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Previous issue date: 2012-12-06 === The Bells Test (BT) is one of the most traditionally used neuropsychological instruments in the
diagnosis of hemineglect and attention deficits. Based on a cancellation paradigm, the original Canadian
version also known as Test des Cloches was adapted to Brazilian population, in a project that also
involved the development of a second version of the task which added visually related distractors to the
original stimuli. The aim of this thesis was to collect evidence toward the validity and reliability of both
versions of the instrument, as well as to investigate whether age and education had an impact in
individuals performance in these tasks. In the process, the performance in this test was normalized
according to both age and education. Three empirical studies were conducted. The first study looked for
evidence toward the construct/convergent validity and reliability of the instrument in a sample of 66
healthy adults, who completed both versions of the BT as well as other measures of sustained attention
(AS, AC-15 and NEUPSILIN Line Cancelling Task). Reliability was analyzed by means of an analysis of
test-retest. The second study investigated the influence of age and education in the attentional process,
obtaining norms for specific groups divided by age and education. A total of 341 individuals aged between
19 and 75, with a minimum of 5 years of schooling, took part in this study. The third study collected
evidence toward the criterion validity of the BT through the assessment of individuals with previously
established clinical conditions which should interfere in their performance of the task. The sample was
comprised of 30 patients with right brain damage (RBD) and 30 control individuals. Overall, the findings
of all three studies suggest that the BT has adequate validity in respect to external variables, both related
to performance in other assessment tools of attention and the presence of visual hemineglect. Age and
education proved to influence performance in the BT, affecting both the number of omissions and the time
taken to perform the test, all of which was reflected in normative data. Studies on different clinical
samples with possible attention deficits and/or hemispatial neglect will be carried out so as to seek further
evidence regarding the sensitivity and specificity of the BT in Brazilian population. === O Teste de Cancelamento dos Sinos (TS) ? uma das tarefas cl?ssicas na avalia??o neuropsicol?gica para o diagn?stico da s?ndrome de hemineglig?ncia visual e de d?ficits atencionais por meio de um paradigma de cancelamento. A vers?o original canadense Test des Cloches ou Bells Test foi adaptada para a popula??o brasileira, desenvolvendo-se, ainda, uma segunda vers?o alternativa do teste, com a inclus?o de distratores visualmente relacionados. Esta tese visou a investigar evid?ncias de validade e de fidedignidade das duas vers?es do instrumento, verificando-se o papel da idade e da escolaridade no desempenho por eles mensurados, obtendo-se, ainda, normas segundo estes fatores, por meio de tr?s estudos emp?ricos. O primeiro estudo avaliou evid?ncias de validade de construto/convergente e de fidedignidade do instrumento em uma amostra de 66 adultos saud?veis, avaliados com ambas as vers?es do TS e com outros testes que avaliam aten??o (AS, AC-15 e Cancelamento de linhas do NEUPSILIN). A fidedignidade do TS foi analisada mediante a t?cnica de teste-reteste. O segundo estudo investigou a influ?ncia da idade e da escolaridade no processamento atencional e obteve normas por grupos et?rios e educacionais. Participaram 341 adultos saud?veis com idades de 19 a 75 anos, com no m?nimo de 5 anos de escolaridade. O terceiro estudo averiguou evid?ncias de validade com rela??o a crit?rios externos cl?nicos. Participaram 30 pacientes com les?o de hemisf?rio direito (LHD) comparados a 30 adultos saud?veis quanto ao seu desempenho no TS. Os achados dos tr?s estudos sugeriram ?ndices de validade por rela??o com vari?veis externas, tanto de desempenho com outros testes que mensuram componentes cognitivos semelhantes como com o crit?rio de LHD e de s?ndrome de hemineglig?ncia. A escolaridade e a idade foram fatores que influenciaram nas vari?veis das omiss?es e do tempo, norteando dados normativos dos TS. Estudos com diferentes amostras cl?nicas com poss?veis d?ficits atencionais e/ou hemeglig?ncia ser?o conduzidos em busca de ?ndices de sensibilidade e especificidade do TS na popula??o brasileira.
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