xv, 134 p. : ill. A print copy of this thesis is available through the UO Libraries. Search the library catalog for the location and call number. / Prior research finds that exposure to traumatic stress negatively impacts physical and mental health, and that the social context in which trauma occurs is an important predictor of symptom development. Eight-hundred thirty-three members of an ethnically diverse longitudinal cohort study in Hawaii were surveyed about their personal exposure to several types of traumatic events, socioeconomic resources, mental health symptoms, and health status. Rates of trauma exposure were predicted to vary as a function of type of trauma and participant gender and ethnicity. In addition, access to social resources and the relational context of trauma were predicted to be associated with symptom reports in this ethnically diverse sample of men and women. Results replicated findings that while men and women are exposed to similar rates of trauma overall, women report more exposure to traumas high in betrayal. while men report exposure to more lower-betrayal traumas. Women also reported more mental health symptoms, and traumas higher in betrayal were generally more predictive of symptoms. Ethnic group variation in trauma exposure and physical and mental health symptoms was also present: ethnic groups with lower socioeconomic status generally reported more trauma exposure and symptoms, although in some cases the pattern of results was not straightforward. This study adds new information about the prevalence of traumatic stress and mental health symptoms across ethnic groups in Hawaii, and how these relate to social context. In addition, this study provides preliminary information on the independent contribution of neglect and household dysfunction to the prediction of symptoms. The relevance of these results can be summarized with three main arguments. First, measures of trauma exposure must include events that occur across relational contexts if they are to be gender equitable and most predictive of symptoms. Second, gender and ethnic group differences in symptoms are largely explained by differential trauma exposure and differential access to educational and economic resources. Third, prevention and intervention efforts must address both trauma exposure and social context, as each is implicated in the presentation of symptoms. / Committee in charge: Jennifer Freyd, Chairperson, Psychology; Anne Simons, Member, Psychology; Gerard Saucier, Member, Psychology; Debra Merskin, Outside Member, Journalism and Communication

Objetivo: Avaliar os efeitos da Sulpirida 50mg/dia comparado a placebo sobre os sintomas vasomotores (frequência e intensidade) e na qualidade de vida de mulheres climatéricas. Métodos: Mulheres climatéricas (N=28), idade entre 47 e 62 anos, com pelo menos cinco episódios de sintomas vasomotores por dia, foram recrutadas em uma clínica especializada de um hospital terciário no sul do Brasil e através de chamamentos na mídia; após os critérios de inclusão e de exclusão, elas foram randomizadas. Placebo (n=14) e Sulpirida 50mg/dia (n=14) foram administrados durante o ensaio. O número e a intensidade dos fogachos foram registrados 1 semana antes e ao longo de 8 semanas após intervenção. Aplicou-se o WHQ – 36 itens para avaliação da qualidade de vida. Resultados: As frequências e as intensidades dos fogachos/dia foram similares em ambos os grupos, observando-se uma redução em ambos os parâmetros durante as semanas de follow-up após a intervenção com Sulpirida (p=0,019 e p=0,009, respectivamente). Quanto à qualidade de vida das mulheres, Sulpirida 50mg/dia reduziu os escores dos problemas com o sono após 8 semanas de tratamento, quando comparada ao grupo placebo (p=0,017). Conclusions: Nossos resultados sugerem que o tratamento com a Sulpirida 50mg/dia se apresentou com tendências significativas na redução dos sintomas climatéricos, se justificando a replicação e outros estudos que investiguem os possíveis mecanismos pelos quais a Sulpirida poderia reduzir os fogachos, de forma segura. / Objective: To assess the effects of Sulpiride 50mg/day compared with placebo on vasomotor symptoms (frequency and intensity) and on quality of life of climacteric women. Methods: Climacteric women (N=28), aged between 47–62 years, with at least five episodes of vasomotor symptoms per day were recruited from a specialized outpatient clinic at a tertiary hospital in the south of Brazil and through a media call after inclusion and exclusion criteria were ensured. Placebo (n=14) and Sulpiride 50mg/day (n=14) were administrated during all trial period. The number and intensity records of hot flushes were evaluated for 1 week before and along 8 weeks after the intervention. The 36-item version Women’s Health Questionnaire (WHQ) was applied to assess the quality of life. Results: The frequencies and the intensities of hot flushes /day happened in a similar way in both groups, with an observed reduction of both parameters during the weekly follow up after the Sulpiride intervention (p=0.019 and p=0.009, respectively). Regarding women’s quality of life, Sulpiride 50mg/day reduced sleep problems scores after 8 weeks of treatment, when compared to placebo group (p=0.017. Conclusions: Our results suggest that the Sulpiride 50mg/day treatment showed significant trends on reducing climacteric vasomotor symptoms, justifying replication and further studies addressing the possible mechanisms by which Sulpiride could safely reduce hot flushes.

Introdução: A percepção do paciente sobre a relação com seu psicoterapeuta é determinante para a sua permanência em tratamento e para o sucesso da psicoterapia. Entretanto, pouco se tem investigado sobre quais fatores disponíveis na fase de avaliação para uma psicoterapia psicanalítica são indicadores de melhor aliança entre terapeuta e paciente. Objetivo: Investigar se há associação entre fatores sociodemográficos e clínicos e a aliança terapêutica, na percepção do paciente. Método: Trata-se de um estudo transversal que avaliou a qualidade da aliança terapêutica em pacientes adultos atendidos em psicoterapia psicanalítica em um ambulatório de saúde mental em Porto Alegre, Rio Grande do Sul, Brasil. A amostra foi constituída por 118 pacientes que chegaram até a quarta ou quinta sessão de psicoterapia psicanalítica e foram avaliados pela escala Calpas – P. Resultados: O estudo mostrou que pacientes do sexo masculino tiverem média (6.44) significativamente menor (p=0.036) a das mulheres (6.66) na escala de avaliação e percepção do trabalho do terapeuta. Encontrou também que quanto maior a intensidade dos sintomas de psicoticismo menor a percepção de aliança na escala de comprometimento com o processo de psicoterapia (r=0.231, p=0.05). Conclusões: Os resultados mostraram que, no início da psicoterapia, gênero e severidade dos sintomas interferem na percepção da aliança terapêutica. Identificou-se que os pacientes homens percebem, em media, menor aliança na dimensão que se refere à compreensão e ao envolvimento do psicoterapeuta, independente do sexo deste. Isso indica, possivelmente, que homens tendem a considerar seus terapeutas com menor capacidade de entender seu ponto de vista e sofrimento, demonstrar aceitação sem julgamentos, dirigir-se ao ponto central de dificuldade, intervir com tato e no tempo certo, e mostrar real compromisso em ajudar e vencer os problemas. Pacientes com sintomas de psicoticismo mais severos apresentaram menor aliança na dimensão que avalia esforço do paciente em empreender uma mudança, boa vontade em fazer sacrifícios em relação ao tempo e ao dinheiro; visão da terapia como uma experiência importante; confiança na terapia e no terapeuta; participação na terapia, apesar de momentos de sofrimento; e compromisso de completar o processo terapêutico. Devido à complexidade do conceito de aliança terapêutica, mais pesquisas são necessárias, a fim de reforçar e demonstrar a influência de variáveis objetivas em seu desenvolvimento (fatores do paciente, do terapeuta e da interação da dupla). Os achados agregam importância à preparação técnica dos terapeutas, para poderem desenvolver melhores alianças com esse tipo de paciente, propiciando maior aderência ao tratamento. / Introduction: The patient's perception of the relationship with their therapist is determinant for their treatment adherence and for the success of psychotherapy. However, little has been investigated about which factors available at the evaluation stage for psychoanalytic psychotherapy are indicators of a better alliance between therapist and patient. Objective: To investigate whether there is an association between sociodemographic and clinical factors and the therapeutic alliance in the patient's perception. Method: This work consists of a crosssectional study that evaluated the quality of the therapeutic alliance in adult patients receiving psychoanalytic psychotherapy in a mental health outpatient clinic in Porto Alegre, state of Rio Grande do Sul, Brazil. The sample was made up of 118 patients who had at least four or five sessions of psychoanalytic psychotherapy and were evaluated using the Calpas – P scale. Results: The study showed that male patients have average (6.44) significantly lower (p=0.036) than women (6.66) in the scale of evaluation scale and perception of the therapist‟s work. He also find that the intensity of the symptoms of psychoticism present lesser alliance in the scale of commitment with the psychotherapy process (r=0.231, p=0.05). Conclusions: The results showed that, at beginning of psychotherapy, gender and severity of the patient‟s symptoms interfere with the perception of therapeutic alliance. It was identified that male patient‟s are, on average, worse at perceiving the alliance in the dimension that refers to therapist understanding and involvement regardless of gender this. This indicate, perhaps, that men tend to consider their therapists with less capacity to understand their point of view and suffering, show acceptance without judgment, address the key point of difficulty, intervene tactfully and timely and show commitment to helping and overcome the problems. Patients with more severe symptoms of psychoticism had lower alliance in the dimension that assess patient‟s effort in undertaking change, willingness to make sacrifices regarding time and money; having a vision of therapy as an important experience; confidence in therapy and in the therapist; engagement in therapy, despite moments of suffering; commitment to completing the therapeutic process. The alliance is a complex concept. This is why more research is necessary in order to reinforce and show the influence of objective variables on its development. Factors related to patient, therapist, and the interaction of the duo are worthy of attention. The findings add to the importance of therapists' technical preparation, so as to enable them to develop better alliances with this type of patient, thus allowing for a better adherence to treatment.

abstract: Touch appears to be an important component for understanding psychological and emotional well-being, as well as the formation and maintenance of interpersonal relationships later in life. While research about touch in relation to these topics is gaining momentum, there is still little evidence on the specific effects and processes that take place when touch is negative or harmful. The current study examined how women who have experienced physical or sexual abuse perceive touch in the context of interpersonal relations and in turn, how these experiences, perceptions and attitudes are related to depressive symptoms. Taking into consideration the significance of interpersonal touch, I speculated that 1) attitudes towards touch would be more negative among women who reported physical or sexual abuse than among women who did not; 2) among women who reported past abuse, increased abuse severity would predict increased current depressive symptoms; and 3) among women who reported past abuse, current attitudes towards touch would mediate the relationship between abuse severity and depressive symptoms. As predicted, results indicated that women who reported physical or sexual abuse had less positive attitudes towards touch than women who did not report any abuse. Echoing prior research, reports of childhood and adult abuse predicted increased depressive symptoms. Finally, for women who reported childhood abuse, Discomfort with Social Touch was a significant partial mediator of depressive symptoms, whereas for women who reported adult abuse, both Desire for More Partner Touch and Discomfort with Social Touch were significant partial mediators of depressive symptoms. Results suggested that negative attitudes towards general social touch, in particular, may play a strong role in mediating depressive symptoms among women who reported abuse. / Dissertation/Thesis / Masters Thesis Psychology 2015

Made available in DSpace on 2014-06-11T19:27:19Z (GMT). No. of bitstreams: 0 Previous issue date: 2001Bitstream added on 2014-06-13T20:56:12Z : No. of bitstreams: 1 luppi_chb_me_botfm.pdf: 931869 bytes, checksum: 6138aa9a682dc8848134f7e751a3da49 (MD5) / A Organização Mundial de Saúde (WHO) estima que haja cerca de 1100000 tabagistas, representando um terço da população mundial aproximadamente. As pesquisas mostram que o tabagismo é a principal causa prevenível de mortalidade nos países desenvolvidos. Os objetivos deste trabalho foram verificar a prevalência do hábito de fumar e identificar os sintomas respiratórios entre o corpo discente, docente e técnico-administrativo do Campus de Botucatu/Unesp. O estudo englobou as unidades do campus, discriminadas em Administração Geral e Unidades Universitárias (IB, FM, FMVZ e FCA), bem como os Cursos de Graduação relacionados (Biologia, Medicina, Enfermagem, Medicina Veterinária, Zootecnia, Engenharia Agronômica e Florestal). O instrumento utilizado para coleta dos dados foi o questionário da ATS-DLD, 78, adaptado à população local. Três mil e noventa indivíduos participaram da pesquisa, subdivididos em 1008 discentes, 302 docentes, 1673 servidores e 107 classificados como outros. A classificação da população de acordo com o hábito de fumar revelou 21,4% de fumantes, 15,9% de ex-fumantes e 62,7% de não fumantes. A variável sexo não apresentou diferença de proporção entre os fumantes. A maioria dos tabagistas consumia de meio a um maço diariamente, utilizava cigarro com filtro, tragava constantemente a fumaça e iniciou no hábito entre 11 e 21 anos. Os estados de estresse e as reuniões sociais foram as situações mais relacionadas ao tabagismo. Sintomas como tosse, catarro e chiado foram mais freqüentes entre os fumantes, ao passo que a falta de ar, entre os não fumantes. A maior proporção de tabagistas ocorreu entre indivíduos com graus de escolaridade primário e secundário incompleto, mais especificamente entre os servidores... / The World Health Organization (WHO) estimates that there are about 1100 million smokers, representing approximately one third of the world population. Smoking remains the leading cause of preventable mortality in developed countries. This study was designed to verify the smoking habit prevalence and identify smoking-related respiratory symptoms among the students, teachers and technical-administrative employees of the Campus from Botucatu/UNESP. The study involved all Units of the Campus, including the Courses of Biology, Medicine, Nursing, Veterinary, Zootechny, Agronomy and Forestry Engineering. Modified ATS-DLD questionnaire, 78 was the instrument used to collect the data. Three thousand ninety individuals answered the questionnaire: 1008 students, 302 teachers, 1673 employees and 107 classified as others. According to the smoking habit 21,4% were smokers, 15,9% ex-smokers and 62,7% no-smokers. The proportion of smoking between males and females was not statiscally different. The majority of the smokers was between 11 and 21 years old when started the habit, consumed a half to one pack daily, used filter cigarette and inhaled the smoke. Stress and social meetings were the most probable situations to trigger the smoking. Symptoms as coughing, expectoration and wheezes were more frequent among the smokers and dyspnea, among no-smokers. The higher proportion of smokers occurred among individuals with lower degree of formal education, more specifically among the technical-administrative employees. Among undergraduates there was a tendency for a higher proportion of smokers... (Complete abstract click electronic access below)

Objetivo: Avaliar os efeitos da Sulpirida 50mg/dia comparado a placebo sobre os sintomas vasomotores (frequência e intensidade) e na qualidade de vida de mulheres climatéricas. Métodos: Mulheres climatéricas (N=28), idade entre 47 e 62 anos, com pelo menos cinco episódios de sintomas vasomotores por dia, foram recrutadas em uma clínica especializada de um hospital terciário no sul do Brasil e através de chamamentos na mídia; após os critérios de inclusão e de exclusão, elas foram randomizadas. Placebo (n=14) e Sulpirida 50mg/dia (n=14) foram administrados durante o ensaio. O número e a intensidade dos fogachos foram registrados 1 semana antes e ao longo de 8 semanas após intervenção. Aplicou-se o WHQ – 36 itens para avaliação da qualidade de vida. Resultados: As frequências e as intensidades dos fogachos/dia foram similares em ambos os grupos, observando-se uma redução em ambos os parâmetros durante as semanas de follow-up após a intervenção com Sulpirida (p=0,019 e p=0,009, respectivamente). Quanto à qualidade de vida das mulheres, Sulpirida 50mg/dia reduziu os escores dos problemas com o sono após 8 semanas de tratamento, quando comparada ao grupo placebo (p=0,017). Conclusions: Nossos resultados sugerem que o tratamento com a Sulpirida 50mg/dia se apresentou com tendências significativas na redução dos sintomas climatéricos, se justificando a replicação e outros estudos que investiguem os possíveis mecanismos pelos quais a Sulpirida poderia reduzir os fogachos, de forma segura. / Objective: To assess the effects of Sulpiride 50mg/day compared with placebo on vasomotor symptoms (frequency and intensity) and on quality of life of climacteric women. Methods: Climacteric women (N=28), aged between 47–62 years, with at least five episodes of vasomotor symptoms per day were recruited from a specialized outpatient clinic at a tertiary hospital in the south of Brazil and through a media call after inclusion and exclusion criteria were ensured. Placebo (n=14) and Sulpiride 50mg/day (n=14) were administrated during all trial period. The number and intensity records of hot flushes were evaluated for 1 week before and along 8 weeks after the intervention. The 36-item version Women’s Health Questionnaire (WHQ) was applied to assess the quality of life. Results: The frequencies and the intensities of hot flushes /day happened in a similar way in both groups, with an observed reduction of both parameters during the weekly follow up after the Sulpiride intervention (p=0.019 and p=0.009, respectively). Regarding women’s quality of life, Sulpiride 50mg/day reduced sleep problems scores after 8 weeks of treatment, when compared to placebo group (p=0.017. Conclusions: Our results suggest that the Sulpiride 50mg/day treatment showed significant trends on reducing climacteric vasomotor symptoms, justifying replication and further studies addressing the possible mechanisms by which Sulpiride could safely reduce hot flushes.

The main objective of this thesis was to evaluate various fertility indicators of dairy cows of Holstein cattle bred in modern farming techniques on the farm Rolnička Lipanovice and contribute to the clarification of interdependence of the factors, which influence fertility results. 288 inseminated breeding cows were included in to the reference group, in which it was possible to significantly demonstrate data collected by own observation or from the farm owner and inseminators. These data were collected since 1. 7. 2009 to 30. 6. 2010 and revealing information about rut course and intensity of observed breeding cows. The results that were concluded from recorded and processed data characterize the influence of various factors on fertility.

Introdução: A percepção do paciente sobre a relação com seu psicoterapeuta é determinante para a sua permanência em tratamento e para o sucesso da psicoterapia. Entretanto, pouco se tem investigado sobre quais fatores disponíveis na fase de avaliação para uma psicoterapia psicanalítica são indicadores de melhor aliança entre terapeuta e paciente. Objetivo: Investigar se há associação entre fatores sociodemográficos e clínicos e a aliança terapêutica, na percepção do paciente. Método: Trata-se de um estudo transversal que avaliou a qualidade da aliança terapêutica em pacientes adultos atendidos em psicoterapia psicanalítica em um ambulatório de saúde mental em Porto Alegre, Rio Grande do Sul, Brasil. A amostra foi constituída por 118 pacientes que chegaram até a quarta ou quinta sessão de psicoterapia psicanalítica e foram avaliados pela escala Calpas – P. Resultados: O estudo mostrou que pacientes do sexo masculino tiverem média (6.44) significativamente menor (p=0.036) a das mulheres (6.66) na escala de avaliação e percepção do trabalho do terapeuta. Encontrou também que quanto maior a intensidade dos sintomas de psicoticismo menor a percepção de aliança na escala de comprometimento com o processo de psicoterapia (r=0.231, p=0.05). Conclusões: Os resultados mostraram que, no início da psicoterapia, gênero e severidade dos sintomas interferem na percepção da aliança terapêutica. Identificou-se que os pacientes homens percebem, em media, menor aliança na dimensão que se refere à compreensão e ao envolvimento do psicoterapeuta, independente do sexo deste. Isso indica, possivelmente, que homens tendem a considerar seus terapeutas com menor capacidade de entender seu ponto de vista e sofrimento, demonstrar aceitação sem julgamentos, dirigir-se ao ponto central de dificuldade, intervir com tato e no tempo certo, e mostrar real compromisso em ajudar e vencer os problemas. Pacientes com sintomas de psicoticismo mais severos apresentaram menor aliança na dimensão que avalia esforço do paciente em empreender uma mudança, boa vontade em fazer sacrifícios em relação ao tempo e ao dinheiro; visão da terapia como uma experiência importante; confiança na terapia e no terapeuta; participação na terapia, apesar de momentos de sofrimento; e compromisso de completar o processo terapêutico. Devido à complexidade do conceito de aliança terapêutica, mais pesquisas são necessárias, a fim de reforçar e demonstrar a influência de variáveis objetivas em seu desenvolvimento (fatores do paciente, do terapeuta e da interação da dupla). Os achados agregam importância à preparação técnica dos terapeutas, para poderem desenvolver melhores alianças com esse tipo de paciente, propiciando maior aderência ao tratamento. / Introduction: The patient's perception of the relationship with their therapist is determinant for their treatment adherence and for the success of psychotherapy. However, little has been investigated about which factors available at the evaluation stage for psychoanalytic psychotherapy are indicators of a better alliance between therapist and patient. Objective: To investigate whether there is an association between sociodemographic and clinical factors and the therapeutic alliance in the patient's perception. Method: This work consists of a crosssectional study that evaluated the quality of the therapeutic alliance in adult patients receiving psychoanalytic psychotherapy in a mental health outpatient clinic in Porto Alegre, state of Rio Grande do Sul, Brazil. The sample was made up of 118 patients who had at least four or five sessions of psychoanalytic psychotherapy and were evaluated using the Calpas – P scale. Results: The study showed that male patients have average (6.44) significantly lower (p=0.036) than women (6.66) in the scale of evaluation scale and perception of the therapist‟s work. He also find that the intensity of the symptoms of psychoticism present lesser alliance in the scale of commitment with the psychotherapy process (r=0.231, p=0.05). Conclusions: The results showed that, at beginning of psychotherapy, gender and severity of the patient‟s symptoms interfere with the perception of therapeutic alliance. It was identified that male patient‟s are, on average, worse at perceiving the alliance in the dimension that refers to therapist understanding and involvement regardless of gender this. This indicate, perhaps, that men tend to consider their therapists with less capacity to understand their point of view and suffering, show acceptance without judgment, address the key point of difficulty, intervene tactfully and timely and show commitment to helping and overcome the problems. Patients with more severe symptoms of psychoticism had lower alliance in the dimension that assess patient‟s effort in undertaking change, willingness to make sacrifices regarding time and money; having a vision of therapy as an important experience; confidence in therapy and in the therapist; engagement in therapy, despite moments of suffering; commitment to completing the therapeutic process. The alliance is a complex concept. This is why more research is necessary in order to reinforce and show the influence of objective variables on its development. Factors related to patient, therapist, and the interaction of the duo are worthy of attention. The findings add to the importance of therapists' technical preparation, so as to enable them to develop better alliances with this type of patient, thus allowing for a better adherence to treatment.

Introdução: A percepção do paciente sobre a relação com seu psicoterapeuta é determinante para a sua permanência em tratamento e para o sucesso da psicoterapia. Entretanto, pouco se tem investigado sobre quais fatores disponíveis na fase de avaliação para uma psicoterapia psicanalítica são indicadores de melhor aliança entre terapeuta e paciente. Objetivo: Investigar se há associação entre fatores sociodemográficos e clínicos e a aliança terapêutica, na percepção do paciente. Método: Trata-se de um estudo transversal que avaliou a qualidade da aliança terapêutica em pacientes adultos atendidos em psicoterapia psicanalítica em um ambulatório de saúde mental em Porto Alegre, Rio Grande do Sul, Brasil. A amostra foi constituída por 118 pacientes que chegaram até a quarta ou quinta sessão de psicoterapia psicanalítica e foram avaliados pela escala Calpas – P. Resultados: O estudo mostrou que pacientes do sexo masculino tiverem média (6.44) significativamente menor (p=0.036) a das mulheres (6.66) na escala de avaliação e percepção do trabalho do terapeuta. Encontrou também que quanto maior a intensidade dos sintomas de psicoticismo menor a percepção de aliança na escala de comprometimento com o processo de psicoterapia (r=0.231, p=0.05). Conclusões: Os resultados mostraram que, no início da psicoterapia, gênero e severidade dos sintomas interferem na percepção da aliança terapêutica. Identificou-se que os pacientes homens percebem, em media, menor aliança na dimensão que se refere à compreensão e ao envolvimento do psicoterapeuta, independente do sexo deste. Isso indica, possivelmente, que homens tendem a considerar seus terapeutas com menor capacidade de entender seu ponto de vista e sofrimento, demonstrar aceitação sem julgamentos, dirigir-se ao ponto central de dificuldade, intervir com tato e no tempo certo, e mostrar real compromisso em ajudar e vencer os problemas. Pacientes com sintomas de psicoticismo mais severos apresentaram menor aliança na dimensão que avalia esforço do paciente em empreender uma mudança, boa vontade em fazer sacrifícios em relação ao tempo e ao dinheiro; visão da terapia como uma experiência importante; confiança na terapia e no terapeuta; participação na terapia, apesar de momentos de sofrimento; e compromisso de completar o processo terapêutico. Devido à complexidade do conceito de aliança terapêutica, mais pesquisas são necessárias, a fim de reforçar e demonstrar a influência de variáveis objetivas em seu desenvolvimento (fatores do paciente, do terapeuta e da interação da dupla). Os achados agregam importância à preparação técnica dos terapeutas, para poderem desenvolver melhores alianças com esse tipo de paciente, propiciando maior aderência ao tratamento. / Introduction: The patient's perception of the relationship with their therapist is determinant for their treatment adherence and for the success of psychotherapy. However, little has been investigated about which factors available at the evaluation stage for psychoanalytic psychotherapy are indicators of a better alliance between therapist and patient. Objective: To investigate whether there is an association between sociodemographic and clinical factors and the therapeutic alliance in the patient's perception. Method: This work consists of a crosssectional study that evaluated the quality of the therapeutic alliance in adult patients receiving psychoanalytic psychotherapy in a mental health outpatient clinic in Porto Alegre, state of Rio Grande do Sul, Brazil. The sample was made up of 118 patients who had at least four or five sessions of psychoanalytic psychotherapy and were evaluated using the Calpas – P scale. Results: The study showed that male patients have average (6.44) significantly lower (p=0.036) than women (6.66) in the scale of evaluation scale and perception of the therapist‟s work. He also find that the intensity of the symptoms of psychoticism present lesser alliance in the scale of commitment with the psychotherapy process (r=0.231, p=0.05). Conclusions: The results showed that, at beginning of psychotherapy, gender and severity of the patient‟s symptoms interfere with the perception of therapeutic alliance. It was identified that male patient‟s are, on average, worse at perceiving the alliance in the dimension that refers to therapist understanding and involvement regardless of gender this. This indicate, perhaps, that men tend to consider their therapists with less capacity to understand their point of view and suffering, show acceptance without judgment, address the key point of difficulty, intervene tactfully and timely and show commitment to helping and overcome the problems. Patients with more severe symptoms of psychoticism had lower alliance in the dimension that assess patient‟s effort in undertaking change, willingness to make sacrifices regarding time and money; having a vision of therapy as an important experience; confidence in therapy and in the therapist; engagement in therapy, despite moments of suffering; commitment to completing the therapeutic process. The alliance is a complex concept. This is why more research is necessary in order to reinforce and show the influence of objective variables on its development. Factors related to patient, therapist, and the interaction of the duo are worthy of attention. The findings add to the importance of therapists' technical preparation, so as to enable them to develop better alliances with this type of patient, thus allowing for a better adherence to treatment.

O presente estudo aborda a função dos sintomas das doenças inflamatórias intestinais (DII) para o sujeito do ponto de vista do referencial psicanalítico. Partimos da solicitação de intervenção junto a portadores de DII, feita pela equipe médica, que havia observado uma dependência psíquica extremada entre paciente e cuidador (em sua maior parte, mães), que parecia colaborar na manutenção das manifestações clínicas da doença, dificultando a condução do tratamento médico. Consideramos o referencial teórico psicanalítico apropriado para darmos encaminhamento à nossa questão, tendo em vista que a matriz freudiana e as contribuições de Lacan nos levam além da constatação de um ganho secundário relacionado ao adoecimento, ao pensarmos o sintoma como modo de gozo, implicando o efeito da palavra no real do corpo. Analisamos três casos de pacientes com doenças inflamatórias intestinais (DII), sendo um caso com retocolite ulcerativa e os demais com doença de Crohn, com objetivo de discutir as formas pelas quais o sintoma orgânico pode fazer o enlaçamento do sujeito com seu corpo e com o Outro. No primeiro caso, pudemos ver que os sintomas da retocolite faziam suplência, servindo como o significante que faltou para interpretar o desejo materno, único recurso da paciente para enlaçar-se ao Outro. No segundo caso, a função dos sintomas da doença de Crohn foi revelar a relação sintomática do casal parental e encobrir o que estava em jogo para à sujeito na assunção da sexualidade. No terceiro caso, os sintomas físicos encobrem a ausência de um saber acerca do sexo e da feminilidade. A concepção de corpo libidinal permite considerarmos as manifestações somáticas como algo próprio do sujeito. O sintoma, como modo de gozo, é a própria junção do significante com o corpo do ser vivo que fala, podendo ser chamado de acontecimento de corpo. Entendemos que o sintoma decorre da forma como o sujeito interpretou seu lugar no desejo do Outro, e, reciprocamente, como o discurso do Outro afetou seu corpo, produzindo gozo. Concluímos que, o sintoma somático está intimamente ligado à posição que o sujeito assume em relação ao desejo do Outro, o que determinará as vicissitudes de seu adoecimento. O caráter crônico de certas doenças é um fator a dar fixidez a esse modo de existir e de se relacionar com o Outro. Pela perspectiva psicanalítica, as DII, bem como qualquer outra doença crônica, são tidas como acontecimentos de corpo, independentemente de presumíveis fatores emocionais aventados em sua patogenia. Entender o adoecimento crônico dessa forma permite abordá-lo pela palavra, mobilizando o gozo específico de cada um para produzir mudanças subjetivas. Tais deslocamentos possibilitam ao sujeito inscrever seu mal-estar fora da esfera do adoecimento físico. / The current study was aimed at assessing the function of the manifestations of inflammatory bowel diseases (IBD) to the subject, from a psychoanalytical perspective. The medical staff of our institution has observed a deep psychological dependency between the patient and the one who takes care of him, the mother in most of the times, which required the intervention of the Psychology Division. According to those observations, the dependency seemed to contribute to the maintenance of the symptoms and to hamper medical therapy. To our knowledge, the psychoanalytical theory was appropriate to this investigation, since the contributions of Freud and Lacan strengthen the notion of secondary gain derived from an illness, consider symptom as a way of jouissance and implicate the effect of the speech in the body. Three patients with IBD were analyzed in the current investigation (one patient had ulcerative proctocolitis and two had Crohn disease).Our aim was to assess the function of the disease in the life of each patient. In the first case, we could observe the suppletive function of symptoms of IBD, which played the role of the missing signifier for the interpretation of the mother desire, representing the last resource of the patient in order to articulate with the Other. In the second case, the function of Crohn disease symptoms was to disclose the symptomatic relationship of the parental couple and to cover interplaying factors of the sexuality of the subject. In the third case, physical symptoms had hidden the unawareness about sex and femininity. According to the concept of libidinal body, somatic manifestations of a disease are something related to one\'s own subject. The symptom, understood as a way of jouissance, is the association of the signifier with the body of the human being that talks, and may be denominated events in the body. We are aware that the symptom is a consequence of the way the subject has interpreted his own place in the desire of the Other and, reciprocally, as the speech of the Other has affected his body to produce jouissance. In summary, somatic symptoms are c1osely related to the position of the subject regarding the desire of the Other and this is an important determinant of the characteristics of the sickness process. In this regard, the chronic course of some diseases is a factor that may contribute to the strong attachment of one\'s subjective position to the Other. By the psychoanalytical point of view, the IBD and any other chronic disease are events in the body, regardless of presumed emotional factors involved in their pathogenesis. Such understanding of the chronic sickness process gives grounds for a therapeutic approach by the speech, mobilizing the specific jouissance to produce changes in the subjective position of the analysand. Those changes will displace the ill-being to outside the field of physical sickness.