Julieta Azevedo

• Doctor of Psychology
• PostDoc Position at University of Coimbra

Introduction: Our research team has shown the need for prevention/early intervention for perinatal depression in Portugal. Our objectives are: to present a prevention/early intervention program for perinatal depression developed by our team, focused in the previously identified risk factors (lifetime history of depression, prenatal insomnia and pre...

Alexithymia and dissociation are two constructs which have been related to borderline personality disorder (BPD), and gathered contradictory opinions considering the association between them, however several studies already sustained their association. The difficulty in achieving successful psychotherapeutic results with BPD patients are well know...

Introduction Mindfulness refers to the capacity of being present and aware, without feeling the need to react or judge that experience (Kabat Zinn, 1990). This ability is associated with mental health and stress reduction (Baer, 2014; Teasdale et al., 2014). Five Facet Mindfulness Questionnaire (FFMQ) is widely used to measure mindfulness and its r...

Abstract The emergence of studies about shame and emotional memories has been increasing over the past years, and several researchers stated the important impact that negative emotional experiences in early life, can have in the person’s development and adult life, increasing the vulnerability to psychopathology, such as personality disorders, and...

Bipolar disorder (BD) and emotion dysregulation present substantial challenges for individuals and healthcare providers. Although pharmacological treatments remain the primary approach, psychosocial interventions show promise in addressing sub-threshold symptoms and deepening understanding of mood and emotion dysregulation mechanisms. The European...

Introduction: The paradigm in mental health care is progressively moving towards a recovery-focused perspective. Thus, there is a need for validated instruments to measure recovery in bipolar disorder (BD). The Bipolar Recovery Questionnaire (BRQ) is the most used instrument to assess it. The aim of this study was to translate and perform a cross-c...

Abstract International guidelines endorse psychological treatment for Bipolar Disorder (BD); however, the absence of a recognised gold-standard intervention requires further research. A Dialectical Behaviour Therapy (DBT) skills group intervention with 12 sessions was developed. This pilot randomised controlled trial (RCT) aims to evaluate the feas...

Background: Dialectical Behaviour Therapy (DBT) is a multi-component cognitive behavioural intervention with proven efficacy in treating people with borderline personality disorder symptoms. Establishing benchmarks for DBT intervention with both adults and adolescents is essential for bridging the gap between research and clinical practice, improvi...

Perceived everyday discrimination is a transversal phenomenon with a negative impact on people’s health. This study aimed to explore the factor structure and psychometric properties of three versions of the Everyday Discrimination Scale, with three different samples: the European Portuguese validation (EDS-PT, considering any reason for discriminat...

Bipolar Disorder (BD) is underdiagnosed, and the average time gap between the onset and diagnosis due to poor screening is 7 years. This study aims to describe the development of the semi-structured Clinical Interview for Bipolar Disorder (CIBD) for diagnosing bipolar spectrum disorders and assessing the impact of psychological interventions, using...

Affective temperaments are frequently described as a biologically determined early emerging variation in emotional reactivity, with solid temporal stability. We aimed to analyse affective temperament variation and dominance while adapting and translating the Affective Temperament Questionnaire (ATQ) to European Portuguese in both clinical (Major De...

AIM Submit the CIBD to a panel of experts in mental health evaluation Procedures: The experts were asked to analyse and evaluate the interview's structure in terms of: (a) usefulness, (b) clarity and (c) completeness; and to evaluate the main sections in terms of: (a) relevance, (b) clarity and (c) completeness. All questions were rated on a 5-poin...

The Brief Quality of Life in Bipolar Disorder (Brief QoL.BD) questionnaire is a short version of the first disorder-specific scale developed for Bipolar Disorder (BD), the QoL.BD, designed for use in research settings. This questionnaire has been considered a useful measure to assess psychological interventions' improvements. This study aimed to va...

Background: Dialectical Behaviour Therapy (DBT) is a multi-component cognitive behavioural intervention with proven efficacy in treating people with borderline personality disorder symptoms. Establishing benchmarks for DBT treatment with adults and adolescents is crucial to fill the gap between research and clinical practice and improve team perfor...

Cognitive behavioral therapies and mindfulness training during pregnancy have already been recognized as important tools in improving perinatal mental health [1]. Nevertheless, further randomized controlled trials (RCTs) are needed [2]. This study aimed to test the efficacy of Mother in Me (MiM), a prevention/ early intervention program for perinat...

Dialectical Behavioural Therapy (DBT) is known to be an efficacious treatment for people with BPD, with growing evidence of its transdiagnostic efficacy in different clinical settings and significant outcome improvements for clients. However, having a research study in place, even an effectiveness study, changes the buy-in of the organisation, and...

Introduction Almost 5 million people worldwide have lost their lives due to SARS-CoV-2 (source: WHO coronavirus (COVID-19) dashboard, data of 1.10.2021; https://covid19.who.int/ ) and therefore, globally, there is an increase of people in grief due to the death of a significant other. Objectives To study psychological correlates of grief during th...

Introduction We have recently validated the Portuguese shortest version of the Perinatal Depression Screening Scale-PDSS-7 (items selected from the PDSS-21; each one representing a dimension evaluated by the PDSS-35), for the assessment of depression severity in pregnancy, both in Portugal and Brazil. Objectives To analyze the validity and reliabi...

Introduction The Portuguese shortest version of the Perinatal Depression Screening Scale/PDSS-7 proved to be valid and reliable, in Portugal and Brazil, but it is essential to analyze its operational characteristics before using it for screening purposes. Objectives To determine PDSS-7 cut-off points and associated conditional probabilities to scr...

Introduction The Short Form of the Self-Compassion Scale (SCS-SF; Raes et al. 2011) is composed of 12 items that evaluate the same six dimensions (Self-Kindness/SK, Self-Judgement/SJ, Common Humanity/CH, Isolation, Mindfulness/M, Over-Identification/OI) as the long scale (26 items). The Portuguese version of the SCS-SF (Castilho et al. 2015) was va...

Background: Although obsessive-compulsive (OC) symptoms are common in the perinatal period, measures to comprehensively assess their presence, frequency, interference and severity are lacking. The Perinatal Obsessive-Compulsive Scale (POCS) is the only self-report questionnaire with context-specific items. It includes items to assess perinatal-spe...

Introduction: Trans people are frequently reported as having a high prevalence of suicidal behaviours, which have been associated with minority stress experiences suffered in their daily lives (discrimination, violence, and marginalization). Psychological processes such as distress tolerance and psychological flexibility may play a protective role...

Introduction: Trans people live in a cisnormative society that hampers their self-affirmation, which entails additional psycho-emotional distress. The transition process is a way of relieving suffering from gender dysphoria. Aim: The current study aimed to describe mental health indicators (e.g., mental health disorders, psychiatric medication inta...

Introduction: Gender and sexual minority groups are often victims of daily discrimination. Trans people are a gender minority group that often experiences prejudice and discriminatory social treatment. The Everyday Discrimination Scale (EDS) was designed to assess perceived discrimination experiences in people’s daily lives. In Portugal, the EDS wa...

INTRODUCTION: Freudenberger (1974) described the concept of burnout, including exhaustion, despersonalisation, feelings of ineffectiveness and lack of achievement. Years later, Maslach (1981) introduced the Maslach Burnout Inventory, which is known to be the best gold standard measure of burnout. According to a recent meta-analysis the worldwide bu...

Introduction Bipolar disorder (BD) is frequently underdiagnosed and due to poor screening, the average time between onset of symptoms and diagnosis is more than 7-years (Mantere et al., 2004). Improper diagnosis has serious consequences in intervention (Ghaemi et al., 2001), and previous assessment instruments are now considered insufficient to det...

Introduction Both original Big Three Perfectionism Scale (BTPS; Smith et al. 2016), and the Portuguese version validated with a sample of university students (Lino et al. 2018) evaluates three second-order factors (rigid, self-oriented and narcissistic perfectionism) and ten facets. Objectives To confirm the BTPS three-factors-ten-dimensions’ stru...

Introduction The Perinatal period is a time of vulnerability for developing psychiatric disorders of higher prevalence in the female gender - depression and anxiety ¹ . Numerous authors have proposed that maternal psychological factors could influence pregnancy course and the well-being of mother and newborn ² . Objectives To explore the relations...

Introduction Postpartum depression (PPD) is the commonest postpartum psychiatric condition, with prevalence rates around 20% ¹ . PPD is associated with a range of adverse outcomes for both the mother and infant ² . Therefore, identifying modifiable risk factors for perinatal depression is an important public health issue ³ . Objectives To explore...

Introduction Burnout occurs in every stage of a medical graduation and career. In the first years of graduation, is affects 35-45% of medical and dentistry students. This has severe consequences, such as: higher levels of suicidal ideation, substance abuse, medical errors and medical neglect; lower levels of empathy and self-compassion - essential...

Introduction Screening programs for perinatal depression are systematicly implemented in developed countries. To circumvent the most commonly pointed limitation by the primary healthcare professionals (the questionnaires length), we have developed shorter forms of the Beck and Gable Postpartum Depression Screening Scale-35. The shortest version con...

Introduction Motherhood-related beliefs are characterized by themes of failure and maternal role idealization. Recent studies found that postpartum depression/PPD is both predicted and a predictor by/for dysfunctional beliefs/DB. Additionally, it is possible that when contextual factors (eg. lack of social support) are present, women may anticipate...

Introduction The effects on the population’s mental health due to the rapid global spread of COVID-19 are even greater for specific groups such as pregnant women. Objectives To compare levels of depressive and anxiety symptoms of pregnant women before vs. during the COVID-19 pandemic and to analyze the role of COVID-19 fear in perinatal psychologi...

During pregnancy, obsessive-compulsive (OC) symptoms and disorder are underdiagnosed and undertreated. The Prenatal Obsessive-Compulsive Scale (PreOCS; Lord, Rieder, Hall, Soares, & Steiner, 2011) is the only self-report questionnaire that evaluates the severity and interference of specific pregnancy-related obsessions and compulsions. We aimed to...

Introduction: Perinatal obsessive-compulsive disorder (pOCD) is characterized by content-specific obsessions and compulsions (mainly avoidance and covert rituals). The distinction between OCD, depression and anxiety is particularly difficult in the perinatal period. The Perinatal Obsessive-Compulsive Scale/POCS is a self-report questionnaire compos...

Introduction: Early cognitive-behavioural models of postnatal Obsessive-Compulsive (OC) phenomena highlighted the role of negative traits, cognitive styles and specific dysfunctional beliefs (Fairbrother & Abramowitz 2007). However, the examination of key mediating factors is lacking to understand the mechanisms by which variables influence one ano...

The objective of the present study was to develop and assess the validity of a short form of the Child–Adolescent Perfectionism Scale (CAPS). Two Portuguese samples composed of 756 adolescents were used to cross-validate the factorial structure of a nine-item Child–Adolescent Perfectionism Scale—Short Form (CAPS–SF). The CAPS–SF consists of a four-...

Introdução: O stresse, a perturbação psicológica e outras variáveis que influenciam o bem-estar materno podem ter implicações negativas no desenvolvimento da criança, incluindo no seu temperamento. Objetivo: analisar a relação das variáveis sociodemográficas, ginecológicas/obstétricas e relativas à maternidade, do stresse materno, dos sintomas depr...

Several studies suggested that Borderline Personality Disorder is related to early invalidating and harsh environments, characterized by scarce experiences of warmth and safeness, and possibly traumatic shameful memories. On the other hand, the ability to take a stance and not get fused with one’s internal experiences seems to be linked to diminish...

Introdução: O stresse, a perturbação psicológica e outras variáveis que influenciam o bem-estar materno podem ter implicações negativas no desenvolvimento da criança, incluindo no seu temperamento. Objetivo: analisar a relação das variáveis sociodemográficas, ginecológicas/obstétricas e relativas à maternidade, do stresse materno, dos sintomas depr...

Introdução: A gravidez e o pós-parto normais caracterizam-se por mudanças físicas, emocionais e familiares que podem gerar stresse, sentimentos de desamparo e falta de controlo e emoções negativas. O Perfil dos Estados de Humor (POMS) consiste numa lista de palavras que avaliam os estados flutuantes do humor positivo/negativo e pode traduzir caract...

Introdução: A gravidez e o pós-parto normais caracterizam-se por mudanças físicas, emocionais e familiares que podem gerar stresse, sentimentos de desamparo e falta de controlo e emoções negativas. O Perfil dos Estados de Humor (POMS) consiste numa lista de palavras que avaliam os estados flutuantes do humor positivo/negativo e pode traduzir caract...

Bipolar disorder (BD) is a serious mental disorder characterized by episodes of mania/hypomania and depression, mood instability, significant functional impairment, lower quality of life, and higher rates of suicide than the general population. Pharmacological interventions prevail as the primary intervention in BD, however, most patients are not f...

The team presented the program Mother in Me (for perinatal psychological distress=.

Introduction The F-Multidimensional Perfectionism Scale is a widely used instrument to assess perfectionism trait. The original scale comprises 35-items that measure the six dimensions of Frost et al (1990) conceptualization of perfectionism: personal standards (PS), concern over mistakes (CM), doubts about actions (DA), parental criticism (PC), Pa...

Introduction The Five-Factor Model organizes human personality traits under a comprehensive framework of five dimensions–neuroticism, extraversion, openness to experience, agreeableness and conscientiousness. The dimensions are empirical generalizations of enduring differences in behavioural, emotional and cognitive patterns between individuals. Th...

Introduction Pereira et al. (2013) adapted to the antenatal period and validated a shorter version of the original 35-items Postpartum Depression Screening Scale (PDSS [1] ), composed of 24 items, selected from the exploratory factor analysis matrix. In their study, the researchers considered this version a useful alternative to evaluate depressive...

Introduction The postpartum depression screening scale (PDSS; Beck & Gable, 2002) is a widely used measure to assess women's depressive symptoms after their children's birth. Pereira et al. adapted, validated and developed a short-version of PDSS for Portuguese women (PDSS-21). Objective To examine the factor structure of the PDSS–21, using confir...

Introduction Perseverative Negative Thinking (PNT) is a transdiagnostic cognitive process [1] characterized by repetitiveness, intrusiveness and difficulties to disengage (Ehring, 2011). The Perseverative Thinking Questionnaire (PTQ-15; [2] ) is a self-reported instrument, developed to evaluate these characteristics. The Portuguese version assess t...

To our knowledge there is no published study on the prevalence and incidence of postpartum Major Depression according to the DSM-5 (APA, 2013) diagnostic criteria.Our aims are: to estimate the prevalence and incidence of postpartum Major Depression according to the DSM-5 diagnostic criteria, using the Diagnostic Interview for Psychological Distress...

Depressive symptoms decrease after participation in mindfulness based interventions for pregnant women (e.g. Hall et al. 2016). To our knowledge, apart from intervention trials, there are few studies on the relationship between mindfulness and depressive symptoms in the perinatal period. After reviewing the literature on this topic, we will present...

Self-compassion has been associated with depressive and anxiety symptoms in general population. Although recent research indicates that dysfunctional maternal attitudes predict the development of perinatal depression and anxiety symptoms, few studies have examined the role of self-compassion and its relationship with psychological well-being in wom...

Few studies combine a categorical and dimensional approach to explore risk factors for postpartum depressive symptoms/depression (PPD). Our objective is to present our results on the predictive role of several risk factors/correlates in the development of PPD, including sleep variables which are rarely considered. Our sample is composed by 236 wome...

Perinatal depression (PD) is a significant public health concern, needing a more efficient detection, prevention and treatment. Experts in the area recently recommended universal psychosocial assessment programs that combine the evaluation of PD symptoms and psychosocial risk factors. Within a new research project, our team has been exploring this...

Introduction Although self-compassion has been pointed as an effective strategy for coping with depression, there are not any studies investigating its association with lifetime history of depression (LTHD). Objective To compare self-compassion levels in pregnant women with vs. without LTHD and to analyze if self-compassion dimensions are signific...

Introduction: Despite the empirical support for the effects of mindfulness based interventions for recurrent depression (Velden et al., 2015), the literature on the relation between Mindfulness and Lifetime History of Depression/LTHD are scarce. Objective To compare Mindfulness levels between women with vs. without LTHD and to analyze if mindfulnes...

Introduction Depressive symptoms in pregnancy are risk factors for postpartum depression and associated to adverse child outcomes (Glover, 2014). Depressive symptoms decreases after participation in mindfulness and self-compassion based interventions for pregnant women (e.g. Goodman et al., 2014). However, apart from intervention trials, there are...

Introduction: The Depressive Anxiety and Stress Scale (DASS-21; Antony et al., 1998) had been widely used to measure psychological distress among clinical and non-clinical populations, including in Portugal (Pais-Ribeiro et al. 2004). Although DASS-21 has been considered useful to evaluate psychological distress in the perinatal period, studies rep...

Introduction Self-Concealment Scale (SCS) is composed of ten items to measure self-concealment, defined as a tendency to conceal from others personal information that one perceives as distressing or negative (Larson and Chastain, 1990). Objective To investigate the psychometric properties of the SCS-10 Portuguese version and of an adapted version c...

Introduction: In recent years, researchers and clinicians have shown an increasing interest in self-compassion. Indeed, several studies have suggested that self-compassion is a positive factor for mental and physical health. The Self-Compassion Scale (SCS; Neff, 2003) has been widely used to assess six dimensions of self-compassion (Self-kindness,...

Introduction Anxiety, depression, and stress in pregnancy are risk factors for adverse outcomes for mothers and children (Glover, 2014). There is good evidence showing a decrease in psychological distress when pregnant women participate in interventions comprising mindfulness and self-compassion practices (Dunn et al., 2012). However, there are few...

Introduction The impact of mindfulness in improving insomnia symptoms is documented in different samples (e.g. anxiety disorders; insomnia samples) and mindfulness based programs for pregnancy refer the association between mindfulness development and the reduction of insomnia symptoms/improvement of sleep. Objective To explore differences in the F...

Introduction Mindfulness based programs during pregnancy (some including self-compassion components) increase self-compassion, mindfulness and maternal self-efficacy, and reduce anxiety, stress and psychological distress in pregnant women. According to our knowledge, there are no studies about the association between self-compassion and sleep outco...

Introduction Pregnancy is characterized by important changes in sleep and some of them (as insomnia) predict negative outcomes, like depression, through all the perinatal period. There are few Portuguese adapted and validated instruments assessing insomnia in pregnancy. Objective To validate the Insomnia Assessment Scale in a sample of Portuguese...

Introduction Several studies have shown that evolutionary relevant fear stimuli hold a privileged access to the fear module, an independent behavioral, psychophysiological and neural system that is automatically and selectively activated, and is relatively encapsulated from more advanced human cognition. However, to the best of our knowledge no stu...

Introduction Counterfactual thinking is a set of mental representations of alternatives to the past actions. When it focuses on personal decisions, the emotion that results is regret, which has important implications for psychological distress (Borges et al., 2015). The Bedtime Counterfactual Processing Questionnaire (BCPQ; Schmidt and Linden, 2009...

Borderline Personality disorder (BPD) is by far one of the personality disorders (PD) with greater prominence among scientific research, being one of the most common PD and more expensive in health services. BPD has a well-known chronic and complex pervasive pattern of instability in interpersonal relationships, self-concept, emotion, behavior, and...

Introduction: Our research team has shown the need for prevention/early intervention for perinatal depression in Portugal. Our objectives are: to present a prevention/early intervention program for perinatal depression developed by our team, focused in the previously identified risk factors (lifetime history of depression, prenatal insomnia and pre...

Introduction: Depression and anxiety are the most prevalent and pernicious perinatal mental disorders. In spite of the DSM-5 depression specifier “with peripartum onset” (4/6 weeks postpartum), experts consensually consider that the perinatal period includes the first year after delivery. Due to the lack of a diagnostic interview according to DSM-5...

The emergence of studies about shame and emotional memories has been increasing over the past years, and several researchers stated the important impact that negative emotional experiences in early life, can have in the person's development and adult life, increasing the vulnerability to psychopathology, such as personality disorders, and namely, b...

Este capítulo diz respeito aos crimes rituais em Portugal, procurando reunir os principais casos mediáticos que surgiram ao longo da história e alguns bem recentes, que se destacaram pela sua bizarria e violência ficando por isso na memória de todos. Numa segunda parte deste capitulo é feito um enquadramento teórico, jurídico e clínico que procura...