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The neurophysiological assessment of infants in their first developmental year can provide important information about the functional changes of the brain and supports the study of behavioral and developmental characteristics. Infants' cortical auditory evoked potentials (CAEPs) reflect cortical maturation and appear to predict subsequent language abilities. This study aimed to identify CAEP components to two auditory stimulus intensities in 1-month-old infants and to understand how these are associated with social interactive and self-regulatory behaviors. In addition, it examined whether CAEPs predicted developmental outcomes when infants were assessed at 12 months of age. At 1 month, P2 and N2 components were present for both auditory stimulus intensities, with an increased P2 amplitude being observed for the higher-intensity stimuli. We also observed that an increased P2 amplitude in the lower intensity predicted receptive and expressive language competencies at 12 months. These results are consistent with previous findings indicating an association between auditory processing and developmental outcomes in infants. This study suggests that specific auditory neurophysiological markers are associated with developmental outcomes in the first developmental year.

"Published online: 28 Dec 2022", Objective When therapists’ proposals are too demanding exceeding clients’ readiness to move into change, clients may resist advancing. We aimed to understand how a therapist behaved immediately after the client resisted advancing into change within Cognitive–Behavioral Therapy. Methods We analyzed a recovered and an unrecovered case, both with Major Depression, and followed by the same therapist. Through the Therapeutic Collaboration Coding System, we analyzed 407 exchanges of interest. Results In both cases, clients resisted more in advancing at intermediate sessions, mainly by the therapist’s challenges to raise insight and debate cognitive beliefs in the recovered case, and to seek experiential meanings in the unrecovered case. Immediately after clients resisted advancing, the therapist tended to insist on challenging them in the same direction. In the recovered case, the therapist did so continually throughout the therapy, sometimes balancing between insisting or stepping back. In the unrecovered case, the therapist insisted on challenging, but mostly at the final session. Occasionally, the therapist insisted on challenging, and clients resisted over consecutive exchanges. Conclusion: Our results reinforce that to enact progress and change clients need to be pushed into change, however it requires therapists’ skillful assessment of clients’ tolerance to move in time., This study was conducted at the Psychology Research Centre (PSI/01662), School of Psychology, University of Minho. This work was partially supported by the Foundation for Science and Technology (FCT) through the Portuguese State Budget (Ref.: UIDB/PSI/01662/2020)., This work was supported by Fundação para a Ciência e a Tecnologia [grant number 130304/ 2017]; Fundação Bial [grant number ].

Published online: 07 Jun 2020, Portugal is one of the European countries that implemented early protective measures in the context of the COVID-19 pandemic. Portugal declared a state of emergency on 18 March, and a set of regional and national preventive public health measures was progressively implemented. Studies on the psychological impact of pandemics show evidence of the negative impact on mental health. Of particular concern are individuals with previous fragility (e.g. personal, family or occupational) and those undergoing life transitions. In this paper, we present a telephone-based psychological crisis intervention that was implemented to provide brief, appropriate, and timely psychological help. This intervention follows standard models of crisis intervention and is structured in five phases and five different intervention modules to take into account the impact of the pandemic on the mental health of specific risk groups. With these support services, we hope to help our community better cope with the immediate impact of the pandemic and to contribute to preventing serious mental health problems in the medium and long term., This study was partially conducted at the Psychology Research Centre (PSI/01662), University of Minho, and supported by the Portuguese Foundation for Science and Technology and the Portuguese Ministry of Science, Technology and Higher Education (UID/PSI/01662/2019), through the national funds (PIDDAC). We acknowledge Associação de Psicologia da Universidade do Minho (APsi-UMinho) and APsiUMinho collaborators for supporting the telephone-based psychological crisis intervention: Ana Daniela Silva, Ana Isabel Gonçalves, Ana Rita Pereira, Andreia Milhazes, Ângela Ferreira, Alexandra Vieira, Célia Sampaio, Carina Magalhães, Cátia Braga, Delfina Fernandes, Dulce Lopes, Dulce Pinto, Inês Castro, Inês Marques, Gabriela Santana, Joana Andrade, Joana Coutinho, Joana Guimarães, Joana Soares, Joana Teixeira, Joana Torres, João Batista, João Tiago Oliveira, Mariana Leite, Marta Sousa, Patrícia Mendes, Sara Lima, Soraia Mesquita, Teresa Castanho. We would like to thanks P5 and affiliated Psychologists: Liliana Amorim, and Inês Fernandes. We gratefully acknowledge OutSystems for the financial support through OutSystems COVID-19 Community Response Program.

The mapping of therapeutic collaboration throughout counseling deepens our understanding of how the helping relationship fosters client change. To better understand the process of career construction counseling (CCC), we analyzed the therapeutic collaboration on six successful face-to-face cases. The participants were six Portuguese adults, five women and one man, real clients of a career counseling service, and four psychologists, three female and one male trained in the career intervention model. The participants completed demographic questions and measures of career certainty, vocational identity, career indecision, and psychological functioning. The Therapeutic Collaboration Coding System was used to track collaboration throughout all interactive episodes. The clinical significance of the intervention was calculated by analyzing pre-post-test statistical differences for each case, with the Reliable Change Index and Z score. The findings evidenced a pattern of therapeutic collaboration evolution for good outcome cases. Based on this pattern, we propose a model of process-outcome evolution for the three phases of CCC.

Aim: This study analyzes how a therapist contributed to therapeutic collaboration reestablishment by describing his actions after therapeutic collaboration breaks in a recovered completer clinical case. Method: Data was collected from a narrative therapy case with the diagnosis of depression spanning 19 sessions. We identified sequences in which therapeutic collaboration breaks were re-established (or not) through the Therapeutic Collaboration Coding System. We analyzed the therapist's actions after the therapeutic collaboration breaks through Conversation Analysis. Results: Typically, the therapist maintained the action that preceded the therapeutic collaboration break. When he did so by proposing a new meaning to the client's experience or by highlighting the client's agency, the therapeutic collaboration was usually re-established; however, when he did so by guiding or making exploratory questions to deepen the client's experience, the therapeutic collaboration was usually not re-established. When the therapist retreated from his previous action, the therapeutic collaboration tended to be re-established, mainly when he reflected the client's previous turn. Conclusion: This study suggests that more important than maintaining or retreating from the previous action is how the therapist does so. The therapist's actions of acknowledging the client's experience and agency contributed to therapeutic collaboration reestablishment., This study was conducted at Psychology Research Centre (PSI/01662), University of Minho, and supported by the Portuguese Science and Technology Foundation and the Portuguese Ministry of Science, Technology and Higher Education through national funds, and co-financed by FEDER through COMPETE2020 under the PT2020 Partnership Agreement (POCI-01-0145-FEDER007653).

Team-based learning (TBL) is an active learning pedagogy developed for in-class sessions and based on the collaborative work of small groups of students. The increasing push to online and blended learning has enhanced the need to expand this pedagogy to a virtual environment, but little evidence has been produced on how students accept online synchronous sessions of TBL. The purpose of this study, that relies on 427 responses, is to present a comparative perspective of traditional in-class versus adapted fully synchronous online TBL and across different disciplinary fields. Students of two different academic years and different programs were surveyed for their acceptance of TBL. They were invited to answer closed-ended questions focused on their engagement in all TBL learning process and the final outcomes provided. Results obtained from this unique comparative study revealed a wide approval of TBL, regardless of the environment (online or in-class TBL sessions), scientific area of courses and student gender. The acceptance of fully online TBL sessions, in a similar way as traditional in-class sessions, could be a rationale for giving more use to the ‘virtual’ context. Other results corroborated previous researches on TBL, such the need of student awareness of TBL benefits to get more engaged in the process or the impact of student activities overload on the TBL process. Implications are informative for pedagogical practice.

Purpose - A better therapeutic alliance at the beginning of treatment for addictive behaviours has been found to prevent dropout. The purpose of this paper is to evaluate how the development of therapeutic alliance dimensions was associated with the dropout prevention.Design/methodology/approach - A total of 23 participants presented a substance use disorder related to heroin or cocaine and were in three distinct treatment phases of a therapeutic community. Each participant filled in the therapeutic alliance measures once a week after mini-groups. A naturalistic prospective research design was used to collate 198 repeated alliance measures.Findings - Participants who presented stable bond development at higher levels tended to stay in treatment, whereas those who developed stable bonds at lower levels tended to drop out. The goals and tasks dimension increased significantly across the phases and was not associated with dropout.Practical implications - To prevent dropout, therapists should pay special attention to residents who manifest difficulties in establishing stable and secure bonds and not overestimate the impact of the goals and tasks alliance dimension, as it is not a failsafe indicator of treatment retention.Originality/value - The alliance dimensions were differentiated (bond, goals and tasks) and studied throughout the treatment, pointing out the importance of therapeutic relationship dynamic variables to prevent dropout., This study was partially conducted at Psychology Research Centre (UID/PSI/01662/2013), University of Minho, and supported by the Portuguese Foundation for Science and Technology and the Portuguese Ministry of Science, Technology and Higher Education through national funds and co-financed by FEDER through COMPETE2020 under the PT2020 Partnership Agreement (POCI-01-0145-FEDER-007653). This work was supported by national Portuguese funding through FCT - Fundacao para a Ciencia e a Tecnologia, Project Ref. UID/BIM/04773/2013 CBMR.

Although the Therapeutic Communities (TCs) have been considered a useful drug addiction treatment resource, much remains to be understood about the process of change in this treatment. The TC residents’ perspectives on their change can contribute towards an understanding of this process of change. This study aims to describe residents’ perspectives on change through each of the three treatment phases. We used a longitudinal and prospective research design with 25 residents from the three treatment phases. All residents filled in the Helpful Aspects of Therapy sheet after their weekly therapies; those who ended the treatment phase were interviewed using the Change Interview. A total of 427 documents were analyzed using grounded theory data procedures. According to residents’ views, the study results suggest that their agency was the core factor in the change, while treatment tasks and healing relationships established the context for change. During each phase, contextual factors acquired particular features, with the common factor being conduciveness to action by the residents themselves. Such agency enabled the residents to appropriate treatment resources across three phases. By the end of the treatment, residents had made major changes to the way in which they relate to themselves and others and could envisage a new life in which drugs had no place. Based on the results of the study, we suggest that clinicians should monitor and support the agency of the residents. We also propose that further studies focus on residents’ perspectives about the events that limited their mobilization for change as agents., Psychology Research Centre (UID/PSI/01662/2013), University of Minho, and supported by the Portuguese Foundation for Science and Technology and the Portuguese Ministry of Science, Technology and Higher Education through national funds and co-financed by FEDER through COMPETE2020 under the PT2020 Partnership Agreement (POCI-01-0145-FEDER-007653), info:eu-repo/semantics/publishedVersion

This study aimed to describe the therapy significant events’ impacts, identified by the client and the therapist, throughout a good outcome case. We used a methodology of case study with an adult client diagnosed with panic disorder and followed in cognitive-behavioral therapy. The Portuguese version of the Helpful Aspects of Therapy questionnaire was administered over all sessions to collect the significant events and their helpful impacts. We categorized the type of impact using a system of thematic categories, based on literature. The results showed that impacts, identified by the therapist and the client, were different. Whereas for the therapist these impacts were focused on categories such as Guidance, Self-understanding, Empowerment and Behavioral Change, for the client the impacts were focused on Self-understanding and Empowerment. The results suggest that both perspectives should be considered in order to better understand what is helpful to the client’s change. Moreover the therapist should be sensitive to other possible impacts on the client, aligning his or her intervention accordingly and contributing in this way to the client change., Este estudo teve como objetivo descrever os impactos associados aos acontecimentos significativos, identificados pelo cliente e terapeuta, ao longo de um caso de sucesso clínico. Utilizámos a metodologia de estudo de caso, com um cliente adulto, diagnosticado com perturbação de pânico e acompanhado em terapia comportamental e cognitiva. A versão portuguesa do questionário Helpful Aspects of Therapy foi administrada em todas as sessões para a recolha dos acontecimentos significativos e respetivos impactos. Categorizámos o tipo de impacto percebido a partir de uma grelha de análise temática construída com base na literatura. Os resultados mostram diferenças nos impactos percebidos pela terapeuta e pelo cliente. Enquanto para a terapeuta esses impactos incidiram sobre as categorias de Orientação, Autocompreensão, Sensação de fortalecimento e Mudança de comportamento, para o cliente os impactos percebidos incidiram nas categorias de Autocompreensão e Sensação de fortalecimento. Estes resultados sugerem que ambas as perspetivas devem ser consideradas na compreensão do que é útil para a mudança do cliente e que o terapeuta deve atender à possibilidade de emergirem outros possíveis impactos no cliente, alinhando a sua intervenção no sentido de os potenciar e contribuir dessa forma para a mudança do cliente., (undefined), info:eu-repo/semantics/publishedVersion

Objective: Striking the balance between creating challenge through confrontation (drawing attention to discrepancies) to encourage change and offering support through the therapeutic relationship to ensure safety for patients represents a central issue for psychotherapists. The aim of the present study was to assess immediate effects of confrontations by therapists on the therapeutic alliance. Method: We rated video recordings of 77 therapies to measure incidences of alliance ruptures/resolution attempts as well as confrontations by therapists. Change in the therapeutic alliance and therapy outcome were measured through questionnaires filled out by patients. Results: Confrontations were significantly associated with ruptures/resolution attempts on the micro level. Changes in the therapeutic alliance moderated the association between confrontations and alliance ruptures on the macro level: The bigger the fraction of a session containing confrontations, the larger the fraction containing ruptures, given a prior positive change in the therapeutic alliance. Therapists’ use of confrontation during a resolution attempt was associated with significantly better therapy outcomes than no use of confrontation during or no resolution attempt. Conclusions: Confrontations by therapists may temporarily impair the therapeutic alliance, but might also lead to better therapy outcomes when used to make an alliance rupture explicit as part of a resolution attempt., (undefined), info:eu-repo/semantics/publishedVersion

This article explores the role of ambivalence in grief therapy within a narrative framework. From this perspective, change starts with the occurrence of innovative moments, which can be nullified by reaffirmation of the problematic self-narrative as a sign of ambivalence. This study analyzed ambivalence in six complicated grief cases using the “Return to the Problem Coding System.” Markers of ambivalence emerged in all cases, with a decreasing profile in cases with greater symptomatic improvement, suggesting an association between clinical change and ambivalence evolution in therapy. Addressing ambivalence may bring to light important aspects of client’s selfreconstruction after a major loss., Portuguese Foundation for Science and Technology, through the Grant PTDC/PSI-PCL/121525/2010 (Ambivalence and Unsuccessful Psychotherapy,2012–2015) and the PhD Grant SFRH/BD/48607/2008

A qualidade da interacao terapeutica constitui-se como um importante preditor dos resultados terapeuticos e como crucial na decisao dos clientes para se manterem na terapia. O presente estudo teve como objetivo descrever e comparar o desenvolvimento da colaboracao terapeutica em dois casos clinicos, um finalizado e um de desistencia, ambos de insucesso e seguidos em Terapia Narrativa. Foi utilizado o Sistema de Codificacao da Colaboracao Terapeutica, que permite distinguir episodios colaborativos, nao colaborativos e de ambivalencia por referencia a Zona de Desenvolvimento Proximal Terapeutica (ZDPT) dos clientes. A codificacao foi realizada independentemente por dois pares de juizas, tendo as discrepâncias sido resolvidas por consenso e mediante posterior auditoria. Os resultados mostram que no caso de desistencia os episodios nao colaborativos foram cinco vezes mais frequentes do que no caso finalizado. Em ambos os casos, verificou-se uma tendencia crescente do terapeuta para estimular o movimento das clientes ao longo da ZDPT no sentido da inovacao. Contudo, se nas ultimas sessoes do caso finalizado a cliente foi capaz de com o terapeuta, no caso de desistencia ocorreu um aumento de episodios nao colaborativos entre a diade. Palavras-chave: Colaboracao terapeutica, Caso finalizado, Desistencia, Insucesso. O presente estudo teve como objetivo analisar e comparar a qualidade da interacao entre terapeuta e cliente ao longo do processo terapeutico de dois casos clinicos, um finalizado e um de desistencia, ambos de insucesso e seguidos em Terapia Narrativa. A investigacao em psicoterapia tem suportado de forma consistente a contribuicao dos fatores relacionais para o sucesso terapeutico. Entre estes, a alianca terapeutica e atualmente reconhecida como um preditor moderado e robusto dos resultados da psicoterapia (Horvath, 2013). A alianca terapeutica, para alem de incluir uma dimensao afetiva entre terapeuta e cliente, o vinculo terapeutico, e tambem entendida como um fator relacional intrinsecamente associado ao trabalho que ocorre no contexto da terapia, orientado para a mudanca do cliente. No sentido de compreender o papel da alianca terapeutica no processo de mudanca, Horvath (2006) recomenda que a investigacao evolua no sentido de identificar e analisar os microprocessos relacionais (ex., colaboracao terapeutica) situados no contexto de praticas terapeuticas especificas. Nesta linha de investigacao, incluem-se os estudos focados no conceito de colaboracao terapeutica, entendida como um processo interativo e analisada a um nivel micro analitico. Embora este conceito de colaboracao terapeutica seja definido de diferentes formas, a natureza bidirecional e a contribuicao mutua do terapeuta e do cliente e

With the present study we aimed to analyze the relationship between infants' behavior and their visual evoked-potential (VEPs) response. Specifically, we want to verify differences regarding the VEP response in sleeping and awake infants and if an association between VEP components, in both groups, with neurobehavioral outcome could be identified. To do so, thirty-two full-term and healthy infants, approximately 1-month of age, were assessed through a VEP unpatterned flashlight stimuli paradigm, offered in two different intensities, and were assessed using a neurobehavioral scale. However, only 18 infants have both assessments, and therefore, these is the total included in both analysis. Infants displayed a mature neurobehavioral outcome, expected for their age. We observed that P2 and N3 components were present in both sleeping and awake infants. Differences between intensities were found regarding the P2 amplitude, but only in awake infants. Regression analysis showed that N3 amplitude predicted an adequate social interactive and internal regulatory behavior in infants who were awake during the stimuli presentation. Taking into account that social orientation and regulatory behaviors are fundamental keys for social-like behavior in 1-month-old infants, this study provides an important approach for assessing physiological biomarkers (VEPs) and its relation with social behavior, very early in postnatal development. Moreover, we evidence the importance of the infant's state when studying differences regarding visual threshold processing and its association with behavioral outcome., We wouldlike to thank the families andinfants whoparticipated in this study. Also, we would like to thank Pedro Hispano Hospital, particularly to Dr. J. Lopes dos Santos, for all the kindness throughout the time that we were there for the data collection process. We thank to Maria de Góis-Eanes for all the help and knowledge entailed throughout this study. Furthermore, we thank Associac¸ ão Viver a Ciência for the Simbiontes prize in 2013. This work was supported by Fundac¸ ão Bial (grant number 42/08) and financed by Fundac¸ ão para a Ciência e Tecnologia (FCT) under a PhD grant (reference SFRH/BD/68263/2010).

Sex differences between men and women in social anxiety are largely unexplored. This study sought to shed some light on this topic. We administered self-report measures of social anxiety to community samples of 17,672 women and 13,440 men from 16 Latin American countries, Spain and Portugal, as well as to a clinical sample of 601 patients diagnosed with social anxiety disorder. Small but significant differences were found between men and women in the general degree of social anxiety and self-reported fears of interactions with the opposite sex, criticism and embarrassment, and speaking in public-talking to people in authority. These results point to small, but meaningful differences between men and women in social anxiety. Implications of these results for the self-report measurement of social anxiety in men and women are discussed.

Several studies have proposed that self-narrative transformation occurs through the elaboration of “Innovative Moments” (IMs), which are alternative experiences to the problematic self-narrative. This study aimed to analyze the emergence of IMs among 6 complicated grief women undergoing grief therapy according to the meaning reconstruction approach and to examine associations of IMs to the severity of grief symptomatology, assessed by the “Inventory of Complicated Grief.” Eighty-three sessions were analyzed using the “Innovative Moments Coding System” (IMCS). A generalized linear model analysis (GLM) showed a significant association between the emergence of IMs and the interaction between time and symptomatic improvement, indicating a higher rate of IM production over time in cases with better clinical outcomes. These results reinforce IMs' relevance in studying narrative change among cases with distinct clinical progressions.

No processo psicoterapeutico a mudanca constroi-se atraves da emergencia e expansao de excepcoes ao funcionamento problematico do cliente. Contudo, o potencial de mudanca destas excepcoes ou inovacoes pode ser abortado atraves da atenuacao do seu significado quando o cliente as desvaloriza, trivializa ou nega. Quando este processo se repete ao longo da terapia estamos na presenca de ambivalencia, na medida em que ocorre uma oscilacao recorrente entre duas posicoes opostas (inovacao-retorno ao funcionamento problematico). O presente estudo exploratorio tem como principal objectivo descrever a interaccao terapeutica nestes momentos de ambivalencia, num caso de insucesso psicoterapeutico, recorrendo ao Sistema de Codificacao da Colaboracao Terapeutica. Os resultados sugerem que a ambivalencia emerge maioritariamente no seguimento de intervencoes em que a terapeuta desafia a perspectiva habitual da cliente. Os resultados mostram ainda que a terapeuta tende a responder a ambivalencia da cliente com um novo desafio, sendo que a cliente tende a expressar novamente ambivalencia ou a discordar da terapeuta. Deste modo, quando a terapeuta persiste no desafio verifica-se frequentemente uma escalada no desconforto da cliente, que se manifesta na evolucao de uma resposta de ambivalencia para uma resposta de invalidacao por parte da cliente. Palavras-chave: Ambivalencia, Colaboracao terapeutica, Estudo de caso unico, Insucesso terapeutico.

The Assimilation of Problematic Experiences Scale (APES) summarizes a developmental continuum along which psychological problems progress in successful psychotherapy. The therapeutic zone of proximal development (TZPD) is the segment of the APES continuum within which the clients can proceed from their current APES level to the next with the therapist's assistance. It is the therapeutic working zone for a particular problem. As the client makes progress on a problem, its TZPD shifts up the APES. Theoretically, so long as the therapist's interventions remain within the TZPD, the client feels safe enough to work. However, when an intervention aims beyond the upper limit, the client will find it too risky and will reject or avoid the proposal. In this sense, exceeding the TZPD can be considered as a clinical error. This article presents examples of exceeding the TZPD and ways the error can be repaired., A part of this research was conducted at the Psychology Research Centre (UID/PSI/01662/2013), University of Minho, and was supported in part by the Portuguese Foundation for Science and Technology, the Portuguese Ministry of Science, Technology, and Higher Education, and FEDER through COMPETE2020 under the PT2020 Partnership Agreement (POCI-01-0145-FEDER-007653). This study was also partially supported by the BIAL Foundation., info:eu-repo/semantics/publishedVersion

Much has been written about the situations most often feared by persons with social phobia, and several self-report measures are frequently used to assess such feared situations. However, it is not clear whether the situations feared by persons with social phobia form unidimensional or multidimensional factors. If these situations are multidimensional, reliance on a total score of feared situations would not reflect important differences between those dimensions. This research examined the multidimensional nature and multicultural validity of a newly developed instrument (the Social Anxiety Questionnaire for Adults [SAQ-A]) in two studies with a total of 539 patients diagnosed with social phobia and 15,753 nonpatients from 20 different countries. The structure (five clear and solid factors) and psychometric properties of the final instrument (the SAQ-A30) support the multidimensional nature of social anxiety and provide a new perspective in the assessment of social phobia.

This work was supported by the Portuguese Foundation for Science and Technology (FCT); the PhD Grant SFRH/BD/46189/2008.

Apresentamos um estudo de caso cujo objectivo foi explorar a associação entre as rupturas na aliança terapêutica e a expressão verbal de necessidades do cliente em psicoterapia. Foi analisado um caso de insucesso de um cliente diagnosticado com Transtorno de Pânico com Agorafobia, através do Rupture Resolution Rating System (3R’s) e do Sistema de Observação de Responsividade Terapêutica Os dados resultantes da aplicação dos dois sistemas de observação foram analisados com o software de análise de séries temporais SMA. Os resultados indicam que um aumento da Expressão Verbal de Necessidades numa sessão está associada a uma diminuição dos marcadores de ruptura após três e quatro sessões e um aumento dos marcadores de rupturas numa sessão está associado a um aumento da EVN após quatro sessões. Esta associação foi mais evidente entre as rupturas de confronto, particularmente do marco de insatisfação com as actividades da terapia, e a expressão de necessidades directamente relacionadas com a terapia., We present a case study whose main goal was to explore the relationship between therapeutic alliance´s ruptures and the client’s verbal expression of needs in psychotherapy. We intensively analyzed an unsuccessful case of a client with Panic Disorder with Agoraphobia. The sessions were analyzed using the Ruptures Resolution Rating System (3R’s) and the Sistema de Observação de Responsividade Terapêutica . The results indicate that an increase in the Verbal Expression of Needs (EVN) is associated with a decrease of the ruptures three and four sessions later and that an increase in ruptures is associated with an increase of EVN four sessions later. There was a more clear association between the confrontation ruptures, particularly the expression of dissatisfaction about therapeutic activities, and a specific type of EVN:the client´s expression of direct requests related to therapy., Fundação para a Ciência e a Tecnologia (FCT)

The relationship between war exposure and PTSD has been largely investigated but the impact of the combat experience on physical health has only recently merited attention. The authors investigated the relationship between war exposure, psychological and physical health among 350 Portuguese colonial war veterans. The role of current PTSD symptoms as a mediator of these relationships was also investigated. The results showed that 39% of the veterans met criteria for current PTSD diagnosis and psychological distress was present in half of the sample. Pain, fatigue and sleep problems were the most reported physical symptoms and mental health and gastro-intestinal problems, the most reported illnesses. Combat exposure variables were significant predictors of current health. The results indicated that veterans with higher exposure to war trauma maintained higher current levels of psychological distress and presented more physical health problems and physical symptoms than those less exposed. Mediation analyses showed that current PTSD was a full mediator of the relationship between war exposure and physical health outcomes., The authors wish to thank the Fundação para a Ciência e Tecnologia, grant POCTI (POCTI/ESP/39515/2000), for financing this project. The authors are also grateful for the collaboration of the Associação Portuguesa de Veteranos de Guerra and their aid with the data collection.

Emergency service workers continuously face situations where they are in charge of the lives of others, and this can be a risk factor for their mental health. This study aims to determine the psychological impact of exposure to current death and physical injury events in the context of motor vehicle accidents among emergency personnel and which variables better predict posttraumatic stress disorder. Participants were National Institute of Medical Emergency workers (nurses and medical doctors; n= 59) in the north of Portugal. They filled out a trauma exposure and posttraumatic stress disorder scale (PTSD), a scale that assesses distress (General Health Questionnaire 12), a peritraumatic dissociation scale (Peritraumatic Dissociative Experiences Questionnaire) and a coping scale (Ways of Coping Questionnaire). Participants reported high exposure to events evaluated as traumatic, but low prevalence of PTSD. When the relation between exposure, time in emergency, sex, distress symptoms, peritraumatic dissociation, and PTSD symptoms was examined, peritraumatic dissociation and distress were the only predictors of PTSD symptoms, but beyond their contribution direct coping explains PTSD variance. In conclusion, taking into account the contribution of distress and peritraumatic dissociation to predict psychopathological symptoms, and the contribution of coping to lower PTSD scores, education and training should help the professionals deal with these reactions and improve coping, and organizations should support professionals in the most disturbing situations.

Objectives: This study evaluated the development of the therapeutic alliance and the emergence of alliance ruptures, in a sample of patients with different diagnosis and different therapeutic outcome. Design: We examined the longitudinal data of 38 therapeutic dyads receiving cognitive-behavioural therapy, including dropouts as well as successful and unsuccessful cases. The sample included cases with Axis I and Axis II disorders. Method: At the end of each session, patients evaluated the alliance using the Working Alliance Inventory (WAI). Six judges trained in the observation of alliance rupture markers with an observational system of ruptures, rated 201 videotaped sessions. Longitudinal statistical models were applied to the data. Results: We found that the pattern of alliance development of successful cases was different from the unsuccessful and dropouts cases. In addition on average, patients with personality disorders began therapy with a lower WAI score that decreased over time, whereas patients with Axis-I disorders began therapy with a higher WAI score that increased over time

The quality and strength of the therapeutic collaboration, the core of the alliance, is reliably associated with positive therapy outcomes. The urgent challenge for clinicians and researchers is constructing a conceptual framework to integrate the dialectical work that fosters collaboration, with a model of how clients make progress in therapy.We propose a conceptual account of how collaboration in therapy becomes therapeutic. In addition, we report on the construction of a coding system - the therapeutic collaboration coding system (TCCS) - designed to analyse and track on a moment-by-moment basis the interaction between therapist and client. Preliminary evidence is presented regarding the coding system's psychometric properties. The TCCS evaluates each speaking turn and assesses whether and how therapists are working within the client's therapeutic zone of proximal development, defined as the space between the client's actual therapeutic developmental level and their potential developmental level that can be reached in collaboration with the therapist.We applied the TCCS to five cases: a good and a poor outcome case of narrative therapy, a good and a poor outcome case of cognitive-behavioural therapy, and a dropout case of narrative therapy.The TCCS offers markers that may help researchers better understand the therapeutic collaboration on a moment-to-moment basis and may help therapists better regulate the relationship.

Several studies have suggested that the process of narrative change in psychotherapy occurs through the emergence and expansion of moments of novelty, known as innovative moments (IMs), that allow changes in the problematic self-narrative responsible for the client’s suffering. However, as these IMs challenge typical (and problematic) ways of acting, feeling, and thinking, they may also generate discrepancy or uncertainty. Clients may reduce uncertainty by returning to the problematic self-narrative immediately after the emergence of an IM, thus ensuring the homeostasis of the previous meaning system. This cyclical movement is a form of ambivalence, which can maintain problematic stability across therapy and lead to therapeutic failure. In this study, we identified return to the problem markers (RPMs), which are empirical indicators of the ambivalence process, for all IMs in two cases of constructivist grief psychotherapy. Both cases evidenced a high percentage of IMs with RPMs, and the evolution of IMs and RPMs along treatment was significantly correlated. We suggest that stability of the ambivalence process in grief psychotherapy may represent a form of self-protection from the anxiety or guilt of releasing pain as a disconnection from the deceased.

A new genus of fungus gnats Lusitanoneura gen. n. (Diptera: Mycetophilidae), allied to Ectrepesthoneura Enderlein, 1911, is described to include Ectrepesthoneura chandleri Caspers, 1991 from Crete and Cyprus and L. grandolensis sp. n. from Portugal. These species are considered congeneric with each other but not with the bulk of species hitherto assigned to Ectrepesthoneura.

O self de carreira constituí um subconjunto organizado do universo cognitivo de uma pessoa, responsável pelo carácter subjetivo que a mesma confere à carreira. Este estudo pretende avaliar mudanças no conteúdo do self de carreira de estudantes universitários, do início para o final do último ano de graduação. Para tal, recorreu-se a medidas repetidas dos índices da Grelha de Repertório da Carreira (Silva & Taveira, 2005; Silva, 2008). Na investigação, participaram 80 estudantes, dos quais 49 são mulheres (61,25%) e 31 são homens (38,75%), com idades entre os 21 e os 45 anos (M= 23,9, DP= 4,31). Os resultados indicam que, no final da licenciatura, os estudantes diminuem a distância como se constrõem em relação aos outros e mantêm uma construção positiva do self de carreira., Fundação para a Ciência e a Tecnologia (FCT)

En este estudio se presenta el análisis intensivo de un caso de abandono de terapia en el que se identificaron varios eventos de ruptura sin reparar. Hemos centrado nuestro análisis en la contribución de la terapeuta a estos episodios no resueltos. El número de intentos de intervención de la terapeuta fue cuatro veces menor que el número de las intervenciones previstas de acuerdo con los Modelos de Resolución de Rupturas. Las principales fallas de la terapeuta fueron: incapacidad para advertir el marcador de la ruptura, para validar la experiencia emocional de la paciente y para reconocer su propia responsabilidad en el problema. La evaluación de la terapeuta indicó un buen funcionamiento interpersonal y psicológico, lo que sugiere que su incapacidad para resolver adecuadamente las rupturas estuvo menos relacionada con este tipo de variables y más relacionada con el nivel de experiencia clínica y con factores de entrenamiento/supervisión., In this study we present the intensive analysis of a dropout case in which several unrepaired rupture events were identified. We focused our analysis on the therapist's contribution to these unresolved episodes. The number of therapist intervention attempts was about four times less than the number of expected interventions according to Rupture Resolution Models. The main therapist's failures were: inability to attend to the rupture marker; inability to validate the client's emotional experience and to acknowledge her own responsibility for the problem. Therapist's assessment indicated a good interpersonal and psychological functioning which suggests that her inability to adequately resolve ruptures was less related with this kind of variable and more related to the level of clinical experience and training/supervision factors., Fundação para a Ciência e a Tecnologia (FCT)

Tese de mestrado. Engenharia de Segurança e Higiene Ocupacionais. Faculdade de Engenharia. Universidade do Porto. 2012