Multimedia installation combining photography, music and noises, representing the story of the killer and the victim, from their meeting up to death in five main parts.

Depression is a major public health problem. Decades of research have been conducted to create a classification system aligned with the complex phenomenological features of depression. The dominant classification system for depression is the latent paradigm, which conceptualizes observable symptoms of depression as effects of an underlying disorder. There is increasing evidence, however, that the latent model is inadequate to inform the prognosis and treatment of depression. Specifically, evidence is accumulating that symptoms of depression do not necessarily arise due to an underlying condition, but that symptoms occur as a network in which each one is causally related to a previous symptom. This dissertation critically evaluated the underlying assumptions of this “network paradigm,” one of the frameworks which had been proposed as an alternative to the traditional latent paradigm, as an appropriate model for studying depression. The first chapter systematically evaluated empirical depression network studies regarding whether the study design included an examination of the paradigm’s assumptions. In the second chapter, I investigated the relationships among depressive symptoms and determined whether causal relationships among depressive symptoms, a key assumption underlying this paradigm, could be a plausible explanation. The last chapter investigated a central controversy within the network literature regarding consistent findings and measurement error. The first chapter found that the majority of depression network studies published in the literature were not capable of providing empirical support of symptom causal relationships and often neglected to investigate the impact of measurement error. The second chapter estimated a significant relationship between two depressive symptoms - sadness and anhedonia, using an inverse probability treatment-weighted regression estimation approach in the context of longitudinal data. Causal relationships among symptoms, a key assumption underlying the network paradigm, may be a plausible explanation for the depressive symptom relationships. The third chapter found that statistical network models are not robust to measurement error through a series of simulation studies. Measurement error remained a general threat against the network paradigm, and existing network findings should be interpreted with caution. Overall, the network paradigm may be appropriate for study depression, but existing findings should be interpreted with caution. There is a need to explore the fundamental assumptions of paradigms prior to widespread application.

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Perhaps the most important single finding in the field of emotional aging has been that the overall quality of affective experience steadily improves during adulthood and can be maintained into old age. Recent lifespan developmental theories have provided motivation- and experience-based explanations for this phenomenon. These theories suggest that, as individuals grow older, they become increasingly motivated and able to regulate their emotions, which could result in reduced negativity and enhanced positivity. The objective of this paper is to expand existing theories and empirical research on emotional aging by presenting a discrete emotions perspective. To illustrate the usefulness of this approach, we focus on a discussion of the literature examining age differences in anger and sadness. These two negative emotions have typically been subsumed under the singular concept of negative affect. From a discrete emotions perspective, however, they are highly distinct and show multidirectional age differences. We propose that such contrasting age differences in specific negative emotions have important implications for our understanding of long-term patterns of affective well-being across the adult lifespan.

The study investigated how distinctions in perception might affect emotional responding to a change in an affordance. There is evidence that Europeans tend to perceive salient objects in the foreground, while East Asians tend to perceive holistically. Due to sensitivity to focal objects, European Americans (EA) were hypothesized to respond negatively with increased HR variance on perceiving loss of connection when playing Cyberball. EA would also feel sadness more intensely, in terms of decreased heart rate and increased RSA, at an earlier time during a sad clip. Chinese Americans (CA) were predicted to show no difference in affect from controls. ECG, fEMG, respiration and self-report data were acquired from 51 subjects (38 EA, 13 CA, 25 male, mean age 21.1) in a between-subjects design. 26 subjects (19 EA, 6 CA) received 2 out of 48 balls tossed and the controls received 10. 88% in the experimental condition reported a negative emotion (e.g. anger). Control subjects reported mainly neutral affect. ANOVA analyses revealed HR variance had an interaction effect (time x condition, p=0.009) and RSA had a main effect (condition, p=0.033). Both experimental groups had increased heart rate variance and increased RSA. Facial coding revealed EA expressed more negative emotion. CA in the experimental condition showed correlation across measures: HR variance, RSA and respiration, suggesting automatic regulation to perceiving loss contained its expression. Most subjects reported feeling sad during the clip. fEMG of the corrugator muscle revealed EA activated higher peak intensity 5.5 seconds earlier than CA (increased 1.571 vs 0.844). EA also had decreased HR and increased RSA, a sign of withdrawal in sadness, earlier. Evidence suggests exposure to loss had stronger effect on EA to increase their arousal and sensitivity thereafter. / M.S. / The study investigated how differences in perceiving a change in social connection might affect emotional responses. There is evidence that Europeans tend to perceive salient objects in the foreground, while East Asians tend to perceive holistically. Due to sensitivity to focal objects, European Americans (EA) were hypothesized to respond negatively with increased heart rate variance on perceiving loss of connection when playing Cyberball, a ball-tossing video game. EA would also feel sadness more intensely, in terms of decreased heart rate and increased vagal activation, at an earlier time during a sad clip. Chinese Americans (CA) were predicted to show no difference in affect from controls. ECG, fEMG, respiration and self-report data were acquired from 51 subjects (38 EA, 13 CA, 25 male, mean age 21.1) in a between-subjects design. 26 subjects (19 EA, 6 CA) received 2 out of 48 balls tossed and the controls received 10. 88% in the experimental condition reported a negative emotion (e.g. anger). Control subjects reported mainly neutral affect. Unexpectedly, both experimental groups had increased heart rate variance. CA in the experimental condition showed correlation across physiological measures: heart rate variance, vagal activation and respiration, suggesting automatic regulation to perceiving loss during Cyberball. These correlations were not observed in the EA, but as predicted, EA in the experimental condition had decreased heart rate and increased vagal activation, a sign of withdrawal in sadness, earlier during a sad clip. Evidence suggests exposure to loss had stronger effect on EA to increase their arousal and sensitivity thereafter.

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Research suggests that depressive symptoms and financial stress are both associated with increased levels of cigarette smoking, yet not every individual who experiences depressive symptoms or financial stress smokes. The primary purpose of this study was to examine whether positive and negative religious coping moderated the influence of depressive symptoms and financial stress on current (past 30-day) cigarette smoking over and above the contributions of demographic covariates and nonreligious problem- and emotion-focused coping. Participants were drawn from a larger study comprised of a convenience sample of 1,120 post-secondary vocational/technical school students enrolled in programs such as welding, air-conditioning, and vocational nursing at two different two-year public colleges in Texas. These students are training to work in blue-collar occupations, which have higher smoking rates compared to white-collar occupations. Negative binomial regression analysis was used to test the study hypotheses. Depressive symptoms and financial stress increased the likelihood of smoking for female students, whereas financial stress decreased the likelihood of smoking for male students. Positive religious coping decreased the likelihood of smoking for females only. Consistent with religious coping theory and as expected, negative religious coping moderated the depressive symptoms-smoking relationship such that negative religious coping exacerbated the impact of depressive symptoms on cigarette smoking among females. Positive religious coping also moderated the depressive symptoms-cigarette smoking relationship for females. Contrary to expectations, positive religious coping exacerbated the likelihood of cigarette smoking among females with high levels of depressive symptoms. Negative religious coping moderated the financial stress-cigarette smoking relationship such that males who reported low financial stress and high levels of negative religious coping had the highest likelihood of smoking in the past month. For females, religious coping was associated with current cigarette use, but did not moderate the association between financial stress and smoking. Even after controlling for demographic covariates and nonreligious coping, positive and negative religious coping influenced the smoking behaviors of vocational students experiencing depressive symptoms and financial stress, and these outcomes varied by gender. Study limitations, implications, and suggestions for future directions in research are discussed. / text

Sadness in literature has often been thematically interpreted as an indication of literary originality. Notions of solitude, silence, and alienation contribute to the idea that melancholy benefits the introspective work of the artist. But it is also possible to explore sadness as a more complex literary phenomenon, one that expands the dimensions of affect and influences possibilities of aesthetic and ethical renovation that gesture beyond the usual themes of melancholy and solitude. Sadness thus does not come to be conceived as merely an aspect of mourning, but as a structure of loss that is intrinsic to our concept of the world's composition and insufficiencies. The energies that surround the experience of sadness measure the degree to winch many writers have been able to develop their sense of unhappiness into a way of charting the difficulties and transformative power of their own labours. As well, sadness in literature can be seen as illuminating a loss that writers generate in order to achieve through their art the possibility of aesthetic and even social reparation.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2018-04-26T14:33:14Z No. of bitstreams: 1 angelamariacorreagoncalves.pdf: 4370650 bytes, checksum: 24ade33c303eec8b353e06d169ceaa6b (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2018-08-31T12:22:29Z (GMT) No. of bitstreams: 1 angelamariacorreagoncalves.pdf: 4370650 bytes, checksum: 24ade33c303eec8b353e06d169ceaa6b (MD5) / Made available in DSpace on 2018-08-31T12:22:29Z (GMT). No. of bitstreams: 1 angelamariacorreagoncalves.pdf: 4370650 bytes, checksum: 24ade33c303eec8b353e06d169ceaa6b (MD5) Previous issue date: 2018-03-15 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / FAPEMIG - Fundação de Amparo à Pesquisa do Estado de Minas Gerais / Introdução: A depressão clínica é um dos principais problemas de saúde pública na atualidade. No Brasil, segundo o Ministério da Saúde, são mais de 10 milhões de pessoas que sofrem com depressão. A incidência maior da doença se dá entre os 20 e os 40 anos, justamente no auge da vida profissional. As mulheres são as mais vulneráveis ao problema, sendo que o número de casos é o dobro dos homens. Objetivo: Avaliar a prevalência de depressão e os fatores associados em mulheres de 20 a 59 anos de áreas cobertas pela Estratégia de Saúde da Família de município da Zona da Mata Mineira; analisar a experiência de adoecimento de mulheres de 20 a 59 anos atendidas na atenção primária, avaliadas com depressão segundo o PHQ-9. Métodos: Trata-se de um estudo transversal, com mulheres de 20 a 59 anos, cadastradas em duas Unidades de Saúde da Família, que utilizou um questionário contendo variáveis sociodemográficas, apoio social, autoavaliação de estado de saúde, estilo de vida, morbidade e saúde da mulher. O desfecho depressão foi avaliado segundo o PHQ-9, considerando como positivas as mulheres que obtiveram um score ≥ 10 pontos. Para a análise dos fatores associados, foram calculadas as razões de prevalência brutas e ajustadas, por meio de regressão robusta de Poisson. Para a análise da experiência de adoecimento, as mulheres que pontuaram positivamente no PHQ-9 passaram por uma entrevista com médicos psiquiatras que utilizaram como instrumento o CIS-R (Clinical Interview Schedule - Revised), instrumento que tem sido utilizado como padrão de referência em estudos de transtornos mentais comuns. Foram então identificadas mulheres com diagnóstico positivo para depressão e outras em que o afeto de tristeza estava presente, mas que não caracterizavam depressão clinica. Para o conjunto destas mulheres, foi aplicado o questionário McGillIllness Narrative Interview (MINI) e realizada análise de conteúdo deste material. Resultados: Das 1.958 mulheres incluídas nesta análise, 28,5% encontravam-se na faixa etária entre 30 e 39 anos; 15,4% não haviam concluído o ensino elementar; 54,5% não trabalhavam ou nunca trabalharam; e 44,2% declararam não ser da raça branca. A prevalência de depressão encontrada foi de 19,7%, e os fatores associados foram: possuir baixa escolaridade, trabalhar atualmente e ter doença mental prévia. Os fatores associados à ocorrência de depressão na população estudada foram: possuir baixa escolaridade, trabalhar atualmente e ter doença mental prévia. Como fatores de proteção, observaram-se: ser casada ou viver com companheiro, realizar atividades físicas regularmente e relatar autoavaliação positiva de saúde. A análise qualitativa revelou que as mulheres com depressão se tornam descuidadas de seus compromissos devido a um sentimento de incapacidade, prostração, desmotivação, que não lhes permite sair da inércia e assumir a rotina da vida cotidiana. A morte aparece, para algumas, como um alívio e única solução possível para o término do sofrimento. A espiritualidade e a religiosidade contribuíram para amenizar o sofrimento, sendo importantes para a mudança de vida e para a reabilitação. 14 Conclusão: Os resultados revelam que uma assistência específica na atenção primária à saúde deve ser dada às mulheres, especialmente àquelas com baixa escolaridade, que trabalham, apresentam doença mental e não praticam exercícios físicos, a fim de reduzir o sofrimento e promover a saúde. Foi também evidenciado que a falta de sentido na vida torna-se algo aparentemente normal, a ponto de não motivar a procura de ajuda para tratar a doença. Ressalta-se a lacuna na utilização de instrumentos de rastreamento dos casos de depressão na atenção primária. É preciso que os profissionais sejam capacitados para diagnosticar corretamente os transtornos mentais, visando especialmente discriminar depressão e tristeza, evitando a medicalização e a estigmatização. É importante fortalecer a rede assistencial, reconhecendo a necessidade de articular, de forma incisiva, a atenção primária à saúde e as políticas/ações específicas da área da saúde mental. / Introduction: Clinical depression is one of the major public health problems facing our society today. According to the Ministry of Health, there are more than 10 million people suffering from depression in Brazil. Incidence rates were higher among people aged 20 to 40 years old, just at the peak of professional career. Women are the most vulnerable and the number of cases is twice as high as compared to men. Objective: to evaluate the prevalence of depression and associated factors among women aged 20 to 59 years including areas covered by Family Health Strategy at a city in Zona da Mata Mineira; to analyse the illness experience among women aged 20 to 59 assisted in primary care and evaluated with depression according to PHQ-9. Methods: A cross-sectional study with women aged 20 to 59 enrolled in two Family Health Units, using a questionnaire containing sociodemographic variables, social support, self-reported health status, lifestyle, morbidity and women's health. The depression diagnosis was assessed according to the PHQ-9, considering as positive women scoring ≥ 10 points. In order to analyse the associated factors, crude and adjusted prevalence ratios were calculated using robust Poisson regression. To analyze illness experience, women who scored positively on PHQ-9 were interviewed by psychiatrists using the CIS-R (Revised Clinical Interview Schedule), an instrument which has been used as a reference standard in studies of common mental disorders. Women with a positive diagnosis for depression were identified and there were others with symptoms of sadness, but were not diagnosed with clinical depression. For this group of women McGill Illness Narrative Interview questionnaire (MINI) was applied and content analysis of the material was performed. Results: Considering 1,958 women included in this analysis, 28.5% were aged 30 to 39 years; 15.4% had not finished elementary school; 54.5% were not employed or have never worked and 44.2% declared themselves not White. The prevalence of depression was 19.7% and the associated factors were: low level of education, currently employed, and with previous diagnosis of mental disorder. The factors associated with the depression in the investigated population were: low level of education, currently employed and with previous diagnosis of mental disorder. Among the protection factors, there are: be married or live with a partner, perform physical activities regularly and report positive health self-assessment. Qualitative analysis revealed that women with depression do not pay much attention to her appointments due to a sense of inability, prostration, demotivation which prevents her from overcoming inertia and take on daily routine. Death is seen as a relief and the only possible solution to end suffering. Spirituality and religiosity have played a crucial role in order to relieve suffering, being important factors to promote a change in life and rehabilitation. Conclusion: The outcomes have shown that a specific assistance in primary health care should be delivered to women, especially to those with low levels of education, those who are employed and do not practice exercise, in order to reduce suffering and promote health. It was also highlighted that lack of meaning in life appears normal to the extent that it prevents women from searching treatment for the disease. There is a clear gap in the use of screening instruments for cases of depression in primary care. Health professionals must be trained so they may correctly make the diagnosis of mental disorders, especially to distinguish depression and sadness, avoiding medicalization and stigmatization. It is crucial to improve healthcare network, recognizing how important it is to sharply articulate primary health care and specific policies/actions directed to mental health field