Orientador: Raul Aragão Martins / Resumo: O consumo abusivo de álcool é considerado um problema de saúde pública, sendo a terceira causa de absenteísmo no trabalho e a oitava causa para a concessão de auxílio-doença pela Previdência Social no Brasil. A performance do trabalhador e o ambiente de trabalho são afetados pelas consequências do uso abusivo do álcool, causando queda de produtividade e qualidade no trabalho, bem como ausências no período de sua jornada; mudanças de hábitos pessoais, relacionamento ruim com os colegas, acidentes de trabalho, entre outras vulnerabilidades. Esta pesquisa teve por objetivo identificar o padrão de uso do álcool em trabalhadores e posteriormente realizar uma aplicação de Intervenção Breve (IB) nos que apresentarem padrão de beber excessivo, visando o retorno à abstinência ou pelo menos à moderação. A pesquisa foi exploratória, descritiva e quase-experimental, realizada em quatro etapas: levantamento inicial, entrevista, intervenção breve e seguimento. Na primeira etapa, participaram 230 trabalhadores e foi utilizado na coleta de dados o questionário autoaplicado composto de dados sociodemográficos e o Alcohol Use Disorders Identification (AUDIT). Atingiram a pontuação de oito ou mais no AUDIT 34% dos trabalhadores e foram classificados como positivos, pois apresentaram uso de risco ou nocivo ou dependente do álcool. Quanto aos 71 trabalhadores classificados como positivos, na segunda etapa, foram investigadas informações do seu padrão do beber através do Perfil Breve Bebedor (PBB)... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Alcohol abusive is considered a public health problem, being the third cause of absenteeism in the workplace and the eighth cause of disability benefits granted by Social Security in Brazil. The worker performance and the work environment are affected by the consequences of alcohol abuse, causing a decrease in productivity, decline in quality of work, absences from work, changes in personal habits, bad working relationship, work accident, among other vulnerabilities. The objective of this research was to identify the pattern of alcohol consumption in workers and then apply the Brief Intervention (BI) in those who presented a pattern of excessive drinking, aiming withdrawal or at least a decrease in consumption. This research was exploratory, descriptive, quasi-experimental, and carried out in 4 stages: initial screening, interview, Brief Intervention (BI), and follow-up sessions. Two hundred and thirty workers took part in the first stage and the data collection was obtained by selfreport questionnaires, with sociodemographic data, and the Alcohol Use Disorders Identification (AUDIT). Thirty four percent of workers reached an AUDIT score of eight or higher and were classified as positive, as they were either at risk or under harmful use or dependent on alcohol. As for the 71 workers classified as positive in the second stage, information on their drinking pattern was investigated through the Brief Drinker Profile (BDP) modified and applied to the Alcohol Dependence Scale - AD... (Complete abstract click electronic access below) / Doutor

[pt] Pacientes com lesões encefálicas adquiridas (LEA) apresentam prejuízos neuropsicológicos e funcionais. O presente estudo teve como objetivo identificar o perfil neuropsicológico destes pacientes atendidos em um serviço de neurocirurgia de um hospital público do Rio de Janeiro, avaliando as evidências de validade clínica da Bateria Breve de Rastreio Cognitivo (BBRC) no comprometimento cognitivo. Método: Participaram do estudo 30 pacientes submetidos a neurocirurgia de crânio e 30 de de coluna atendidos no ambulatório neurocirúrgico. Todos realizaram a BBRC que mostrou que o grupo crânio apresentou um comprometimento do funcionamento cognitivo global (MEEM- 35), memória incidental e imediata e no desenho do relógio. O resultado inicial mostrou prejuízo em alguns domínios das funções executivas, tais como memória operacional, estratégias de memória episódica e planejamento. A pesquisa sugere que a BBRC pode ser utilizada no contexto hospitalar para pacientes com LEA pós cirúrgicos. / [en] Patients with Acquired Brain Injury (ABI) have neuropsychological and functional injuries. The present study aimed to identify the neuropsychological profile of these patients treated at a neurosurgical service of a public hospital in Rio de Janeiro, evaluating the evidence of clinical validity of the Battery Cognitive Screening brief (BCSB) in cognitive injuries. Method: Thirty patients who was submitted to brain s neurosurgery and 30 spinal s neurosurgeries attended at clinic participated in the study. All underwent the BCSB, which showed that the search group had impairment in global cognitive functioning (MMSE-35), memory and in clock drawing test. The initial result showed injuries in the domains of executive functions, such as working memory, episodic memory strategies and planning. Research suggests that BBRC can be used in the hospital setting for post-surgical ABI patients.

Title: Vladimir Nabokov’s Russian short stories (1921-1942): The game between real and supernatural in short fiction. (Italian title: I racconti in lingua russa di Vladimir Nabokov (1921-1942): il gioco tra reale e soprannaturale nella forma breve). In this Ph.D. research project, I examined several short stories written by Vladimir Nabokov (1899-1977). I focused my attention on the relationship between the real and the supernatural and examined how such a relationship evolved over the years. My research aims to highlight how Nabokov introduced innovations in the European literary tradition with his supernatural short fiction. The core of Nabokov’s first short stories is a binary opposition between something that can be described as real (or realistic), and something that belongs to the realm of the fantastic. The dynamic tension between the real and the supernatural allows Nabokov to renew the European and Russian tradition of “novellas” and supernatural tales. Gradually, Nabokov phased out the fantastic elements and focused on the inner life of the characters that he unveiled through a series of epiphanic moments. The evolution of Nabokov’s short fiction reflects the crisis of the artistic representation experienced by the European intellectuals at the beginning of the 20th century. Nabokov experimented with different kinds of narratives forms to examine the condition of the Russian immigrants and how they relied on imagination and memory to deal with the pain of exile. In this regard, he underscores that only the act of remembering can give new life to the lost past thus conferring dignity to the troublesome present life. The first chapter starts with an overview of numerous studies on short fiction to determine what a “short story” actually is. I then examine the definition of “real” and “supernatural” as well as the most significant scholars’ interpretations of Nabokov’s short stories. Subsequently, I investigate the social, cultural, and historical background of Nabokov’s stories. Finally, I present a chronological list of the stories examined in the thesis. In the second chapter, I carry out the analysis of the short stories I selected for my research. Most of the stories are characterized by the presence of fantastic and supernatural elements. I divided the stories into five different sections, each dedicated to a specific type of supernatural. In this chapter, I examine the different interpretations that have been offered by Nabokov scholars and I provide a new understanding of the evolution of Nabokov’s narrative. In the third chapter, I analyze the relationship among the different short stories to draw a hermeneutic map of the transformations of the narrative core and the themes of the stories. In the conclusion, I outline the main insights of my research.

[ES] El propósito de esta investigación es dar a conocer e intentar comprender la función de la intertextualidad en la obra literaria del autor mexicano Juan José Arreola (1918- 2001). Su estilo ecléctico, marcado por la prosa poética, la brevedad y la ironía, comparte un claro denominador común: la continua referencia a otros textos. A través de múltiples referencias a otras obras, Arreola nos invita en sus cuentos a un nuevo modo de lectura basado en un escritura que define una voz única y original, construida, paradójicamente, a través de otras voces. Esta tesis presenta un acercamiento teórico al concepto de la intertextualidad literaria, su conexión con la narrativa breve posmoderna y por qué es un recurso fundamental en la literatura hispanoamericana del siglo XX y, especialmente, en la mexicana. Asimismo, se plantea un análisis detallado de la última edición de su obra Bestiario que incluye una propuesta metodológica de lectura, en busca de referencias a otros textos, cómo se relacionan, cómo se utilizan y con qué intenciones. La obra de Arreola debe ser leída desde la intertextualidad, ya que se construye a través de ella, en una suerte diálogo permanente con la propia literatura. Esta técnica de escritura, tan característica en la narrativa breve de un autor de tan difícil catalogación como Juan José Arreola, hace imprescindible tanto una lectura intertextual como, sobre todo, la participación de la comunidad lectora, que será la que conecte el entramado de referencias y complete su significado, en un adelanto de las estéticas del pensamiento posmoderno literario del siglo XX. / [CA] El propòsit d'aquesta investigació és donar a conèixer i intentar comprendre la funció de la intertextualitat en l'obra literària de l'autor mexicà Juan José Arreola (1918- 2001). El seu estil eclèctic, marcat per la prosa poètica, la brevetat i la ironia, comparteix un clar denominador comú: la contínua referència a altres textos. A través de múltiples referències a altres obres, Arreola ens convida en els seus contes a una nova manera de lectura basat en un escriptura que defineix una veu única i original, construïda, paradoxalment, a través d'altres veus. Aquesta tesi presenta un acostament teòric al concepte de la intertextualitat literària, a la seua connexió amb la narrativa breu postmoderna i als motius pels quals és recurs fonamental en la literatura hispanoamericana del segle XX i, especialment, en la mexicana. Així mateix, es plantegen una anàlisi detallada de l'última edició de la seua obra Bestiari i una proposta metodològica de lectura, a la recerca de referències a altres textos, com es relacionen, com s'utilitzen i amb quines intencions. L'obra de Arreola ha de ser llegida des de la intertextualitat, a través de la qual es construeix, en una mena de diàleg permanent amb la mateixa literatura. Aquesta tècnica d'escriptura, tan característica en la narrativa breu d'un autor de tan difícil catalogació com Juan José Arreola, fa imprescindible tant la lectura intertextual com, sobretot, la participació de la comunitat lectora, que serà la que connecte l'entramat textual i complete el seu significat, en un avançament de les estètiques de la pensament postmodern literari del segle XX. / [EN] This research aims to present and understand the function of intertextuality in the literary work of the Mexican author Juan José Arreola (1918-2001). His eclectic style, marked by poetic prose, brevity, and irony, shares a clear common denominator: the continuous reference to other texts. Through multiple references to other works, Arreola invites the recipient of his stories to a new way of reading on account to author's unique style and original voice, constructed, paradoxically, through other voices. This dissertation presents a theoretical approach to the concept of literary intertextuality, its connection with the Postmodern short narrative, and explores why it is a fundamental resource of 20th Century Hispanic American literature and, especially, in Mexican literature. Likewise, this work presents a detailed analysis of the latest edition of his work Bestiary and a methodological reading proposal, searching for references to other texts, how they are related, how they are used, and with what intentions. Arreola's work must be read from intertextuality since it is built through it, in a permanent dialogue with literature itself. This writing technique, so characteristic in the short narrative of an author of such difficult cataloging as Juan José Arreola, makes essential intertextual reading and, above all, the readers' participation, which will be the ones that connect the framework of references and complete its meaning, in a preview of the aesthetics of 20th Century literary Postmodern thinking. / López Medel, P. (2021). La intertextualidad como recurso literario en la narrativa breve posmoderna de Juan José Arreola [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/170355

La violencia contra las mujeres es una de las problemáticas sociales con más incidencia en el contexto peruano actual. Debido a que esta suele surgir dentro del ámbito familiar, las investigaciones exponen que el maternaje de las madres que han sido violentadas se ve afectado, pero sus resultados son contradictorios respecto a cuál es el impacto. Por ello, la presente investigación busca comprender las configuraciones relacionales materno-filiales de una mujer víctima de violencia, así como describir las cualidades particulares de las mismas a lo largo del proceso de terapia. Para ello, se llevó a cabo un análisis temático de los episodios relacionales y narrativas relacionales de una mujer violentada con sus hijos, obtenidos de la transcripción literal de los audios del proceso terapéutico. Los hallazgos muestran distintos niveles de violencia que atraviesan las configuraciones materno-filiales de la consultante con sus hijos, los cuales se evidenciaron en la caracterización de las representaciones, deseos y respuestas encontradas. Además, se encontraron configuraciones ambivalentes y contradictorias, lo cual reflejan la propia vivencia de la consultante sobre su maternidad y la dificultad para integrar sus experiencias. Sin embargo, hacia el final de la terapia muestra una mayor integración en sus configuraciones materno-filiales, así como representaciones del self y de su hija como agentes de su propia vida. Así, se puede decir que en el transcurso del proceso habría tenido la oportunidad de reeditar los vínculos consigo misma y con sus hijos, a pesar de no ser el objetivo del mismo. / Intimate partner violence (IPV) is a social topic that is currently relevant in Peruvian society as it is greatly prevalent, being women the main gender affected by it. Due to it often emerging within families, investigations show that mothering of women who have experienced IPV can also be affected, but there are contradictory findings about how it is impacted. For that reason, this study aims to understand the relational configurations between a mother who has experienced IPV and her children, as well to describe the characteristics found in her configurations throughout therapy. To achieve that, we conducted an inductive thematic analysis of the relational episodes and narrations between a mother who has experienced IPV and her children, taken from the literal transcriptions of the audio recordings of the therapy sessions. Findings suggest that there are different levels of violence that are evidenced within the relational configurations with her children, based on the characteristics of the representations, wishes and responses found. Also, the configurations that emerged were ambivalent and contradictory, qualities that reflect how the consultant experiences her own maternity and how difficult it is for her to perceive situations and people in an integrated manner. Nevertheless, towards the end of the therapeutic process she shows greater integration in her relational configurations with her children, as well as representations of self and her daughter centered around the agency in their own lives. Therefore, throughout the process the consultant would have been able to reedit the relationship with herself and her children, even though that was not the focus of the therapy. / Tesis

La presente investigación es un estudio sistemático de caso único de una mujer víctima de violencia en el contexto de pareja en el curso de un proceso de psicoterapia psicoanalítica breve. Se tuvo como objetivo evaluar el cambio de la configuración relacional a partir de los patrones relacionales con la pareja por un lado y de las representaciones de sí misma y de su pareja por otro entre la fase inicial y la fase final del tratamiento. Se desarrollo un esquema que integre ambos aspectos de la configuración relacional para tener comprensión más profunda y dinámica del estado inicial de la consultante, así como de los cambios acontecidos hacia el final del tratamiento. Los resultados encontrados evidencian la utilidad del esquema integrado propuesto para tener un entendimiento más completo y exhaustivo de la configuración relacional de la consultante, brindando una lectura más articulada de su funcionamiento, logrando incorporar elementos intrasubjetivos, intersubjetivos y transubjetivos de la violencia al interior de la relación de pareja. Así mismo, se evidenciaron cambios hacia el final de la intervención en ambos aspectos de la configuración relacional de la consultante con su pareja, así como en el esquema integrado. Alcances y limitaciones de estos resultados son discutidos hacia el final de la investigación. / This research is a single case and systematic study of a woman victim of violence in the context of an intimate relationship during the curse of a brief psychoanalytic psychotherapy process. The aim of this study is to evaluate the change in the relational configuration from the relational patterns with the partner and from her self and partner representations between the initial phase and the final phase of the treatment. A scheme that integrates both aspects of the relational configuration was developed to have a deeper and more dynamic understanding of the initial state of the consultant, as well as the changes that occurred towards the end of the treatment. The results show the usefulness of the integrated scheme proposed to formulate a more complete and comprehensive understanding of the relational configuration of the consultant, providing a more articulated reading of its functioning, managing to incorporate intrasubjective, intersubjective and transubjective elements of violence within her relationship with her partner. Likewise, there were evidence of changes toward the end of the intervention in both aspects of the consultant's relational configuration with her partner, as well as in the integrated scheme. Implications and limitations of these results are discussed towards the end of the investigation. / Tesis

Esta es una investigación de caso único llevada a cabo a partir de un proceso de psicoterapia psicoanalítica breve. Tiene por objetivo principal el análisis del cambio en las configuraciones relacionales entre una mujer violentada y su hija, así como la descripción detallada y la comprensión de las configuraciones en dos momentos distintos: al inicio y al final del proceso terapéutico. Para esta finalidad, se identificó la configuración relacional en ambas fases, utilizando el CCRT Lu S para identificar el patrón relacional central y el D-RS para evaluar las representacionales mentales del self y de la hija. Los resultados mostraron que, en la primera fase, con respecto a las representaciones del self, la paciente se ubicó en un nivel 4 de desarrollo según el D-RS; es decir, con descripciones unitarias y polarizadas, basadas principalmente en características denigratorias. En la segunda fase pasa a un nivel 5; es decir, considera otros aspectos de sí misma, pero estos se mantienen polarizados. En cuanto a la representación de la hija, la estrategia más prevalente se mantuvo en el nivel 3 en ambas fases, implicando un funcionamiento de nivel bajo, que funciona como una extensión de su self, o “reflejo self-otro”. El patrón relacional presentó cambios tanto en los deseos como en las respuestas. En relación a los primeros, al inicio del proceso terapéutico, la consultante desea cumplir con sus responsabilidades; al final, desea estar determinada por la hija. En ambas fases desea apoyar y ser apoyada por la hija, pero al final desea, además, que esta cumpla sus obligaciones y que se acerque al padre. Por último, en ambas fases la consultante reacciona sintiéndose insatisfecha y temerosa. / This is a single case study carried out in a brief psychoanalytic psychotherapy process. Its main objective is the analysis of the change in the relational configurations between a woman victim of violence and her daughter, as well as the detailed description and understanding of the configurations in two different moments: at the beginning and at the end of the therapeutic process. For this purpose, the relational configuration was identified in both phases, using the CCRT Lu S, to identify the central relational pattern and the D-RS to evaluate the mental representations of the self and the daughter. The results showed that in the first phase, with respect to the representations of the self, the patient scored a level 4 of development, with unitary and polarized descriptions, based mainly on denigratory characteristics. In the second phase it goes to a level 5, she can consider other aspects of the self, but they remain polarized. Regarding the representation of the daughter, the most prevalent strategy remained at level 3 in both phases, based on a low level of functioning, as an extension or mirror reflection of the self. The relational pattern presented changes in both the wishes and the responses. In relation to the first, the consultant, at in the first phase, wants to fulfill her responsibilities and in the last phase she wants to be determined by the daughter. In both phases she wants to support and be supported by the daughter, but towards the end she also wants her to fulfill her obligations and to approach the father. Finally, in both phases the client reacts feeling dissatisfied and fearful. / Tesis

El presente estudio sistemático de caso único investiga las formas de relacionamiento y las representaciones de sí misma y de los otros, de una mujer violentada por su pareja tal como aparecen al inicio de un proceso de psicoterapia psicoanalítica breve. Con este fin, se empleó un método mixto novedoso que integra el Core Conflictual Relational Theme (CCRTLU- S) y el Role Relationship Model Configuration (RRMC), y permite codificar e interpretar los relatos de la consultante en los que narra su interacción con otras personas significativas. Se pudo identificar la manera en la que la consultante desearía relacionarse con los demás, la manera que le genera más temor y evita defensivamente, y dos modos defensivos de relacionarse, uno caracterizado por el rechazo y la búsqueda de independencia, y otro por la sumisión y la búsqueda de validación. El método también permite captar la relación dinámica que existe entre estas cuatro formas prevalentes de relacionarse. Los resultados obtenidos con el método parecen ofrecer una mirada más profunda que la del CCRT-LU-S por sí solo y permiten discutir con la literatura relevante de la problemática estudiada, facilitando la articulación de hallazgos de diferentes estudios que emplean otros métodos. / This systematic single-case study investigates the forms of relationships and representations of herself and others, of a woman violated by her partner as they appear at the beginning of a brief psychoanalytic psychotherapy process. To this end, a new mixed method was used that integrates the Core Conflictual Relational Theme (CCRT-LU-S) and the Role Relationship Model Configuration (RRMC). It allows for coding and interpreting the client's narrations of her interaction with significant others. It was possible to identify the way in which the client would wish to relate to others, the way that generates the most fear and avoids defensively, and two other defensive ways of iii relating, one characterized by rejection and the search for independence, and the other by submission and the search for validation. The method also allows to capture the dynamic relationship that exists between these four prevalent ways of relating. The results obtained with this method seem to offer a deeper look than that of the CCRT-LU-S by itself and allows to discuss with the relevant literature that pertains to the subject, facilitating the articulation of findings from different studies that use other methods. / Tesis

O conflito entre a maternidade idealizada e a experienciada pode originar um grande sofrimento psíquico na puérpera. Os sentimentos de perda e de ganho podem resultar em sentimentos de culpa e de inadequação além da dificuldade em integrar realização profissional, vida amorosa e maternidade. De acordo com a literatura, a depressão pós-parto (DPP) no Brasil atinge entre 12 a 29% das puérperas. Segundo a Teoria da Adaptação de Ryad Simon, a DPP é uma crise adaptativa por ser um período em que o equilíbrio psicológico está perturbado por um obstáculo que a pessoa não sabe como superar e que gera grande sofrimento. A puérpera, diante da intensa pressão emocional e das situações imprevistas da maternidade, pode buscar soluções pouco ou pouquíssimo adequadas e, consequentemente, agravar a crise. A DPP pode acarretar problemas no relacionamento do casal e familiar. Na relação mãe-bebê, a puérpera pode reduzir a afetividade e cuidados que são direcionados ao bebê, o que pode causar prejuízos em seu desenvolvimento cognitivo e social, além de comprometimento da saúde física do bebê. O objetivo do estudo foi verificar a aplicação da Psicoterapia Breve Operacionalizada (PBO) em puérperas com sintomas da DPP. Os objetivos específicos foram: compreender os dinamismos inconscientes ; averiguar os efeitos das interpretações teorizadas. Os instrumentos utilizados foram: Entrevistas, Escala Diagnóstica Adaptativa Operacionalizada (EDAO) e Psicoterapia Breve Operacionalizada (PBO). A PBO foi realizada na Clínica Durval Marcondes do Instituto de Psicologia da USP, na cidade de São Paulo. O estudo realizado foi clínico qualitativo e constituiu-se de três puérperas com idades variando entre 19 e 29 anos, que apresentavam sintomas da DPP. Todas tiveram seus partos realizados no Hospital Universitário da Universidade de São Paulo. Duas delas participaram de pesquisa sobre depressão pós-parto neste hospital e foram selecionadas conforme os critérios de inclusão e convidadas para a participação no presente estudo. A terceira participante foi encaminhada por profissional da saúde do Departamento de Obstetrícia do Hospital Universitário da Universidade de São Paulo (HU-USP). O resultado apresentado foi uma melhora na eficácia adaptativa após a PBO em todos os três casos: duas puérperas (A e C) do grupo 4 (adaptação ineficaz severa) passaram para o grupo 2 (adaptação ineficaz leve); uma puérpera (B) do grupo 5 (adaptação ineficaz grave) para o grupo 1 (adaptação eficaz). Na entrevista de retorno a participante A manteve-se no Grupo 2 e a participante B passou do Grupo 1 para o Grupo 3. Não foi possível entrevistar a participante C. Conclui-se que as entrevistas pormenorizadas são importantes para a compreensão psicodinâmica que, por sua vez, foi fundamental para o estabelecimento da situação-problema e para a formulação das interpretações teorizadas. A motivação e a interpretação teorizada auxiliaram as participantes a encontrarem soluções mais adequadas para as suas situações-problema e a superarem a crise adaptativa. A compreensão das interpretações pelas puérperas foi percebida através das descrições dos sonhos e nas buscas de soluções mais adequadas. A PBO mostrou-se eficaz nos três casos com melhoras significativas na classificação pela EDAO e essas melhoras foram mantidas nas entrevistas de retorno. A aplicação da PBO em puérperas com sintomas depressivos é possível e recomendável / The conflict between the idealized motherhood and the lived experience can cause a great psychological distress in postpartum women. The feelings of loss and gain can result in feelings of guilt and inadequacy besides the difficulty in integrating professional fulfillment, love life and motherhood. According to the literature, postpartum depression (PPD) in Brazil affects between 12-29% of postpartum women. According to the Ryad Simon\'s Theory of Adaptation, the PPD is an adaptive crisis (crise adaptativa) because it is a period where the psychological equilibrium is disturbed by an obstacle that the person does not know how to overcome and causes great suffering. The postpartum women that suffer with intense emotional pressure and unforeseen situations of motherhood, may seek solutions little or very little appropriated (soluções pouco ou pouquíssimo adequadas) wich will exacerbate the crisis. The PPD may cause problems to the couple and to the family relationship and to the mother and baby relationship. The woman with PPD\'s symptons can reduce the affection and care to the baby, which can cause damage to their cognitive and social development and impaired baby´s physical health. The aim of the study was to verify the application of Operationalized Brief Psychotherapy (OBP) among women with PPDs symptoms. The specific objectives were: to understand the unconscious dynamics and to investigate the effects of theorized interpretations.. The instruments used were: Interviews, Operationalized Adaptive Diagnostic Scale (OADS) (Escala Diagnóstica Adaptativa Operacionalizada - EDAO) and Operationalized Brief Psychotherapy (OBP). The OBP was performed at the Durval Marcondes Clinic, at the Institute of Psychology of the USP, in São Paulo. This study case was clinical qualitative and consisted of three postpartum women aged between 19-29 years who had symptoms of PPD. They all gave birth at the University Hospital of the University of São Paulo. Two of them took part in a research on postpartum depression in this hospital and were invited to the present study. Health professional of Obstetrics Department, University Hospital-São Paulo University (HU-USP), sent the third participant. The result presented was an improvement in adaptive efficacy (eficácia adaptativa) after OBP in all three cases: two women (A and C) group 4 (severe ineffective adaptation) (adaptação ineficaz severa) passed to group 2 (mild ineffective adaptation) (adaptação ineficaz leve); one postpartum (B) of group 5 (grave ineffective adaptation) (adaptação ineficaz grave) to group 1 (effective adaptation) (adaptação eficaz). In the interview the participant\'s return remained in Group 2 and participant B went from Group 1 to Group 3. It was not possible to interview the participant C. It was concluded that the detailed interviews are important to psychodynamic understanding that, in turn, was instrumental in the establishment of the problem-situation (situação-problema) and the formulation of theorized interpretations. The motivation and the interpretations helped the participants to find appropriate solutions to their problem-situations and overcome the adjustment crisis. The understanding the interpretations by the women was perceived through the descriptions of their dreams and in the search of more appropriate solutions. The OBP was effective in all three cases with significant improvements in classification by OADS and these improvements were maintained in return interviews. The application of OBP in mothers with depressive symptoms is possible and recommended

O Ministério da Saúde adverte que o Diabetes Mellitus é um problema de saúde pública devido sua alta taxa de prevalência. Estudos demonstram a correlação entre o funcionamento psicodinâmico de pacientes com diabetes mellitus tipo 1 e o controle glicêmico. Considerando que o controle glicêmico adequado minimiza os riscos para a mãe, o feto e o futuro bebê, salienta-se a importância de um atendimento psicoterápico na fase gestacional. Contudo, não existem pesquisas sobre Psicoterapia Breve Operacionalizada (PBO) enquanto técnica terapêutica para este tipo de população. O objetivo da pesquisa foi investigar possibilidades e limites da PBO no atendimento a gestantes portadoras de diabetes mellitus tipo 1 (DM1) com mau controle glicêmico. A metodologia utilizada para a pesquisa foi o clinico-qualitativo. O estudo envolveu quatro gestantes portadoras de DM1 com mau controle glicêmico. As gestantes foram encaminhadas pela Clínica Obstétrica do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, local onde as mesmas são atendidas. Foram utilizados como instrumentos: entrevista clínica psicológica; Escala Diagnóstica Adaptativa Operacionalizada; e Psicoterapia Breve Operacionalizada. As gestantes que concordaram em participar assinaram o Termo de Consentimento Livre e Esclarecido que após lido e explicado, foi assinado pela pesquisadora e gestante. Foram realizadas duas ou três entrevistas inicias para o diagnóstico adaptativo operacionalizado e planejamento da PBO. O número de sessões utilizadas para PBO foi definido conforme o diagnóstico adaptativo da gestante e sua situação-problema. As entrevistas e as sessões psicoterápicas tiveram duração de 45 minutos e frequência de uma vez por semana. A análise dos resultados foi realizada através da comparação entre o diagnóstico adaptativo operacionalizado realizado antes e depois da PBO. Foi verificado se ocorreu nas gestantes, durante estes períodos, mudanças adaptativas; além da averiguação das alterações no controle glicêmico, antes e após a PBO. A pesquisa expôs que houve mudanças de grupo adaptativo da qual as gestantes pertenciam. Cecília e Beatriz obtiveram melhora no diagnóstico adaptativo. Por intermédio do acompanhamento da evolução do controle glicêmico, pode-se verificar alterações com o decorrer da PBO: a porcentagem de hipoglicemias e hipoglicemias graves melhoraram; as porcentagens de valores alterados e de hiperglicemias, por sua vez, tiveram piora com o decorrer da gravidez, e, mesmo com a PBO, o rigoroso controle alimentar e insulinoterapia, inclusive em internações, foram dificilmente controlados. Das quatro gestantes estudadas duas tiveram crise adaptativa e as soluções encontradas por elas foram satisfatórias. O que pode restringir o processo psicoterapêutico é a transferência negativa persistente, contudo, ela pode ser trabalhada e minimizada. As possibilidades da PBO no atendimento às gestantes com DM1 encontradas na pesquisa foram: melhorar a eficácia da adaptação; auxiliar as pacientes em crise a solucionarem-na sem a queda da eficácia da adaptação; e, possibilitar as pacientes encontrarem soluções mais adequadas para suas situações-problema / The health ministry adverts that Diabetes Mellitus is a public health concern due to its high prevalence rate. Studies demonstrate the existing relation between the psychodynamic functioning of patients with type 1 diabetes mellitus and the glycemic control. Considering that the adequate glycemic control minimizes risks for the mother, fetus and the future baby, it reinforces the importance of psychotherapeutic treatment during the pregnancy. However, there arent any researches on Operationalized Brief Psychotherapy (OBP) as a therapeutic technique for this kind of population. The aim of the research was to investigate the possibilities and the limits of OBP in the treating of pregnant women with type 1 diabetes mellitus with deficient glycemic control. The methodology used for the research was the clinical-qualitative method. The study involved four pregnant women with DM1 with deficient glycemic control. The women were appointed by the Obstetric Clinic of the Hospital das Clínicas da Faculdade de Medicina from the University of São Paulo, place where they were already being treated. The instruments employed were Psychological Interviews, the Operationalized Adaptive Diagnosis Scale and Operationalized Brief Psychotherapy. The women who agreed to take part in the research signed a consent form that, after read and explained, was then signed by the research agent and the subjects. Two or three initial interviews took place for the Operationalized Adaptive Diagnosis and the planning of the. The number of sessions employed for the OPB was defined in accordance to the adaptive diagnosis of the subject and their problem-situation. The interviews and the psychotherapeutic sessions lasted 45 minutes with the frequency of once a week. The analysis of the results was made through the comparison between the operationalized adaptive diagnosis done before and after the OPB. During these periods, it was verified if there were any adaptive changes in the subjects and, moreover, the analysis of any alterations in the glycemic control before and after the OPB. The research showed that there were changes in the adaptive group to which the subjects belonged. Cecília and Beatriz had an improvement in the adaptive diagnosis. Through the analysis of the evolution of the glycemic control, it was possible to verify alterations during the OPB: the percentage of both hypoglycemia and severe hypoglycemia showed improvement; however, the percentage of altered rates and of hyperglycemia showed a downturn throughout the pregnancy and, even with the OPB, a strict diet control and insulin therapy, including during admissions, were hardly controlled. From the four pregnant women in the study, two of them had an adaptive crisis and the solution found by them was satisfactory. What can restrict the therapeutic process is the persisting negative transference, however, it can be minimized. The possibilities of the OPB in the treatment of pregnant women with DM1 found with the research were: improving the efficiency of the adaptation, assisting patients in crisis to resolve them without losses in adaptation efficiency and, make patients more able to find more adequate solutions to their problem-situations