Made available in DSpace on 2016-04-04T18:27:34Z (GMT). No. of bitstreams: 1 Ana Paula FPregnolatto.pdf: 230365 bytes, checksum: f0f9540c03031709a2d9741c1eaeeda4 (MD5) Previous issue date: 2005-02-11 / The chronic renal failure is a disease that evolves slowly, gradually and irreversibly causing physical and emotional damage. Studies on the emotional aspects of patients undergoing hemodialysis procedures emphasize that they are a special group among chronic disease patients, because the procedure itself and the individual s dependence on the equipment involved assume great importance on the individual s life. These stressful aspects can, therefore, cause special effects on the emotions and behavior of these patients, overloading the depressive symptoms caused by uremia itself. Among the pathologies and conditions related to emotions, alexithymia stands out. The term been applied to an individual s difficulty to express emotions and affection. Alexithymia and its psychopathological symptoms are considered to have influence on diagnosis, prognosis, and the way a patient can cope with the different forms of treating renal failure. That being so, the evaluation and identification of these aspects can provide a better understanding of them in order to identify and offer to these patients more adequate psychological treatment and a program of prevention and mental health involving patients and the health team. For this study the sample include 48 patients who have been receiving hemodialysis at the hospital of the University School of Medicine in the state of S?o Paulo, Brazil. The sample was stratified according to the type of renal disease presented. The tools used were Identification Form, The Toronto Alexithyimia Scale (TAS) and the Symptoms Evaluation Scale (EAS-40). The sample was distributed like the following: men (60,4%); age between 40 and 59 years of age (58,3%); basic education (50%); retired or on sick leave (47,9%). High blood pressure (41,6%); diabetes mellitus (31,3%); chronic glomerule nephritis (27,1%). Regarding alexithymia 52% of the patients presented scores equal or superior to 74, and 4,2% presented scores equal or inferior to 62. 43,8% of the subjects are on the range between 63 and 73 points. The average score of the sample was 74 and DP 7,52. The results show that patients undergoing hemodialysis present high scores on TAS, regardless of sex, level of education, marital status, occupation, age or diagnosis, and the differences between these variables were not significant. Concerning the psychopathological symptoms, the average score was 0,63 and DP 0,37 , and there were no significant differences between the social and demographic variables. Regarding the association between alexithymia and psychopathological symptoms the results show significant relation between the total scores of TAS and EAS-40; and also between the total score of TAS and Factors 1, 2 and 3 of EAS-40, which fulfill the theoretical expectations. Although further research is needs to identify how these aspects believe in other groups, our finding confirm that alexithymia is related to psychopathological symptoms. / A insufici?ncia renal cr?nica (IRC) ? a uma doen?a de instala??o lenta, gradativa e irrevers?vel das fun??es renais, levando o indiv?duo a ter altera??es f?sicas e emocionais. Estudos sobre os aspectos emocionais de pacientes em hemodi?lise enfatizam que estes comp?em um grupo especial entre os portadores de doen?a cr?nica, pois o tratamento, e a depend?ncia dos equipamentos utilizados assume grande import?ncia na vida da pessoa. Assim, estes aspectos podem acentuar caracter?sticas especiais na sua afetividade e no seu comportamento, salientando que a pr?pria uremia pode produzir sintomas depressivos. Dentre as altera??es e patologias relacionadas ?s emo??es destaca-se a alexitimia, que designa a dificuldade de expressar afetos ou emo??es. Considera-se que a alexitimia e os sintomas psicopatol?gicos podem influenciar no diagn?stico, no progn?stico e na forma de rea??o do sujeito ? modalidade de tratar a insufici?ncia renal. Desta maneira a avalia??o e identifica??o destes aspectos possibilitam uma melhor compreens?o destes visando um tratamento psicol?gico mais adequado a esta popula??o e um trabalho de preven??o e promo??o da sa?de mental com estes pacientes e tamb?m com a equipe. Para este estudo a amostra ? composta de 48 pacientes em hemodi?lise de um hospital escola no interior de S?o Paulo. Esta foi estratificada em fun??o da doen?a renal apresentada. Os materiais utilizados foram ficha de Identifica??o, a Escala de Alexitimia de Toronto (TAS) e a Escala de Avalia??o de Sintomas (EAS-40). Amostra ficou distribu?da com um predom?nio de: pacientes do sexo masculino (60,4%), casados (50%), na faixa et?ria entre 40 e 59 anos de idade (58,3%), com ensino b?sico (50%), aposentados ou afastados do trabalho (47,9%). Quanto ao diagn?stico, 41,6% t?m hipertens?o arterial sang??nea, 31,3% diabetes mellitus e 27,1%, glomerunefrite cr?nica. Quanto ? alexitimia, observou-se que 52% dos participantes apresentaram pontua??o igual ou maior que 74 e que 4,2% obtiveram escore igual ou inferior a 62. E, 43,8% dos sujeitos encontram-se na faixa de 63 a 73 pontos. J? a m?dia geral da amostra foi 74 e DP 7,52. Verificou-se que pacientes submetidos a hemodi?lise apresentam altos escores na TAS, independentemente do sexo, n?vel de escolaridade, estado civil, atividade profissional, idade e hip?tese diagn?stica e que n?o houve diferen?as significantes entre estas vari?veis.Em rela??o aos sintomas psicopatol?gicos a pontua??o m?dia foi de 0,63 e DP 0,37 e tamb?m n?o houve diferen?as significantes nas categorias segundo as vari?veis s?cio-demogr?ficas. Em rela??o ? associa??o entre alexitimia e sintomas psicopatol?gicos averiguou-se correla??o significantes entre os escores totais da TAS e EAS_40 e entre o escore total da TAS e os fatores 1, 2 e 3 da EAS-40, que correspondem a expectativa te?rica. Logo, os resultados deste trabalho confirmam que para esta popula??o a alexitimia se associa com os sintomas psicopatol?gico e a necessidade de futuras pesquisas para conhecermos como estes aspectos se comportam em outras popula??es.

Made available in DSpace on 2016-04-04T18:27:54Z (GMT). No. of bitstreams: 1 Maria Claudia Roberta Tombolato.pdf: 377189 bytes, checksum: 92c0bdaaa746d0e98588e70e405599c4 (MD5) Previous issue date: 2005-02-14 / Brazil has registered more than three millions of undergraduate students, prevailing private schools. A growing demand for this population has been to conciliate studies and work regularly. This search is focused on evaluation of quality of life, psychopathologic symptoms and social-demographic factors of a group of college students that also work. For this, 122 undergraduate student workers and 18 non-workers, of a night Business Administration faculty of a private university, from S. Paulo State, answered three questionnaires: social-demographic questionnary, WHOQOL-bref (Fleck & et al.,2000), and EAS-40 / Symptoms Evaluation Scale (Laloni, 2001). Results showed, in general, differently than expected, that work was not a variable that would distinguish undergraduate worker from non-worker concerning to quality of life level and severity of psychopathologic symptoms, in general. Exceptions were: for women and age between 18 and 22 categories, on physical and ambient domain, and obsessive/compulsive psychopathologic symptom, that showed significant differences. Quality of life and psychopathologic symptoms were negatively correlated among the workers as far as for the non-workers, except on domain 4, in which the correlation coefficient did not reach significant levels although it was negative (r=0,36, p>0,05). So, women and youngers showed to be more susceptible to work, but, in general, work did not show to be a problem for quality of life and psychopathologic symptoms manifestation among undergraduate students. This suggests further studies with these groups to clear up about it. / O Brasil registra mais de tr?s milh?es de estudantes no ensino superior, com presen?a dominante de escolas privadas. Conciliar cotidianamente estudo e trabalho tem sido uma demanda crescente nesta popula??o. Este estudo realizou uma avalia??o de grupos de universit?rios-trabalhadores com respeito ? qualidade de vida, sintomas psicopatol?gicos e alguns fatores s?cio-demogr?ficos. Para isso, 122 estudantes universit?rios trabalhadores e 18 n?o trabalhadores da faculdade noturna de Administra??o de Empresas de uma institui??o privada de ensino superior, no interior do Estado de S?o Paulo, responderam a tr?s instrumentos: Question?rio socio-demogr?fico, WHOQOL-bref (Fleck et al.,2000), e EAS-40/Escala de Avalia??o de Sintomas (Laloni, 2001). Os resultados indicaram que o trabalho, ao contr?rio do que era esperado, n?o se mostrou vari?vel que discrimina universit?rio trabalhador de n?o trabalhador, quanto ? qualidade de vida nem a sintomas psicopatol?gicos, no geral. Apenas nas categorias mulheres e idade entre 18 e 22 anos, os dom?nios f?sico, meio ambiente e sintomas obsessivos/compulsivos apresentaram diferen?as que foram significantes. Uma avalia??o do grau de associa??o da qualidade de vida com sintomas psicopatol?gicos mostrou correla??es negativas significantes tanto para os trabalhadores como para os n?o trabalhadores, exceto pelo dom?nio 4 Ambiente no qual o coeficiente de correla??o n?o chegou a ser significante embora negativo (r=0,36, p>0,05). Enfim, as mulheres e os mais jovens apontaram ser mais suscet?veis ao trabalho que, por?m, n?o se mostrou ser um problema para a qualidade de vida e manifesta??o de sintomas psicopatol?gicos do universit?rio de uma maneira geral, sugerindo que se realizem futuras pesquisas com estes grupos que possam trazer maior esclarecimento a respeito.

The aim of this study is to discover nonverbal, bodily gesture and contextual cues indicating self-conscious emotions and use these clues to examine personal differences and psychopathological symptoms. Moreover, possible effects of cultural differences on self-conscious emotions&rsquo / recognition and their relation to psychopathology are meant to be discussed. To achieve aforementioned goals, the study is partitioned into three separate but interdependent phases. The aim of the study is scale adaptation for which the State Shame and Guilt Scale, Test of Self-Conscious Affect-3, Guilt- Shame Scale, State-Trait Anxiety Inventory, and Beck Depression Inventory are applied to a group of 250 university students. The second study&rsquo / s objective is to determine the nonverbal expressions used in recognition of self-conscious emotions. To meet this goal, 5 TAT cards, whose compatibility with the research questions is verified, are applied to 45 university students in separate sessions by using close ended questions. In the third part of the study, 9 TAT cards, which include clues about recognition and nonverbal expressions of self-conscious emotions, adapted corresponding scales, and a psychopathological symptoms measuring scale (SCL-90) in self-report format are applied on a group of 250 university students. Factor and correlation analyses done in the first part reveal that adapted scales are reliable and valid, while group comparisons and measurements of the second part indicate differences in emotions. Findings reveal that shame can be recognized by nonverbal expressions whereas for guilt contextual clues are facilitated. In the third part, group comparisons and regression analyses, which are done in order to reveal self-conscious emotions&rsquo / recognition and their significant relationships with psychopathology, display that state self-conscious emotions and shame-proneness have very important roles on psychopathology. All these findings are discussed in the light of cultural effects.

I) Hintergrund Die chronische Hepatitis-C-Infektion stellt global ein wesentliches Gesundheitsproblem dar. Diese Virusinfektion kann bei unbehandelten Patienten zur Leberzirrhose und im weiteren Verlauf bis hin zur Entwicklung eines hepatozellulären Karzinoms führen. Die einzige Behandlungsoption mit der Aussicht auf dauerhafte Viruselimination besteht in modernen Kombinationstherapien, die das Zytokin Interferon alfa enthalten. Wesentliche Merkmale sind – neben inzwischen sehr hohen Ansprechraten – eine Behandlungsdauer zwischen 24 und 48 Wochen, hohe Therapiekosten und ein Nebenwirkungsprofil, das sowohl somatische als auch psychopathologische Symptome umfassen kann. II) Untersuchungsgegenstand und Fragestellungen Sowohl die chronische Virusinfektion an sich als auch die aktuell verfügbaren Therapieverfahren bergen ein erhebliches psychisches Belastungspotential. Hauptgegenstand dieser Dissertation ist die Erfassung der psychologischen Aspekte der Erkrankung und der psychischen und psychopathologischen Nebenwirkungen einer Interferonbehandlung. Wesentliche bearbeitete Fragestellungen sind: - Welchen Belastungsfaktoren sind Hepatitis-C-Patienten bereits ohne aktuelle antivirale Interferontherapie ausgesetzt bzw. welche psychopathologischen Symptome zeigen diese Patienten? - Wie ist der zeitliche Verlauf psychopathologischer Symptome bei Hepatitis-C-Patienten vor, während und nach einer antiviralen Therapie? - Wie wirksam und wie sicher ist eine medikamentöse Behandlung der Interferon-induzierten Depression mit selektiven Serotonin-Wiederaufnahmehemmern (SSRI) unter Fortführung der antiviralen Therapie? III) Patienten und Methoden Studienteilnehmer waren Hepatitis-C-Patienten, die sich ambulant vorstellten bzw. in unsere Ambulanz überwiesen wurden und die jeweiligen Einschlusskriterien erfüllten. Zu den wichtigsten verwendeten psychometrischen Selbstbeurteilungsskalen zählen: HADS (Depressivität, Angst), SCL-90-R (psychopathologische Symptome), SF-36 (Lebensqualität) und FKV (Krankheitsverarbeitung). IV) Wesentliche Forschungsergebnisse Bereits ohne Einfluss des Zytokins Interferon bestehen starke Krankheits-assoziierte psychische bzw. psychosoziale Belastungen der Patienten, die sich in einem erhöhten Depressionsrisiko ausdrücken. Die erhobenen Depressionsscores stehen in signifikantem Zusammenhang mit der Erkrankungsdauer und den individuell bestehenden Optionen und Erfolgsaussichten einer antiviralen Interferontherapie. Prospektive Erfassungen der Auftretenshäufigkeit klinisch relevanter Interferon-assoziierter Depressionen ergeben Raten von ca. 30 %. Diese Größenordnung wurde sowohl in einer eigenen prospektiven Studie als auch im Rahmen einer vorgestellten Übersichtsarbeit bestätigt. Die Umstellung der verwendeten Formulierung des Medikaments von herkömmlichem Interferon alfa auf die pegylierte Variante brachte keine Verbesserung der Verträglichkeit z.B. im Hinblick auf die interferonassoziierte Depression. Ein rechtzeitiges Erkennen der entsprechenden Symptome vorausgesetzt, ist die antidepressive Behandlung der Interferon-assoziierten Depression mit Hilfe von selektiven Serotonin-Reuptake-Inhibitoren auch ohne generelle Prophylaxe sehr effektiv und sicher möglich. V) Diskussion Empfohlen wird ein engmaschiges psychometrisches Monitoring aller Hepatitis-C-Patienten im Therapieverlauf. Ausführliche Aufklärung, enger Arzt-Patienten-Kontakt während der Therapie, sowie die Betreuung durch einen festen Ansprechpartner während der bis zu einem Jahr dauernden Therapie sind wichtige Rahmenbedingungen für eine solche Behandlung. Für die medikamentöse Behandlung der Interferon-induzierten Depression gilt: Bei besonderer Indikation (z.B. Interferon-assoziierte Depression bei früheren Therapieversuchen) sollte eine SSRI-Sekundärprophylaxe in Betracht gezogen werden. Ansonsten ist eine entsprechende SSRI-Intervention beginnend mit dem Einsetzen einer klinisch relevanten Depression ausreichend.

Made available in DSpace on 2016-04-04T18:29:32Z (GMT). No. of bitstreams: 1 Jena Hanay Doutorado.pdf: 721081 bytes, checksum: 65f8d839cf686774d38170e56199f048 (MD5) Previous issue date: 2006-12-18 / Evaluates depression, anxiety, psychopathologic symptoms, alexithymia and defensive style of grade III obese patients, before and after bariatric surgery, as well as estimates the level of association among such variables. Methodological study design was correlational crosssectional type. 65 patients took part in the study (Group 1: surgical candidates vs. Group 2: postoperative patients), mainly females (92,3%), who answered the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI), the Symptoms Assessment Scale (EAS- 40), and the version in Portuguese of The Toronto Alexithymia Scale (TAS-26) and of the Defensive Style Questionnaire (DSQ-40). Gr 1 showed mild anxiety and depression levels and Gr 2 minimum level (respectively, p< 0,001 e p< 0,01). The total average score for EAS- 40 and F2 and F3 (obesity-compulsion and somatization) were higher in Gr 1 when compared to Gr 2 (repetitively, p< 0,005, p< 0,005 e p< 0,001). On TAS, the total average score for F1 (ability to identify and describe feelings and distinguish them from bodily sensations) were higher in Gr 1 than in Gr 2 (respectively, p< 0,01 e p< 0,005). According to DSQ-40, there was a tendency for an immature defensive style in Gr 1 in comparison to Gr 2 (p< 0,02). In relation to the association between the variables and BMI, the correlations were negative for Gr 1 and F2 of TAS (daydreaming, p < 0,05) and for the mature factor of DSQ- 40 and Gr 2 (p < 0,05), which shows a trend towards a more mature and adaptive style in Gr 2. Correlations were positive and significant in relation to immature defenses - acting out (Gr 1: p<0,005 and Gr 2: p<0,05) and in the autistic fantasy in Gr 1 (p<0,05). The results show the psychological status of the participants, who are apt for bariatric surgery and point to a decrease in psychopathological symptoms proportional to weight loss after surgery. / Avalia depress?o, ansiedade, sintomas psicopatol?gicos, alexitimia e o estilo defensivo de pacientes obesos grau III, antes e depois de cirurgia bari?trica, e estima o grau de associa??o entre essas vari?veis. O delineamento metodol?gico foi correlacional de tipo cross-sectional. Participaram do estudo 65 pacientes (Gr 1: pr?-cir?rgico vs. Gr 2: p?scir?rgico), predominantemente do sexo feminino (92,3%), que responderam o Invent?rio de Depress?o de Beck (BDI), o Invent?rio de Ansiedade de Beck (BAI), a Escala de Avalia??o de Sintomas (EAS-40), a Vers?o em Portugu?s da Escala de Alexitimia de Toronto (TAS-26) e a Vers?o em Portugu?s da Defensive Style Questionnaire (DSQ-40). O Gr 1 apresentou n?vel de depress?o e ansiedade leve e o Gr 2 n?vel m?nimo (respectivamente, p< 0,001 e p< 0,01). O escore m?dio total da EAS-40 e de F2 e F3 (obsessividade-compulsividade e somatiza??o) foram mais elevados no Gr 1 quando comparados aos do Gr 2 (respectivamente, p< 0,005, p< 0,005 e p< 0,001). Na TAS, o escore m?dio total e de F1 (habilidade de identificar e descrever sentimentos e distingui-los de sensa??es corporais) foram maiores no Gr 1 do que no Gr 2 (respectivamente, p< 0,01 e p< 0,005). De acordo com o DSQ-40, houve tend?ncia a um estilo defensivo imaturo no Gr 1 quando comparado ao Gr 2 (p< 0,02). Em rela??o ? associa??o das vari?veis com o IMC, as correla??es foram negativas no Gr 1 e o F2 da TAS (sonhar acordado, p < 0,05) e no fator maduro do DSQ-40 e o Gr 2 (p < 0,05), apontando uma propens?o de estilo mais maduro e adaptativo no Gr 2. As correla??es foram positivas e significantes nas defesas imaturas acting out (Gr 1: p<0,005 e Gr 2: p<0,05) e na fantasia aut?stica no Gr 1 (p<0,05). Os resultados mostram o modo de funcionamento psicol?gico dos participantes aptos ? cirurgia bari?trica e assinalam uma diminui??o da sintomatologia psicopatol?gica na propor??o da perda de peso ap?s a cirurgia.

I) Hintergrund Die chronische Hepatitis-C-Infektion stellt global ein wesentliches Gesundheitsproblem dar. Diese Virusinfektion kann bei unbehandelten Patienten zur Leberzirrhose und im weiteren Verlauf bis hin zur Entwicklung eines hepatozellulären Karzinoms führen. Die einzige Behandlungsoption mit der Aussicht auf dauerhafte Viruselimination besteht in modernen Kombinationstherapien, die das Zytokin Interferon alfa enthalten. Wesentliche Merkmale sind – neben inzwischen sehr hohen Ansprechraten – eine Behandlungsdauer zwischen 24 und 48 Wochen, hohe Therapiekosten und ein Nebenwirkungsprofil, das sowohl somatische als auch psychopathologische Symptome umfassen kann. II) Untersuchungsgegenstand und Fragestellungen Sowohl die chronische Virusinfektion an sich als auch die aktuell verfügbaren Therapieverfahren bergen ein erhebliches psychisches Belastungspotential. Hauptgegenstand dieser Dissertation ist die Erfassung der psychologischen Aspekte der Erkrankung und der psychischen und psychopathologischen Nebenwirkungen einer Interferonbehandlung. Wesentliche bearbeitete Fragestellungen sind: - Welchen Belastungsfaktoren sind Hepatitis-C-Patienten bereits ohne aktuelle antivirale Interferontherapie ausgesetzt bzw. welche psychopathologischen Symptome zeigen diese Patienten? - Wie ist der zeitliche Verlauf psychopathologischer Symptome bei Hepatitis-C-Patienten vor, während und nach einer antiviralen Therapie? - Wie wirksam und wie sicher ist eine medikamentöse Behandlung der Interferon-induzierten Depression mit selektiven Serotonin-Wiederaufnahmehemmern (SSRI) unter Fortführung der antiviralen Therapie? III) Patienten und Methoden Studienteilnehmer waren Hepatitis-C-Patienten, die sich ambulant vorstellten bzw. in unsere Ambulanz überwiesen wurden und die jeweiligen Einschlusskriterien erfüllten. Zu den wichtigsten verwendeten psychometrischen Selbstbeurteilungsskalen zählen: HADS (Depressivität, Angst), SCL-90-R (psychopathologische Symptome), SF-36 (Lebensqualität) und FKV (Krankheitsverarbeitung). IV) Wesentliche Forschungsergebnisse Bereits ohne Einfluss des Zytokins Interferon bestehen starke Krankheits-assoziierte psychische bzw. psychosoziale Belastungen der Patienten, die sich in einem erhöhten Depressionsrisiko ausdrücken. Die erhobenen Depressionsscores stehen in signifikantem Zusammenhang mit der Erkrankungsdauer und den individuell bestehenden Optionen und Erfolgsaussichten einer antiviralen Interferontherapie. Prospektive Erfassungen der Auftretenshäufigkeit klinisch relevanter Interferon-assoziierter Depressionen ergeben Raten von ca. 30 %. Diese Größenordnung wurde sowohl in einer eigenen prospektiven Studie als auch im Rahmen einer vorgestellten Übersichtsarbeit bestätigt. Die Umstellung der verwendeten Formulierung des Medikaments von herkömmlichem Interferon alfa auf die pegylierte Variante brachte keine Verbesserung der Verträglichkeit z.B. im Hinblick auf die interferonassoziierte Depression. Ein rechtzeitiges Erkennen der entsprechenden Symptome vorausgesetzt, ist die antidepressive Behandlung der Interferon-assoziierten Depression mit Hilfe von selektiven Serotonin-Reuptake-Inhibitoren auch ohne generelle Prophylaxe sehr effektiv und sicher möglich. V) Diskussion Empfohlen wird ein engmaschiges psychometrisches Monitoring aller Hepatitis-C-Patienten im Therapieverlauf. Ausführliche Aufklärung, enger Arzt-Patienten-Kontakt während der Therapie, sowie die Betreuung durch einen festen Ansprechpartner während der bis zu einem Jahr dauernden Therapie sind wichtige Rahmenbedingungen für eine solche Behandlung. Für die medikamentöse Behandlung der Interferon-induzierten Depression gilt: Bei besonderer Indikation (z.B. Interferon-assoziierte Depression bei früheren Therapieversuchen) sollte eine SSRI-Sekundärprophylaxe in Betracht gezogen werden. Ansonsten ist eine entsprechende SSRI-Intervention beginnend mit dem Einsetzen einer klinisch relevanten Depression ausreichend.

[pt] O abuso sexual na infância e adolescência é um problema de saúde pública, possuindo possíveis repercussões ao longo da vida. Por exemplo, é associado a maior risco para o desenvolvimento de diversos sintomas psicopatológicos. Com o aumento do acesso à internet nos últimos 15 anos, principalmente entre crianças e adolescentes, a probabilidade de abertura a novas formas de abuso sexual torna-se uma preocupação. A vitimização sexual online surge nesse contexto. Já se sabe que durante as experiências de vitimização, há maior possibilidade de sintomas depressivos, ansiosos, ligados ao uso de substâncias e até ideação suicida, mas não se sabe exatamente o risco a médiolongo prazo. Assim, o objetivo desta dissertação foi investigar se a vitimização sexual online precoce (na infância e adolescência) tem associações com sintomas psicopatológicos na vida adulta. A dissertação foi elaborada na forma de artigos, sendo dividida nas seguintes etapas: um capítulo introdutório, dois artigos e um capítulo conclusivo. O ARTIGO 1 é uma tradução e adaptação de um instrumento de avaliação de vitimização sexual online (Online Sexual VictimizationScale). O ARTIGO 2 é um estudo online para investigar retrospectivamente, em uma amostra de adultos jovens e usuários de internet desde a infância, os diferentes efeitos da história de abuso sexual online e não online para sintomas de transtornos mentais. No Artigo 1, após todas as etapas de tradução e adaptação planejadas terem sido cumpridas com sucesso, foram realizadas análises fatoriais confirmatórias para verificar os índices de confiabilidade e validade do construto. De acordo com a análise fatorial, a escala possuimodelo de dois fatores: com um fator geral de segunda ordem e três fatores de primeira ordem que correspondem a subescalas- insistência (4 itens), ameaças (4 itens) e disseminação (2 itens). O modelo de segunda ordem apresentou bom a excelente ajuste do modelo entre os índices e todos os itens apresentaram cargas fatoriais significativas. Tal modelo replica o proposto originalmente pelo autor. Portanto, apresentamos a tradução, adaptação, bem como índices de confiabilidade e validade de construto da escala. No artigo 2, os resultados apontaram os efeitos da vitimização sexual online ocorridos precocemente como fatores de risco para diversos sintomas psicopatológicos. Além disso, observamos uma alta prevalência de vitimização sexual online durante a infância e adolescência, apresentada por três a cada quatro participantes. Para sustentar as experiências adversas como risco para sintomas, comparamos os grupos de participantes com e sem história de vitimização sexual online durante a infância e adolescência. Ao comparar o grupo controle e o grupo referente à vitimização sexual online antes dos 18 anos, notamos diferenças nas manifestações de sintomas psicopatológicos, indicando que tais eventos de vida negativos podem estar relacionados a efeitos duradouros na saúde mental. Os dados apresentados neste estudo sugerem que a vitimização sexual online de forma precoce é um tema emergente de preocupação à medida que a internet se torna cada vez mais acessível à população em geral. Surge então a necessidade de recursos de proteção mais fortes para evitar que crianças e adolescentes sejam expostos a tais situações estressantes. / [en] Child sexual abuse can be considered a public health problem, since its repercussions throughout life are associated with a greater risk for the development of several psychopathological symptoms. With the increase in internet access in the last 15 years, especially among children and adolescents, the likelihood of opening up to new forms of sexual abuse becomes a concern. Online sexual victimization emerges in this context, bringing relevant evidence of associations with symptoms such as depression, anxiety, suicide and substance use. Therefore, this dissertation aims to investigate early online sexual victimization associated with the manifestation of psychopathological symptoms in adulthood. The dissertation was prepared in the form of articles, being divided into the following steps: an introductory chapter, two articles and a concluding chapter. ARTICLE 1 is a translation and adaptation of an online sexual victimization assessment tool. ARTICLE 2 is an online study to retrospectively investigate, in a sample of young adults and internet users since childhood, the different effects of online and non-online sexual abuse history on symptoms of mental disorders. In Article 1, after all the planned translation and adaptation steps had been successfully completed, confirmatory factor analyzes were performed to verify the reliability and validity indices of the construct. According to factor analysis, the OSV is a second-order factor composed of three first-order factors - insistence (4 items), threats (4 items) and dissemination (2 items). The second order model showed good to excellent model fit between the indices and all items presented significant factor loadings. Therefore, we present the translation, adaptation, as well as reliability and construct validity indices of the scale. In article 2, the results pointed to the effects of early sexual victimization online as risk factors for several psychopathological symptoms. We observed a high prevalence of early online sexual victimization reported by participants, showing that three out of four adults who grew up with internet access experienced online sexual victimization during childhood and/or adolescence. When comparing the control group and the group referring to online sexual victimization before the age of 18, we noticed differences in the manifestations of psychopathological symptoms, indicating that such negative life events may be related to lasting effects on mental health. The data presented in this study suggest that early sexual victimization online is an emerging topic of concern as the internet becomes increasingly accessible to the general population. Our study found extremely relevant results, drawing attention to the importance of building stronger protective resources to prevent children and adolescents from being exposed to such stressful situations.

[pt] A discriminação percebida é um elemento estressor de saúde mental que consiste na capacidade de percepção dos sujeitos acerca das interações e experiências discriminatórias vividas no cotidiano. O objetivo desta dissertação foi explorar as associações entre a Discriminação Percebida e Sintomas de Saúde Mental. Para tanto, um trabalho dividido em três partes foi concebido. Uma revisão de literatura, sequência, uma revisão narrativa sobre discriminação percebida e transtorno mentais, sintomas psicopatológicos e por fim, avaliação das propriedades psicométricas da Escala de Discriminação Cotidiana e um estudo empírico que avaliou de forma online a presença de sintomas psicopatológicos e testou associações com a discriminação percebida. Trata-se de uma Pesquisa, com delineamento transversal e análise quantitativa, considerou as respostas de 547 brasileiros natos, adultos com idade entre 18 e 72 anos. Os participantes responderam quatro questionários autoaplicáveis, questionários, são eles, o sociodemográfico, a Escala de Discriminação Cotidiana, a Escala de Sofrimento Psicológico e a Escala Transversal de Sintomas Nível 1 do Manual Diagnóstico e Estatístico de Transtornos Mentais, quinta versão. Quanto aos resultados a validade baseada na estrutura interna foi realizada por meio da Análise Fatorial Exploratória que detectou que todos os itens funcionaram normalmente. A escala de demonstrou unidimensional por avaliar apenas um constructo, além de apresentar validade convergente com medidas externas através da Escala K10, que tem por finalidade avaliar relatos de sofrimento psicológico recente. A hipótese de que estigma e a discriminação possam interferir em movimentos de busca por ajuda psicológica foi confirmada neste estudo. Nosso estudo sustenta que a Escala de Discriminação Cotidiana possui propriedades confiáveis para ser utilizada no ambiente virtual, ampliando a viabilidade de estudos na temática. Logo, observamos que a EDS se associa positivamente com sintomas psicopatológicos e com o sofrimento psicológico recente. / [en] Perceived discrimination is a mental health stressor that involves individuals ability toperceive interactions and discriminatory experiences in their daily lives. The aim of this dissertation was to explore the associations between Perceived Discrimination and Psychopathological Symptoms. For this purpose, a three-part study was designed. It includeda literature review, a narrative review on perceived discrimination and disorders, symptoms, and other signs of psychological morbidity, and finally, an assessment of the psychometric properties of the Everyday Discrimination Scale along with an empirical study that evaluatedthe presence of psychopathological symptoms online and tested associations with perceived discrimination. A cross-sectional research design with quantitative analysis was employed, considering responses from 547 native Brazilian adults aged 18 to 72 years old. Participants completed four self-administered questionnaires: sociodemographic, Everyday Discrimination Scale, Psychological Distress Scale, and the Level 1 Cross-Cutting Symptom Scale from the Fifth Edition of the Diagnostic and Statistical Manual of Mental Disorders. Regarding the results, validity based on internal structure was conducted using Exploratory Factor Analysis,which found that all items functioned appropriately. The scale demonstrated unidimensionalityby assessing a single construct and showed convergent validity with external measures throughthe K10 Scale, designed to assess recent psychological distress reports. The hypothesis that stigma and discrimination might impact seeking psychological help was confirmed by this study. Our research supports that the Everyday Discrimination Scale possesses reliable properties for online use, enhancing the feasibility of studies in this area. Thus, we observed apositive association between the Everyday Discrimination Scale and psychopathologicalsymptoms as well as recent psychological distress.

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