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Objective This study thus aims to test differences between patients with inflammatory bowel disease (IBD) regarding IBD symptomatology, cognitive fusion, and psychological and physical health, as well as to explore whether the maladaptive emotion regulation process of cognitive fusion longitudinally impacts on the baseline and evolution of these outcomes over a period of 18 months. Design and methods Participants include 116 IBD patients with a mean age of 36.76 (SD = 11.39) of both genders (69.83% females) that completed the self-report measures of interest in three different times, equally spaced 9 months apart, over a period of 18 months. Latent growth curve models were conducted using structural equation modelling to estimate the growth trajectory of the variables in study. Results Inflammatory bowel disease symptomatology and cognitive fusion's levels were negatively associated with psychological health and physical health's baseline levels. Furthermore, IBD symptomatology did not influence the growth of psychological health, while cognitive fusion did (β = .30, p = .007). The same result was found for physical health (β = .26, p = .024). These findings indicate that individuals with higher levels of cognitive fusion present lower levels of psychological health and physical health that tend to further decrease over the time through the effects of this maladaptive emotion regulation process. Conclusions This study implies that it is of crucial importance to include psychotherapeutic interventions in the health care of patients with IBD. If successful, these interventions could represent decreases in the cost of IBD treatment and in the use of drugs with adverse side effects, in addition to improving patients’ mental health and quality of life. Further implications for clinical and research work are discussed. Statement of contribution What is already known on this subject? Research has demonstrated the impact of emotion regulation on both physical and mental health. Nevertheless, the longitudinal effects of the specific emotion regulation process of cognitive fusion on physical and psychological health have never been explored. Additionally, no study has yet examined the causal role of emotion regulation in evolution of physical health in inflammatory bowel disease (IBD). What does this study add? Cognitive fusion longitudinally impacted on IBD patients’ physical and mental health. These variables were measured over a period of 18 months. Treatment for IBD should include interventions aiming to diminish maladaptive emotion regulation.

This study aimed to examine the mediating role of rumination, experiential avoidance, dissociation and depressive symptoms in the association between daily peer hassles and non-suicidal self-injury among adolescents. Additionally, this study explored gender differences in these associations and tested whether the proposed model was invariant across genders. The sample consisted of 776 adolescents, of them 369 are males (47.6%) and 407 are females (52.4%), aged between 12 and 18 years old from middle and high schools in Portugal. Participants completed self-report questionnaires to assess daily peer hassles, rumination in its severe component (i.e., brooding), experiential avoidance, dissociation, depressive symptoms and non-suicidal self-injury. Path analysis showed that daily peer hassles indirectly impact on non-suicidal self-injury through increased levels of brooding, experiential avoidance, dissociation, and depressive symptoms. Results indicated significant gender differences in mean scores and path analysis. Male adolescents were more likely to engage in brooding and experiential avoidance in response to external distress (particularly, daily peer hassles), whereas female adolescents were more likely to engage in non-suicidal self-injury in response to internal distress (particularly, depressive symptoms). These findings suggest relevant preventive and intervention actions to address emotion dysregulation in adolescence, by teaching them acceptance and mindfulness skills as a way of coping with stressful experiences and internal distress.

This study presents the Inflexible Eating Questionnaire (IEQ), which measures the inflexible adherence to subjective eating rules. The scale's structure and psychometric properties were examined in distinct samples from the general population comprising both men and women. IEQ presented an 11-item one-dimensional structure, revealed high internal consistency, construct and temporal stability, and discriminated eating psychopathology cases from non-cases. The IEQ presented significant associations with dietary restraint, eating psychopathology, body image inflexibility, general psychopathology symptoms, and decreased intuitive eating. IEQ was a significant moderator on the association between dietary restraint and eating psychopathology symptoms. Findings suggested that the IEQ is a valid and useful instrument with potential implications for research on psychological inflexibility in disordered eating.

Purpose This study explored the role of several psychological factors in professional quality of life in nurses. Specifically, we tried to clarify the relationships between several dimensions of empathy, self-compassion, and psychological inflexibility, and positive (compassion satisfaction) and negative (burnout and compassion fatigue) domains of professional quality of life. Methods Using a cross-sectional design, a convenience sample of 221 oncology nurses recruited from several public hospitals filling out a battery of self-report measures. Results Results suggested that nurses that benefit more from their work of helping and assisting others (compassion satisfaction) seem to have more empathic feelings and sensibility towards others in distress and make an effort to see things from others' perspective. Also, they are less disturbed by negative feelings associated with seeing others' suffering and are more self-compassionate. Nurses more prone to experience the negative consequences associated with care-providing (burnout and compassion fatigue) are more self-judgmental and have more psychological inflexibility. In addition, they experience more personal feelings of distress when seeing others in suffering and less feelings of empathy and sensibility to others' suffering. Psychological factors explained 26% of compassion satisfaction, 29% of burnout and 18% of compassion fatigue. Conclusion We discuss the results in terms of the importance of taking into account the role of these psychological factors in oncology nurses' professional quality of life, and of designing nursing education training and interventions aimed at targeting such factors.

A síndrome de Gorlin-Goltz é uma patologia hereditária, rara, autossómica dominante de penetrância completa, com expressividade variável. Caracterizada pelo aparecimento de múltiplos basaliomas, cursa, frequentemente, com o desenvolvimento de queratoquistos. Depressões palmares/plantares, calcificações da foice cerebral, anomalias esqueléticas congénitas, constituem, igualmente, critérios de diagnóstico, embora menos frequentes. Este artigo expõe dois casos clínicos, envolvendo familiares diretos, referenciados após identificação de vários basaliomas e quistos maxilares. Estabelecido o diagnóstico, perante a identificação de três critérios major, o tratamento consistiu na excisão das lesões, seguida, num dos casos, da terapêutica com vismodegib, com remissão completa. A síndrome de Gorlin-Goltz é, assim, um desafio multidisciplinar, cuja morbilidade variável e o elevado risco de recorrência tornam fundamental o tratamento e vigilância. Contudo, o aparecimento de novas terapêuticas moleculares dirigidas trazem uma nova esperança no tratamento destes doentes.

Antecedentes/Objetivo: Este estudio tuvo como objetivo explorar las propiedades psicométricas del BI-AAQ (Body-Image Acceptance and Action Questionnaire) y el papel mediador de la inflexibilidad psicológica relacionada con la imagen corporal en una trayectoria nociva hacia la ingesta compulsiva en muestras brasile˜nas. Método: Este estudio transversal se llevó a cabo en grupos clínicos (mujeres con sobrepeso u obesidad actualmente en tratamiento para la pérdida de peso; n= 330) y no clínicos (grupo de población general; n= 682) de mujeres. Resultados: BI-AAQ presenta la estructura de un factor, excelente consistencia interna, capacidad para detectar diferencias entre grupos e invariancia de medida entre diferentes muestras. Sus puntuaciones se asociaron negativamente con la autocompasión y positivamente con la severidad de la compulsión alimentaria, búsqueda de la delgadez y autocrítica. Conclusiones: Este estudio proporcionó datos que confirman que el BI-AAQ tiene propiedades psicométricas sólidas en muestras cualitativamente diferentes. Además, un estudio adicional efectuado en una muestra clínica de mujeres con sobrepeso u obesidad reveló que la inflexibilidad psicológica relacionada con la imagen corporal emergió como mediadora parcial y significativa del efecto de

Objectives Mindfulness-based interventions (MBIs) have received large empirical support for their efficacy. In comparison, few studies have explored the underlying mechanisms and processes through which MBIs impact outcomes. This study aimed to explore the potential role of trait mindfulness, self-compassion and psychological inflexibility as mediators of the effects of a MBI on burnout, compassion fatigue, psychological symptoms and satisfaction with life. Method This study used data from a non-randomized controlled study with a sample of oncology nurses. Participants were recruited from two large oncology hospitals in Portugal's north and centre regions. A sample of 94 oncology nurses agreed to participate in the study and self-selected into an experimental ( n =45) and a wait-list comparison condition ( n =48). Participants in the wait-list comparison condition received the intervention at a later date. Complete data was obtained for 48 of the initial 94 participants, mainly due to poor follow-up data rather than high drop-out rate. The data analysed was from both waitlist and intervention participants after the waitlist group had received the intervention. Participants completed self-report measures to assess several processes, such as mindfulness, psychological inflexibility, self-compassion, and several outcomes, such as burnout and compassion fatigue, depression, anxiety and stress symptoms, and satisfaction with life. Results Changes in mindfulness mediated changes in burnout, anxiety and stress, and satisfaction with life; changes in self-compassion mediated the impact of the intervention on burnout, depression, anxiety, stress and satisfaction with life; and psychological inflexibility mediated reductions in burnout, compassion fatigue, depression, and stress. Conclusions These findings contribute to the growing body of research examining the underlying mechanisms at work in MBIs, and highlight the importance of mindfulness, self-compassion and psychological inflexibly as key change processes.

Alguns besouros atacam a madeira imediatamente após o abate da árvore, enquanto outros preferem a madeira em diferentes estágios de degradação. Nesta categoria estão inseridos os besouros da família Passalidae. O objetivo deste estudo foi avaliar a ocorrência de besouros dessa família em amostras provenientes de troncos de Scleronema micranthum, espécie florestal da Amazônia Central. As amostras ficaram expostas à biodegradação durante 24 meses no solo da floresta da Estação Experimental de Silvicultura Tropical do Instituto Nacional de Pesquisas da Amazônia, em Manaus, Amazonas, Brasil. Durante esse período, a cada dois meses, 15 amostras foram removidas da floresta para a coleta desses insetos e avaliação da infestação. Foi registrada a presença de seis espécies, todas da tribo Passalini: Passalus (Pertinax) latifrons, P. (Passalus) variiphyllus, P. (Pertinax) convexus, P. (Passalus) interstitialis, P. (Passalus) lanei e Paxillus leachi. Dentre as espécies, P. (Passalus) interstitialis foi a mais abundante, com 18 indivíduos; foi a primeira a infestar as amostras e foi registrada entre o oitavo e o vigésimo mês do experimento. A infestação ocorreu predominantemente na casca e alburno da madeira. Some beetles can attack the wood immediately after the tree is felled, but there are those that start their attack at different stages of wood degradation. Beetles of the family Passalidae belong to this latest category. The objective of this study was to assess the occurrence of beetles of this family in wood samples taken from trunks of Scleronema micranthum, a forest species from Central Amazon. The samples were exposed to biodegradation for 24 months on the forest ground of the Experimental Station of Tropical Silviculture of the National Institute for Amazonian Research, in Manaus, Amazon State, Brazil. During that period, 15 samples were removed from the experiment, every two months, for insect collection and evaluation of infestation. The presence of six species was recorded, all of them of the Passalini tribePassalus (Pertinax) latifrons, P. (Passalus) variiphyllus, P. (Pertinax) convexus, P. (Passalus) interstitialis, P. (Passalus) lanei, and Paxillus leachi. Among these species, P. (Passalus) interstitialis was the most abundant, with 18 individuals. This species was the first one to infest the samples and was found between the eighth and twentieth month of the experiment. The infestation occurred predominantly in the bark and sapwood.

Background\ud Binge eating disorder (BED) is associated with several psychological and medical problems, such as obesity. Approximately 30% of individuals seeking weight loss treatments present binge eating symptomatology. Moreover, current treatments for BED lack efficacy at follow-up assessments. Developing mindfulness and self-compassion seem to be beneficial in treating BED, although there is still room for improvement, which may include integrating these different but complimentary approaches. BEfree is the first program integrating psychoeducation-, mindfulness-, and compassion-based components for treating women with binge eating and obesity.\ud \ud Objective\ud To test the acceptability and efficacy up to 6-month postintervention of a psychological program based on psychoeducation, mindfulness, and self-compassion for obese or overweight women with BED.\ud \ud Design\ud A controlled longitudinal design was followed in order to compare results between BEfree (n = 19) and waiting list group (WL; n = 17) from preintervention to postintervention. Results from BEfree were compared from preintervention to 3- and 6-month follow-up.\ud \ud Results\ud BEfree was effective in eliminating BED; in diminishing eating psychopathology, depression, shame and self-criticism, body-image psychological inflexibility, and body-image cognitive fusion; and in improving obesity-related quality of life and self-compassion when compared to a WL control group. Results were maintained at 3- and 6-month follow-up. Finally, participants rated BEfree helpful for dealing with impulses and negative internal experiences.\ud \ud Conclusions\ud These results seem to suggest the efficacy of BEfree and the benefit of integrating different components such as psychoeducation, mindfulness, and self-compassion when treating BED in obese or overweight women.\ud \ud Key Practitioner Message\ud The current study provides evidence of the acceptability of a psychoeducation, mindfulness, and compassion program for binge eating in obesity (BEfree);\ud Developing mindfulness and self-compassionate skills is an effective way of diminishing binge eating, eating psychopathology and depression, and increasing quality of life in women with obesity;\ud Integrating psychoeducation, mindfulness, and compassion seem to be effective in diminishing binge eating, with results maintained up to 6-month postintervention.

Ferreira, C., Duarte, C., Pinto-Gouveia, J., & Lopes, C. (2016). The need to present a perfect body image: Development of a new measure of perfectionistic self-presentation. Current Psychology, 1-9. doi: 10.1007/s12144-016-9537-9. Perfectionistic self-presentation is linked to different clinical conditions and especially to eating disorders. In fact, the role that the drive to reach “perfection” and display it to others plays on eating and body image-related symptoms has long been the target of theoretical and empirical interest. However, an instrument that specifically assessed the need to present a perfect body image to others did not exist. The current study presents the development and validation of the Perfectionistic Self-Presentation Scale – Body Image (PSPS-BI), a measure designed to assess the need to present a perfect body image to others by displaying a flawless physical appearance and by occulting perceived imperfections in a public context. Three studies that included a total of 364 males and 541 females with ages between 18 to 38 years, were used to examine the scale’s structure and psychometric properties. Results showed that PSPS-BI presents two factors that measure the concealment of body imperfections and the display of body perfection. PSPS-BI revealed good internal reliability and temporal stability. Also, the PSPS-BI revealed good concurrent validity, tested with measures of perfectionism, body image flexibility, and general and eating psychopathology. Furthermore, a mediational analysis indicated that the need to present a perfect body image to others fully mediates the relationship between a general measure of perfectionistic self-presentation and drive for thinness, in both men and women. PSPS-BI showed good preliminary evidence as a reliable and accurate measure, and seems to offer new possibilities to the research field of body image and eating-related difficulties.

Objectives The current study examined a path model testing the indirect effect of negative body-image related memories of being teased and bullied in childhood and adolescence on binge eating severity symptoms, via its effect on current body image shame and body image flexibility. Methods Participants were 853 Portuguese women from the general community who completed a set of self-report measures of body image-related bullying and teasing experiences in childhood and adolescence, current body image shame, body image flexibility, binge eating symptoms, body mass index (BMI) and depressive symptoms. Results The path model accounted for 40% of the variance of binge eating symptoms and 14% of the variance of BMI, and revealed a very good fit. Findings corroborated the plausibility of the hypothesized associations suggesting that negative body image-related memories and emotional experiences are significantly associated with binge eating symptoms and BMI, and that body image flexibility is a significant mediator of these associations. The examined relationships were preserved after controlling for the effect of depressive symptoms. Conclusions The current study's findings contribute to clarify the role that body image-related memories and emotional experiences may play on individuals' difficulties in regulating eating behaviour and weight, and provides preliminary support for the potential effect of body image flexibility as a self-regulatory process that operates in these associations.

Background Job stress and burnout are highly frequent in healthcare professionals, and prevalence in nurses can be as high as 40%. Mindfulness-based interventions have been shown to be effective in reducing stress and increasing well-being in a wide range of populations and contexts. However, controlled studies with healthcare professionals, and especially nurses, are scarce. Objectives, design and setting The aim of this study was to explore the effectiveness of an on-site, abbreviated mindfulness-based intervention for nurses, using a nonrandomized, wait-list comparison design. The effectiveness of the intervention was measured through several validated self-report measures that participants completed before and after the intervention, assessing burnout, compassion fatigue, psychological symptoms, mindfulness, self-compassion, experiential avoidances, rumination, and satisfaction with life. Participants A sample of 94 oncology nurses agreed to participate in the study and self-selected into an experimental ( n =45) and comparison condition ( n =48). Complete data was obtained for 48 of the initial 94 participants, mainly due to poor follow-up data rather than high drop-out rate. Results Statistical analyses included a series of 2×2 ANOVAs and ANCOVAs. Results indicated that nurses in the intervention reported significant decreases in compassion fatigue, burnout, stress, experiential avoidance, and increases in satisfaction with life, mindfulness and self-compassion, with medium to large effect sizes. Nurses in the comparison group didn't present significant changes in these variables. Results also pointed to a high degree of acceptability of the intervention. Conclusions This study provides preliminary evidence that mindfulness-based interventions may be efficacious in reducing oncology nurses' psychological symptoms and improving their overall well-being, and thus may be worthy of further study in this population.

Several studies have highlighted the adaptive role of self-compassion on human suffering and on a wide range of psychopathological conditions. Extensive research has shown that emotional intelligence has been associated with well-being, mental and physical health and quality of interpersonal relationships. We set out to explore the mediating role of self-compassion and emotional intelligence on the relationship between shame traumatic memories and depressive symptoms, and to explore if these were different between female and male adolescents. The sample was composed of 1101 adolescents from general population, whose age ranged from 14 to 18 years. Participants filled out a battery of self-report questionnaires designed to measure shame traumatic memories, self-compassion, emotional intelligence and depressive symptoms. Correlational analysis showed that in male and female adolescents, shame traumatic memories are associated with more depressive symptoms and with lower levels of self-compassion and emotional intelligence. Multigroup analysis showed that emotional intelligence has a greater impact on depression in female adolescents. Also, the impact of shame traumatic memories on depression is stronger in males, even though females report shame traumatic memories as more impactful. This study provides preliminary evidence that self-compassion and emotional intelligence are important emotion regulation processes for depressive symptoms in adolescence.

This study explores the efficacy of BEfree, a 12-session group intervention that integrates psychoeducation, mindfulness, compassion and value-based action, in a sample of overweight and obese women with binge eating disorder ( N = 31). We used repeated measures analyses of variance and explored processes of change in binge eating and eating psychopathology. At post-intervention, participants decreased in binge eating severity, eating psychopathology, external shame, self-criticism, psychological inflexibility, body image cognitive fusion and increased self-compassion and engagement with valued actions. These results were maintained at 3- and 6-month follow-up. The changes in binge eating were mediated by the changes in the psychological processes promoted by BEfree.

This psychometric study explores the Portuguese version of the Posttraumatic Stress Disorder (PTSD) Checklist (PCL-5). It aims to clarify the best-fitting latent structure among competing PTSD models (Diagnostic and Statistical Manual of Mental Disorders-fifth edition [DSM-5], Dysphoria, Dysphoric Arousal, Anhedonia, Externalizing Behavior, And Hybrid models) and its implications for PTSD measurement.Psychometric analyses were conducted in a sample from the general population of firefighters (N = 446), except the temporal stability, which was tested in a subsample of 100 participants.The models presented significant differences in a global fit. The Hybrid model presented the best-fitting structure, but the DSM-5 model showed more favorable reliability and convergent validity in Confirmatory Factor Analyses. The DSM-5 model also proved to be internally consistency, temporally stable, and presented convergent validity.The Portuguese version of PCL-5 is reliable and valid. The findings suggest the appropriateness of the DSM-5 model to assess PTSD symptomatology, encouraging its use in clinical, and research settings.

A comunicação sexual entre pais e filhos é um dos fatores que mais influência o comportamento sexual preventivo dos jovens. Este estudo teve como objetivo conhecer as perspetivas de pais e mães sobre a educação sexual na família e na escola. Para isso, 367 pais de ambos os sexos responderam ao "Questionário para pais sobre educação sexual". Os resultados evidenciam que os pais apoiam a educação sexual nas escolas e a inclusão de um programa abrangente entre o 2º e o 3ºciclo do ensino básico. Todos os temas são importantes para o currículo da educação sexual nas escolas. Apesar de considerarem proporcionar uma boa educação sexual em casa, muitos pais comunicam de forma superficial sobre diversos temas, revelando dificuldades na comunicação. Ter conhecimentos e sentir-se confortável parece ter implicações positivas na extensão da comunicação, na qualidade da educação sexual oferecida e no incentivo aos/às filhos/as para participarem em atividades de educação sexual na escola. São apresentadas sugestões e implicações para futuros estudos e intervenções com pais.

The PCL (Weathers et al., 1993) is a useful and widely used measure to assess PTSD symptoms in clinical and research contexts, exhibiting adequate psychometric properties across its several versions and translations (e. g. Carvalho et al., 2015; Wilkins et al., 2011). The current study analyzed the psychometric properties (latent structure, internal consistency, temporal reliability, and convergent validity) of the Portuguese version of the PCL for the DSM-5 (PCL-5, Weathers et al., 2013) in a sample of firefighters. This study also aimed to contribute with empirical data to clarify the best latent structure of DSM-5 PTSD symptoms. Specifically, the DSM-5 four-factor model and other competing models for PTSD symptoms (four-factor Dysphoria model, five-factor Dysphoric Arousal model, six-factor Anhedonia model, six-factor Externalizing Behavior model, and seven-factor Hybrid model) applied to PCL-5 were analyzed and compared in this paper.

This study consisted of secondary data analysis of information collected from inmates who had participated in an earlier independent randomized controlled trial testing the effects of the Growing Pro-Social (GPS) program. The current study assessed personality disorders as moderators of the GPS effects in cognitive malfunctioning, emotion regulation strategies, and prison misconduct in male prison inmates. Participants were 254 inmates randomly assigned to either the GPS (n = 121) or the control group (n = 133). Participants completed self-report measures at four time points, and were interviewed with the SCID-II at baseline. Prison misconduct information was collected from prison records. Latent profile analysis identified four different personality pathology profiles. Mixed ANOVAs showed non-significant time × condition × personality pathology profiles effects, indicating that change on the outcome measures was not affected by personality pathology. Findings suggested that severely disturbed inmates could benefit from the GPS program, which stresses the need to provide appropriate treatment to offenders.

The Mindfulness-Based Program for Infertility (MBPI) was developed for people facing infertility and proved effective in cultivating mindfulness skills, improving infertility self-efficacy, and decreasing depression, shame, entrapment, and defeat feelings. Fifty-five women attended the MBPI sessions and completed self-report measures of depression, anxiety, mindfulness, and experiential avoidance at post-MBPI (T1), 6-month follow-up (T2), and 7-year follow-up (T3). There were significant direct time effects regarding experiential avoidance (F = 3.81; p < 0.033; ηp 2 = 0.08), the mindfulness facets describing (F = 3.54; p = 0.037; ηp 2 = 0.13), acting with awareness (F = 6.87; p = 0.002; ηp 2 = 0.22), nonjudging of inner experience (F = 10.66; p < 0.001; ηp 2 = 0.31), and depressive symptoms (F = 4.85; p = 0.020; ηp 2 = 0.10). There was an increase in the describing facet from T1 to T3 (p = 0.036). The act with awareness facet increased from T1 to T2 (p = 0.010) and from T1 to T3 (p = 0.007), as well as the nonjudging of inner experience facet (T1 to T2 [p = 0.030] and T1 to T3 [p = 0.002]). Experiential avoidance decreased from T1 to T3 (p = 0.022) and depressive symptoms from T1 to T2 (p = 0.019). Post-MBPI scores were maintained at T2 and T3 concerning anxiety symptoms and the observing and no-reactivity mindfulness facets. There were long-term effects of MBPI on mindfulness and experiential avoidance. Moreover, therapeutic gains were maintained regarding depression and anxiety symptoms, independently of the reproductive outcome.

Objective: The potential benefit or harm of immersion (egocentric perspective) and distancing (observer perspective) on negative experiences are unclear and have not been empirically investigated in therapy. This is a first exploratory study aimed to analyze and compare the perspectives adopted on reflection (immersion and distancing) of negative experiences across therapy and the relationship between them and depressive symptoms in contrasting therapeutic outcomes of emotion-focused therapy (EFT). Method: Three good-outcomes cases and three poor-outcomes cases of EFT, diagnosed with mild to moderate depression at the beginning of therapy, were randomly selected. Immersion and distancing on negative experiences were analyzed using the measure of immersed and distanced speech. The depressive symptoms were assessed by the Beck Depression Inventory-II. Results: Significant differences across sessions were only found in the good-outcome cases which showed a significant decrease of immersion and an increase of distancing, and this evolution pattern was found related to the reduction of symptoms. Moreover, at the beginning of therapy, distancing was higher in the poor-outcome cases rather than in the good-outcome cases. Conclusion: The progressive and significant evolution from higher immersion at the initial phase to higher distancing in the final phase may be helpful in EFT for depression. info:eu-repo/semantics/publishedVersion

This paper aims to adapt and validate the Risk-taking and Self-harm Inventory for Adolescents (RTSHIA) in Portuguese language. Results confirm the two-factor structure originally proposed (Risk-taking; Self-harm). Both dimensions presented an adequate internal reliability and temporal stability. Convergent validity and socio-demographic differences are analyzed. Preventive and clinical implications are discussed.

Published: 26 November 2018/ Issue Date: March 2021 This study explores the mediating role of rumination and valued living in the relationship between mindfulness and depressive symptoms in a sample of women with chronic pain. Women with musculoskeletal chronic pain (N = 124) were recruited online through the advertisement of the study in several national associations for individuals with chronic pain. Participants responded a set of questionnaires that aimed to assess mindfulness, rumination, obstructions to and progress in valued living, and depressive symptoms. All variables were significantly associated in the expected directions. Results showed the relationship between mindfulness and depressive symptoms was fully mediated by rumination and experiencing obstructions in valued living, but not by difficulties in moving forward towards valued living. Clinical implications are discussed. Results seem to suggest the potential benefits of explicitly targeting general rumination and internal obstructions to living congruently to personal values, when conducting mindfulness-based interventions for reducing depression in chronic pain.

Weight self-stigma is conceptualized as a multidimensional concept involving experiences of shame, self-devaluation and the perception of being discriminated against in social situations due to one's weight. It has been associated with experiential avoidance, unhealthy eating behaviors, binge eating and diminish quality-of-life (QoL). The current study aims to explore the mediation effect of weight-related experiential avoidance on the relationship between weight self-stigma and obesity-related QoL in women with and without binge eating (BE). The sample comprised 282 women with overweight or obesity, from which 100 presented BE symptoms. Sample's mean age was 44.24 years (SD = 11.30), with a mean BMI of 31.40 kg/m(2) (SD = 4.53). Participants completed a set of self-reported measures regarding BE symptoms, weight self-stigma, weight-related experiential avoidance and QoL. Results from path analysis supported the mediation of weight-related experiential avoidance on the relationship between weight self-stigma and QoL, even when controlling for BMI. The model accounted 58% of QoL variance. Furthermore, the multi-group analysis revealed that the model was not invariant for both groups. The analysis of the critical ratios showed that the path from weight-related experiential avoidance to QoL was stronger for the BE group. Also the model only explained 39% of QoL for the group without BE and 65% of QoL for the BE group. This study highlights the pervasive role of weigh self-stigma, particularly fear of being discriminated and weigh-related experiential avoidance on obesity-related quality-of-life, especially for those women with BE. Additionally, it supports that interventions should focus not only in weight loss but also in improving individual's QoL, promoting the development of adaptive emotional regulation strategies. FCT (Portuguese Foundation for Science and Technology)

Several studies point out to the influence of social experiences on perceptions of the environment and others in cognitive functioning and different aspects of psychopathology. The current study aimed at studying the influence of the psychosocial risk factors in a mixed sample of participants from the general population and affected by paranoid schizophrenia. The extent to which the existence of negative life events and events that are threatening to the inner models of the self (i.e., history of maltreatment, physical, social or psychological abuse) or the memories of these traumatic events occurring during childhood are related to the existence of paranoid beliefs in adulthood was explored. RESULTS suggested that memories of parental behaviours characterized by antipathy from both parental figures, submissiveness and bullying victimization were important predictors of paranoid ideation in adult life. This further emphasizes the need for understanding the family and social dynamics of people presenting paranoid ideations to the development of therapeutic interventions that can effectively reduce the invalidation caused by severe psychopathology, as is the case of schizophrenia. Copyright © 2015 John Wiley & Sons, Ltd. KEY PRACTITIONER MESSAGE: Memories of family dynamics characterized by behaviours of antipathy from both parental figures, submissiveness and bullying victimization are important predictors of paranoid ideation in adult life. The study highlights the importance of exploring subjective recalls of feelings and behaviours associated with early rearing experiences, peer relationships and themes related to social rank theory in the roots of internal models of relationship with the self and others in the general sample, patients diagnosed with schizophrenia and their first-degree relatives. Our findings indicate that schizophrenic patients in active phase differ regarding memories of threat and submission and are more likely to remember childhood experiences perceived as threatening during an active phase than when in remission. It is possible that by changing these internal models and social interaction styles, patients may be able to get involved in more cooperating and affiliative interactions, disconfirming these early beliefs about others being rejecting, critical or hostile towards the self, and more effectively reducing the invalidation caused by positive and negative symptomatology of schizophrenia on social functioning. Language: en

O carcinoma espinhocelular cutâneo é uma neoplasia cutânea não melanocítica, potencialmente fatal, que resulta da proliferação descontrolada dos queratinócitos. Predominante na cabeça e pescoço, esta surge preferencialmente em zonas expostas ao sol. O diagnóstico tem por base a apresentação clínica da lesão, corroborado com o auxílio da dermatoscopia, necessitando, porém, da confirmação histológica.Este trabalho reporta o caso de um homem de 71 anos referenciado por lesão do lábio inferior, hiperqueratósica e infiltrativa, sugestiva de carcinoma espinhocelular cutâneo. Confirmado a suspeita procedeu-se à excisão radical da lesão, cujo defeito resultante ocupava 70% do comprimento do lábio inferior na sua porção mediana, em espessura total, tendo-se recorrido à reconstrução com recurso aos retalhos de deslizamento e rotação descritos por Karapandzic. O resultado final caracterizou-se por cicatrizes a preencherem os sulcos fisiológicos e pela manutenção da continência oral, bem como da sensibilidade e mobilidade labiais.

O eritema acral da quimioterapia é caracterizado por áreas eritematosas e dolorosas, envolvendo predominantemente as mãos e pés, com formação de bolhas em casos severos. A gemcitabina é responsável frequentemente por reacções adversas cutâneas, embora estas sejam habitualmente transitórias e ligeiras. Relatamos o caso de um doente sob quimioterapia paliativa com gemcitabina por adenocarcinoma ductal pancreático, que desenvolveu lesões bolhosas em ambos os pés, de maiores dimensões à esquerda. A histopatologia foi consistente com eritema acral. A variante bolhosa do eritema acral da quimioterapia é uma reacção rara e, embora descrita para agentes citotóxicos estruturalmente semelhantes, não tem sido associada à gemcitabina. No doente apresentado, os antecedentes pessoais de doença arterial periférica podem ter desempenhado um papel importante na apresentação clínica final.

Background Job stress and burnout are common among healthcare professionals, and nurses in particular. In addition to the heavy workload and lack of recourses, nurses are also confronted with emotionally intense situations associated with illness and suffering, which require empathic abilities. Although empathy is one of the core values in nursing, if not properly balanced it can also have detrimental consequences, such as compassion fatigue. Self-compassion, on the other hand, has been shown to be a protective factor for a wide range of well-being indicators and has been associated with compassion for others. Objectives The main goal of this study was to explore how empathy and self-compassion related to professional quality of life (compassion satisfaction, compassion fatigue and burnout). In addition, we wanted to test whether self-compassion may be a protective factor for the impact of empathy on compassion fatigue. Methods and participants Using a cross-sectional design, 280 registered nurses from public hospitals in Portugal's north and center region were surveyed. Professional quality of life (Professional Quality of Life), empathy (Interpersonal Reactivity Index) and self-compassion (Self-compassion Scale) were measured using validated self-report measures. Results Correlations and regression analyses showed that empathy and self-compassion predicted the three aspects of professional quality of life. Empathic concern was positively associated with compassion satisfaction as well as with compassion fatigue. Mediation models suggested that the negative components of self-compassion explain some of these effects, and self-kindness and common humanity were significant moderators. The same results were found for the association between personal distress and compassion fatigue. Conclusions High levels of affective empathy may be a risk factor for compassion fatigue, whereas self-compassion might be protective. Teaching self-compassion and self-care skills may be an important feature in interventions that aim to reduce burnout and compassion fatigue.

The aims of the present study were to develop and validate a scale specifically focused on shame feelings derived from chronic illness-related experiences, the Chronic Illness-related Shame Scale (CISS) and to fill a gap in literature and analyse the role of this construct in the association between inflammatory bowel disease (IBD) symptomatology and depressed mood. This study comprised two samples: a sample of 161 IBD patients and a mixed sample of 65 chronic patients that reported medical data and completed self-report measures. The CISS's unidimensional seven-item structure was evaluated through confirmatory factor analyses. These analyses revealed good to excellent global and local adjustments in both samples. Results also showed that the CISS presents excellent internal consistencies and convergent, concurrent and divergent validity, being a valid, short and robust scale. Furthermore, the present study explored through path analyses, the role of CISS and self-judgement in the relationship between IBD symptomatology and depressed mood. Results showed that, although the level of IBD symptomatology directly predicted patients' depressive symptoms, the majority of this effect was mediated by CISS and self-judgement. Possible explanations for these findings are discussed in more detail in the succeeding text. The present study seems to highlight the pertinence of developing IBD patients' self-compassionate abilities to adaptively deal with symptomatology and related shame feelings. It thus may represent an avenue for the development of compassionate-based interventions for IBD patients and for the conduction of future studies exploring the shame phenomenon in other chronic illnesses. Copyright © 2016 John Wiley & Sons, Ltd. Key Practitioner Message A new measure, the Chronic Illness-related Shame Scale (CISS), was developed CISS was revealed to be robust instrument in samples of inflammatory bowel disease (IBD) and cancer patients CISS and self-judgement mediate the relationship between IBD symptomatology and depressed mood This model presented an excellent adjustment and explained 55% of depressed mood's variance Results suggest that treatment programmes for IBD should include compassionate-based interventions

Experiential avoidance, defined as attempts to control or change unwanted internal experiences when doing so causes harm, has been consistently associated with physical and mental health problems and has been traditionally measured using the Acceptance and Action Questionnaire. Several studies have highlighted the importance of developing content-specific measures to better capture relevant processes for specific populations. One such measure is the Acceptance and Action Questionnaire for Weight-Related Difficulties (AAQ-W), which measures experiential avoidance of unwanted weight related thoughts, feelings and actions. The AAQW factor structure still requires further examination. The present study aims to contribute to the further development of the AAQW by conducting a confirmatory factor analysis (CFA) based on the existent factor structures and testing the measurement invariance across groups, through a multi-group analysis. Three distinct samples were used: the CFA used 215 women from the general population with BMI

The mediating effect of acceptance and mindfulness in the relationship between pain, depression, and physical disability was examined in 55 rheumatoid arthritis patients. Results showed that the relationship between pain and depression was mediated by both nonreact and acceptance. By contrast, the relationship between pain and physical disability was mediated by acceptance but not by nonreact. This study provides evidences that the influence of these processes is different on depression and on physical disability. These findings support models that take both general measures of mindfulness and content-specific measures of acceptance into account when conceptualizing rheumatoid arthritis. Theoretical and clinical implications are discussed.

Cognitive fusion has been related to the development and maintenance of a series of mental health difficulties. Specifically, growing research on eating psychopathology has been demonstrating the important role of cognitive fusion related to body image in these disorders. Nonetheless, cognitive fusion specifically focused on eating remained to be investigated. The current study aimed at developing and validating the Cognitive Fusion Questionnaire-Food Craving, a measure assessing the extent to which an individual is fused with food-craving undesirable and disturbing thoughts and urges. This study was conducted with distinct samples comprising men and women from the student and general population. A principal component analysis was conducted to assess the scale's structure, which was further examined in a confirmatory factor analysis. The scale's reliability and validities were also analysed. Results indicated that the CFQ-FC presented a one-dimensional structure with 7 items, accounting for 66.14% of the variance. A CFA confirmed the plausibility of the measurement model, which was found to be invariant in both sexes. The CFQ-FC also revealed very good internal consistency, construct reliability, temporal stability, and convergent and divergent validity, being positively associated with similar constructs and with indicators of eating and general psychopathology. CFQ-FC also discriminated individuals with clinically significant symptoms of binge eating from participants with no symptoms. Finally, the CFQ-FC presents incremental validity over a global measure of cognitive fusion in predicting eating psychopathology, namely binge eating. The CFQ-FC is a psychometrically sound measure that allows for a brief and reliable assessment of eating-related cognitive fusion. This is a novel measure that may significantly contribute for the assessment of this specific dimension of cognitive fusion and for the understanding of its role in eating psychopathology.

Background: Non-suicidal self-injury (NSSI) is a serious and relatively prevalent problem in adolescence. Although several studies have identified risk factors for the aetiology and maintenance of NSSI, little is known about the impact of individual and contextual variables in such pervasive behaviors among adolescents. Objective: This paper aims to test whether specific internal traits characterized by shame, self-criticism and fear of self-compassion impact on NSSI, through their effect in daily peer hassles and depression. Methods: Participants are 782 adolescents with 12-18 years-old from middle and secondary schools (years of education’s mean = 9.46). This study has a cross-sectional design. Self-report measures include external shame, self-criticism, fear of self-compassion, daily peer hassles, depressive symptoms and NSSI. Results: External shame, hated self and fear of self-compassion indirectly predict NSSI, through their effect in daily peer hassles and depression. The most pathological form of self-criticism (hated self) is strongly associated with NSSI. Conclusions: These findings contribute to clarification of the paths through which the belief that one is seen negatively by others, the hostile self-to-self relationship and the inability to direct compassion for self may increase NSSI. Daily peer hassles and current depressive symptoms seem to play an important role in the association between internal traits and NSSI. Preventive and intervention actions for reducing NSSI in adolescence should address not only interpersonal difficulties but also self-to-self relationship.

Binge Eating Disorder (BED) is currently recognized as a severe disorder associated with relevant psychiatric and physical comorbidity, and marked emotional distress. Shame is a specific negative emotion that has been highlighted as central in eating disorders. However, the effect of shame and underlying mechanisms on binge eating symptomatology severity remained unclear. This study examines the role of shame, depressive symptoms, weight and shape concerns and eating concerns, and body image-related cognitive fusion, on binge eating symptomatology severity. Participated in this study 73 patients with the diagnosis of BED, established through a clinical interview—Eating Disorder Examination 17.0D—who completed measures of external shame, body-image related cognitive fusion, depressive symptoms and binge eating symptomatology. Results revealed positive associations between binge eating severity and depressive symptoms, shame, weight and shape concerns, eating concerns and body image-related cognitive fusion. A path analysis showed that, when controlling for the effect of depressive symptoms, external shame has a direct effect on binge eating severity, and an indirect effect mediated by increased eating concern and higher levels of body image-related cognitive fusion. Results confirmed the plausibility of the model, which explained 43% of the severity of binge eating symptoms. The proposed model suggests that, in BED patients, perceiving that others see the self negatively may be associated with an entanglement with body image-related thoughts and concerns about eating, which may, in turn, fuel binge eating symptoms. Findings have important clinical implications supporting the relevance of addressing shame and associated processes in binge eating. Copyright © 2015 John Wiley & Sons, Ltd. Key Practitioner Message Shame is a significant predictor of symptomatology severity of BED patients. Shame significantly impacts binge eating, even controlling for depressive symptoms. Shame significantly predicts body image-related cognitive fusion and eating concern. Body image-fusion and eating concern mediate the link between shame and binge eating. Binge eating may be seen as an avoidance strategy from negative self-evaluations.

A longitudinal study examined the association between interpersonal goals (self-image and compassionate goals) and depression, anxiety, and stress symptoms. We propose that having self-image goals (trying to create and manage a positive image) may lead to psychological distress, while genuinely taking others’ needs into account and caring for their welfare (compassionate goals) may promote psychological well-being. The sample was composed by 161 university students (151 female, 8 male) who completed 6 surveys, every two weeks, assessing depression, anxiety, and stress symptoms, interpersonal goals, goal-related affect, feelings of closeness and loneliness, interpersonal conflicts, and positive emotions. Regression analysis suggested that compassionate goals predicted decreases in pre- and post-levels of depression, anxiety and stress, while self-image goals predicted increases in these psychopathological symptoms. Positive affect and feelings of clarity and closeness and less interpersonal conflicts media...