Ana Fonseca

Ana Fonseca
University of Coimbra | UC · CINEICC - Cognitive and Behavioral Centre for Research and Intervention

PhD

About

117
Publications
12,002
Reads
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924
Citations
Additional affiliations
January 2014 - present
University of Coimbra
Position
  • PostDoc Position
Description
  • Preventing persistent post-partum depression trough ehealth interventions
January 2009 - May 2013
Universidade de Coimbra
Position
  • Transition to parenthood after a prenatal or postnatal diagnosis of congenital anomaly: reactions to the disclosure of the diagnosis, individual and parental adjustment
Description
  • PhD Project, supported by a PhD Scholarship from the Portuguese Foundation for Science and Technology (SFRH/BD/47053/2008)
Education
October 2008 - May 2013
Faculty of Psychology and Educational Sciences, University of Coimbra and Faculty of Psychology, University of Lisbon
Field of study
  • Psychology - Clinical Psychology (Family Psychology and Familiar Intervention)
October 2003 - July 2008
Faculty of Psychology and Educational Sciences, University of Coimbra
Field of study
  • Psychology - Clinical and Health Psychology

Publications

Publications (117)
Article
Objectives Web-based interventions for the promotion of maternal mental health could represent a cost-effective strategy to reduce the burden associated with perinatal mental illness. This study aimed to evaluate the cost-utility of Be a Mom, a self-guided web-based cognitive behavioral therapy intervention, compared with a waiting-list control. M...
Article
Objective: This study aims to systematically review all Clinical Practice Guidelines (CPGs) with recommendations for peripartum depression in European countries. Methods: A systematic review according to the PRISMA statement was conducted. CPGs focussing on peripartum depression or with at least one specific recommendation for peripartum depress...
Article
Full-text available
This study aimed to examine the (uni) dimensionality of the Parental Acceptance Questionnaire (6-PAQ) in a sample of Portuguese parents of children within the community using a bifactor model that can test the separate contribution of the dimensions and of the general score. 390 parents of children (1–11 years) recruited online and in-person comple...
Article
Universal screening for perinatal depression (PND) has been widely debated, and several trustworthy guidelines have been published worldwide on how to effectively conduct it. Nevertheless, a narrow view of perinatal mental health and the strict adherence to condition-specific assessment protocols limit the clinical utility of such screenings. In th...
Preprint
BACKGROUND Postpartum depression (PPD) is treatable and preventable, but most women do not seek professional help for their perinatal depressive symptoms. One increasingly popular approach of improving access to care is the utilization of web-based intervention programs. OBJECTIVE The objective of this study was twofold: first, to assess the effic...
Article
Full-text available
The Cognitive Emotion Regulation Questionnaire-Kids (CERQ-Kids) is a self-report questionnaire that assesses cognitive emotional regulation strategies that children may employ when they face traumatic or stressful events. However, its psychometric properties were only analyzed among participants from the general community. The goal of this study is...
Article
Background Perinatal depression is a highly prevalent mental health problem with severe consequences, which is still underdiagnosed and undertreated. Frontline health professionals directly assisting and providing regular care to women in pregnancy and postpartum period play a critical role in early detection and management of perinatal depression....
Article
Postpartum depression is a highly prevalent mental health problem with harmful consequences for women, babies, and mother–infant relationships. Cognitive–behavioral therapy (CBT) is among the most effective treatment options for postpartum depression. However, a large number of postpartum women do not seek professional help, suggesting the need for...
Article
Full-text available
Background Be a Mom is a self-guided web-based intervention developed to prevent postpartum depression (PPD) symptoms and to promote maternal wellbeing, respectively among high and low-risk new mothers. This study aims to examine and compare (1) Be a Mom's patterns of usage and (2) Be a Mom's acceptability among women presenting high and low risk f...
Article
Full-text available
This study examined (1) the availability and content of national CPGs for treatment of peripartum depression, including comorbid anxiety, with antidepressants and other psychotropics across Europe and (2) antidepressant and other psychotropic utilization data as an indicator of prescribers’ compliance to the guidelines. We conducted a search using...
Article
Objectives: There is evidence suggesting that self-compassion is linked to key mechanisms in emotion regulation models of depression and anxiety. However, the majority of prior research has targeted community samples and overlooked the analysis of such mechanisms in relation to positive mental health. This study sought to examine the direct and in...
Article
Objectives: To examine the multidimensionality of symptoms assessed with the Edinburgh Postnatal Depression Scale (EPDS) and to identify and characterize the profiles of women with Postpartum Depression (PPD) symptoms. Methods: A sample of 487 Portuguese postpartum women with clinically relevant depressive symptoms participated in this cross-sec...
Article
The Display of Negative Emotions scale and The Social Consequences Of Negative Emotions scale are two understudied questionnaires that assess parents' emotion beliefs about their children's expression of negative emotions. Therefore, the aims of this study were to ascertain the factorial structure of both questionnaires, to reexamine the internal c...
Article
Clinicians trained in cognitive–behavioural therapy (CBT) are frequently not trained to work with dreams. Given the high prevalence and impact of nightmares and bad dreams, empowering CBT therapists to effectively work with these sleep phenomena is crucial to improve therapeutic outcomes. This article briefly outlines a cognitive–behavioural model...
Article
Full-text available
Introduction Perinatal depression is one of the most common complications during pregnancy and one year following childbirth. A negative impact on the mental and physical health of women, their children, partners, or significant others has been associated with this disease. Web-based and Mobile-based psychological interventions can reduce the burde...
Article
Objective: The aim of this study was to investigate the factor structure and psychometric properties of the Perceived Maternal Parenting Self-Efficacy (PMPS-E) Scale among Portuguese postpartum women. Design: Quantitative cross-sectional study. Setting: Data were collected through an online survey placed on social media websites targeting Portugues...
Article
Socratic questioning is at the core of collaborative clinical communication, with a wide array of applications in behavioural medicine and psychotherapy. This brief article describes the process of therapeutic Socratic questioning, illustrates its clinical applications in therapy and provides a brief update on its recent developments.
Article
Full-text available
In the context of interpersonal risk models of psychopathology, little is known about the role of self-expressiveness within the family (SEF) in individual psychological distress. Therefore, the aim of this exploratory study was to examine main and interaction effects of positive and negative SEF on maternal depression and anxiety symptoms. The “Se...
Conference Paper
Introduction. Postpartum depression (PPD) is a prevalent and undertreated clinical condition, which is nevertheless amenable to preventive efforts. “Be a Mom” is a feasible internet-based CBT (iCBT) intervention that has shown promising evidence in enhancing emotion regulation skills and decreasing depressive symptoms of postpartum women. However,...
Article
Objectives To evaluate the acceptability of and preferences for a blended psychological intervention (combining face-to-face sessions and web-based interventions) for the treatment of postpartum depression among Portuguese women presenting depressive symptoms and to explore the factors associated with its acceptability. Background Despite its high...
Article
Full-text available
Background: This study explored whether Be a Mom, a brief and unguided cognitive behavioral web-based intervention, was effective in promoting psychological processes (self-compassion, psychological flexibility, emotion regulation) among low-risk postpartum women. Effects of Be a Mom in psychological processes compared with a control group were exa...
Article
Full-text available
Background Non-invasive brain stimulation (NIBS) techniques have been suggested as alternative treatments to decrease depression symptoms during the perinatal period. These include brain stimulation techniques that do not require surgery and that are nonpharmacological and non-psychotherapeutic. NIBS that have showed antidepressant effect so far in...
Article
Background: Perinatal depression is a high prevalent mental health problem with serious consequences. Evidence about effective psychological interventions in treating perinatal depression has been increasing, but it lacks a comprehensive synthesis of findings. Methods: A systematic review of systematic reviews and meta-analyses concerning the effec...
Article
Full-text available
Mental disorders are a recognized population health issue, with recent estimates placing mental illness as the first in global burden of disease in terms of years lived with disability, and comparable to cardiovascular and circulatory diseases in terms of disability-adjusted life years [...]
Article
E-mental health tools are a new format of treatment delivery that can increase population’s access to mental health services. Its effectiveness is higher when grounded on evidence-based therapeutic protocols, such as Cognitive-Behavior Therapy (CBT). We aim to understand how CBT principles can be applied in the development of e-mental health tools,...
Article
This study examined the mediating role of dyadic coping (DC) in the association between internalizing symptoms and dyadic adjustment in a sample of 184 couples expecting their first child. Each partner completed self-report questionnaires assessing symptoms of depression and anxiety, dyadic adjustment and DC during the second trimester of pregnancy...
Article
Full-text available
This study aimed to examine the psychometric properties of the Child Post-Traumatic Cognitions Inventory (CPTCI) in a sample of Portuguese children and adolescents, following the exposition to a wildfire disaster. The sample included 533 children and adolescents living in regions exposed to the wildfire disaster (non-clinical sample: n = 483; clini...
Article
Natural disasters are potentially traumatic events due to their disruptive nature and high impact on social and physical environments, particularly for children and adolescents. The present study aimed to examine the psychometric properties of the Children's Revised Impact of Event Scale (CRIES‐13) in a sample of Portuguese children and adolescents...
Article
Full-text available
Despite the existence of effective treatment for postpartum depression, few women seek professional help, indicating the need for a new and innovative format of treatment that can overcome help-seeking barriers. This article presents the study protocol for a blended cognitive–behavioral intervention for the treatment of postpartum depression, by in...
Article
Full-text available
Professional help-seeking for postpartum depression is very uncommon, despite its adverse effects. However, women’s support network can have an important role in the professional help-seeking behaviour. This study aimed to characterize the intentions to recommend professional help-seeking for postpartum depression in the Portuguese population, as w...
Article
Objective Exploring a wide range of factors associated with flourishing and with the absence of depressive symptoms among postpartum women. Methods A sample of 661 postpartum women completed a set of questionnaires assessing sociodemographic and infant‐related data, flourishing, psychological flexibility, self‐compassion, resilience, and maternal...
Article
Full-text available
The way couples jointly manage pregnancy-related demands may prevent both members from experiencing psychosocial maladjustment after childbirth. This study examined (a) changes in dyadic coping (DC) and indicators of psychosocial adjustment [depressive and anxiety symptoms and quality of life (QoL)] from the second trimester of pregnancy (T1) to 6...
Article
This study aimed to explore the role of psychological flexibility within parenting in the relationship between parenting stress and parenting styles (authoritative, authoritarian and permissive) in mothers of early and school-aged children, as well as the moderator role of global psychological flexibility. The sample comprised 250 mothers of childr...
Article
Full-text available
In this study, we conducted a preliminary investigation of the efficacy of Be a Mom, a web-based self-guided intervention, in enhancing positive mental health among postpartum women at low risk for postpartum depression. Additionally, we examined Be a Mom’s efficacy regarding secondary outcomes as well as its acceptability and adherence. A total of...
Article
Background : Peripartum depression [PPD] is a public health problem which has been widely studied. Nonetheless, study findings and clinical guidelines for PPD treatment differ among countries and the condition is still underdiagnosed and undertreated, suggesting the importance of a global understanding of PPD. The Riseup-PPD Cost Action aims to est...
Article
This study aimed to investigate the factor structure of the Mental Health Continuum-Short Form (MHC-SF) in the postpartum context using a single-factor model, a correlated three-factor model, and a bifactor model. The reliability and validity of the MHC-SF were also examined. The total sample consisted of 882 postpartum Portuguese women. Confirmato...
Article
Objective: We assessed (1): the factorial and convergent validity of the Portuguese version of the Stress Appraisal Measure (SAM); (2) maternal primary and secondary appraisals of the birth of a child; and (3) the influence of appraisals on stress. Background: Parental stress is common during transition to parenthood and may be detrimental for pare...
Presentation
Introdução: Este estudo pretende explorar a existência de diferenças em recursos psicológicos (flexibilidade psicológica, autocompaixão, resiliência) em mulheres no período pós-parto, em função da presença/ausência de níveis elevados de saúde mental positiva (i.e., flourishing) e de sintomas depressivos. Método: Uma amostra de 661 mulheres no perío...
Article
Be a Mom is a self-guided web-based intervention, grounded in cognitive behavioral therapy, delivered to postpartum women to prevent persistent postpartum depression [PPD] symptoms. We aimed to evaluate Be a Mom in terms of its preliminary efficacy, feasibility, and acceptability. A pilot randomized, two-arm controlled trial was conducted. Eligible...
Poster
There is a lack of research on the determinants of high positive mental health (i.e., flourishing) in the general population. This gap is even more evident when considering the postpartum period. A greater knowledge on the factors related to flourishing during this period is important for women’s overall mental health, which has an impact on the ch...
Article
Full-text available
Women’s partners may act as facilitators of professional help-seeking for mental health problems in the postpartum period. This study aimed to examine the sociodemographic and clinical correlates of men’s intentions to recommend professional help-seeking to their partners if they display postpartum mood and anxiety disorders and to explore the rela...
Poster
Full-text available
Postpartum women who are not at an immediate risk of developing postpartum depression still face several challenges that may have a negative effect in their mental health, such as dealing with child care tasks, changes in marital and social relationships and transitioning back to work. One effective way of overcoming the practical barriers to help...
Article
Full-text available
This study explored the mediating role of common dyadic coping (common DC) on the longitudinal associations between attachment‐related anxiety and avoidance and parental adjustment to the first year postpartum. A total of 92 Portuguese couples completed self‐report questionnaires of romantic attachment, common DC, parenting stress, and parental con...
Article
Objective: This study aimed to characterize the Portuguese general population's knowledge and attitudes about postpartum depression, and analyze its sociodemographic and clinical correlates. Design: A cross-sectional internet survey. Setting: Participants were recruited through advertisements on social media websites, in thematic forums and by...
Presentation
Objetivo: O presente estudo tem como objetivo a investigação da estrutura fatorial, fiabilidade e validade do Mental Health Continuum-Short Form (MHC-SF) no período pós-parto. Metodologia: No total, 882 mulheres no período pós-parto responderam a um conjunto de questionários online, no qual estava incluído o MHC-SF, assim como outras medidas relac...
Article
Unlike individual perceptions of a couple's functioning, couple‐level protective factors against poor adjustment to the birth of a child have rarely been studied. This study examined similarity or reciprocal exchanges in dyadic coping (DC) during pregnancy (T1) and at 6 weeks postpartum (T2) and its effects on both partners’ adjustment at 6‐9 month...
Article
Objective: This study aimed to explore the direct and indirect effects of self-criticism on postpartum depressive symptoms, through postpartum cognitions, and analyse the moderating role of self-compassion in this relationship. Background: Self-criticism and self-compassion are associated with postpartum depression. However, further research is nee...
Article
Background: Despite the extensive research on interpersonal and clinical risk factors for postpartum depression (PPD), there is a paucity of research on the potential role of cognitive variables (dysfunctional beliefs and negative thoughts) as correlates of PPD symptoms. Aims: This exploratory study aimed to understand the cognitive processes of wo...
Article
Full-text available
Aims: The aims of the current study are to examine whether parents’ work-family conflict, emotional distress (anxiety/depressive symptoms and parenting stress) and mindful parenting vary according to the type of employment (full-time, part-time, and occasional), the type of work schedule (fixed, flexible, and shift), and the number of working hours...
Article
Full-text available
Aim: Be a Mom is a self-guided, web-based intervention to prevent persistent postpartum depression symptoms [PPD], targeting both at-risk postpartum women and/or women presenting early-onset postpartum depressive symptoms (selective/indicated preventive intervention). Be a Mom is grounded on the principles of Cognitive-Behavior Therapy and incorpor...
Preprint
Full-text available
1. Executive Summary This survey and data analysis were conducted by the European Network of Postdoctoral Associations (ENPA) with the aim of assessing the current research and work conditions, aspirations and support received by postdoctoral researchers working in Europe. The Results section is structured into three main parts. The first one desc...
Article
Background Not all women presenting risk factors for postpartum depression (PPD) develop depressive symptoms. Research has shown that acceptance-focused processes (nonjudgmental appraisal of thought content, psychological flexibility) and self-compassion play an important protective role in the development of psychological symptoms. However, consid...
Article
Full-text available
Attachment security can act as an inner resource to promote women’s adjustment to motherhood. However, the mechanisms explaining the relationship between attachment representations and maternal adaptation outcomes are not well understood. This study aimed to examine the direct and indirect effects of attachment representations on maternal confidenc...
Article
Objective This study examined the predictive validity of the prenatal and postnatal versions of the Postpartum Depression Predictors Inventory-Revised (PDPI-R) in European Portuguese women, considering two gold standards to determine postpartum depression (PPD). Design Prospective longitudinal study conducted between November 2015 and September 20...
Poster
Full-text available
In the last decades, research and practice in psychology have emphasized the need to approach mental health not only as the absence of psychopathology but also as the presence of flourishing (i.e., high levels of emotional, psychological and social functioning and thriving). Research on the transition to motherhood has largely focused on mental il...
Poster
Background: Not all women presenting risk factors for Postpartum Depression (PPD) develop clinically relevant symptoms. Research has increasingly shown that acceptance-focused processes (nonjudgmental appraisal of thoughts’ content [NATC], psychological flexibility [PF]) and self-compassion (SC) seem to play an important protective role in the deve...
Article
Objective: The present study aimed to compare dyadic coping (DC) and dyadic adjustment in couples in which the woman was experiencing high levels of depressive symptoms and in couples in which the woman presented minimal or no depressive symptoms. Background: Pregnancy may be considered a situation of dyadic stress, during which the presence of hig...
Article
Goals: This study examined Portuguese women’s help-seeking intentions to address their emotional problems during pregnancy andthe first 12 months after childbirth, and the relative influence of main attitudinal and knowledge barriers and facilitators (prior experienceand encouragement from the partner).Methods: Pregnant women or women within the fi...
Article
1 Objective This study aimed to examine the relationship between dysfunctional motherhood‐related beliefs and postpartum anxiety and depression symptoms, and whether experiential avoidance may be a potential mechanism in explaining these relationships. 2 Method A sample of 262 postpartum women participated in a cross‐sectional online survey. 3 Re...
Article
Full-text available
Dysfunctional beliefs toward motherhood have been identified as a risk factor for postpartum depression. The aim of this study was to adapt the Attitudes Toward Motherhood Scale (AToM), that evaluates dysfunctional beliefs toward motherhood, for the Portuguese population and to evaluate its psychometric qualities. The sample included 387 women in t...
Article
Background: Insecure attachment representations have been established as a vulnerability factor for postpartum depressive symptoms. However, there is a lack of studies on the effects of attachment (in)security on postpartum anxiety symptoms, and on the mechanisms through which attachment representations may affect women's postpartum adjustment, na...
Article
Full-text available
Introduction Postpartum depression (PPD) is a prevalent condition with a serious impact. The early identification of women at risk for developing PPD allows for primary prevention and the delivery of timely appropriate referrals. This study investigated the validity and reliability of the postnatal version of the Postpartum Depression Predictors In...
Article
Full-text available
Purpose: To assess female cancer patients’ perceptions of the fertility preservation decision-making process and to examine the effect of clinicians’ support on the decision quality. Methods: A total of 71 patients participated in this longitudinal study with two assessment time points (before cancer therapy, after cancer therapy). Self-report meas...
Article
Objective: This study aimed to investigate the effect of one’s attachment representations on one’s and the partner’s caregiving representations. Background: According to attachment theory, individual differences in parenting and caregiving behaviours may be a function of parents’ caregiving representations of the self as caregiver, and of others as...
Article
A formative evaluation (consisting of two phases: a scoping literature review and a focus group with mental health professionals) was conducted to inform the design of a web-based intervention to prevent postpartum depression, in terms of its characteristics and content: the Be a Mom program. The results showed that the web-based intervention shoul...
Article
Full-text available
This study aimed at (1) examining how women’s attachment representations influence their intentions to seek formal help for their emotional problems, either directly or by affecting attitudes towards professional help-seeking (stigma and psychological openness), and (2) examining whether these effects are moderated by the presence of clinically sig...
Article
Full-text available
Partner-related factors associated with the occurrence of Postpartum Depression (PPD) may justify the partner’s inclusion in preventive and treatment approaches. The aim of this qualitative systematic review was to synthesize the literature on partner-inclusive interventions designed to prevent or treat postpartum depression (PPD) in women. In acco...
Article
O presente estudo teve como objetivo avaliar o comportamento psicométrico da versão portuguesa do Inventário de Atitudes face à Procura de Serviços de Saúde Mental (IAPSSM) numa amostra de mulheres no período perinatal. As participantes (175 mulheres grávidas ou no período pós-parto) responderam a um conjunto de questionários (IAPSSM, Questionário...
Article
Better understanding how cognitive processes operate to influence women's depressive symptoms during the postpartum period is crucial for informing preventive and treatment approaches. The present study aimed to examine the relationship between women's dysfunctional attitudes towards motherhood and depressive symptoms, considering the mediating rol...