Publications by authors named "Jéssica Puchalski Trettim"

11 Publications

  • Page 1 of 1

Evidence of validity of the Revised Helping Alliance Questionnaire based on the internal structure IN A Brazilian CLINICAL sample.

Clin Psychol Psychother 2021 Jul 28. Epub 2021 Jul 28.

Catholic University of Pelotas (UCPel), Pelotas, RS, Brazil.

The revised Helping Alliance questionnaire (HAq-II) is among the most used instruments that measure therapeutic alliance. Despite its use in research, this instrument is not validated for the Brazilian population. The aim of this study was to explore the evidence of validity of the HAq-II based on the internal structure in a sample of Brazilian psychiatric patients. An ambulatory convenience sample of 204 patients with major depressive disorder (MDD) and 81 patients with obsessive-compulsive disorder (OCD) was randomized between two different types of treatment. The HAq-II was completed by patients (patient version) and by 33 therapists who performed the interventions (therapist version) between second and third sessions. We used confirmatory factor analysis (CFA) to investigate two models: (1) a one-dimensional therapeutic alliance model and (2) a two-dimensional model considering the factors "positive alliance" and "negative alliance". The internal consistency of the HAq-II was measured by Cronbach's alpha. To investigate discriminant validity, we used the t-test for independent samples, ANOVA, and Pearson's correlation coefficient. The analysis showed that the best model of the instrument was one-dimensional. Cronbach's alpha for both versions displayed values above 0.89. The Brazilian version of the HAq-II presented properties similar to those found in the original version. However, studies related to the one-dimensional model with other samples are necessary.
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http://dx.doi.org/10.1002/cpp.2654DOI Listing
July 2021

Brief cognitive behavioral therapy in pregnant women at risk of postpartum depression: Pre-post therapy study in a city in southern Brazil.

J Affect Disord 2021 07 30;290:15-22. Epub 2021 Apr 30.

Catholic University of Pelotas, Brazil; PQ CNPq, Brazil.

Background: Postpartum depression (PPD) affects a high number of women, often the first manifestation of a mood disorder that will occur later in life, bringing serious consequences for the patient and her offspring. Depression today is the leading cause of disability worldwide. The aim of this study was to evaluate the effectiveness of a preventive cognitive behavioral therapy (CBT) for PPD.

Methods: Pre-post therapy study, as part of a population-based cohort study. Pregnant women without a diagnosis of depression participated, who were divided into two groups: risk of depression (CBT) and a control group (without therapy). The preventive therapy consisted of six sessions of CBT, administered weekly. The Outcome Questionnaire (OQ-45) was used in all sessions. The Mini International Neuropsychiatric Interview and Beck Depression Inventory-II were used on three occasions. The final statistical analyses were performed by Poisson regression.

Results: The prevalence of PPD in the risk group was 5.5% and in the control group 2.2%, with no difference between the groups (PR 1.66 95% CI 0.44-6.18). The OQ-45 averages gradually reduced during the therapy sessions, indicating therapeutic progress. Schooling was an associated factor, both with the manifestation of PPD and with the greater effectiveness of the therapy.

Limitations: Rate of 40.5% refusal to preventive treatment and absence of a group with similar characteristics in another therapy model.

Conclusions: Brief cognitive behavioral therapy applied by mental health professionals with basic training was effective in preventing the manifestation of PPD.
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http://dx.doi.org/10.1016/j.jad.2021.04.031DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8220301PMC
July 2021

Maternal-fetal attachment and perceived parental bonds of pregnant women.

Early Hum Dev 2021 Mar 22;154:105310. Epub 2021 Jan 22.

Postgraduate Program in Health and Behavior, Catholic University of Pelotas (UCPel), Gonçalves Chaves, 373 - 411 C, 96015-560 Pelotas, RS, Brazil. Electronic address:

Background: The parental bond is characterized by the perception of care and protection received by parental figures throughout human development. During the gestational period, the intensity in which the woman manifests behaviors and feelings for the fetus was denominated maternal-fetal attachment (MFA). In this perspective, the literature indicates that there is association between MFA and the pregnant woman's perception about the bond established with her parents.

Aims: This study aimed to evaluate the association between MFA and perceived parental bonds of pregnant women in the city of Pelotas/RS (Brazil).

Study Design: This is a cohort study with 839 women during their gestational period. All women answered to the Parental Bonding Instrument to investigate the perceived parental bonds, and the MFA was assessed through the Maternal-Fetal Attachment Scale.

Results: The main results showed that perceived paternal overprotection was associated with a higher MFA after adjustment (B 2.00 CI95% 0.30; 3.70). Additionally, the pregnant women who were in the first trimester of pregnancy (p < 0.001), who did not live with a partner (p = 0.018), and who did not feel supported by the baby's father during pregnancy (p = 0.014) presented lower scores of MFA.

Conclusion: This study showed the importance of the paternal role in the women's life, considering the perception of the bond with their father during their development, an adequate support by the father of the baby, and the presence of a partner during pregnancy. As a result, the paternal role may influence the feelings and behaviors of greater affection, care, and concern regarding the fetus.
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http://dx.doi.org/10.1016/j.earlhumdev.2021.105310DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7910275PMC
March 2021

Maternal-fetal attachment and perceived parental bonds of pregnant women.

Early Hum Dev 2021 Mar 22;154:105310. Epub 2021 Jan 22.

Postgraduate Program in Health and Behavior, Catholic University of Pelotas (UCPel), Gonçalves Chaves, 373 - 411 C, 96015-560 Pelotas, RS, Brazil. Electronic address:

Background: The parental bond is characterized by the perception of care and protection received by parental figures throughout human development. During the gestational period, the intensity in which the woman manifests behaviors and feelings for the fetus was denominated maternal-fetal attachment (MFA). In this perspective, the literature indicates that there is association between MFA and the pregnant woman's perception about the bond established with her parents.

Aims: This study aimed to evaluate the association between MFA and perceived parental bonds of pregnant women in the city of Pelotas/RS (Brazil).

Study Design: This is a cohort study with 839 women during their gestational period. All women answered to the Parental Bonding Instrument to investigate the perceived parental bonds, and the MFA was assessed through the Maternal-Fetal Attachment Scale.

Results: The main results showed that perceived paternal overprotection was associated with a higher MFA after adjustment (B 2.00 CI95% 0.30; 3.70). Additionally, the pregnant women who were in the first trimester of pregnancy (p < 0.001), who did not live with a partner (p = 0.018), and who did not feel supported by the baby's father during pregnancy (p = 0.014) presented lower scores of MFA.

Conclusion: This study showed the importance of the paternal role in the women's life, considering the perception of the bond with their father during their development, an adequate support by the father of the baby, and the presence of a partner during pregnancy. As a result, the paternal role may influence the feelings and behaviors of greater affection, care, and concern regarding the fetus.
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http://dx.doi.org/10.1016/j.earlhumdev.2021.105310DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7910275PMC
March 2021

Family perception of the symptoms of Obsessive-Compulsive Disorder patient and the family accommodation.

Int J Soc Psychiatry 2020 Dec 9:20764020981107. Epub 2020 Dec 9.

Postgraduate Program in Health and Behavior, Universidade Católica de Pelotas, UCPel, Pelotas, RS, Brazil.

Background: Family members tend to modify their routine by assisting or participating in the patient's rituals. These behaviors have been identified as family accommodation (FA).

Aims: The aim of this study was to describe the relationship between family accommodation of relatives of Obsessive-Compulsive Disorder (OCD) patients and their perceptions about the obsessions and compulsions of the patient.

Method: This was a cross-sectional study with family members of Obsessive-Compulsive Disorder in a Southern Brazilian city. The family perception of the OCD symptoms and their accommodation were assessed through the Family Accommodation Scale for Obsessive-Compulsive Disorder - Interviewer-Rated (FAS-IR).

Results: The level of family accommodation was higher in those family members who lived with the patient when compared to those who did not live with them ( = .011). The obsessions associated with higher levels of family accommodation were: contamination ( < .001), hoarding/saving ( = .001), symmetry/exactness ( = .001), religious ( = .019), and diverse ( = .003). Regarding compulsions, the perception of all symptoms was associated with higher levels of family accommodation ( < .05).

Conclusion: The family accommodation is present in family members of Obsessive-Compulsive Disorder patients, regardless of the type of obsessive/compulsive symptom perceived.
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http://dx.doi.org/10.1177/0020764020981107DOI Listing
December 2020

Generalized Anxiety Disorder, Depressive Symptoms and the Occurrence of Stressors Events in a Probabilistic Sample of Pregnant Women.

Psychiatr Q 2021 03;92(1):123-133

Postgraduate Program in Health and Behavior, Catholic University of Pelotas (UCPel), Gonçalves Chaves, 377 - 411 C - 96015-560, Pelotas, RS, Brazil.

The aim of the study is to verify the association between GAD, the severity of depressive symptoms and stressors in pregnant women between the first and second trimester. Cross-sectional study, part of a cohort that followed 980 women during the gestational period of a city in southern Brazil. We performed bivariate analysis using the t-test and chi-square. The variables that presented p ≤ 0.20 were taken for multivariate analysis, through logistic regression, in order to control possible confounding factors. The Mini International Neuropsychiatric Interview Plus was used to evaluate GAD, the severity of depressive symptoms was investigated through the Beck Inventory of Depression II, and stress events according to the Social Readjustment Assessment Scale of Holmes e Rahe. The sample consisted of 980 women. Women with mild depression symptoms had 9.8 (IC95% 4.6;21.0) times more GAD, those with moderate symptoms had 27.5 (IC95% 12.5;60.0) times more GAD, and those with severe symptoms had 52.9 (IC95% 19.1;146.5) times more GAD when compared to pregnant women with no symptoms or minimal symptoms. Regarding the stressful events, the pregnant women who presented GAD had an increase of 1.0 (IC95% 1.0;1.1) point in the mean of occurrence of stressor events when compared to those without GAD. These findings highlight the need for prevention strategies and interventions to promote maternal mental health, which benefit the development of infants in the long term.
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http://dx.doi.org/10.1007/s11126-020-09763-0DOI Listing
March 2021

Thimerosal-containing vaccines and deficit in child development: Population-based study in southern Brazil.

Vaccine 2020 02 31;38(9):2216-2220. Epub 2020 Jan 31.

Postgraduate Programme in Health and Behavior - Catholic University of Pelotas (UCPel), Gonçalves Chaves, 377 - 411 C - 96015-560, Pelotas, RS, Brazil.

Background: The discussion on the safety of thimerosal-containing vaccines (TCVs) and their impact on child development it́s very relevant.

Methods: This is a cohort study with mother-child dyads who received prenatal care in the Unified Health System. The domains of motor, cognitive and language development were evaluated in children between 24 and 36 months of age. Data on vaccination were obtained through the child's immunization record. A linear regression analysis was carried out considering possible confounders.

Results: In bivariate analyses, motor and language development were associated with TCVs (p < 0.05). However, in the multivariate analysis, this association was not maintained (p > 0.05). These results indicate that the use of TCVs is not associated with child development. The importance of this study is summarized in transmitting relevant information regarding public health, based on reliable data.
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http://dx.doi.org/10.1016/j.vaccine.2019.12.044DOI Listing
February 2020

Prevalence of mental health problems in preschoolers and the impact of maternal depression.

Eur Child Adolesc Psychiatry 2020 May 7;29(5):605-616. Epub 2019 Aug 7.

Postgraduate Programme in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil.

A large number of children of depressed mothers have one or more mental disorders. This study aimed to evaluate the impact of maternal depression on the mental health of 4-5-year-old children of adolescent mothers, according to the hypotheses generated from the model of accumulation. Between October 2009 and March 2011, all pregnant adolescents who received prenatal care from the public health system in Pelotas (southern Brazil) were invited to participate in the study and have been prospectively followed. Of these individuals, 413 participants were evaluated in the postpartum period and when the child was 2-3 years old and 4-5 years old (current stage). The Strengths and Difficulties Questionnaire was used to assess mental health problems in children, and the Mini International Neuropsychiatric Interview (MINI)-Plus version was used to assess maternal depression. We applied a structured modeling approach to examine the relations between three different hypothesized life course models (accumulation, critical period, and mobility) and maternal depression. After selecting the most appropriate model, we used a logistic regression analysis to assess the effect of depression on mental health problems in 4-5-year-old children of adolescent mothers. We used the Chi square test to estimate the prevalence of mental health problems in 4-5-year-old children. The longer the time of exposure to maternal depression, the greater the probability that the child would present behavioral problems. Investments in strategies to prevent mental disorders beginning in the gestational period are important.
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http://dx.doi.org/10.1007/s00787-019-01381-xDOI Listing
May 2020

The influence of therapeutic alliance in the quality of life of obsessive-compulsive disorder patients: An intervention study.

Gen Hosp Psychiatry 2020 May - Jun;64:112-114. Epub 2019 Jun 15.

Postgraduate Program in Health and Behavior, Catholic University of Pelotas (UCPel), Gonçalves Chaves, 377 - 411 C, 96015-560, Pelotas, RS, Brazil.

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http://dx.doi.org/10.1016/j.genhosppsych.2019.06.007DOI Listing
May 2021

The perception of parental bonding in pregnant adolescents and its association with generalized anxiety disorder.

Eur Psychiatry 2018 10 24;54:51-56. Epub 2018 Aug 24.

Postgraduate Programme in Health and Behavior, Catholic University of Pelotas (UCPel) - Gonçalves Chaves, 377 - 411 C - CEP: 96015-560 Pelotas, RS Brazil.

Background: The parental bonding is influenced by two dimensions: care and control or protection over the child of both parents. The lack of care during childhood may make the individual more susceptible to the onset of psychiatric disorders when adult. These psychiatric disorders when present during pregnancy may have a negative impact on the health of pregnant women and children. The aim of this study was to assess the association between generalized anxiety disorder (GAD) in pregnant adolescents and the perception of parental bonding.

Methods: This is a cross-sectional study with 871 pregnant women under the age of 19, receiving prenatal care in 47 Basic Health Units in the one city, Brazil. The generalized anxiety disorder was measured using the Mini International Neuropsychiatric Interview (MINI) and the perception of parental bonding in childhood using the Parental Bonding Instrument (PBI).

Results: The prevalence of GAD was 8.5%. Among all the parental bonding dimensions, only a perceived lack of maternal care under 16 years was associated with GAD.

Conclusions: The results showed that only the perception of maternal bonding was associated with later GAD. It suggests that an adequate maternal bond is an essential component of psychological health.
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http://dx.doi.org/10.1016/j.eurpsy.2018.07.011DOI Listing
October 2018

[Quality of life with Obsessive-Compulsive Disorder: a study among Primary Care users].

Cien Saude Colet 2017 Apr;22(4):1353-1360

Programa de Pós-Graduação em Saúde e Comportamento da Universidade Católica de Pelotas (UCPel). R. Gonçalves Chaves 373/prédio C/411, Centro. 96015-560 Pelotas RS Brasil.

Quality of life (QOL) can be affected by the presence of mental disorders, like Obsessive-Compulsive Disorder (OCD). Thus, the evaluation and monitoring of QOL in patients with mental disorders enables the identification of priorities, making it possible to implement actions to improve QOL among health system users. The scope of this article is to measure QOL in OCD patients in primary health care. It involves a cross-sectional study with a convenience sample including all users of three Basic Health Units of Pelotas in the State of Rio Grande do Sul, Brazil. The quality of life was measured with the WHOQOL-Bref and the OCD was assessed using the Mini-International Neuropsychiatric Interview (M.I.N.I.) This study included 1081 individuals. The prevalence of OCD was 3.9%. OCD patients had a lower average in all domains of QOL when compared to individuals without OCD (p < 0.001). The findings of this study emphasize the importance of using QOL as a monitoring tool of the disorder in basic health care.
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http://dx.doi.org/10.1590/1413-81232017224.02062015DOI Listing
April 2017
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