o instrumento mede os mesmos construtos em diferentes grupos culturais e linguísticos),
importante passo na validação de um dado instrumento (Ziegler & Bensch, 2013).
PAI-A em Portugal: Adaptação e validação
O processo de adaptação e validação do PAI-A para a população portuguesa foi iniciado em
2023, conta com a parceria protocolada da editora Hogrefe, e visa incluir vários estudos de vali-
dação com amostras da comunidade, clínicas (e.g., com perturbação depressiva, perturbação de
ansiedade, perturbação de hiperatividade e défice de atenção), e forenses (e.g., vítimas, agresso-
res). Adicionalmente, na sequência do trabalho realizado com a versão de adultos, irá ser desen-
volvida uma versão abreviada do PAI-A, mediante a extração dos itens com melhores indicado-
res psicométricos.
Conclusões
A adolescência é um estádio de desenvolvimento marcado por stress e vulnerabilidade a per-
turbações psicológicas e os procedimentos de avaliação psicológica devem considerar o rápido
desenvolvimento e transformações que acompanham estas faixas etárias, bem como as implica-
ções que um incorreto diagnóstico pode ter na vida do jovem, a curto e longo prazo.
Em Portugal, estima-se que 15% dos adolescentes sofre de sintomatologia depressiva mode-
rada ou grave, o que releva para a necessidade de desenvolvimento de técnicas e instrumentos
de avaliação psicológica objetivos e fiáveis (Santos et al., 2016). Contudo, observa-se uma enorme
escassez de instrumentos psicométricos para este fim, validados para a população portuguesa.
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O Inventário de Avaliação da Personalidade – Adolescentes (PAI-A):
Contributos para a avaliação psicológica de adolescentes
A tradução, adaptação e validação do PAI-A para a população portuguesa contribuirá, como tal,
para a expansão do campo da avaliação da personalidade e da psicopatologia em adolescentes
em Portugal, nomeadamente em amostras clínicas e forenses.
O PAI-A, desenvolvido em 2007, é um instrumento objetivo de autorresposta que reúne diver-
sas mais-valias, designadamente uma dimensão e consequente tempo de administração acessí-
veis, facilidade de leitura, assim como inclusão de escalas de validade e de escalas com particu-
lar interesse em contexto clínico (e.g., escalas clínicas e de contingência clínica) e forense (e.g.,
escalas que medem agressividade ou consumos).
A principal limitação associada a este instrumento é a escassez de estudos existentes até à
data com diferentes amostras, comparativamente com o número elevado de estudos realizados
com a sua versão de adultos (PAI). No entanto, a literatura disponível reforça a sua robustez psi-
cométrica, validade (convergente e discriminante) e utilidade em contextos clínicos, forenses e
escolares (Sandström, 2024; Vanwoerden et al., 2018; Venta et al., 2018), reforçando o interesse do
presente projeto de adaptação e validação do PAI-A para a população portuguesa. Nesta senda,
o PAI-A integra escalas que analisam domínios de especial interesse clínico (e.g., perturbações
da personalidade, ansiedade, depressão) e forense (e.g., abuso de substâncias, trauma, agressivi-
dade, traços calosos), assim como índices suplementares que, se adaptados a partir da versão de
adultos, são úteis para avaliar o risco de violência, reincidência criminal e suicídio (Charles et al.,
2022a; Diaz de Tuesta et al., 2021; Preston et al., 2021). A sua capacidade de prever a resistência ou
adesão à intervenção psicológica, ideação suicida e comportamentos autolesivos reforçam a sua
utilidade e relevância clínica e forense (Charles et al., 2021, 2022b).
A relativa escassez de estudos com o PAI-A pode dever-se aos desafios que advêm da avalia-
ção de menores, particularmente no que concerne à necessidade de obtenção de consentimento
informado junto dos representantes legais, o que é um desafio a antecipar no processo de adap-
tação e validação do instrumento em Portugal. Complementarmente, o protocolo de avaliação a
administrar aos adolescentes portugueses, durante o processo de adaptação e validação do PAI-
A, deverá ter uma dimensão que atenda à motivação dos respondentes e à capacidade limitada
para manter a atenção focada durante longos períodos, sobretudo no que respeita a populações
clínicas e forenses.
Outra limitação atribuível ao instrumento remete para o conteúdo dos itens. Alguns dos itens
do PAI-A dizem respeito a matérias sensíveis (e.g., consumo de álcool, consumo de drogas, idea-
ção suicida), sendo possível que alguns jovens não respondam com sinceridade. Esta limitação
é reconhecida na versão de adultos (Paulino et al., 2023), sendo expectável, de igual modo, que
também esteja presente na versão de adolescentes.
O presente estudo procurou sistematizar, de forma compreensiva, as características, quali-
dades e aplicabilidade do PAI-A em contextos diversificados, no sentido de dar a conhecer um
instrumento robusto, válido, fiável e internacionalmente reconhecido de avaliação de personali-
dade de adolescentes, evidenciando o modo como a sua validação para a população portuguesa
contribuirá para o aprofundamento do conhecimento atualmente existente sobre o funciona-
mento psicológico dos adolescentes portugueses, em contexto comunitário, clínico e forense,
onde estudos são ainda escassos.
O acesso a instrumentos devidamente validados e aferidos para a população portuguesa,
como é o caso do PAI-A, contribuirá positivamente não só para a prática clínica (ao proporcionar
um instrumento que auxiliará os psicólogos no delineamento de objetivos terapêuticos, tomada
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Mariana Moniz, Mauro Paulino, Octávio Moura, Mário R. Simões
de decisão, monitorização de eficácia da intervenção e adesão ao tratamento), mas também para
o campo da investigação sobre a personalidade, psicopatologia e dimensões interpessoais de
jovens entre os 12 e os 18 anos de idade, em diversos contextos (e.g., clínico, educacional, forense),
contribuindo para o acréscimo do conhecimento neste domínio.
A existência de uma versão análoga para adultos (PAI) validada para a população portuguesa
(Paulino et al., 2024a), abre ainda portas para a realização de estudos longitudinais futuros sobre
a personalidade dos portugueses, em contexto comunitário, clínico e forense, que acompanhe
o seu percurso desenvolvimental, desde a adolescência à idade adulta, recorrendo sequencial-
mente ao PAI-A e ao PAI.
Finalmente, o eventual desenvolvimento de uma versão reduzida permitirá alargar protoco-
los de avaliação a mais instrumentos, potenciando dados de avaliação psicológica mais comple-
tos e válidos.
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THE PERSONALITY ASSESSMENT INVENTORY ADOLESCENT
PAIA: CONTRIBUTIONS TO THE PSYCHOLOGICAL ASSESSMENT
OF ADOLESCENTS
Mariana Moniz, Mauro Paulino, Octávio Moura, Mário R. Simões
Abstract
Adolescence is a developmental stage marked by physical, social, and psychological changes
that, when combined with individual, social, or environmental risk factors, make this period
particularly vulnerable to the development of psychopathology. Psychological assessment of
adolescents must consider these vulnerabilities by providing objective, reliable, and valid assess-
ment instruments. In Portugal, however, objective measures for assessing personality and psy-
chopathology in adolescents remain scarce. Currently undergoing validation for the Portuguese
population, the Personality Assessment Inventory – Adolescent (PAI-A) is an objective self-re-
port questionnaire that provides information on adolescents’ personality, psychopathology, and
psychosocial context, complementing the adult version from which it was derived. This article
reviews the development process, structure, psychometric characteristics, administration, scor-
ing, and interpretation of the PAI-A. Its applicability in clinical, educational, and forensic contexts
is highlighted, and the relevance of its adaptation for the Portuguese population is discussed.
Keywords Personality Assessment Inventory – Adolescent; Personality; Psychometrics; Validation;
Psychological Assessment.
Introduction
Adolescence is a developmental stage marked by numerous physical (e.g., onset of puberty,
development of secondary sexual characteristics, hormonal changes), social (e.g., emotional sep-
aration from parents, strong identification with peers, exploratory and risk-taking behaviors,
formulation of vocational plans, increased social autonomy, formation of intimate relationships),
and psychological transformations (e.g., cognitive development, consolidation of identity and
sexual orientation, reappraisal of body image) (Kar et al., 2015; McIntosh et al., 2003). Morpho-
logical and functional brain changes occurring during this period, in conjunction with hormonal
and biological alterations and the cultural and socioeconomic context in which adolescents are
embedded, shape how they think, feel, and behave (Spear, 2013). When combined with risk fac-
tors (e.g., psychological and familial factors), these transformations render adolescence a stage
particularly susceptible to the development of psychological difficulties (Shorey et al., 2022).
Conversely, certain personal characteristics (e.g., temperament, personality traits), maladap-
tive coping strategies (e.g., engagement in risk behaviors), experiences of significant loss (e.g.,
death of parents or key attachment figures), perceived social isolation, experiences of discrimi-
nation, and the presence of chronic illness (e.g., oncological disease) also constitute risk factors
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THE PERSONALITY ASSESSMENT INVENTORY – ADOLESCENT (PAI-A):
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Mariana Moniz, Mauro Paulino, Octávio Moura, Mário R. Simões
for the development of psychological problems in adolescents (Ati et al., 2021; Carballo et al.,
2020; Lu, 2019). Furthermore, inadequate parenting styles, nutritional imbalance, poor sleep
hygiene, conflictual peer relationships, excessive use of technology and social media, a family
history of mental health problems, and family instability represent important risk factors for
the development of psychopathology during this developmental stage (Ati et al., 2021; Lu, 2019).
Exposure to violent experiences is likewise identified as a risk factor for the development of psy-
chopathology in adolescence (Fowler et al., 2009; Wilmshurst, 2015).
Among the most prevalent mental health problems in this age group are depression and anx-
iety (e.g., Shorey et al., 2021; Skrove et al., 2012), commonly associated with self-injurious behav-
iors (e.g., Gillies et al., 2018; Muehlenkamp et al., 2012); attention-deficit/hyperactivity disorder
(ADHD) (e.g., Polanczyk et al., 2014); and personality disorders, with borderline personality dis-
order being the most frequently referenced (e.g., Sharp & Fonagy, 2015). In this regard, although
the diagnosis of personality disorders in individuals under 18 years of age remains a subject of
debate due to concerns about potential labeling and the unstable and transitional nature of this
developmental stage, an increasing body of research has demonstrated that such diagnoses can,
in fact, be established reliably, given that personality disorders tend to show stability across the
lifespan (e.g., Guilé et al., 2018; Sharp, 2017). Notwithstanding the ongoing debate, it is widely
recognized that all the aforementioned conditions, if not identified and addressed, may persist
into adulthood (Butcher, 2018).
Recent years have witnessed a high prevalence of psychopathology among adolescents at
both national and international levels. By way of example, in 2022 Portugal recorded the highest
suicide rate of the past 20 years (Instituto Nacional de Estatística, 2024), and the national school-
based suicide prevention program Mais Contigo reported that, in 2025, approximately 40% of
Portuguese adolescents experienced depressive symptoms and 12% were at risk of engaging in
suicidal behaviors (Santos et al., 2025). Furthermore, a study conducted by UNICEF (2025) revealed
that mental health remains the primary concern of Portuguese children and adolescents. At the
international level, scientific evidence indicates a prevalence of psychopathology among young
people aged 10 to 19 years of approximately 15% (Organização Mundial da Saúde, 2024).
These national and international data highlight an urgent need to develop or adapt assess-
ment and intervention methods that are appropriate and responsive to the specific needs of
this population. Additionally, it is important to consider that recent decades have brought about
substantial changes in adolescents’ socialization experiences. For instance, the near-unlimited
access to social media, which may negatively affect young people’s emotional and social func-
tioning (Keles et al., 2020), underscores the contemporary relevance of assessing psychological
functioning in this age group.
Given the prevalence of psychopathology among adolescents, psychological assessment
emerges as a fundamental step in understanding adolescent functioning and in guiding subse-
quent clinical decision-making or referral to mental health services.
Butcher (2018) identifies several reasons why adolescents may be referred for psychologi-
cal assessment, including: (i) parental concerns regarding the adolescent’s behavior (e.g., social
withdrawal, school absenteeism, oppositional behaviors); (ii) the presence of family problems;
(iii) behavioral and legal issues (e.g., conducts classified as crime under penal law, substance use,
aggressive behaviors); and (iv) contexts involving the regulation of parental responsibilities and
parental disputes, among others.
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THE PERSONALITY ASSESSMENT INVENTORY – ADOLESCENT (PAI-A):
CONTRIBUTIONS TO THE PSYCHOLOGICAL ASSESSMENT OF ADOLESCENTS
Mariana Moniz, Mauro Paulino, Octávio Moura, Mário R. Simões
However, psychological assessment in adolescence is often more complex than assessment
in adulthood, as it pertains to a period of rapid development and transformation in which the
risk of premature diagnoses and the need for differential diagnosis constitute important chal-
lenges (Neal et al., 2022). It is also necessary to consider the possibility that adolescents may not
understand the reasons for their evaluation and may therefore be unmotivated to participate
in the assessment process. Consequently, it is incumbent upon the professional to address such
demotivation and to adopt a multimethod approach that includes interviews with the adolescent
and their parents, as well as instrument-based assessment using standardized tools capable of
detecting demotivation or response distortion (e.g., symptom validity tests or personality inven-
tories that incorporate response validity scales). Although relevant, exclusive reliance on inter-
views with adolescents or reports from parents and teachers is insufficient (Srinath et al., 2019).
A responsible and critical use of psychological measures grounded in normative data is therefore
also essential (Kazdin, 2005).
A utilização de instrumentos de avaliação psicológica permite obter informação fiável e
objetiva sobre o funcionamento psicológico de adolescentes, sendo as medidas de autorresposta
particularmente comuns para recolher dados sobre o estado psicológico dos sujeitos (Meyer et
al., 2015). Dado que os adolescentes, geralmente, já possuem as capacidades desenvolvimen-
tais necessárias para fornecer informação precisa acerca do seu estado subjetivo e das suas
experiências de vida (Krishnamurthy, 2010), a utilidade de instrumentos de autorresposta, como
inventários de personalidade, é reforçada.
The aforementioned complexity inherent in the assessment of adolescents is also reflected
in the limited number of personality inventories specifically developed for and intended for this
age group (e.g., Archer & Newsom, 2000; Archer et al., 1991; Cashel, 2002).
Among the self-report measures specifically designed for adolescent populations are the Per-
sonality Inventory for Youth (PIY; Lachar & Gruber, 1995), the Millon Adolescent Clinical Inven-
tory (MACI; Millon et al., 1993; Portuguese adaptation: Cavaco, 2004), the Minnesota Multiphasic
Personality Inventory – Adolescent (MMPI-A; Butcher et al., 1992; Portuguese adaptation: Silva
et al., 2006; Carvalho & Novo, 2018), and, more recently, the Personality Assessment Inventory –
Adolescent (PAI-A; Morey, 2007).
Additionally, the Massachusetts Youth Screening Instrument – Version 2 (MAYSI-2; Grisso
& Barnum, 2014; Portuguese adaptation: Almiro et al., 2017) and the Youth Self Report (YSR) –
included in the Achenbach System of Empirically Based Assessment (ASEBA) for the Preschool
and School-Age Periods (Achenbach & Rescorla, 2001; Portuguese adaptation: Achenbach et al.,
2014) – emerge as other important self-report tools aimed at assessing psychopathology and
problem behaviors in adolescents.
To date, in Portugal, validation studies have already been conducted for some of these inven-
tories, namely the MACI (e.g., Ramos et al., 2014) and MMPI-A (e.g., Carvalho et al., 2014; Santos et
al., 2024), but only the MAYSI-2 and YSR – two instruments of psychopathology, not personality
– are commercially available.
In summary, there is a recognized high prevalence of psychopathology and psychopatholog-
ical symptoms in adolescents, as well as a need to use multiple methods to assess their mental
state. However, the scarcity of personality assessment instruments for adolescents in Portugal is
evident, making it necessary to carry out adaptation and validation studies of robust and reliable
measures to ensure good psychological assessment practice with this population.
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THE PERSONALITY ASSESSMENT INVENTORY – ADOLESCENT (PAI-A):
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Mariana Moniz, Mauro Paulino, Octávio Moura, Mário R. Simões
In this context, the PAI-A emerges as an objective self-report instrument that offers several
advantages compared to other adolescent personality assessment instruments (e.g., MMPI-A),
due to its comparatively smaller length, its structure (organized into four-point scales that allow
reporting not only the presence of symptoms but also their severity), and its reading ease, requir-
ing only a 4th-grade reading level (unlike the MMPI-A, which requires a reading level equivalent
to the 6th grade) (Charles et al., 2021; Morey & Meyer, 2014).
Regarding another instrument validated for the Portuguese population, the MAYSI-2 (which
is exclusively validated for forensic contexts), it should be noted that the PAI-A is longer, which
implies a greater administration time. Nevertheless, it is important to emphasize that the PAI-A
includes scales measuring image distortion (both positive and negative), and studies have shown
that it is an instrument with superior accuracy for detecting aggressiveness in adolescents and
for identifying suicidal and self-harming behaviors at this developmental stage (e.g., Shaffer et
al., 2018).
Given these potentialities and its proven applicability in diverse contexts, it is recognized
that the adaptation and validation of the PAI-A for the Portuguese population will help address
the problem of the lack of personality assessment instruments available and validated for Por-
tuguese adolescents. The primary objective of the present study is to provide a comprehensive
organization and analysis of the characteristics of the PAI-A, possible contexts of application,
and applicability in different countries and cultures, serving as a starting point to understand
the potential contributions of this measure in the field of psychological assessment of adoles-
cents in Portugal.
Personality Assessment Inventory – Adolescent (PAI-A)
Development and Structure of the PAI-A
The PAI-A, a direct derivation of the Personality Assessment Inventory (PAI; Morey, 1991;
Paulino et al., 2023), is an objective self-report instrument that includes 264 items providing
information about adolescents’ personality, psychopathology, and psychosocial environment
(i.e., ages 12 to 18), through a version comparable to the adult version in terms of item content and
psychometric properties (Morey, 2007; Venta et al., 2018).
According to the instrument’s author, Leslie Morey, the PAI-A was developed in response to
growing “interest expressed by many professionals who wanted to apply the PAI to adolescents”
(Morey, 2007, p. 1). The main goal of adapting a version for adolescents was to maintain the adult
version’s structure while adjusting only items considered inappropriate for younger populations,
making them suitable for adolescents aged 12 to 18 years (Morey, 2007).
As with the PAI, the clinical constructs assessed by the PAI-A were selected based on two
criteria: (i) their historical importance regarding the nosology of psychological disorders, and (ii)
their relevance for current diagnostic practice (Morey, 2018). The items and scales of the PAI, later
adapted to the adolescent version, were designed to provide information on the constructs being
measured, regarding the diversity and severity of symptoms (Morey & McCredie, 2020). The final
version of the PAI-A thus retained a scale and subscale structure analogous to the adult version.
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THE PERSONALITY ASSESSMENT INVENTORY – ADOLESCENT (PAI-A):
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Mariana Moniz, Mauro Paulino, Octávio Moura, Mário R. Simões
The original standardization of the PAI-A included a general population sample (n = 707)
aged 12 to 18 years, stratified by gender, race/ethnicity, and age according to the 2003 U.S. Cen-
sus. The clinical group (n = 1,160), in turn, included youth with conduct disorder, depressive dis-
order, anxiety, ADHD, among others (Morey, 2007).
The PAI-A includes 22 non-overlapping scales, organized into four validity scales, 11 clinical
scales, five clinical treatment consideration scales, and two interpersonal style scales, supple-
mented by a set of 31 subscales reflecting clinical areas or treatment-related domains (Krishna-
murthy, 2010) (see Table 1). Given the desire to maintain the PAI’s structure, the adolescent ver-
sion scales retain the original names, with differences associated with the number of items per
scale and their wording
TABLE1
Structure of PAI-A Scales and Subscales
Scale Description Subscale
Validity Scales
Inconsistency (ICN) Patterns of random responding
Infrequency (INF) Patterns of atypical responding
Negative Impression (NIM) Tendency to present oneself in an excessively negative
manner
Positive Impression (PIM) Tendency to present oneself in an excessively positive
manner
Clinical Scales
Somatic Complaints (SOM) Concerns about health problems or specic somatic
complaints
Conversion (SOM-C)
Somatization (SOM-S)
Health Concerns / Hypochondria
(SOM-H)
Anxiety (ANX) Observable manifestations and signs of anxiety Cognitive (ANX-C)
Aective/Emotional (ANX-A)
Physiological (ANX-P)
Anxiety-Related Disorders
(ARD)
Symptoms and behaviors related to personality disorders Obsessive-Compulsive (ARD-O)
Phobias (ARD-P)
Traumatic Stress (ARD-T)
Depression (DEP) Manifestations and symptoms of depressive disorders Cognitive (DEP-C)
Aective/Emotional (DEP-A)
Physiological (DEP-P)
Mania (MAN) Aective, cognitive, and behavioral symptoms of mania
and hypomania
Activity Level (MAN-A)
Grandiosity (MAN-G)
Irritability (MAN-I)
Paranoia (PAR) Symptoms of paranoid disorders and stable personality
traits
Hypervigilance (PAR-H)
Persecution (PAR-P)
Resentment (PAR-R)
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Scale Description Subscale
Schizophrenia (SCZ) Relevant symptoms on the schizophrenia spectrum Psychotic Experiences (SCZ-P)
Social Isolation (SCZ-S)
Thought Disorder (SCZ-T)
Borderline Features (BOR) Attributes of borderline personality functioning Aective Instability / Irritability (BOR-A)
Identity Problems (BOR-I)
Negative Relationships (BOR-N)
Self-Harm (BOR-S)
Antisocial Features (ANT) Attributes of antisocial personality functioning Antisocial Behavior (ANT-A)
Egocentricity (ANT-E)
Risk-Taking (ANT-S)
Alcohol Problems (ALC) Problematic consequences of alcohol abuse and alcohol
dependence traits
Drug Problems (DRG) Problematic consequences of substance abuse and
substance dependence traits
Clinical Contingency Scales
Aggression (AGG) Characteristics and attitudes related to anger, hostility,
and aggression Aggressive Attitude (AGG-A)
Verbal Aggression (AGG-V)
Physical Aggression (AGG-P)
Suicidal Ideation (SUI) Suicidal thoughts, including planning and ideation
Stress (STR) Stress (STR) | Impact of recent stressful circumstances or
situations on major life areas
Nonsupport (NON) Perceived lack of social support in terms of quantity and
quality
reatment Rejection /
Resistance (RXR)
Attributes and attitudes indicating a lack of interest or
motivation for psychological intervention
Interpersonal Style Scales
Dominance (DOM) Degree of control and independence in interpersonal
relationships
Warmth / Agreeableness
(WRM)
Degree of interest in empathetic and supportive
interpersonal relationships
Psychometric Qualities of the PAI-A
Psychometric studies indicate acceptable internal consistency (Cronbach’s alphas: M = .79;
median = .80; Min. = .70, on the Positive Impression scale; Max. = .90, on the Aggression scale)
and test–retest reliability (Pearson correlation: M = .78; median = .79; Min. = .65, on the Positive
Impression scale; Max. = .89, on the Somatization scale) across the 22 PAI-A scales, in both com-
munity and clinical samples (Morey, 2007).
It should be noted that Cronbach’s alphas for the Inconsistency and Infrequency scales were
not calculated in the original manual or subsequent adaptations of the instrument (e.g., Spanish,
South Korean, Italian), as these scales do not contain substantive or specific content; very low
values are therefore expected (e.g., in the U.S. adult version, the Inconsistency scale yielded an
alpha of .45 and the Infrequency scale .52; in the Portuguese version, the Inconsistency scale
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recorded an alpha of .08 and the Infrequency scale .19) (Morey, 1991; Morey, 2018; Paulino et al.,
2024a).
Administration, Scoring, and Interpretation of Results
The PAI-A items were written to be comprehensible to adolescents with a fourth-grade read-
ing level and can be responded to using a four-point scale: “False, Slightly False, Mostly True, and
True.” This four-point scale provides dimensional information about symptoms and experiences,
allowing not only the assessment of the presence of symptoms but also their severity (Morey,
2007).
The PAI-A manual indicates an average completion time of 45 minutes, although adolescents
with concentration difficulties or psychomotor delays may require more time to complete the
inventory (Morey, 2007, 2018). Test materials include an item booklet and the option for manual
(HS-A Form) or digital (SS-A Form) administration. In addition, the manual provides profile forms
and critical item sheets (Morey, 2007).
PAI-A administration requires a qualification level categorized as Level C (Hogrefe, n.d.; Per-
sonality Assessment Resources, n.d.) and should be conducted by professionals with training in
psychology and in the administration, scoring, and interpretation of psychological assessment
instruments, who are familiar with the PAI-A items and norms. Additionally, the user must have
knowledge in the domains of psychopathology and personality (Morey, 2007).
The PAI-A may be administered individually or in groups, with the sole requirement being
the confidentiality of responses. The examiner is responsible for ensuring suitable spatial and
temporal conditions for the test and for providing clarifications regarding item content or the
meaning of words and/or phrases (Morey, 2018).
Contexts of PAI-A Application
Clinical Context
Because the PAI-A was designed as a clinically useful instrument, with clinical and clinical
contingency scales, its use allows for the collection of information that facilitates the diagnostic
process and intervention planning (Krishnamurthy, 2010). For example, studies conducted by
Charles et al. (2021, 2022b) demonstrated that the PAI-A provides useful information for predict-
ing adherence to intervention programs, as well as premature dropout, based on results obtained
from several of its scales (e.g., Depression, Antisocial Features, Aggression, Borderline Features,
Alcohol Problems, Lack of Social Support, Treatment Resistance, and Dominance).
Other research has shown that the PAI-A Depression and Anxiety scales can accurately detect
anxiety and depression in adolescents, correlating positively and strongly with other measures
of these constructs, including the Beck Depression Inventory (BDI-II; Beck et al., 1996, in the pro-
cess of commercial release in Portugal), the Child Behavior Checklist (CBCL; Achenbach, 2001;
Achenbach et al., 2014), the Minnesota Multiphasic Personality Inventory – Adolescent (MMPI-A;
Butcher, 1992), among others (e.g., Ryszewska et al., 2024; Vanwoerden et al., 2018). These and
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other scales (e.g., the PAI-A Self-Harm subscale) are also associated with self-harming behaviors
in adolescents (Caguana, 2022).
The PAI-A’s ability to identify adolescents with suicidal ideation and to differentiate between
low- and high-risk adolescents has been reinforced by research using regression analyses and
ROC curve analyses (e.g., Kim et al., 2021; Spencer, 2021). Additionally, given its relatively brief
administration time and low reading level required, some studies have highlighted its usefulness
for adolescent populations with autism spectrum disorder (e.g., Hooks et al., 2021).
In the realm of personality disorder assessment in adolescents, the literature has emphasized
the utility of the Borderline Features scale, which has shown good convergent and discriminant
validity with other measures of this disorder (e.g., Borderline Personality Features Scale for Chil-
dren – BPFSC; Crick et al., 2005), although it should be noted that this scale does not capture all
diagnostic criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-
5-TR; American Psychiatric Association, 2022) (e.g., Chanen et al., 2020; Glenn et al., 2013; Kalpa-
kci & Sharp, 2018; Sharp et al., 2012; Stokes et al., 2019).
Forensic Context
The extensive history of studies conducted with the adult version (i.e., PAI), which attest to
its applicability in forensic settings (e.g., Paulino et al., 2024b), as well as the characteristics of
the adolescent version (e.g., reduced number of items, rapid administration, low reading level
required, inclusion of defensiveness and symptom/response simulation scales), support the rele-
vance of applying the PAI-A to samples of youths involved in the justice system, as this popula-
tion tends to have lower academic performance and a higher potential for response simulation
or dissimulation (Gremmen et al., 2019).
The utility of the PAI-A for forensic samples is further reinforced by the fact that approxi-
mately one-third of the clinical sample in the validation studies of the instrument’s manual was
recruited from juvenile justice contexts, reflecting the association between legal involvement
and mental health problems in adolescents (Charles et al., 2022a).
The PAI-A includes scales and subscales focused on alcohol use (Alcohol Problems) and drug
use (Drug Problems), trauma (Traumatic Stress), anxiety (Anxiety), depression (Depression), sui-
cidal ideation (Suicidal Ideation), borderline personality traits (Borderline Features), and antiso-
cial traits (Antisocial Features), all constructs prevalent in youth involved in the justice system
(Abram et al., 2015; Farwell, 2011; Shaffer et al., 2018). Additionally, attempts to exaggerate or
minimize psychological symptoms are a significant concern in forensic psychological assess-
ments due to the potential implications, and these are assessed by the PAI-A through its validity
scales (e.g., Negative Impression, Positive Impression) (Charles et al., 2022a).
Accordingly, the PAI-A’s ability to detect symptom exaggeration or malingering in adoles-
cents has been examined in several studies since the inventory’s inception. Indeed, the instru-
ment’s manual emphasizes the diagnostic utility of certain scales in detecting malingering, par-
ticularly the Negative Impression scale, which demonstrates a sensitivity of 100% and specificity
of 88.4% when a cutoff superior to 2.5 standard deviations is used (i.e., T-score = 75) (Morey, 2007).
Another study by Rios and Morey (2013) showed that the PAI-A profile validity indicators, espe-
cially Rogers’ Discriminant Function (sensitivity = 82.2%, specificity = 75.7%), are effective tools
for identifying response simulation.
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In this regard, the PAI-A’s ability to detect symptom exaggeration or malingering in ado-
lescents has been the subject of numerous studies since the inventory’s inception. Indeed, the
instrument’s manual emphasizes the diagnostic utility of certain scales in detecting malingering,
particularly the Negative Impression scale, which demonstrates a detection sensitivity of 100%
and specificity of 88.4% when using a cutoff greater than 2.5 standard deviations, corresponding
to a T-score of 75 (Morey, 2007). Another study by Rios and Morey (2013) showed that the PAI-A
profile validity indicators, especially Rogers’ Discriminant Function (sensitivity = 82.2%, speci-
ficity = 75.7%), are effective measures for identifying response exaggeration.
Although not developed specifically for the PAI-A (but for the adult PAI), some studies sug-
gest that the supplementary indices of the adult version may also be useful for the adolescent
version. For example, the adult PAI response distortion indicators are helpful for detecting simu-
lated ADHD symptoms in adolescents, with particular utility attributed to Rogers’ Discriminant
Function (RDF; Morey, 1996), which is considered the most accurate indicator for identifying ado-
lescents feigning this neurodevelopmental disorder (Diaz de Tuesta, 2012; Rios & Morey, 2013).
Rogers’ Discriminant Function, along with the Negative Impression scale, also appears effective
in detecting exaggeration of depressive and anxiety symptoms (e.g., Malm et al., 2020). Other
indicators, such as the Negative Distortion Scale (Mogge et al., 2010), Hong’s Simulation Index
(Hong & Kim, 2001), and Hong’s Defensiveness Index (Hong & Kim, 2001), also appear relatively
useful for identifying response distortion when applied to adolescents in community settings
(Meyer et al., 2015).
The PAI-A is also applicable in predicting self-harm, aggressive, and delinquent behaviors in
youth involved in the justice system (Charles et al., 2021; Floyd et al., 2022; Shaffer et al., 2018),
as well as in classifying different types of offending youth (e.g., interpersonal offenses, property
offenses, substance use), proving more effective than other adolescent assessment instruments
such as the MMPI-A (Humenik et al., 2019). Furthermore, recent studies have reported strong
positive correlations between the PAI-A and other measures of conduct disorder, such as the Pro-
posed Specifiers for Conduct Disorder Scale (PSCD; Salekin, 2016) (Neumann et al., 2024; Salekin
et al., 2022), supporting its applicability in offender samples.
School Context
Since most PAI-A literature focuses on clinical and forensic contexts, research on its use in
schools remains very preliminary. Nevertheless, its applicability in this context has substantial
potential. For example, a study by Sandström (2024) demonstrated that certain scales (e.g., Treat-
ment Resistance, Anxiety, Depression) are significant predictors of school rejection and dropout.
Additionally, the study concluded that the Somatization, Paranoia, Aggression, and Treatment
Resistance scales could also help better understand school rejection and dropout.
Despite the scarcity of school-based studies, the PAI-A provides adolescents an opportunity
to disclose personal difficulties and experiences, serving as a communication medium (Krishna-
murthy, 2010), from which school psychologists can identify key problems and areas of vulnera-
bility, and subsequently design individualized intervention plans.
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PAI-A Adaptation and Validation in Other Countries
Unlike the adult version, which has been adapted and validated in multiple countries (e.g.,
China, Germany, Spain, Greece, Italy, Mexico, Argentina, Vietnam, Iran, South Korea, Canada,
Portugal) (Paulino et al., 2023), few countries have adapted and validated the PAI-A. To date, only
Spain (Cardenal et al., 2018), Argentina (Iglesia et al., 2018; Stover et al., 2017), South Korea (Kim
et al., 2015), and Italy (Pezzuti et al., 2021) have adapted the inventory for their populations, with
validation ongoing in Uruguay (Machado et al., 2022). Except for the Spanish version, all adap-
tations have occurred in the past seven years, reflecting the instrument’s recent and growing
dissemination. Table 2 presents the main psychometric properties of the international PAI-A ver-
sions.
TABLE2
Psychometric Properties of the PAI-A: Cross-Country Comparisons
Psychometric Properties
N.º of
items
N.º of
factors
Mean
internal
consistency
(α)a
Median
internal
consistency
(α)a
Min. Máx.
Mean
test-retest
reliability
Median
test-retest
reliability
Min. Máx.
Versions
USA 264 4 .79 .80 .70 .90 .78 .79 .65 .89
Spain 264 4 .83 .85 .65 .96 .79 .79 .71 .87
Argentina 264 4 .82 .83 .68 .95 — — — —
South Korea 344 5 .75 .77 .51 .88 .91 .93 .65 .87
Italy 264 4 .72 .74 .52 .88 .72 .77 .45 .85
Note. a The Infrequency and Inconsistency scales were not taken into account
The first international adaptation of the PAI-A was conducted in Spain by Cardenal et al.
(Morey, 2018), following procedures of the original version and based on the Spanish adult PAI.
Retaining 264 items, the Spanish PAI-A shows adequate internal consistency, with Cronbach’s
alphas ranging from .65 (Dominance) to .96 (Suicidal Ideation) in the general population sample.
Similarly, it demonstrates adequate temporal stability, with test-retest correlations ranging from
.71 (Drug Problems) to .87 (Antisocial Features) over a two-week interval (Cardenal et al., 2018).
The Argentine adaptation was developed in collaboration with the Spanish version authors,
analyzed by a panel of Latin American experts to assess suitability for Spanish-speaking ado-
lescents. Cronbach’s alpha ranged from .68 (Dominance) to .95 (Suicidal Ideation) (Morey, 2018).
The South Korean adaptation (Kim et al., 2006) was based on the adult Korean PAI and
re-standardized in 2018 by Lim et al. (2018). It retained the original PAI structure—four validity
scales, 11 clinical scales, five treatment scales, and two interpersonal scales—comprising 344
items. Cronbach’s alphas ranged from .51 (Alcohol Problems) to .88 (Borderline Features), and
test-retest correlations ranged from .80 to .96 (Lim et al., 2018).
Finally, the Italian adaptation by Pezzuti et al. (2021) maintained the internal structure of 264
items divided into 22 scales and 31 subscales, showing adequate internal consistency (mean α
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= .72 for community sample, α = .79 for clinical sample) and a mean test-retest correlation of .72
over 11–41 days (n = 60 adolescents).
International PAI-A versions differ in translation and adaptation criteria, resulting in notable
differences in content (e.g., some original items omitted or significantly altered in the Spanish
version) and item count (e.g., 264 items in the US, Spanish, Argentine, and Italian versions; 344
items in the South Korean version). These methodological differences may challenge cross-cul-
tural studies, potentially leading to inconsistent results and complicating measurement invari-
ance testing (i.e., the extent to which the instrument measures the same constructs across cul-
tural and linguistic groups), a critical step in instrument validation (Ziegler & Bensch, 2013).
PAI-A in Portugal: Adaptation and Validation
The adaptation and validation process of the PAI-A for the Portuguese population began in
2023, in collaboration with Hogrefe publisher, and aims to include multiple validation studies
with community, clinical (e.g., depressive disorders, anxiety disorders, ADHD), and forensic sam-
ples (e.g., victims, offenders). Additionally, following the adult PAI work, an abbreviated version
of the PAI-A will be developed, based on selecting items with the best psychometric properties.
Additionally, following the work carried out with the adult version, a short form of the PAI-A
will be developed through the selection of items with the best psychometric indicators.
Conclusions
Adolescence is a developmental stage marked by stress and vulnerability to psychological
disorders, and psychological assessment procedures must consider the rapid development and
transformations that accompany this stage, as well as the implications of incorrect diagnoses in
the short and long term.
In Portugal, approximately 15% of adolescents experience moderate to severe depressive
symptoms, highlighting the need for objective and reliable psychological assessment tools (San-
tos et al., 2016). However, there is a significant scarcity of validated psychometric instruments for
the Portuguese adolescent population. The translation, adaptation, and validation of the PAI-A
for Portugal will expand the assessment of adolescent personality and psychopathology, partic-
ularly in clinical and forensic samples.
Developed in 2007, the PAI-A is a self-report instrument with multiple advantages, including
manageable administration time, ease of reading, and inclusion of validity scales and scales of
particular clinical (e.g., clinical and clinical contingency scales) and forensic interest (e.g., scales
measuring aggression or substance use).
The main limitation is the scarcity of studies with diverse adolescent samples compared to
the large number conducted with the adult PAI. Nonetheless, existing literature supports its psy-
chometric robustness, convergent and discriminant validity, and utility in clinical, forensic, and
school contexts (Sandström, 2024; Vanwoerden et al., 2018; Venta et al., 2018), justifying its adap-
tation and validation in Portugal.
The PAI-A includes scales covering clinically relevant domains (e.g., personality disorders,
anxiety, depression) and forensic domains (e.g., substance abuse, trauma, aggression, callous
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traits), as well as supplementary indices adapted from the adult version, useful for assessing
violence risk, criminal recidivism, and suicide (Charles et al., 2022a; Diaz de Tuesta et al., 2021;
Preston et al., 2021). Its ability to predict treatment resistance or adherence, suicidal ideation, and
self-harming behaviors reinforces its clinical and forensic relevance (Charles et al., 2021, 2022b).
The relative scarcity of PAI-A studies may be due to challenges in assessing minors, partic-
ularly the need for informed consent from legal guardians—a consideration for the adaptation
process in Portugal. Additionally, assessment protocols must account for adolescents’ motivation
and limited attention spans, especially in clinical and forensic populations.
Another limitation concerns item content. Some items address sensitive topics (e.g., alcohol
and drug use, suicidal ideation), which may reduce response honesty. This limitation is acknowl-
edged in the adult version (Paulino et al., 2023) and is expected to apply to adolescents as well.
This study systematically reviewed the PAI-A’s characteristics, psychometric qualities, and
applicability across contexts, highlighting its robustness, validity, reliability, and international
recognition. Validating the PAI-A for Portuguese adolescents will advance knowledge of their
psychological functioning in community, clinical, and forensic settings, where studies remain
limited.
Access to validated instruments like the PAI-A will benefit clinical practice (supporting ther-
apeutic goal setting, decision-making, intervention monitoring, and treatment adherence) and
research on personality, psychopathology, and interpersonal dimensions of youth aged 12–18 in
diverse contexts (clinical, educational, forensic), expanding knowledge in this domain.
The existence of a validated adult version (PAI) for Portugal (Paulino et al., 2024a) also allows
future longitudinal studies to track Portuguese personality development from adolescence to
adulthood, using the PAI-A and PAI sequentially.
Finally, the potential development of an abbreviated version will enable broader assessment
protocols, generating more complete and valid psychological evaluation data.
Adolescence is a developmental stage characterized by stress and heightened vulnerability
to psychological disorders, and psychological assessment procedures must take into account the
rapid developmental changes typical of this age group, as well as the potential short- and long-
term consequences of inaccurate diagnoses. In Portugal, it is estimated that 15% of adolescents
experience moderate to severe depressive symptoms, highlighting the need for the development
of objective and reliable psychological assessment instruments (Santos et al., 2016). However,
there is a marked scarcity of psychometric tools validated for the Portuguese adolescent popula-
tion. The translation, adaptation, and validation of the PAI-A for Portuguese adolescents will thus
contribute to expanding the assessment of personality and psychopathology in this population,
particularly in clinical and forensic samples.
Developed in 2007, the PAI-A is an objective self-report instrument that offers multiple
advantages, including an accessible length and administration time, readability, and the inclu-
sion of validity scales as well as scales of particular clinical (e.g., clinical and clinical contingency
scales) and forensic interest (e.g., aggression or substance use). A key limitation of the instrument
is the relatively small number of studies conducted with adolescent samples compared with the
extensive literature on the adult version (PAI). Nevertheless, the existing literature supports the
PAI-A’s psychometric robustness, convergent and discriminant validity, and utility across clini-
cal, forensic, and school contexts (Sandström, 2024; Vanwoerden et al., 2018; Venta et al., 2018),
reinforcing the relevance of the present Portuguese adaptation and validation project.
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The PAI-A includes scales that assess domains of particular clinical interest (e.g., personality
disorders, anxiety, depression) and forensic relevance (e.g., substance abuse, trauma, aggression,
callous traits), as well as supplementary indices adapted from the adult version, which can be
useful for evaluating the risk of violence, criminal recidivism, and suicide (Charles et al., 2022a;
Diaz de Tuesta et al., 2021; Preston et al., 2021). Its ability to predict adherence or resistance to
psychological interventions, suicidal ideation, and self-harming behaviors further highlights its
clinical and forensic utility (Charles et al., 2021, 2022b).
The relative scarcity of studies on the PAI-A may reflect the inherent challenges of assessing
minors, particularly the need to obtain informed consent from legal guardians, an issue that must
be carefully addressed during the adaptation and validation process in Portugal. Moreover, the
assessment protocol for Portuguese adolescents must consider respondent motivation and the
limited attention span of adolescents, particularly in clinical and forensic populations. Another
limitation concerns item content, as some PAI-A items address sensitive topics (e.g., alcohol use,
drug use, suicidal ideation), which may lead to underreporting or lack of honesty—an issue also
noted in the adult version (Paulino et al., 2023).
This study aims to systematically present the characteristics, strengths, and applicability of
the PAI-A across diverse contexts, highlighting its robustness, validity, reliability, and interna-
tional recognition as an adolescent personality assessment tool. The validation of the PAI-A for
the Portuguese population will deepen understanding of Portuguese adolescents’ psychological
functioning in community, clinical, and forensic settings, where data are still scarce. Access to
a validated instrument like the PAI-A will positively impact clinical practice—facilitating thera-
peutic planning, decision-making, intervention monitoring, and treatment adherence—and will
advance research on personality, psychopathology, and interpersonal dimensions in adolescents
aged 12 to 18 across multiple contexts (clinical, educational, forensic).
The existence of a validated adult version (PAI) for the Portuguese population (Paulino et al.,
2024a) also enables future longitudinal studies of personality development, following individu-
als from adolescence to adulthood using the PAI-A and then the PAI. Finally, the potential devel-
opment of a short form will allow broader assessment protocols, facilitating more comprehensive
and valid psychological evaluation data.
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Mariana Moniz, Mauro Paulino, Octávio Moura, Mário R. Simões
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CONTRIBUTIONS TO THE PSYCHOLOGICAL ASSESSMENT OF ADOLESCENTS
Mariana Moniz, Mauro Paulino, Octávio Moura, Mário R. Simões
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RECONQUÊTE DU SOI ET QUÊTE DE SENS DE VIE : REGARDS
SUR LES PROCESSUS DE RECONSTRUCTION PSYCHIQUE CHEZ
LES SURVIVANTS DU GÉNOCIDE CONTRE LES TUTSI EN 1994
AURWANDA.
Emmanuel Mihigo M.1, Denis Kazungu2, Innocent Kagabo3, Turikumwenamungu Jean Bosco4
PSIQUE • EISSN 21834806 • VOLUME XXII • ISSUE FASCÍCULO 1
1ST JANUARY JANEIRO 30TH JUNE JUNHO 2026 • PP. 7894
DOI: https://doi.org/10.26619/2183-4806.XXII.1.4
Submited on 13/09/2025 Submetido a 13/09/2025
Accepted on 29/01/2026 Aceite a 29/01/2026
Résumé
Après le génocide perpétré contre les Tutsis en 1994 au Rwanda, diverses approches thé-
rapeutiques ont été utilisées dans l’accompagnement des survivants dans leur reconstruction
psychique. Cependant, la thérapie narrative reste peu documentée. L’étude se propose d’étudier
le rôle de la thérapie narrative, les mécanismes par lesquels elle favorise le dépassement de la
souffrance, son impact dans la reconquête de soi et la restauration du sens de la vie. À partir
d’un échantillonnage raisonné, onze participants ont été interviewés à travers des entretiens
semi-structurés. A travers une analyse thématique, les résultats révèlent que le partage d’ex-
périences permet aux victimes de relativiser, apprivoiser leurs souffrances et ainsi retrouver le
pouvoir d’agir et une certaine capacité de se projeter dans l’avenir. Le cadre groupal devenu un
espace de catharsis collective offre un lieu d’échanges sur le sens existentiel. Les Rwandais ayant
une culture d’oralité, l’approche narrative s’inscrit dans son ancrage socio-culturel et permet une
communication émotionnelle plus aisée pour extérioriser leurs souffrances. La pertinence de la
thérapie narrative dans cette spécificité socio culturelle démontre son potentiel thérapeutique
dans la reconstruction psychique. Toutefois, des études menées sur des échantillons plus éten-
dues seraient nécessaires pour en confirmer la robustesse et la transférabilité des résultats.
Motsclés: reconquête, quête, reconstruction, génocide, Tutsi
1 E-mail : mihigo91@gmail.com. https://orcid.org/0009-0000-6609-9400. Département de santé mentale. School of Nursing
Sciences. Mount Kigali University. Kigali, Rwanda
2 E-mail: kazungud7519@gmail.com. Kigali Psycho-Medical Center, Kigali Rwanda
3 E-mail: kagabo2014@gmail.com, National Council of Nurses and Midwives, Kigali, Rwanda
4 E-mail : turi1jb@gmail.com, Département de Sciences infirmières, School of Nursing Sciences, Mount Kigali University,
Kigali, Rwanda
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Abstract
After the genocide perpetrated against the Tutsis in 1994 in Rwanda, various therapeutic
approaches were used to support survivors in their psychological reconstruction. However, nar-
rative therapy remains poorly documented. The study proposes to study the role of narrative
therapy, the mechanisms by which it promotes the overcoming of suffering, its impact in the
reconquest of oneself and the restoration of the meaning of life. Based on a purposive sample,
eleven participants were interviewed through semi-structured interviews. Through a thematic
analysis, the results reveal that the sharing of experiences allows victims to put their suffering
into perspective, to tame their suffering and thus regain the power to act and a certain ability to
project themselves into the future. The group framework, which has become a space of collective
catharsis, offers a place for exchanges on existential meaning. Rwandans having a culture of
orality, the narrative approach is part of its socio-cultural anchoring and allows for easier emo-
tional communication to externalize their suffering. The relevance of narrative therapy in this
socio-cultural specificity demonstrates its therapeutic potential in psychological reconstruction.
However, studies with larger samples would be needed to confirm the robustness and transfera-
bility of the results.
Keywords: Reclaiming, search, reconstruction, genocide, Tutsi
1. Introduction
Le XX- siècle s’est tragiquement distingué comme une ère marquée par des génocides, notam-
ment ceux perpétrés contre les Arméniens, les Juifs, au Cambodge, contre les Tutsis au Rwanda,
au cours desquels des populations ont été massacrées et systématiquement exterminées sous l’ef-
fet d’une haine viscérale (Alloa & Kristensen, 2007). Quant au génocide de 1994 perpétré contre
les Tutsis au Rwanda, il a été l’un des événements les plus horribles et dévastateurs du XXᵉ siècle,
avec plus de 800 000 personnes tuées en seulement 100 jours (Mafeza,2013) . L’impact de ce géno-
cide sur la santé mentale est à la fois profond et persistant, affectant non seulement ceux qui ont
été directement témoins de la violence ou qui y ont survécu, mais aussi les générations suivantes
(Dozio et al., 2020; Rieder & Elbert, 2013). Au-delà de l’anéantissement physique des victimes, le
génocide de 1994 perpétré contre les Tutsis au Rwanda a laissé aux survivants un lourd héritage
mémoriel et psycho traumatique (Cherifi, 2008).
Compte tenu de l’ampleur des répercussions du génocide sur la santé mentale des individus,
de nombreuses interventions psychothérapeutiques ont été mises en place afin de soutenir les
survivants. La présente étude se propose d’examiner le rôle de la thérapie narrative dans le pro-
cessus de reconstruction psychique et la quête du sens de la vie chez les survivants du génocide
perpétré contre les Tutsis au Rwanda en 1994. Dans une étude nationale effectuée au Rwanda
sur la prévalence des maladies mentales, les comorbidités associées et l’utilisation de services
de santé mentale, des chercheurs ont rapporté que les événements qui se sont déroulés durant la
période du génocide contre les Tutsis en 1994 au Rwanda, de par leur étendue et l’horreur susci-
tée chez les victimes, sont qualifiés d’événements traumatiques majeurs. L’étude a révélé la plus
grande prévalence des maladies mentales parmi les survivants du génocide contre le Tutsi de
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Reconquête du soi et quête de sens de vie : Regards sur les processus de reconstruction
psychique chez les survivants du génocide contre les Tutsi en 1994 au Rwanda.
1994, dont des épisodes de dépressions majeures (35 %), de PTSD (27,9 %) et de troubles paniques
(26,8 %) (Kayiteshonga et al., 2022). Grieder (2016), dans son article, rapporte le témoignage poi-
gnant d’un rescapé du génocide perpétré contre les Tutsis au Rwanda où il dit :« la souffrance a
construit une maison dans mon cœur, je pleure pour qu’elle soit détruite.» Ce témoignage exprime
l’intensité de la souffrance que ce rescapé a vécue et qu’il continue d’éprouver. Comme le montre
ce témoignage de ce rescapé, le trauma l’habite de façon permanente, il ne peut pas s’en défaire
de lui-même. Il demande que cette souffrance le quitte, et soit délogé de son psychisme. Le fait
dévastateur de trauma fait qu’il ne soit plus lui-même, son identité est affectée au plus profond,
et n’en peut plus pour avoir un contrôle sur soi. La reconstruction psychique sur l’élaboration
narrative de son récit de vie, ses valeurs, ses rôles sociaux peut donner une signification de sur-
vie et à son avenir. Faisant référence toujours à l’expérience traumatique de ce rescapé cité plus
haut, (Wolynn, 2017) parle d’un passé traumatique qui ne passe pas, qui ne s’efface pas, sus-
ceptible de transformer profondément l’identité d’un individu. Abondant dans le même sens,
(Munyandamutsa, 2014) parlant de la transmission du traumatisme, l’avait bien dit : «on transmet
ce qu’on est, ce qu’on est devenu et ce que la société a fait de nous». De ceci, il ressort que le trauma
cause une transformation identitaire. Ce passé affecte le sens de la vie, pouvant être transmis sur
plusieurs générations dès lors que le récit familial où le narratif demeure exclusivement centré
sur le traumatisme, et il est difficile de se libérer des souffrances endurées et du pouvoir mor-
tifère des souvenirs tragiques (Anaut, 2016).
Selon H. Audoin-Rouzeau & Dumas, (2014) et Jacques Palard, (2015),le génocide de 1994
contre les Tutsis au Rwanda est un génocide de proximité, qui a été exécuté avec une cruauté
inouïe, où la violence a atteint l’intimité des liens sociaux et affectifs, de manière prévisible.
Les gens vivaient dans un même milieu où les voisins partageaient des boissons et ses donner
des filles et garçons ne mariage. Le caractère particulièrement dramatique du génocide perpétré
contre les Tutsis au Rwanda se manifeste dans le fait qu’il n’a pas été commis par des étrangers,
mais par des voisins et des personnes ayant des liens de parenté ou de proximité avec leurs vic-
times. Ainsi, le cadre social et familial, habituellement perçu comme un lieu de protection, a été
transgressé : l’on a tué sans crainte ceux avec qui on avait partagé beaucoup, ceux avec on avait
des liens de filiation.. Ainsi, les individus qui, en temps normal, qui étaient censés incarner des
figures de protection et de solidarité sont vite devenus des bourreaux, brisant de manière irré-
versible les liens de confiance au sein des communautés. Les violences ont été portées au plus
profond de l’intimité des victimes, précisément parce qu’elles ont été perpétrées par des proches
(Sibertin-Blanc & Vidailhet, 2003).
Ce changement brutal de la proximité sociale et affective remet en question des repères rela-
tionnels fondamentaux, se référant notamment au proverbe rwandais qui dit: «Inshuti ya hafi
ikurutira umuvandimwe wa kure », qui veut dire littéralement : « Un voisin proche vaut mieux qu’un
frère éloigné ». Ce qui souligne traditionnellement l’importance des relations de voisinage fon-
dées sur la solidarité et l’entraide, mais a été tragiquement affecté par la réalité du génocide,
où la proximité géographique a parfois été le vecteur de la trahison. Les violences ont été por-
tées au plus profond de l’intimité des victimes, précisément parce qu’elles ont été perpétrées par
des proches (Sibertin-Blanc & Vidailhet,2003). Ce paradoxe met en évidence l’effondrement des
cadres sociaux traditionnels et la profondeur de la fracture morale induite par la violence extrême.
La communauté qui n’est pas intervenue pour protéger certains de ses membres qui étaient des
cibles, a échoué pour n’avoir rien fait pour sauver les vies en danger, elle aussi, nécessité une
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reconstruction psychique (Staub et al., 2005). En effet, la reconstruction psychique des survi-
vants ne peut donc se dissociée de celle de la communauté elle-même, Les deux sont intégrés
et difficiles à séparer et elles s’influencent mutuellement. Les survivants continuent de vivre à
proximité d’anciens bourreaux, et leurs familles et partagent presque tout dans leur quotidien.
Dans ce contexte, la communauté joue un rôle essentiel dans l’accompagnement et l’intégration
et la restauration du lien social. Sans ce travail de reconstruction psychique communautaire, la
reconstruction psychique des survivants reste partielle.
Par ailleurs, un autre aspect important se révèle dans les propos de certains survivants. Se
référant aux propos d’un survivant observant le retour dans la communauté d’anciens bourreaux
libérés après avoir purgé leurs peines, il rapporte: «ces gens (anciens bourreaux) qui sont relâ-
chés, n’avaient fait aucun aveu, et savent où ils ont jeté les nôtres (ceux qui ont été tués), et n’ont pas
voulu nous montrer où sont les corps de nôtres. On ne peut pas les croire qu’ils ont changé. On ne
doit pas relâcher, car à tout moment on risque encore d’être traumatisé». Ces propos traduisent
une inquiétude permanente, une insécurité intérieure qui pourrait être atténuée seulement s’il y
avait des garanties de changement, de non- dangerosité, reconnaissance de leurs responsabilité,
expression de regret, choses que les bourreaux ne font que rarement(Staub et al., 2005) Une telle
assurance aurait alors un véritable effet apaisant.
En effet, les survivants du génocide ont subi non seulement une altération de leur être, modi-
fiant non seulement leur identité, ce qu’ils sont devenus, mais aussi leur rapport à l’existence, et
leur devenir, ce qu’ils peuvent ou doivent devenir (Munyandamutsa, 2014). Le traumatisme subi
par les survivants a provoqué une effraction psychique qui ne s’est pas limitée à une simple intru-
sion, il a également détruit ou altéré profondément l’être dans son intimité, rompant le sentiment
de continuité et le privant de sa capacité à penser et à se projeter dans l’avenir (Sibertin-Blanc &
Vidailhet, 2003). Cet article vise à explorer les apports de la thérapie narrative dans le processus
de reconstruction psychique et dans la quête du sens de la vie chez les survivants du génocide
perpétré contre les Tutsis au Rwanda en 1994. A cette fin, trois objectifs spécifiques ont été éta-
blis, dont: (1) identifier les transformations majeures dans les récits de vie des survivants ayant
bénéficié de la thérapie narrative, (2) analyser les mécanismes par lesquels cette approche théra-
peutique favorise le développement de la résilience au niveaux individuel et communautaire;
et (3) explorer l’impact de la thérapie narrative dans la reconquête de soi , la restauration du sens
de la vie;des éléments clés qui sont les plus sévèrement touches et qui sont des soubassements
de la reconstruction psychique.
La période post génocide a requis des interventions adaptées tant sur le plan individuel que
collectif, afin d’accompagner la reconstruction psychologique des survivants, et de redonner le
sens de la vie, car cela constitue un besoin fondamental pour l’être humain (Kühn, 2003).
Une nécessité urgente et pressante de mettre en place des interventions thérapeutiques
appropriées afin de répondre aux conséquences psychologiques liées au génocide et d’alléger le
poids des troubles psychologiques chez les survivants de génocide contre les Tutsis de 1994 au
Rwanda était importante. Certaines interventions thérapeutiques ont été initiées au Rwanda
en vue d’améliorer la santé mentale des victimes du génocide. Notamment l’approche de socio-
thérapie communautaire et individuelle comme «Mvura Nkuvure» en Kinyarwanda qui signifie
littéralement «soigne-moi, je te soigne» visant à promouvoir la guérison psychosociale, la récon-
ciliation dans le contexte post génocide au Rwanda (Jansen et al., 2022) . L’EMDR (Eye Movement
Desensitization and Reprocessing) quant à elle, est une approche individuelle visant à permettre
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Reconquête du soi et quête de sens de vie : Regards sur les processus de reconstruction
psychique chez les survivants du génocide contre les Tutsi en 1994 au Rwanda.
le traitement de souvenirs traumatiques de manière moins douloureuse (Carriere, 2014). Bien
que des efforts aient été consacrés à la prise en charge des conséquences psychologiques du
génocide, très peu de recherches, voire aucune, n’ont porté spécifiquement sur la restauration
du sens de la vie, alors même que le génocide a profondément altéré la perception de soi et le
rapport au sens existentiel. La thérapie narrative a été introduite pour la première fois par l’Aus-
tralien Michael White et le Néo-Zélandais David Epston. Elle a été appliquée au début en thérapie
familiale et puis s’étendue par la suite, avec grand succès, au traitement des traumatismes, des
désordres alimentaires, des dépendances, du deuil et de la violence conjugale. La thérapie nar-
rative considère que les réalités sont construites socialement, les personnes comme expertes de
leur propre vie, et que les problèmes sont séparés des personnes. Elle reconnait également que les
personnes ont des compétences qui les aident à changer la relation avec leurs problèmes (Gros-
Louis, 2015) La thérapie narrative, en tant qu’approche axée sur la reconstruction psychique par
le biais du récit, offre un cadre pertinent pour explorer et réhabiliter le sens de la vie chez les sur-
vivants. Elle aide la personne à ne pas se définir par sa situation de victime mais vise à séparer
l’individu de son problème, ce qui permet une reconstruction psychologique (Dekruyf, 2008) Au
Rwanda, la tradition orale occupe une place centrale dans la construction psychique de l’identité
à travers la transmission de récits. Dans cette perspective, la thérapie narrative, qui repose éga-
lement sur l’usage de la narration, pourrait, une fois être contextualisée et adaptée, constitue un
levier pertinent pour favoriser la reconstruction psychique(Betbèze & Ostermann, 2022).
Des études, notamment celle de Karibwende et al.,( 2022) effectuée auprès des orphelins,
celle effectuée par Murengera et al.,( 2025) réalisée auprès des survivants du génocide conte les
Tutsi en 1994 au Rwanda ,ainsi que celle (Rani et al., 2024) portant sur des femmes victimes des
violences domestiques, ont toutes montré que la thérapie narrative contribue efficacement à
la réduction des symptômes d’anxiété et de trouble de stress post-traumatique (TSPT).Toutefois,
peu de recherches ont été menées au Rwanda spécifiquement sur les mécanismes de recons-
truction psychique et de reconquête de soi chez les survivants du génocide contre les Tutsi en
1994. En s’appuyant sur les récits traumatiques des survivants, notre étude vise à combler les
lacunes existantes dans la littérature concernant l’impact de la thérapie narrative dans le pro-
cessus de reconstruction psychique. Elle cherche également à examiner comment cette approche
peut contribuer à restaurer le sens de vie dans un contexte où le traumatisme, par son caractère
d’effraction, a causé une rupture, un blocage et une désorganisation de l’appareil psychique(Si-
bertin-Blanc & Vidailhet, 2003). Cette entrave demeure palpable aujourd’hui car la capacité des
survivants à se projeter dans l’avenir, ou à retrouver la continuité de la vie reste toujours affectée.
2. Méthodologie
2.1 Approche qualitative de l’étude
Cette étude a utilisé une approche qualitative exploratoire pour examiner comment la théra-
pie narrative contribue à la reconstruction psychique,à la reconquête de soi et à la redéfinition
du sens de la vie chez les survivants du génocide contre les Tutsis de 1994 au Rwanda. Cette
approche était appropriée du fait qu’elle favorise l’expression du vécu des individus et s’aligne à
la tradition d’une société rwandaise à culture d’oralité. Les entretiens semi-structurés ont fourni
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un cadre flexible pour la collecte de données qualitatives riches, permettant une compréhension
approfondie des pensées, des sentiments et des croyances des participants concernant leur vécu
et leurs projections dans l’avenir.
2.2 Cadre de l’étude
Cette étude a été menée auprès de survivants du génocide perpétré contre les Tutsis en 1994
au Rwanda. Le choix des participants à notre étude a été dictée par le fait que ces derniers sui-
vaient des sessions de thérapie narratives facilitées par Uyisenga ni Manzi qui reste la seule et
unique organisation reconnue au Rwanda pour son expertise dans l’intégration de la thérapie
narrative au sein de ses interventions psychosociales communautaires. Nous avons recueilli et
analysé les récits de survivants concernant leur processus de reconstruction psychologique à la
suite de leur participation à des sessions de thérapie narrative.
2.3 Méthode et caractéristiques de l’échantillon
Les participants à cette étude étaient des survivants de génocide contre les Tutsis de 1994
au Rwanda, qui précédemment, participaient à des sessions de thérapie narrative. La technique
de l’échantillonnage raisonné était utilisée pour sélectionner 11 survivants qui ont participé à
des sessions de thérapie narrative facilitées par l’organisation Uyisenga Ni Manzi. Les partici-
pants s’exprimaient sur leurs expériences, afin d’explorer les résultats de la thérapie narrative.
La taille de l’échantillon a été déterminée sur la base du principe de saturation des données,
qui postule que la collecte de données peut cesser lorsqu’aucun nouveau thème ou information
n’émerge(Bowen, 2008).
2.4 Collecte de données
Certaines données utilisées dans la présente étude ont été initialement recueillies dans le
cadre d’un projet de recherche plus vaste. Une partie de ces données avait déjà été analysé et
publié dans un travail mémoire de Master, lequel portait sur la contribution de la thérapie narra-
tive à la réduction de l’anxiété, de la dépression et du trouble de stress post-traumatique chez les
survivants du génocide contre les Tutsis en 1994 au Rwanda(Murengera et al., 2025). Cet article
répond toutefois à une question de recherche distincte et aborde un angle analytique différent,
qui n’avait pas été examiné dans le travail de Mémoire de Master. Lorsque nous avons réalisé
cette recherche, de façon générale, nous nous sommes focalisé sur certains éléments qui ont par-
ticipé au processus de résilience chez les survivants du génocide perpètre contre les tutsi en 1994
au Rwanda. Cependant, nous sommes resté sur la soif de comprendre comment les survivants
arrivaient à retrouver le pouvoir d’agir et une certaine capacité de se projeter dans l’avenir. C’est
cet aspect qui n’avait pas été suffisamment abordé et qui objet de notre article.
2.5 Analyse de données
Dans cette étude, les données qualitatives des entretiens ont été enregistrées, transcrites mot
à mot. Les transcriptions ont été revue pour une compréhension approfondie des expériences
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psychique chez les survivants du génocide contre les Tutsi en 1994 au Rwanda.
vécus de participants. L’analyse thématique a été utilisée comme méthode principale pour ana-
lyser les données qualitatives. Cette technique a suivi les six étapes clés de l’analyse thématique
de Braun et Clarke (2019) dont: la familiarisation avec les données, génération initiale des codes,
recherche des thèmes, la revue et la finalisation des thèmes, la définition et rédaction du rap-
port de synthèse. Une équipe de recherche composée de cinq psychologues a été impliquée tout
au long du processus. Chaque membre a codé indépendamment des extraits des données, puis
des réunions régulières ont permis de comparer les codifications, de discuter des divergences et
d’harmoniser des catégories de codes. Cette collaboration a permis de consolider des catégories
de codes cohérentes et pertinentes, favorisant ainsi l’émergence de thèmes significatifs. Le score
obtenu au test de coefficient de Kappa Cohen était de 0,80 indiquant une excellente cohérence
dans l’attribution des codes et la formation de thèmes.
2.6 Considérations éthiques
Conformément aux principes d’éthique établis dans le cadre de l’étude initiale, dont le
présent article constitue une prolongation analytique, cette recherche a été approuvée par le
comité d’éthique institutionnel (Institutional Review Board – IRB) de la faculté de Médecine et
des Sciences de la Santé de l’Université du Rwanda. (Réf: CMHS/IRB/162/2023). Les participants
avaient été informés de manière claire et détaillée des objectifs, des modalités et des implica-
tions de l’étude. Leur consentement libre a été recueilli avant tout engagement. La confidentialité
était garantie par l’anonymisation rigoureuse des données. Ils ont été également informés de leur
droit de se retirer de l’étude à tout moment sans justification ni conséquence. En raison de la sen-
sibilité du sujet, des dispositifs d’écoute et d’accompagnement psychosocial ont été prévus pour
répondre à d’éventuelles réactions émotionnelles susceptibles d’émerger au cours des entretiens.
Les intervieweurs étaient tous des psychologues, avec expérience avérée dans la gestion des
traumatismes psychologiques. Avant la récolte de données, une formation complémentaire a été
dispensée pour sensibiliser aux particularités de crise émotionnelle liée au contexte génocidaire
et aux techniques d’entretien empathique et sécurisant pouvant être utilisée une fois une crise
émotionnelle se produit. Immédiatement après chaque entretien, un service d’accompagnement
psychologique était disponible sur place pour s’assurer du bien-être du participant le ressenti en
ce moment. Cette organisation a garanti un environnement propice, et protecteur réduisant les
risques de re-traumatisations.
3. Analyse des résultats
Amélioration des symptômes invalidants
Certains survivants décrivent des manifestations caractéristiques du traumatisme psychique
telles que les reviviscences des évènements traumatiques, cauchemars, l’insomnies, céphalées,
une peur intense, l’hypervigilance, les réactions de sursauts ainsi que l’isolement. En raison de
cette détérioration psychique et la sévérité des symptômes, certains proches, amis ou membres
de la communauté leur ont recommandé une prise en charge psychologique. Les sessions de thé-
rapie narrative bénéficiées leur ont permis d’améliorer les symptômes
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MUH témoigne:«C’est le président d’Ibuka (collectif des associations des survivants) qui a initié
ma prise en charge psychologique. Mon état montrait une décompensation psychique sévère, je ne
pouvais rien faire. Ce qui affectait ma vie. Le fait que les amis, et voisins ont intervenu pour que je sois
suivi psychologiquement, ’était évident que je ne pouvais pas fonctionner normalement. ESP ajoute
:«C’est la Croix-Rouge qui s nous a invités à participer à des sessions de suivi psychologique après
avoir constaté que nous avions faits des crises émotionnelles lors des événements de la commémo-
ration du génocide contre les Tutsis en 1994». KAY explique:«ce qui m’a amené chez le médecin,
c’était des céphalées atroces. Je ne voulais voir personne, ni parler. J’étais étourdi, je ne comprenais
pas ce qui m’arrivait, et je perdais connaissance». Et pour EMU: «Quand je suis arrivé ici, j’étais
traumatisé, car je suis la seule survivante dans ma famille, je n’avais plus personne. Je m’isolais beau-
coup. Avec difficulté d’acceptation de soi. Rien ne restait chez moi.»
MAGO se rappelle ses multiples retraumatisations. Elle rapporte : « Je faisais environ 30 crises
émotionnelles par an. Il n’y avait pas de périodes de rémissions.»
Les témoignages de MUH, ESP, KAY, EMU et MAGO offrent une fenêtre sur la manière dont
les survivants du génocide contre les Tutsis expriment leur souffrance, tout en laissant entrevoir
les processus thérapeutiques à l’œuvre. A travers leur récits, plusieurs techniques propres à la
thérapie narrative transparaissent. Les participants racontent comment ils ont exteriosé leurs
problèmes. Les survivants expriment leurs souffrances comme des entités envahissantes. Cette
extériorisation étant le premier pas essentiel en thérapie permet d’abord de réduire la charge
émotionnelle longtemps cumulée. Leurs efforts ne s’étaient pas limités seulement à la descrip-
tion du traumatisme, mais aussi vers la prise d’initiatives de recherche de soins. Ils ont décidé de
prendre du pouvoir (re-authoring) sur leur histoire en recherchant de l’aide. Ceci laisse entrevoir
leur capacité à surmonter leurs blessures et à ne pas se laisser submerger par ce qui leur sont arri-
vés. L’intervention des autres acteurs tels qu’Ibuka, la Croix-Rouge, ou encore les voisins, témoins
des souffrances des survivants, a renforcé leur initiative dans leur recherche de soins et de leur
rétablissement psychologique. Cette empathie montre que la souffrance psychique des survi-
vants n’était pas perçue seulement comme un problème individuel, mais une réalité partagée et
nécessitant une prise en charge par une communauté élargie. Tous ces efforts tant individuels
que collectifs leur ont permis de retrouver certaines capacités qui leur permettent de mener une
vie plus ou moins adaptée et de vivre avec un certain équilibre.
Reconstruction identitaire
Les participants témoignent d’un retour tangible leur individualité, malgré l’impact du trau-
matisme. MUK révèle comment la communauté la percevait en raison de son état post-trauma-
tique: «On m’avait surnommée kararubiye. Ce qui signifie, la femme amère» un reflet de sa dépres-
sion, de son retrait social., Puis, elle marque un tournant:«Mais à présent, je suis capable d’aller
vers les autres et de communiquer ». Ce propos illustre la manière dont le soutien psychologique
à travers la thérapie narrative l’a aidée a restaure son image par conséquent a brisé les barrières
communicationnelles et relationnelles. Par ailleurs, le besoin de tisser des liens familiaux bien-
veillants, de trouver amour et soutien dans un environnement structurant est indispensable à la
reconstruction identitaire
Pour MKT, le trauma a coupé toute possibilité d’exprimer son vécu et ressenti qu’elle vivait:«
je sentais que je n’avais personne à qui raconter ce qui m’était arrivé.» Elle souligne néanmoins,
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psychique chez les survivants du génocide contre les Tutsi en 1994 au Rwanda.
qu’après un certain temps ça a changé:«j’ai trouvé quelqu’un à qui raconter mon histoire, et je
me suis sentie libérée., je pouvais voir les choses clairement» poursuit-elle. Ce changement entre
silence et narration a révélé un profond effet libérateur du psychisme. En plus, la narration a
permis au sujet d’extérioriser sa souffrance et la voir dans un autre angle.
EMU, partage un récit poignant. Orphelin dès l’âge de deux ans, privé de ses racines, sans
nom de famille:«Même le nom que j’ai, c’est le bienfaiteur qui me l’a donné. Ce nom signifie Dieu est
avec nous». Sa démarche de reconstruction identitaire commence par la création d’une famille,
le mariage et la naissance d’un enfant:«je veux laisser un héritage, dit-il, laisser une trace ici sur
terre». Ce témoignage illustre à quel point la quête de filiation-même symbolique peut soutenir
la réinvention de soi, récréer l’existence dans une lignée. Ce récit illustre bien une quête pro-
fonde: recréer une continuité identitaire rompue par le génocide. La thérapie a permis au sujet
de reformuler son histoire non pas autour de ce qui n’existe pas (ses repères), mais autour d’une
identité en construction (récits alternatifs). Ce travail de reconstruction identitaire a permis à
la personne à la redéfinition de soi, ses valeurs, ses repères après une rupture de vie ou après
un évènement qui a profondément transformé sa vie. Parmi les conséquences les plus graves du
génocide figure la destruction totale, y compris les familles entières. Cela apparait clairement
dans les récits des survivants, en particulier ceux qui étaient trop jeunes pour en garder les sou-
venirs: leurs familles ayant été entièrement décimées, ils se retrouvent sans repères identitaires.
Alors, fonder une famille procure un sentiment d’appartenance, de sécurité, de perpétuation de
sa lignée, et restauration de son identité. Pour EMU, recréer les liens familiaux de filiation inexis-
tants par procréation lui a permis de retrouver l’identité perdue ou détruite et se reconstruire
psychiquement.
Régulation émotionnelle et quête du sens de la vie
Plusieurs participants soulignent le rôle déterminant de la spiritualité dans la recherche du
sens de la vie et dans leur processus de rétablissement après les traumatismes liés au génocide.
La croyance en une puissance supérieure constitue, selon eux, une source de réconfort et de
confiance qui permet d’affronter les moments les plus difficiles. Certains témoignages mettent
en évidence que le pardon, la prière, les pratiques religieuses procurent un sentiment de sérénité
et de quiétude intérieure. L’expérience de UWI illustre avec force cette dynamique. Convoquée
aux juridictions Gacaca (tribunaux populaires), elle se retrouve en face de l’auteur du meurtre de
son mari. Elle rapporte :«le moment le plus difficile, c’était lorsqu’on nous convoquait dans le cadre
des juridictions Gacaca. Imaginez être en face d’une personne qui a tué et jeté mon mari dans une
fosse. Franchement, j’étais confuse, et je ne comprenais pas ce qui m’arrivait, et une rage de me ven-
ger montait en moi». Elle continue en disant:«Mais, avec l’aide de Dieu, j’ai pu vaincre le sentiment
de vengeance et pardonner. J’ai commencé à aller mieux, et j’ai pu participer aux tribunaux Gacaca
sans problème». Elle décrit également la douleur d’être veuve à un jeune âge et les émotions qui
l’envahissaient lorsqu’elle voyait un couple. Elle dit:«Et lorsque je voyais une femme avec son
mari, Je me disais que moi aussi j’aurais pu en avoir. Devrais-je être veuve à cet âge ? Et dire, c’est
lui qui a tué mon mari. Et pourtant ce n’était pas lui. Oh mon., Dieu, je ne sais pas., Pardonne-moi!
Voir le couple suscitait en moi la jalousie et un sentiment de haine. Je sentais que je ne pouvais m’as-
socier aux autres. Quand je voyais un homme, je le haïssais et je me demandais pourquoi ? Car j’ima-
ginais que c’étaient des hommes qui avaient tué mon mari. Mais, avec les prières, j’ai ressenti une
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transformation, et les problèmes se sont atténués. La spiritualité m’a apporté un autre regard sur la
sens de la vie, à pardonner, et remettre les choses dans les mains de Dieu. Maintenant c’est bon, je me
suis rétabli, et je fais du bien. Je n’ai aucun problème avec les gens, je les rencontre, nous interagissons
et discutons et nous passons un bon moment. Quand je demande quelque chose, ils me le donnent, et
vice versa. Les voisins ont commencé à m’’approcher, mais de mon côté, il a fallu du temps pour leur
faire confiance, se sentir proche d’eux, même s’ils n’ont rien fait contre nous »
De son cote, MUH confie son vécu, en ces termes :«je ne peux pas trouver des mots pour
expliquer ce que j’ai traversé. J’ai tout remis entre les mains de Dieu, car Lui seul connait tout. J’ai
embrassé une nouvelle vie ». Ce témoignage traduit un processus psychologique de lâcher-prise,
où les recours à la transcendance permettent de supporter l’inexplicable, d’atténuer le poids du
traumatisme et de réinvestir l’existence. Ces témoignages montrent comment le génocide a causé
des blessures psychiques majeures qui ont impacté le sens de la vie, affectant l’organisation psy-
chique de l’individu. Certains participants ont montré comment la spiritualité a offert un cadre
symbolique et pratique pour se réorganiser et redonner sens à l’existence. La prière, le pardon,
et le fait de remettre leurs souffrances entre les mains de Dieu constituent autant de ressources
auxquelles les participants ont eu recours pour apaiser leurs émotions et au long terme, mener
une vie plein de sens. En effet, ces pratiques semblent les aider à retrouver un certain apaise-
ment, et réaffirmer les valeurs qui demeurent importantes pour eux et ressentir sur le moment,
une sensation de cohérence intérieur. Dans cet extrait, il dégage les trois dimensions du sens de
la vie (Baatouche et al., 2019) qui sont: la direction (intentionnalité), la valeur (signification sub-
jective) qui lui est propre et la sensation. La direction c’est la dimension qui renvoie aux objectifs,
à l’élan qui oriente la vie, la direction que l’on veut donner à son existence après un traumatisme,
la valeur est ce qui compte pour soi, ce qu’on choisit de garder comme important, quant à la sen-
sation c’est ce qu’on ressent profondément. La compréhension de ses trois dimensions permet
d’explorer les sources de satisfaction, de motivation et de résilience face aux défis de l’existence.
La religion étant une institution établie pour faciliter la spiritualité (recherche du sacré) à aider
à restaurer un équilibre psychique (Harper & Pargament, 2015), mais devrait être aborder avec
grande sensibilité(Malviya et al., 2025) pour ne pas baffer les processus de deuil.
Concernant le pardon, la plupart de religions l’encouragent, même lorsqu’il n’est pas demandé,
afin de pouvoir se libérer du fardeau que représente le non-pardon. De même au Rwanda, durant
les processus de réconciliation et juridictions Gacaca (Staub et al., 2005) les survivants étaient
encouragés par leurs coreligionnaires à pardonner aux anciens bourreaux, affirmant que ce par-
don apporterait un soulagement intérieur et les libérerait du fardeau de non-pardon et du désir
de vengeance. Les survivants peuvent percevoir que le pardon est attendu et ressentir la pres-
sion de l’accorder. Cependant, un pardon qu’on est poussé à donner sans qu’il soit demandé par
l’offenseur, qui n’est pas initié par la victime elle-même, de manière volontaire, peut entrainer
des conséquences psychologiques qui entravent le processus de travail de deuil. Le préjudice
causé par le traumatisme doit d’abord être abordé, reconnu, avant toute tentative d’encourager
la victime de pardonner (Buetow, 2025). Accorder le pardon ne doit jamais devenir une injonc-
tion imposée aux victimes. Aucune pression, implicite, ne devrait être exercée sur les victimes
pour qu’elles pardonnent. Le pardon s’il est accordé, doit venir volontairement de la victime, pas
sous une quelconque pression extérieure implicite. Il ne peut être bénéfique que si les conditions
sont réunies : pour la victime, lorsque son préjudice a été reconnu, validé et réparé ; et pour le
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Reconquête du soi et quête de sens de vie : Regards sur les processus de reconstruction
psychique chez les survivants du génocide contre les Tutsi en 1994 au Rwanda.
bourreau, une possibilité de soulagement et de réintégration au sein de la communauté. Ce tra-
vail a été préalable au Rwanda avant le processus de pardon.
Effet du groupe parole
Les participants ayant pris part au groupe parole, soulignent sont impact thérapeutique
significatif. Ils révèlent l’aspect thérapeutique de ce cadre UWI témoigne:«Dans le groupe, on
me soutient, et je me sens réconfortée.» Le groupe m’aide à ne plus m’isoler»
Du cote de MKK, MKT et MUKES, elles déclarent que le partage des expériences leur pro-
cure soulagement, et se sentent qu’elles ne sont plus les seules à vivre de telles situations. NYIN
ajoute:«je me sens proche des autres, car nous partageons les mêmes expériences. » ESP renché-
rit:«Quand on partage les expériences, nous nous entraidons, on réalise que nos problèmes sont
moins graves en comparaison à ceux des autres, et cela nous réconforte. »
Cependant, VTT et BON disent autres choses qui se manifestent dans le groupe. BON
explique : « il y a risque de contamination des émotions, et surtout celles qui sont négatives. »
VTT évoque un autre aspect marquant dans le partage des expériences au sein du groupe. Elle
témoigne:«Parfois on s’écrivait des lettres pour exprimer nos sentiments et nos souhaits. Et la lettre
était lue dans le groupe. Cette pratique a permis de mettre en mots des ressentis. Ce qu’on n’osait pas
exprimer en paroles était exprimé par écrit»
Dans les récits des participants, trois mécanismes centraux de la thérapie narrative appa-
raissent implicitement: l’extériorisation du problème, la réécriture du problème(re-authoring)
et la création collective de sens. Le partage des expériences facilite l’extérioration du problème,
en permettant aux participants de prendre distance de leurs difficultés, de bénéficier du soutien
du groupe et de sortir progressivement de l’isolement qui les enchaine. La rencontre avec les
autres transforme la manière dont ils appréhendent leur propre histoire en comparaison aux
expériences des autres et la manière dont ils les ont vécus. L’exposition a des récits similaires ou
plus complexes conduit à une réévaluation de son vécu, ou des expériences auparavant perçues
comme insurmontables prennent une signification différente et deviennent plus intégrables.
Cette dynamique ouvre la possibilité de réorganiser son récit personnel, de le reformuler dans
des termes moins pathologisant et ainsi de produire une version alternative de l’histoire, moins
centrée sur la souffrance.
Rupture avec le sentiment de vulnérabilité et la peur de rechute
Certains participants ont exprimé leurs inquiétudes quant à la difficulté de guérir des trau-
matismes. MUH « Je vois que nous ne nous en remettrons pas facilement parce que ceux qui ont tué
les nôtres, ils ont été emprisonnés mais ils sont libérés après avoir purgés leurs peines, et n’ont jamais
fait des aveux. Ils savent aussi où se trouvent ceux qu’ils ont tués, et qu’ils n’ont pas enterrés digne-
ment. Ils sont enterrés dans leurs maisons, ou quelque part, mais ne veulent pas nous montrer là où
ils les ont jetés. Cela nous affecte encore ». Ce témoignage met en évidence que le fait de n’avoir
pas inhumé les siens rend le processus de deuil inachevé, en raison de l’impossibilité de faire des
rituels de deuil et de donner une sépulture digne aux victimes Bhatti et al., (2023).
UWI rapporte dans ces propos : « Par ailleurs, on ne devrait pas relaxer car parfois on peut
être blessé encore. Que les professionnels continuent à nous aider ». Pour ESP : « Nous avons des
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problèmes, car il y a beaucoup de choses qui peuvent nous causer des rechutes. Nous demandons un
plaidoyer ».
La résilience n’est pas une capacité accuse une fois pour toute, il ne s’agit pas non plus un
blindage total, mais les victimes reconnaissent qu’elles gardent une certaine vulnérabilité tout
en ayant une capacité de mieux gérer certains défis et leur état de vulnérabilité. Elles ont alors
raison de reconnaitre que certains défis restent et nous trouvons qu’en garder la conscience est
renforcé aussi cette capacité.
Les propos d’UWI et ESP illustrent une vulnérabilité persistante à la retraumatisation. La
peur d’être blessé à nouveau motive un appel continu à l’aide professionnelle et à un plaidoyer.
NYD illustre son expérience en ces mots:«En dehors du traumatisme, j’ai un problème parti-
culier, j’ai été infecté par le VIH. Cela m’a affecté. Quand je m’assois et que je vois que j’ai ce problème,
que je ne suis pas comme les autres, que ce problème ne guérira pas, je me sens encore très triste». Ce
témoignage met en evidence le sentiment de vulnérabilité liée à l’infection du VIH/SIDA, comme
conséquence du viol pendant le génocide.
4. Discussion
Cette étude a exploré les expériences traumatiques des survivants du génocide contre les
Tutsis en 1994 au Rwanda, les apports de la thérapie narrative dans la reconstruction psychique
et la quête du sens de la vie. Les résultats sont particulièrement significatifs, partant de l’expé-
rience historique et contextuelle par laquelle le pays a traversé et des conséquences sur la santé
mentale de survivants du génocide. Il se remarque que même trois décennies après le génocide,
les répercussions psychologiques demeurent persistantes (Kayiteshonga et al., 2022; Rieder &
Elbert, 2013). Cet article contribue à l’enrichissement de la littérature en apportant un éclairage
sur l’apport de la thérapie narrative dans les processus de reconstruction psychique et la quête
du sens de la vie chez les survivants du génocide. De manière générale, l’analyse des résultats
dégage quatre axes principaux autour desquels tourne la discussion que nous entamons.
La rencontre avec d’autres ayant le même vécu
Les symptômes invalidants du trauma incluent des manifestations physiques, psychiques,
émotionnelles et comportementales qui impactent profondément l’unité psychique des indivi-
dus ont constitué les causes premières de la recherche des soins psychologiques. (Pat Ogden,
2021; Vuillard, 2018)(Pat Ogden, 2021; Vuillard, 2018). Cependant avant même de sentir l’envie
de rechercher les soins, le trauma fait croire à la victime qu’elle est seule et ce sentiment d’injus-
tice ronge le cœur pendant des années souvent jusqu’à ce qu’elle rencontre d’autres personnes
ayant le même vécu ou vécu similaire. Cette rencontre avec les autres ayant les mêmes vécus des
expériences similaires joue un rôle crucial dans la reconstruction psychique. Du point de vue
de la thérapie narrative, cette rencontre constitue un moment de déconstruction de l’histoire
traumatique dominante (dominant problem-saturated story) telle que décrit par (White, 1990) .
La rencontre a également favorisé la rupture avec l’isolement dans lequel se trouvaient certains
survivants. Le fait de se retrouver avec d’autres qui ont peut-être vécu le pire a aidé à relativi-
ser la souffrance, par conséquent l’apprivoiser, mécanisme typique de re-authoring. C’est ce que
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Reconquête du soi et quête de sens de vie : Regards sur les processus de reconstruction
psychique chez les survivants du génocide contre les Tutsi en 1994 au Rwanda.
Bessel A. van der Kolk,(1994) appelle le self-leadership de son histoire. Certains qui sont restés
longtemps dans l’isolément ont pu développer leur sentiment d’appartenance en intégrant cette
espace de rencontre. Cette espace était un milieu propice où ils pouvaient s’exprimer et être
entendu sans jugement, et renouer des liens de confiance avec les autres. Ceci rejoint les tra-
vaux Herman, (1992) qui montre que la sécurité relationnelle et la restauration des liens sociaux
constituent des éléments essentiels dans le rétablissement psychologique. Par ailleurs, les parti-
cipants soulignent que la reconstruction psychique individuelle est indissociable d’une recons-
truction collective. Cette interdépendance explique l’importance de la rencontre avec les autres
dansles processus de reconstruction psychique où l’individu trouve soutien, réconfort, et appar-
tenance. L’espace et la rencontre leur ont permis de retrouver des personnes en qui ils peuvent
faire confiance.
Rôle de l’entourage/professionnel dans la prise de conscience de la nécessité de soins
L’analyse des résultats montre que, la décision de recherche des soins a été fortement influen-
cée par l’entourage : proches, voisins ou professionnels, qui les ont encouragés à rechercher
un accompagnement psychologique face à la persistance de manifestations traumatiques. Ce
constat fait écho aux travaux de Murengera et al., (2025)qui indiquent que la recherche de soins
chez les survivants est fréquemment motivée par la persistance de symptômes psychologiques
et somatiques, affectant le bon fonctionnement de l’individu. Le fait de manifester de symptômes
a été bénéfique du fait que, au lieu d’éloigner l’entourage, a ouvert un espace de rapprochement
aux personnes souffrantes afin de donner encouragement, et soutien. Ainsi, l’intervention de
l’entourage a contribué à créer des conditions favorables pour l’accompagnement psychologique,
étape initiale dans la reconstruction psychologique.
Espace sécurisé favorisant l’expression de souffrance
Le groupe a constitué un cadre idéal de partage d’expérience et d’expression émotionnelle
sans jugement. De plus, cet espace leur offrait la possibilité de diversifier les moyens d’expres-
sion de leurs souffrances notamment par l’oralité ou l’écriture. L’espace sécurisé qui a favorisé
l’expression de la souffrance leur a permis de se sentir libéré du poids du silence morbide poten-
tiellement plus pathogène. Cette situation pèse lourdement sur la possibilité de faire le deuil,
de renouer des liens sociaux, et de faire le travail de mémoire collective(Jacques Palard, 2015).
Toujours en rapport avec la reconstruction psychique, Herman, citée par (Zaleski et al., 2016)
(Zaleski et al., 2016) parle de trois étapes clés dans le rétablissement des survivants du trauma: 1)
la sécurité, 2) la mémoire et le deuil, et enfin 3) la reconnexion.
Au Rwanda, la vie communautaire a joué un rôle essentiel dans le processus de résilience
des victimes du génocide en offrant des espaces de parole qui s’inscrivent dans des pratiques
sociales anciennes. La tradition de gusangira (partage) et les rencontres communautaires favo-
risent un climat où chacun peut exprimer sa douleur sans jugement. Ces espaces collectifs, sou-
vent organisés permettent aux victimes de raconter leur histoire, de rompre l’isolement et de
sentir que leur souffrance est reconnue. Parler ensemble rétablit des liens brisés et leur redonne
une certaine appartenance. Les rituels et activités communs offrent un cadre symboliquement
sécurisé et ce partage aide à transformer la douleur en force et au rétablissement de la confiance
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mutuelle. Ainsi ces espaces de partage de parole leur permettent de se reconstruire en s’appuyant
sur la solidarité, l’écoute et la reconnaissance partagée de l’histoire vécue.
A la recherche du sens de vie
Nos résultats montrent le rôle de la spiritualité dans les processus de reconstruction psy-
chique chez les survivants. Plusieurs participants ayant souffert des conséquences psycholo-
giques liées au génocide ont recouru à la spiritualité pour faire face à leurs difficultés, et en par-
ticulier retrouver du sens à leur vie. Il a été évident que le recours à la spiritualité était adaptatif
afin de faire face à la souffrance. Cette observation rejoint un ensemble d’études montrant que
la spiritualité constitue une stratégie adaptative de coping permettant de réguler la souffrance,
de restaurer un sentiment de cohérence interne et de renforcer la résilience(Harper & Pargament,
2015). Certains participants rapportent avoir pardonné même si le pardon n’était pas demandé.
En plus, ils affirment être capables de se retenir de toute vengeance et pouvoir surmonter les sen-
timents négatifs. Ceci s’articule avec ce que Muñoz Sastre et al., (2014) ont dit que le pardon est le
fait de vaincre son ressentiment envers l’offenseur, non pas en ne niant son droit au ressentiment,
mais en s’efforçant de considérer l’offenseur avec bienveillance, compassion et même amour et
de pouvoir mener une vie ayant un sens, en se libérant du poids paralysant de la culpabilité liée
à la vengeance. Pour Séméria, (2018), le sens de la vie peut se trouver dans la religion ou la spiri-
tualité ou encore dans l’investissement au sein de la communauté.
Nos résultats mettent également en lumière la complexité du rôle de la religion et de la spi-
ritualité dans les trajectoires de reconstruction psychiques des survivants. Selon la distinction
proposée par Harper & Pargament,(2015), la religion peut être comprise comme une quête de
sens structurée par des institutions établies, tandis que la spiritualité renvoie davantage à une
recherche personnelle du sacré. Cette différence conceptuelle apparait pertinente pour interpré-
ter la manière dont les survivants ont mobilisé ces ressources après le génocide. Si la spiritualité
peut soutenir le bien être psycho-spirituel des survivants, elle doit être abordée avec grande
sensibilité. En effet, comme le montrent plusieurs auteurs, une mobilisation prescrite peut inter-
férer avec les étapes nécessaires du travail de deuil, car elle peut risquer d’entraver ou baffer les
processus de deuil (Neimeyer,2016).
Au Rwanda, durant les processus de réconciliation, les survivants étaient encouragés à par-
donner aux anciens bourreaux, affirmant que ce pardon apporterait un soulagement intérieur
et les libérerait du poids du désir de vengeance(Staub, 2003). Ceci s’accorde avec l’étude de Van
Tongeren et al., 2015),qui a montré que le pardon dispositionnel, qui est une tendance générale à
pardonner, réduit les tendances aux représailles, et facilite la réparation psychique, augmente la
chance de mener une vie plein sens. Il se dégage ici la disposition de donner le pardon, pas inciter
à le faire alors qu’on n’est pas encore prêt.
Implications et limitations
L’étude met en lumière les ressources mobilisées par les victimes du génocide perpétré contre
les Tutsis au Rwanda en 1994 pour se reconstruire. Cette étude montre comment elles ont repris
un nouveau départ et mener une vie plein de sens. Elle offre une compréhension plus approfon-
die des processus de reconstruction psychique chez les survivants ayant vécu des expériences
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Reconquête du soi et quête de sens de vie : Regards sur les processus de reconstruction
psychique chez les survivants du génocide contre les Tutsi en 1994 au Rwanda.
traumatiques. En s’appuyant sur la thérapie narrative, l’étude s’inscrit dans la continuité de déve-
loppement des approches adaptées dans le contexte rwandais. Cependant, certaines limites
doivent être reconnues. L’analyse repose sur des données issues de récits individuels, ce qui peut
soulever des défis liés à la remémoration d’événements marquants, dans la mesure où le trauma
entraine fréquemment une fragmentation de la mémoire autobiographique, avec comme effet
le manque de certaines informations. Par ailleurs, la nature qualitative de l’étude, avec un petit
échantillon, limite la possibilité de généraliser les résultats à l’ensemble de la population concer-
née même si elle donne l’idée sur ce qu’est le processus de résilience chez les survivants du géno-
cide perpétré contre les Tutsis en 1994 au Rwanda. La réalisation d’une étude sur une large popu-
lation serait nécessaire afin d’examiner l’impact de la thérapie narrative dans la reconstruction
psychique, et l’intégrer comme pouvant aider les survivants dans le processus de résilience.
Conclusion
Cette étude contribue à la littérature existante en mettant en évidence l’impact profond du
traumatisme sur l’ensemble de l’existence des survivants du génocide contre les Tutsis en 1994 au
Rwanda, entravant durablement avec les processus de reconstruction psychique. S’inscrivant
dans une approche thérapeutique contextualisée au modèle rwandais, le cadre d’intervention
de la thérapie narrative a constitué un espace sécurisant, favorisant le soutien entre pairs et le
partage d’expériences traumatiques sans crainte d’être jugé. Ces résultats sont cohérents avec les
études précédentes qui ont montré que la thérapie narrative de façon plus constructive et permet
survivants de traumatisme de revisiter leur vécu traumatique d’exprimer leurs émotions néga-
tives de manière constructive d’avoir un autre regard sur leur souffrance et statut de victime et
retrouver le sens de vie qui est le plus souvent impacté par le traumatisme. Le Rwanda demeure
une société à dominante tradition orale, cette dynamique de la thérapie narrative s’accorde étroi-
tement avec tradition orale rwandaise, où la transmission du savoir, le partage d’expérience et le
soutien psychologique se perpétuent de génération en génération à travers la parole. Ces dyna-
miques révèlent le potentiel thérapeutique de la thérapie narrative dans la reconstruction psy-
chique et la restauration du sentiment de continuité existentielle. Ces résultats soulignent l’intérêt
théorique, clinique et politique d’une thérapie narrative culturellement ancrée dans les pratiques
rwandaises. Sur le plan théorique, ils confirment la pertinence des approches qui reconnaissent
l’importance de la narration des récits dans la compréhension du traumatisme et des processus
de résilience. Sur le plan clinique, ils mettent en lumière la potentialité de l’efficacité de la théra-
pie narrative dans la réduction des symptômes et la reconstruction psychique. Enfin, sur le plan
politique, ces résultats invitent à une intégration et à la vulgarisation de la thérapie narrative
parmi les approches thérapeutiques efficaces dans le contexte rwandais.
Conflits d’intérêts
Les auteurs déclarent qu’il n’y a pas eu de conflits d’intérêts.
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RECLAIMING THE SELF AND THE QUEST FOR MEANING
IN LIFE: PERSPECTIVES ON THE PROCESSES OF PSYCHIC
RECONSTRUCTION AMONG SURVIVORS OF THE GENOCIDE
AGAINST THE TUTSI IN RWANDA IN 1994
Emmanuel Mihigo M., Denis Kazungu, Innocent Kagabo, Turikumwenamungu Jean Bosco
Abstract
After the genocide perpetrated against the Tutsis in 1994 in Rwanda, various therapeutic
approaches were used to support survivors in their psychological reconstruction. However, nar-
rative therapy remains poorly documented. The study proposes to study the role of narrative
therapy, the mechanisms by which it promotes the overcoming of suffering, its impact in the
reconquest of oneself and the restoration of the meaning of life. Based on a purposive sample,
eleven participants were interviewed through semi-structured interviews. Through a thematic
analysis, the results reveal that the sharing of experiences allows victims to put their suffering
into perspective, to tame their suffering and thus regain the power to act and a certain ability to
project themselves into the future. The group framework, which has become a space of collective
catharsis, offers a place for exchanges on existential meaning. Rwandans having a culture of
orality, the narrative approach is part of its socio-cultural anchoring and allows for easier emo-
tional communication to externalize their suffering. The relevance of narrative therapy in this
socio-cultural specificity demonstrates its therapeutic potential in psychological reconstruction.
However, studies with larger samples would be needed to confirm the robustness and transfer-
ability of the results.
Keywords: Reclaiming, search, reconstruction, genocide, Tutsi
Introduction
The twentieth century tragically distinguished itself as an era marked by genocides, nota-
bly those perpetrated against the Armenians, the Jews, in Cambodia, and against the Tutsi in
Rwanda, during which populations were massacred and systematically exterminated under the
force of visceral hatred (Alloa & Kristensen, 2007). As for the 1994 genocide perpetrated against
the Tutsi in Rwanda, it was one of the most horrific and devastating events of the twentieth cen-
tury, with more than 800,000 people killed in just 100 days (Mafeza, 2013). The impact of this
genocide on mental health is both profound and enduring, affecting not only those who directly
witnessed the violence or survived it, but also subsequent generations (Dozio et al., 2020; Rieder
& Elbert, 2013). Beyond the physical annihilation of the victims, the 1994 genocide perpetrated
against the Tutsi in Rwanda left survivors with a heavy legacy of memory and psychological
trauma burden (Cherifi, 2008).
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TION AMONG SURVIVORS OF THE GENOCIDE AGAINST THE TUTSI IN RWANDA IN 1994
Emmanuel Mihigo M., Denis Kazungu, Innocent Kagabo, Turikumwenamungu Jean Bosco
Given the scale of the genocide’s repercussions on individuals’ mental health, numerous psy-
chotherapeutic interventions have been implemented to support survivors. The present study
seeks to examine the role of narrative therapy in the process of psychological reconstruction
and the quest for meaning in life among survivors of the genocide perpetrated against the Tutsi
in Rwanda in 1994. In a national study conducted in Rwanda on the prevalence of mental disor-
ders, associated comorbidities, and the use of mental health services, researchers reported that
the events that occurred during the 1994 genocide against the Tutsi in Rwanda, by virtue of their
magnitude and the horror inflicted upon victims, are classified as major traumatic events. The
study found the highest prevalence of mental disorders among survivors of the 1994 genocide
against the Tutsi, including episodes of major depression (35%), PTSD (27.9%), and panic disorder
(26.8%) (Kayiteshonga et al., 2022).
Grieder (2016), in his article, reports the poignant testimony of a survivor of the genocide
perpetrated against the Tutsi in Rwanda, who states: “Suffering has built a house in my heart; I
weep so that it may be destroyed.” This testimony conveys the intensity of the suffering that this
survivor experienced and continues to endure. As this account illustrates, the trauma inhabits
him permanently; he cannot rid himself of it on his own. He asks that this suffering leave him
and be dislodged from his psyche. The devastating impact of trauma means that he is no longer
himself: his identity is affected at the deepest level, and he can no longer exercise control over
himself. Psychological reconstruction through the narrative elaboration of one’s life story, val-
ues, and social roles may confer meaning upon survival and one’s future.
Referring again to the traumatic experience of the survivor cited above, Wolynn (2017) speaks
of a traumatic past that does not pass, that does not fade, and that is liable to profoundly trans-
form an individual’s identity. In the same vein, Munyandamutsa (2014), discussing the transmis-
sion of trauma, aptly stated: “We transmit what we are, what we have become, and what society
has made of us.” From this, it follows that trauma brings about an identity transformation. This
past affects the meaning of life and may be transmitted across several generations when the
family narrative remains exclusively centred on trauma, making it difficult to free oneself from
endured suffering and from the deathly power of tragic memories (Anaut, 2016).
According to H. Audoin-Rouzeau & Dumas (2014) and Jacques Palard (2015), the 1994 geno-
cide against the Tutsi in Rwanda was a “genocide of proximity”, carried out with unprecedented
cruelty, in which violence predictably penetrated the intimacy of social and affective bonds.
People lived within the same milieu, where neighbours shared drinks and gave their daugh-
ters and sons in marriage. The particularly dramatic nature of the genocide perpetrated against
the Tutsi in Rwanda is evident in the fact that it was not committed by strangers, but by neigh-
bours and individuals connected to their victims through kinship or close social ties. Thus, the
social and family setting, ordinarily perceived as a locus of protection, was transgressed: people
killed, without fear, those with whom they had shared so much, those with whom they had ties
of filiation. In this way, individuals who, under normal circumstances, were expected to embody
figures of protection and solidarity swiftly became perpetrators, irreversibly shattering bonds
of trust within communities. Violence reached the deepest level of victims’ intimacy precisely
because it was perpetrated by those close to them (Sibertin-Blanc & Vidailhet, 2003).
This abrupt shift in social and affective proximity calls into question fundamental relational
reference points, notably as expressed in the Rwandan proverb: “Inshuti ya hafi ikurutira umu-
vandimwe wa kure”, which literally means: “A close neighbour is better than a distant brother.” This
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TION AMONG SURVIVORS OF THE GENOCIDE AGAINST THE TUTSI IN RWANDA IN 1994
Emmanuel Mihigo M., Denis Kazungu, Innocent Kagabo, Turikumwenamungu Jean Bosco
proverb traditionally underscores the importance of neighbourly relations grounded in solidar-
ity and mutual aid, yet it was tragically undermined by the reality of the genocide, in which
geographical proximity sometimes became the very vector of betrayal. Violence reached the
deepest level of victims’ intimacy precisely because it was perpetrated by those close to them
(Sibertin-Blanc & Vidailhet, 2003). This paradox highlights the collapse of traditional social
frameworks and the depth of the moral rupture induced by extreme violence. The community
that did not intervene to protect some of its members who were targets failed by doing nothing to
save lives in danger and itself required psychological reconstruction (Staub et al., 2005). Indeed,
the psychological reconstruction of survivors cannot be dissociated from that of the community
itself: the two are intertwined, difficult to separate, and mutually influential. Survivors continue
to live in proximity to former perpetrators and their families, and they share almost everything
in their daily lives. In this context, the community plays an essential role in support, integration,
and the restoration of social bonds. Without this work of community-level psychological recon-
struction, the psychological reconstruction of survivors remains partial.
Moreover, another important aspect emerges in the accounts of certain survivors. Referring
to the words of a survivor observing the return to the community of former perpetrators released
after having served their sentences, he reports: “These people (former perpetrators) who are being
released made no confession, and they know where they threw ours (those who were killed), and they
did not want to show us where the bodies of ours are. We cannot believe that they have changed. They
should not be released, because at any moment we risk being traumatised again.” These words con-
vey a persistent anxiety an inner sense of insecurity that could be alleviated only if there were
guarantees of change and non-dangerousness, acknowledgement of responsibility, and expres-
sions of regret, things that perpetrators rarely provide (Staub et al., 2005). Such assurance would
then have a genuinely soothing effect.
Indeed, survivors of the genocide experienced not only an alteration of their being, affecting
not only their identity, that is, what they had become, but also their relationship to existence
and their future becoming, namely what they can or should become (Munyandamutsa, 2014).
The trauma endured by survivors brought about a psychic breach that was not limited to a mere
intrusion; it also destroyed or profoundly altered the person in their innermost being, rupturing
the sense of continuity and depriving them of the capacity to think and to envisage the future
(Sibertin-Blanc & Vidailhet, 2003). This article aims to explore the contributions of narrative ther-
apy to the process of psychological reconstruction and to the quest for meaning in life among
survivors of the genocide perpetrated against the Tutsi in Rwanda in 1994. To this end, three
specific objectives were established: (1) to identify major transformations in the life narratives
of survivors who have received narrative therapy; (2) to analyse the mechanisms through which
this therapeutic approach fosters the development of resilience at both individual and commu-
nity levels; and (3) to explore the impact of narrative therapy on reclaiming the self and restoring
meaning in life, key elements that are most severely affected and that constitute foundations of
psychological reconstruction.
The post-genocide period required interventions adapted at both individual and collective
levels in order to support the psychological reconstruction of survivors and to restore meaning
in life, as this constitutes a fundamental human need (Kühn, 2003).
There was an urgent and pressing need to establish appropriate therapeutic interventions to
address the psychological consequences associated with the genocide and to alleviate the burden
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TION AMONG SURVIVORS OF THE GENOCIDE AGAINST THE TUTSI IN RWANDA IN 1994
Emmanuel Mihigo M., Denis Kazungu, Innocent Kagabo, Turikumwenamungu Jean Bosco
of psychological disorders among survivors of the 1994 genocide against the Tutsi in Rwanda.
Certain therapeutic interventions were initiated in Rwanda with a view to improving the mental
health of genocide survivors, notably the approach of community and individual sociotherapy,
such as “Mvura Nkuvure” in Kinyarwanda, which literally means “heal me, I heal you”, and which
aims to promote psychosocial healing and reconciliation in the post-genocide context in Rwanda
(Jansen et al., 2022). EMDR (Eye Movement Desensitization and Reprocessing) is, for its part, an
individual approach intended to enable the processing of traumatic memories in a less painful
manner (Carriere, 2014). Although efforts have been devoted to addressing the psychological
consequences of the genocide, very few studies, if any, have focused specifically on the resto-
ration of meaning in life, even though the genocide profoundly altered self-perception and the
relationship to existential meaning.
Narrative therapy was first introduced by the Australian Michael White and the New Zea-
lander David Epston. It was initially applied in family therapy and subsequently extended, with
considerable success, to the treatment of trauma, eating disorders, addictions, bereavement,
and intimate partner violence. Narrative therapy holds that realities are socially constructed,
that individuals are experts in their own lives, and that problems are separate from persons. It
also recognises that individuals possess competencies that help them change their relationship
with their problems (Gros-Louis, 2015). As an approach centred on psychological reconstruction
through narrative, narrative therapy offers a relevant framework for exploring and rehabilitat-
ing meaning in life among survivors. It helps individuals not to define themselves by their status
as victims but rather aims to separate the person from the problem, thereby enabling psychologi-
cal reconstruction (Dekruyf, 2008). In Rwanda, oral tradition occupies a central place in the psy-
chological construction of identity through the transmission of narratives. From this perspective,
narrative therapy, which likewise relies on the use of narration, could, once contextualised and
adapted, constitute a relevant lever for fostering psychological reconstruction (Betbèze & Oster-
mann, 2022).
Studies, notably that by Karibwende et al. (2022) conducted with orphans, that by Murengera
et al. (2025) carried out with survivors of the genocide against the Tutsi in Rwanda in 1994, as
well as that by Rani et al. (2024) focusing on women who were victims of domestic violence,
have all shown that narrative therapy contributes effectively to reducing symptoms of anxi-
ety and post-traumatic stress disorder (PTSD; French acronym TSPT). However, few studies have
been conducted in Rwanda specifically on the mechanisms of psychological reconstruction and
reclaiming the self among survivors of the 1994 genocide against the Tutsi. Drawing on survi-
vors’ traumatic narratives, our study aims to address gaps in the literature concerning the impact
of narrative therapy in the process of psychological reconstruction. It also seeks to examine how
this approach may contribute to restoring meaning in life in a context where trauma, by its nature
as a psychic breach, has caused rupture, blockage, and disorganisation of the psychic apparatus
(Sibertin-Blanc & Vidailhet, 2003). This impediment remains palpable today, as survivors’ capac-
ity to envisage the future, or to regain continuity of life, continues to be affected.
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2. Methodology
2.1 Qualitative approach to the study
This study used an exploratory qualitative approach to examine how narrative therapy
contributes to psychological reconstruction, reclaiming the self, and redefining meaning in life
among survivors of the 1994 genocide against the Tutsi in Rwanda. This approach was appro-
priate insofar as it facilitates the expression of individuals’ lived experience and aligns with the
tradition of a Rwandan society characterised by a culture of orality. Semi-structured interviews
provided a flexible framework for the collection of rich qualitative data, enabling an in-depth
understanding of participants’ thoughts, feelings, and beliefs regarding their lived experiences
and their projections into the future.
2.2 Study setting
This study was conducted with survivors of the genocide perpetrated against the Tutsi in
Rwanda in 1994. The selection of participants was guided by the fact that they were attending
narrative therapy sessions facilitated by Uyisenga ni Manzi, which remains the only organisa-
tion recognised in Rwanda for its expertise in integrating narrative therapy within its commu-
nity-based psychosocial interventions. We collected and analysed survivors’ narratives con-
cerning their process of psychological reconstruction following their participation in narrative
therapy sessions.
2.3 Sampling method and sample characteristics
Participants in this study were survivors of the 1994 genocide against the Tutsi in Rwanda
who had previously taken part in narrative therapy sessions. Purposive sampling was used to
select 11 survivors who participated in narrative therapy sessions facilitated by the organisation
Uyisenga Ni Manzi. Participants spoke about their experiences in order to explore the outcomes
of narrative therapy. Sample size was determined on the basis of the principle of data saturation,
which holds that data collection may cease when no new themes or information emerge (Bowen,
2008).
2.4 Data collection
Some of the data used in the present study were initially collected as part of a broader
research project. A portion of these data had already been analysed and published in a Master’s
dissertation, which focused on the contribution of narrative therapy to reducing anxiety, depres-
sion, and post-traumatic stress disorder among survivors of the 1994 genocide against the Tutsi
in Rwanda (Murengera et al., 2025). This article, however, addresses a distinct research question
and adopts a different analytical angle that was not examined in the Master’s dissertation. When
conducting this research, we generally focused on certain elements that contributed to the pro-
cess of resilience among survivors of the 1994 genocide against the Tutsi in Rwanda. However,
we remained driven by a desire to understand how survivors were able to regain agency and a
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degree of capacity to envisage the future. This aspect had not been sufficiently addressed and is
the focus of the present article.
2.5 Data analysis
In this study, the qualitative interview data were audio-recorded and transcribed verbatim.
The transcripts were reviewed to develop an in-depth understanding of participants’ lived expe-
riences. Thematic analysis was used as the primary method for analysing the qualitative data.
This technique followed the six key phases of thematic analysis described by Braun and Clarke
(2019): familiarisation with the data, initial code generation, searching for themes, reviewing
and refining themes, defining themes, and writing the synthesis report. A research team com-
prising five psychologists was involved throughout the process. Each member independently
coded excerpts of the data, after which regular meetings were held to compare coding, discuss
discrepancies, and harmonise coding categories. This collaboration strengthened the coherence
and relevance of coding categories, thereby facilitating the emergence of meaningful themes.
The Cohen’s kappa coefficient was 0.80, indicating excellent consistency in code assignment and
theme development.
2.6 Ethical considerations
In accordance with the ethical principles established for the initial study, of which the pres-
ent article constitutes an analytical extension, this research was approved by the Institutional
Review Board (IRB) of the Faculty of Medicine and Health Sciences at the University of Rwanda
(Ref: CMHS/IRB/162/2023). Participants were provided with clear and detailed information
about the aims, procedures, and implications of the study. Their free and informed consent was
obtained prior to participation. Confidentiality was ensured through rigorous anonymisation of
the data. Participants were also informed of their right to withdraw from the study at any time,
without justification or consequences. Given the sensitivity of the topic, listening and psycho-
social support arrangements were put in place to respond to any emotional reactions that might
arise during the interviews. All interviewers were psychologists with demonstrated experience
in managing psychological trauma. Prior to data collection, additional training was provided to
raise awareness of the specific features of emotional crises related to the genocidal context and
to equip interviewers with empathetic and psychologically safe interviewing techniques to be
used should an emotional crisis occur. Immediately after each interview, on-site psychological
support services were available to ensure participants’ wellbeing at that moment. This organisa-
tion ensured a conducive and protective environment, reducing the risks of re-traumatisation.
3. Results analysis
Improvement in debilitating symptoms
Some survivors describe characteristic manifestations of psychological trauma, such as
intrusive re-experiencing of traumatic events, nightmares, insomnia, headaches, intense fear,
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hypervigilance, startle responses, and social withdrawal. Because of this psychological dete-
rioration and the severity of symptoms, some relatives, friends, or members of the community
recommended psychological care. The narrative therapy sessions they received enabled an
improvement in symptoms.
MUH states: “It was the president of Ibuka (the collective of survivors’ associations) who initiated
my psychological care. My condition showed severe psychological decompensation; I could not do
anything. This affected my life. The fact that friends and neighbours intervened so that I would receive
psychological follow-up made it clear that I could not function normally.”
ESP adds: “It was the Red Cross that invited us to participate in psychological follow-up sessions
after observing that we had experienced emotional crises during the commemoration events of the
1994 genocide against the Tutsi.”.
K AY e x p l a i n s : “W hat brought me to the doctor was excruciating headaches. I did not want to see any-
one, or to talk. I was dizz y, I did not understand what was happening to me, and I was losing consciousness.”
For EMU: “When I arrived here, I was traumatised, because I was the only survivor in my family, and
I had no one left. I isolated myself a great deal, and I struggled to accept myself. Nothing remained
with me.”
MAGO recalls multiple episodes of re-traumatisation. She reports: “I had about 30 emotional
crises per year. There were no periods of remission.”
The accounts of MUH, ESP, KAY, EMU, and MAGO provide a window into how survivors
of the genocide against the Tutsi express their suffering, while also revealing the therapeutic
processes at work. Across their narratives, several techniques specific to narrative therapy are
apparent. Participants describe how they externalised their problems. Survivors express their
suffering as invasive entities. This externalisation, as a first essential step in therapy, initially
helps to reduce the emotional burden accumulated over a long period. Their efforts were not
limited to describing the trauma; they also involved taking the initiative to seek care. They chose
to regain agency over their story by seeking help (re-authoring). This points to their capacity to
overcome their wounds and not to be overwhelmed by what happened to them. The involvement
of other actors, such as Ibuka, the Red Cross, and neighbours who witnessed survivors’ distress,
strengthened their initiative in seeking care and psychological recovery. This empathy indicates
that survivors’ psychological suffering was not perceived solely as an individual problem, but
as a shared reality requiring support from a wider community. These combined individual and
collective efforts enabled survivors to regain certain capacities that allow them to lead a more or
less adaptive life and to live with a degree of balance.
Identity reconstruction
Participants report a tangible return of their individuality despite the impact of trauma.
MUK describes how the community perceived her because of her post-traumatic state: “They had
nicknamed me kararubiye, which means ‘the bitter woman’”, reflecting her depression and social
withdrawal. She then marks a turning point: “But now, I am able to reach out to others and commu-
nicate.” This statement illustrates how psychological support through narrative therapy helped
her to restore her self-image and, consequently, to break down communication and relational
barriers. Moreover, the need to build caring family bonds and to find love and support within a
structuring environment is essential to identity reconstruction.
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For MKT, trauma had cut off any possibility of expressing her lived experience and feelings:
“I felt that I had no one to whom I could tell what had happened to me.” She nevertheless empha-
sises that, after some time, this changed: “I found someone to whom I could tell my story, and I felt
relieved; I could see things clearly,” she continues. This shift from silence to narration reveals a
profound liberating effect on the psyche. In addition, narration enabled the person to externalise
her suffering and to view it from another angle.
EMU shares a poignant account. Orphaned from the age of two, deprived of his roots, and
without a family name, he states: “Even the name I have was given to me by my benefactor. This
name means ‘God is with us’.” His process of identity reconstruction begins with creating a family,
through marriage and the birth of a child: “I want to leave a legacy,” he says, “to leave a trace here
on earth.” This testimony illustrates the extent to which the search for filiation, even symbolic,
can support self-reinvention and recreate existence within a lineage. It also points to a profound
quest: to re-establish an identity continuity ruptured by the genocide. Therapy enabled him to
reframe his story, not around what no longer exists (his reference points), but around an iden-
tity under construction (alternative narratives). This identity reconstruction work supported the
individual in redefining the self, values, and reference points after a life rupture or an event that
profoundly transformed one’s life.
Among the most severe consequences of the genocide was total destruction, including entire
families. This appears clearly in survivors’ accounts, particularly those who were too young to
retain memories: with their families entirely decimated, they find themselves without identity
anchors. Establishing a family can therefore provide a sense of belonging, security, continuity of
lineage, and restoration of identity. For EMU, recreating absent filial bonds through parenthood
enabled him to recover a lost or destroyed identity and to reconstruct psychologically.
Emotional regulation and the quest for meaning in life
Several participants highlight the decisive role of spirituality in the search for meaning in
life and in their recovery process following genocide-related trauma. Belief in a higher power,
they suggest, constitutes a source of comfort and trust that helps them to face the most diffi-
cult moments. Some accounts indicate that forgiveness, prayer, and religious practices provide a
sense of serenity and inner peace. UWI’s experience powerfully illustrates this dynamic. Sum-
moned before the Gacaca jurisdictions (community-based courts), she finds herself facing the
perpetrator of her husband’s murder. She reports: “The most difficult moment was when we were
summoned in the context of the Gacaca jurisdictions. Imagine being in front of the person who killed
my husband and threw him into a pit. Honestly, I was confused, I did not understand what was hap-
pening to me, and a rage to take revenge was rising in me.” She continues: “But, with God’s help, I was
able to overcome the feeling of revenge and forgive. I began to feel better, and I was able to attend the
Gacaca courts without any problems.” She also describes the pain of being widowed at a young
age, and the emotions that overwhelmed her when she saw a couple. She says: “And when I saw
a woman with her husband, I told myself that I too could have had that. Should I be a widow at this
age? And to say, it was he who killed my husband. And yet it was not him. Oh my God, I do not know.
Forgive me! Seeing the couple aroused jealousy and a feeling of hatred in me. I felt that I could not
associate with others. When I saw a man, I hated him and I wondered why, because I imagined that
it was men who had killed my husband. But with prayers, I felt a transformation, and the problems
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diminished. Spirituality gave me another perspective on the meaning of life, to forgive and to place
things in God’s hands. Now it is good, I have recovered, and I do good. I have no problems with people.
I meet them, we interact, we talk, and we have a good time. When I ask for something, they give it to
me, and vice versa. Neighbours began to approach me, but on my side it took time to trust them and
to feel close to them, even though they did nothing against us.”
For his part, MUH shares his experience in these terms: “I cannot find words to explain what
I went through. I placed everything in God’s hands, because He alone knows everything. I embraced
a new life.” This testimony reflects a psychological process of letting go, in which recourse to
transcendence makes it possible to endure the inexplicable, to lessen the weight of trauma, and
to reinvest in existence. These accounts show how the genocide caused major psychological
wounds that affected meaning in life and disrupted the individual’s psychological organisa-
tion. Some participants illustrate how spirituality offered a symbolic and practical framework
through which to reorganise and restore meaning to existence. Prayer, forgiveness, and placing
suffering in God’s hands constitute resources to which participants turned in order to soothe
their emotions and, in the longer term, to lead a meaningful life. Indeed, these practices appear
to help them regain a degree of calm, reaffirm values that remain important to them, and expe-
rience, in the moment, a sense of inner coherence.
This extract brings out the three dimensions of meaning in life (Baatouche et al., 2019): direc-
tion (intentionality), value (its specific subjective significance), and sense (felt experience). Direc-
tion refers to goals and the impetus that orients life, namely the direction one seeks to give one’s
existence after trauma. Value concerns what matters to the person, what they choose to retain
as important. Sense refers to what is deeply felt. Understanding these three dimensions makes it
possible to explore sources of satisfaction, motivation, and resilience in the face of the challenges
of existence. Religion, as an established institution that facilitates spirituality (the search for
the sacred), can help restore psychological balance (Harper & Pargament, 2015), but it should be
approached with great sensitivity (Malviya et al., 2025) so as not to hinder mourning processes.
With regard to forgiveness, most religions encourage it, even when it has not been requested,
in order to enable individuals to free themselves from the burden represented by unforgive-
ness. Similarly, in Rwanda, during reconciliation processes and the Gacaca jurisdictions (Staub
et al., 2005), survivors were encouraged by their co-religionists to forgive former perpetrators,
asserting that such forgiveness would bring inner relief and liberate them from the burden of
unforgiveness and the desire for revenge. Survivors may perceive that forgiveness is expected of
them and may experience pressure to grant it. However, forgiveness that one is pushed to offer
without it being sought by the offender, and which is not initiated by the victim themselves in a
voluntary manner, can entail psychological consequences that hinder the mourning process. The
harm caused by trauma must first be addressed and acknowledged before any attempt is made
to encourage the victim to forgive (Buetow, 2025). Granting forgiveness should never become an
injunction imposed on victims. No implicit pressure should be exerted on victims to forgive. If
forgiveness is granted, it must come voluntarily from the victim, not under any form of implicit
external pressure. It can be beneficial only if conditions are met: for the victim, when the harm
has been recognised, validated, and repaired; and for the perpetrator, as a possibility of relief
and reintegration within the community. This work was undertaken in Rwanda prior to the pro-
cess of forgiveness.
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Effect of the therapeutic discussion group
Participants who took part in the group discussion setting emphasised its significant thera-
peutic impact. They highlight the therapeutic value of this framework. UWI states: “In the group,
I am supported, and I feel comforted. The group helps me not to isolate myself anymore.”
From the perspective of MKK, MKT, and MUKES, they report that sharing experiences brings
them relief and helps them feel that they are no longer the only ones living through such situa-
tions. NYIN adds: “I feel close to others, because we share the same experiences.” ESP further notes:
“When we share experiences, we help one another. We realise that our problems are less severe in
comparison with those of others, and that comforts us.”
However, VTT and BON point to other phenomena that can emerge within the group. BON
explains: “There is a risk of emotional contagion, especially with negative emotions.” VTT evokes
another salient aspect of sharing experiences within the group. She reports: “Sometimes we wrote
letters to express our feelings and wishes, and the letter was read in the group. This practice made it
possible to put feelings into words. What we did not dare to express verbally was expressed in writ-
ing.”
Across participants’ accounts, three central mechanisms of narrative therapy implicitly
emerge: externalisation of the problem, re-authoring, and the collective creation of meaning.
Sharing experiences facilitates externalisation by enabling participants to distance themselves
from their difficulties, benefit from group support, and gradually move out of the isolation that
confines them. Encounters with others transform how participants apprehend their own story,
in comparison with others’ experiences and the ways in which those experiences were lived.
Exposure to similar or more complex narratives leads to a re-evaluation of one’s lived experi-
ence, such that experiences previously perceived as insurmountable acquire a different meaning
and become more integrable. This dynamic opens the possibility of reorganising one’s personal
narrative, reformulating it in less pathologising terms, and thereby producing an alternative ver-
sion of the story that is less centred on suffering.
Rupture with the sense of vulnerability and fear of relapse
Some participants expressed concerns about the difficulty of recovering from trauma. MUH
states: “I see that we will not recover easily, because those who killed ours were imprisoned, but they
are released after serving their sentences and they have never confessed. They also know where those
they killed are, and they did not bury them with dignity. They are buried in their houses, or somewhere,
but they do not want to show us where they threw them. This still affects us.” This testimony high-
lights that not having been able to bury one’s loved ones leaves the mourning process incomplete,
due to the impossibility of carrying out mourning rituals and providing victims with a dignified
burial (Bhatti et al., 2023).
UWI reports: “Moreover, they should not be released, because sometimes we can be hurt again.
Professionals should continue to help us.” For ESP: “We have problems, because there are many things
that can cause relapses. We are asking for advocacy.”
Resilience is not a capacity acquired once and for all, nor does it constitute complete psycho-
logical armouring. Rather, survivors recognise that they retain a degree of vulnerability while
also being better able to manage certain challenges and their vulnerable state. They are therefore
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right to acknowledge that some challenges remain, and we suggest that maintaining awareness
of these challenges can also strengthen this capacity.
The statements of UWI and ESP illustrate a persistent vulnerability to re-traumatisation. The
fear of being hurt again motivates an ongoing call for professional support and for advocacy.
NYD describes their experience in these terms: “In addition to the trauma, I have a particular
problem: I was infected with HIV. That affected me. When I sit down and I see that I have this prob-
lem, that I am not like others, that this problem will not be cured, I feel very sad again.” This testimony
highlights the sense of vulnerability associated with HIV/AIDS infection as a consequence of
rape during the genocide.
4. Discussion
This study explored the traumatic experiences of survivors of the 1994 genocide against the
Tutsi in Rwanda, and the contributions of narrative therapy to psychological reconstruction and
the quest for meaning in life. The findings are particularly significant in view of the historical
and contextual experience through which the country has passed, and the consequences for the
mental health of genocide survivors. It is notable that, even three decades after the genocide,
psychological repercussions remain persistent (Kayiteshonga et al., 2022; Rieder & Elbert, 2013).
This article contributes to the literature by shedding light on the contribution of narrative ther-
apy to processes of psychological reconstruction and the quest for meaning in life among gen-
ocide survivors. Overall, the analysis identifies four main themes around which the discussion
that follows is organised.
Encountering others with the same lived experience
Debilitating trauma symptoms include physical, psychological, emotional, and behavioural
manifestations that profoundly affect individuals’ psychological integrity, and they constitute
primary drivers for seeking psychological care (Pat Ogden, 2021; Vuillard, 2018). However, even
before feeling the desire to seek care, trauma can lead victims to believe that they are alone,
and this sense of injustice can erode them for years, often until they meet others who have lived
through the same or similar experiences. This encounter with others who share the same or com-
parable lived experience plays a crucial role in psychological reconstruction. From the perspec-
tive of narrative therapy, such an encounter constitutes a moment of deconstruction of the dom-
inant trauma narrative (dominant problem-saturated story), as described by White (1990). The
encounter also facilitated a break with the isolation in which some survivors found themselves.
Being with others who may have experienced the worst helped survivors to relativise their suf-
fering and, consequently, to come to terms with it, a mechanism typical of re-authoring. This
corresponds to what Bessel A. van der Kolk (1994) refers to as self-leadership of one’s story. Some
individuals who had remained isolated for a long time were able to develop a sense of belonging
by entering this space of encounter. This space provided a conducive environment in which they
could express themselves and be heard without judgement, and rebuild bonds of trust with oth-
ers. This aligns with Herman (1992), who shows that relational safety and the restoration of social
bonds are essential elements in psychological recovery. Furthermore, participants emphasised
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that individual psychological reconstruction is inseparable from collective reconstruction. This
interdependence helps to explain the importance of encountering others in psychological recon-
struction processes, where the individual finds support, comfort, and belonging. The space and
the encounter enabled them to identify people whom they could trust.
Role of relatives and professionals in recognising the need for care
The analysis of the findings shows that the decision to seek care was strongly influenced by
the surrounding environment, including relatives, neighbours, and professionals, who encour-
aged survivors to pursue psychological support in response to persistent traumatic manifesta-
tions. This observation echoes the work of Murengera et al. (2025), which indicates that help-seek-
ing among survivors is frequently motivated by the persistence of psychological and somatic
symptoms that impair the individual’s functioning. The manifestation of symptoms proved ben-
eficial in that, rather than distancing the surrounding environment, it created an opportunity for
greater closeness, enabling those around the person in distress to provide encouragement and
support. Thus, the involvement of relatives and professionals helped to create favourable condi-
tions for psychological support, as an initial step in psychological reconstruction.
A safe space fostering the expression of suffering
The group provided an ideal setting for sharing experiences and expressing emotions with-
out judgement. Moreover, this space offered participants the possibility of diversifying the ways
in which they expressed their suffering, notably through orality or writing. The safe space that
facilitated the expression of suffering enabled them to feel relieved of the burden of a morbid
silence that may be even more pathogenic. This situation weighs heavily on the possibility of
mourning, re-establishing social bonds, and undertaking the work of collective memory (Jacques
Palard, 2015). In relation to psychological reconstruction, Herman, cited by Zaleski et al. (2016),
identifies three key stages in the recovery of trauma survivors: (1) safety, (2) remembrance and
grief, and finally (3) reconnection.
In Rwanda, community life has played an essential role in the resilience process of genocide
survivors by offering spaces for speech that are embedded in longstanding social practices. The
tradition of gusangira (sharing) and community gatherings foster a climate in which each per-
son can express their pain without judgement. These collective spaces, often organised at the
community level, enable survivors to tell their story, break isolation, and feel that their suffering
is acknowledged. Speaking together restores broken bonds and reinstates a degree of belong-
ing. Shared rituals and activities provide a symbolically safe framework, and this sharing helps
transform pain into strength and contributes to the restoration of mutual trust. In this way, these
spaces for shared speech enable survivors to reconstruct themselves by drawing on solidarity,
listening, and the shared recognition of the lived history.
In search of meaning in life
Our findings highlight the role of spirituality in processes of psychological reconstruc-
tion among survivors. Several participants who suffered from the psychological consequences
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associated with the genocide drew on spirituality to cope with their difficulties, and in particu-
lar to restore meaning in their lives. It was evident that recourse to spirituality was adaptive
in coping with suffering. This observation is consistent with a body of research showing that
spirituality constitutes an adaptive coping strategy that helps regulate distress, restore a sense
of internal coherence, and strengthen resilience (Harper & Pargament, 2015). Some participants
reported having forgiven even when forgiveness was not requested. In addition, they stated
that they were able to refrain from revenge and to overcome negative feelings. This aligns with
Muñoz Sastre et al. (2014), who argue that forgiveness involves overcoming resentment towards
the offender, not by denying one’s right to resentment, but by striving to regard the offender with
benevolence, compassion, and even love, and thereby being able to lead a meaningful life by
freeing oneself from the paralysing burden of guilt associated with revenge. For Séméria (2018),
meaning in life may be found in religion or spirituality, or through engagement within the com-
munity.
Our findings also underscore the complexity of the role of religion and spirituality in sur-
vivors’ trajectories of psychological reconstruction. According to the distinction proposed by
Harper and Pargament (2015), religion may be understood as a search for meaning structured by
established institutions, whereas spirituality refers more to a personal search for the sacred. This
conceptual distinction appears relevant for interpreting how survivors mobilised these resources
after the genocide. While spirituality can support survivors’ psycho-spiritual wellbeing, it must
be approached with great sensitivity. Indeed, as several authors have shown, prescribed mobi-
lisation may interfere with the necessary stages of mourning, because it may risk obstructing
bereavement processes (Neimeyer, 2016).
In Rwanda, during reconciliation processes, survivors were encouraged to forgive former
perpetrators, with the claim that such forgiveness would bring inner relief and free them from
the weight of the desire for revenge (Staub, 2003). This is consistent with the study by Van Ton-
geren et al. (2015), which showed that dispositional forgiveness, defined as a general tendency
to forgive, reduces retaliatory tendencies, facilitates psychological repair, and increases the like-
lihood of leading a meaningful life. What emerges here is the disposition to grant forgiveness,
rather than incitement to forgive when one is not yet ready.
Implications and limitations
The study highlights the resources mobilised by survivors of the genocide perpetrated
against the Tutsi in Rwanda in 1994 in order to reconstruct themselves. It shows how they made a
new start and went on to lead meaningful lives. The study offers a deeper understanding of psy-
chological reconstruction processes among survivors who have lived through traumatic experi-
ences. Drawing on narrative therapy, the study aligns with ongoing efforts to develop contextu-
ally adapted approaches within the Rwandan setting.
However, certain limitations should be acknowledged. The analysis is based on data derived
from individual narratives, which may raise challenges related to the recollection of salient
events, insofar as trauma frequently entails a fragmentation of autobiographical memory, with
the effect that certain information may be missing. In addition, the qualitative nature of the study,
with a small sample, limits the extent to which the findings can be generalised to the wider pop-
ulation concerned, even if it provides insight into the resilience process among survivors of the
108
PSIQUE • e-ISSN 2183-4806 • Volume XXII • Issue Fascículo 1 • 1st january janeiro-30th june junho 2026 • pp. 95-110
RECLAIMING THE SELF AND THE QUEST FOR MEANING IN LIFE: PERSPECTIVES ON THE PROCESSES OF PSYCHIC RECONSTRUC-
TION AMONG SURVIVORS OF THE GENOCIDE AGAINST THE TUTSI IN RWANDA IN 1994
Emmanuel Mihigo M., Denis Kazungu, Innocent Kagabo, Turikumwenamungu Jean Bosco
1994 genocide against the Tutsi in Rwanda. A study conducted with a larger population would
be necessary to examine the impact of narrative therapy on psychological reconstruction and to
support its integration as an approach that can assist survivors in resilience processes.
Conclusion
This study contributes to the existing literature by highlighting the profound impact of
trauma on all dimensions of the existence of survivors of the 1994 genocide against the Tutsi in
Rwanda, with enduring effects that hinder processes of psychological reconstruction. Situated
within a therapeutic approach contextualised to the Rwandan model, narrative therapy consti-
tuted a safe space that fostered peer support and the sharing of traumatic experiences without
fear of judgement. These findings are consistent with previous studies showing that narrative
therapy, in a constructive manner, enables trauma survivors to revisit their traumatic experi-
ences, to express negative emotions constructively, to adopt a different perspective on their suf-
fering and their status as victims, and to restore meaning in life, which is most often affected
by trauma. Rwanda remains a society with a predominantly oral tradition, and the dynamics of
narrative therapy closely align with this Rwandan oral tradition, in which the transmission of
knowledge, the sharing of experience, and psychological support are perpetuated across gener-
ations through speech. These dynamics reveal the therapeutic potential of narrative therapy in
psychological reconstruction and in restoring a sense of existential continuity.
These findings underline the theoretical, clinical, and policy relevance of a form of narrative
therapy that is culturally grounded in Rwandan practices. At the theoretical level, they con-
firm the relevance of approaches that recognise the importance of storytelling in understanding
trauma and resilience processes. At the clinical level, they highlight the potential effectiveness of
narrative therapy in reducing symptoms and supporting psychological reconstruction. Finally,
at the policy level, these results call for the integration and dissemination of narrative therapy
among effective therapeutic approaches in the Rwandan context.
Conflicts of interest
The authors declare that there were no conflicts of interest.
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