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Introduction Psy-Flex is a brief instrument that assesses psychological flexibility defined, according to the theoretical model of Acceptance and Commitment Therapy, by the set of competencies capable of leading the individual to change behavior, facilitating behaviors that are more adaptive and valued by the individual. This set of psychological skills involved in psychological flexibility is associated with psychological well-being and mental health. Objectives The present research sought to translate and adapt Psy-Flex to the Portuguese language and, consequently, to conduct the factor analysis, reliability, and validity studies of this instrument in the Portuguese population (in non-clinical and clinical samples) Methods The non-clinical sample consisted of 566 individuals (372 female and 192 male) ranging in age from 18 to 74 (M = 36.64; SD = 15.11). The clinical sample included 30 participants aged between 20 and 69 years (M=43.13 and SD= 13.85). The minimum number of years of education is 4, and the maximum is 19 (M=11.80 and SD=3.32). The non-clinical sample was filled out on an online platform the protocol that assessed psychological flexibility (Psy-Flex), Psychological Inflexibility and Flexibility (MPFI-24), anxiety and depression symptoms (PHQ-4), and perceived mental health (MHC-SF). In the clinical sample, the protocol was applied individually and face-to-face. Results Psy-Flex evidenced a unifactorial structure attested to by EFA and CFA. Invariance tests revealed the Psy-Flex model to be invariant in configural, metric, and scalar terms for male and female gender and non-clinical and clinical samples. The Psy-Flex revealed adequate reliability as assessed by Cronbach’s alpha and Composite Reliability in non-clinical and clinic samples. In non-clinical sample, the Psy-Flex showed a positive, moderate to strong, association with flexibility (measured by the MPFI-24-FP) and mental health. It also showed a negative, moderate to strong, association with MPFI-24-IP assessed inflexibility and with depression and anxiety symptoms. Age and years of schooling showed a weak positive association with Psy-Flex. Men and women differed significantly, with men showing higher values of psychological flexibility. Psy-Plex showed discriminant validity, differentiating between non-clinical and clinical groups. The non-clinical group showed significantly higher values of psychological flexibility. Conclusions The present study was innovative in making available a new instrument in the Portuguese language that revealed excellent psychometric characteristics that could be used in community and clinical samples. It also allows the evaluation of efficacy studies of interventions that aim to promote psychological flexibility. Disclosure of Interest None Declared

Abstract A 39‐year‐old man presented with an acneiform facial eruption, bilateral vegetating erythematous plaques on the inguinal folds, focal palmoplantar keratoderma, keratotic violaceous plaques of the dorsum of both hands, and whitish striated lesions on the oral mucosa. Laboratory work‐up showed high titre of ANAs, anti‐SSA(Ro) and anti‐SSB(La) and hypocomplementemia (low C4). Three skin biopsies from different locations were suggestive of cutaneous lupus erythematosus (CLE). Treatment with hydroxychloroquine 400 mg/day plus topical and systemic corticosteroids led to significant clinical improvement after 2 months. Lupus erythematosus comedonicus is a form of discoid CLE and clinically characterized by acneiform lesions. Vegetating lesions, named as lupus erythematosus vegetans, are extremely rare in CLE. The combination of both manifestations in our patient may be better described as ‘lupus erythematous comedonicus and vegetans’.

Introduction Endometriosis is a gynaecological pathology characterized by endometrial tissue similar to stroma and endometrium in extra endometrial and myometrial sites. This condition affects women’s mental health and quality of life and can elicit shame feelings. Objectives To explore the role of quality of life in endometriosis, chronic illness-related shame, self-compassion, and psychological flexibility in depressive symptoms. Methods 260 people diagnosed with endometriosis, aged 18 years or older, were recruited through patients’ associations. Participants completed an online sociodemographic and clinical questionnaire and the following self-report instruments: Anxiety, Depression, and Stress Scales (DASS-21), Endometrioses Health Profile (EHP-5), Chronic Illness-Related Shame Scale (CISS), Compassionate Engagement and Action Scales (EEAC-SC), and the Psy-Flex Scale. Results Regression analyses showed that years of education, endometriosis-related quality of life (pain, control, emotional well-being, social support, and self-image), chronic illness-related shame, and psychological flexibility were the significant predictors of depressive symptoms. On the other hand, endometriosis-related quality of life (work life, relationship with children, sexual life, relationship with healthcare professionals, treatment, and infertility) and self-compassion were not significantly associated with depressive symptoms. Conclusions The identification of chronic illness-related shame and quality of life related to endometriosis as relevant variables regarding the presence of symptoms of depression points to the relevance of early detection of these phenomena to prevent the development of depressive symptoms. Moreover, interventions targeting the development of psychological flexibility may contribute to the amelioration and prevention of depressive symptoms. Disclosure of Interest None Declared

Introduction Despite the increased knowledge about the prevalence and consequences of eating disorders (ED), they continue to be underdiagnosed and undertreated. Being more common in women of childbearing age, the perinatal period may play a decisive role in the incidence and course of these pathologies. The Screen for Disordered Eating (SDE) was developed for the screen of ED in primary care. Objectives Our aim was to analyze the psychometric properties of the Portuguese Version of SDE in women during the perinatal period. Methods Participants were 346 women with a mean age of 31.68 of years old (± 4.061; range: 18-42). 160 were pregnant (second or third trimester) and 186 were in the post-partum (mean baby´s age=4.37 months (± 2.87; range: 1-12). They answered an online survey including the Portuguese version of the SDE and of the Eating Disorder Examination – Questionnaire (EDE-Q-7). Results Confirmatory Factor Analysis showed that the unidimensional model presented good fit indexes in pregnancy (), post-partum () and considering both – perinatal period (χ2/df=2.0335; RMSEA=.0547, p

Introduction Psychological Flexibility (PF) is a complex and extensively studied concept within the Acceptance and Commitment Therapy (ACT) framework. PF denotes one’s capacity to effectively navigate psychological distress and challenges while aligning one’s actions with deeply held values. Given its association with mental health and overall well-being, it is crucial to develop assessment tools able to capture the various facets of flexible behaviour and design strategies for its enhancement. Objectives To adapt the Portuguese version of the Multidimensional Psychological Flexibility Inventory (MPFI-24; Grégoire et al., 2020) for the adolescent population. Methods The study involved 269 adolescents aged 12 to 18 years old. Participants completed a set of self-report instruments, including the MPFI24-A, the Depression, Anxiety, and Stress Scales-21 (DASS-21), Mental Health Continuum - Short Form (MHC-SF), and the PsyFlex-A, which also assesses PF. A subsample also completed the MPFI24-A four weeks later to assess test-retest reliability. Results Two models, specifically the six-factor correlated model and the bifactor model, emerged as presenting the best fit when analysing data separately for the Flexibility and Inflexibility indices. The MPFI24-A demonstrated good reliability for both overall scores (α = .90 and α = .85, respectively) and good test-retest reliability. The PF index showed significant positive associations with PsyFlex-A scores, perceived mental health, and a moderate negative association with depression and anxiety. Conversely, the Psychological Inflexibility (PI) index presented the opposite association pattern with these variables and showed no significant correlation with PF as measured by the PsyFlex-A. The two indices of the MPFI24-A demonstrated a weak positive correlation. Significant differences between boys and girls were found for the PF index, with boys showing higher scores. No significant differences were found between boys and girls concerning the PI index. Conclusions Results suggest that the MPFI24-A is a reliable and valid instrument for assessing adolescents’ psychological flexibility and inflexibility competencies. Although further clarification of the MPFI24-A factor structure and the utility of different factors is warranted, the findings support its overall applicability. Disclosure of Interest None Declared

Introduction The EDE-Q-7 Portuguese version presented good reliability and validity in Portuguese women fro the general population (Pereira et al. 2022). Objectives The aim of our study was to analyse the psychometric properties of the EDE-Q-7 in a sample of Portuguese women during the perinatal period. Methods Participants were 346 women with a mean age of 31.68 of years old (± 4.061; range: 18-42). 160 were pregnant (second or third trimester) and 186 were in the post-partum (mean baby´s age=4.37 months (± 2.87; range: 1-12). They answered an online survey including the Portuguese version of the EDE-Q-7 and of the Screen for Disordered Eating/SDE. Results Confirmatory factor analysis (CFA) presented adequate fit, in pregnancy (χ2/df=; RMSEA=, p0.90 for the total and approximately .70 for the three factors - Dietary restraint, Shape/weight overvaluation and Body dissatisfaction. All the items contributed to the internal consistency and presented high internal consistency. Pearson correlations between factors and total scores were significant, positive and high, as well as between the EDE-Q-7 measures and SDE (>.60 with the total; >.40 with the factors), in pregnancy, postpartum and considering both periods. Conclusions Presented sound psychometric properties across the perinatal period, the EDE-Q-7 and can be very useful to evaluate the presence and severity of eating disorders symptoms in women in pregnancy and post-partum. Disclosure of Interest None Declared

Introduction The perinatal period may intensify weight and body image concerns. Due to its specifics, the traditional body image scales are inaccurate in the perinatal period (Fuller-Tyszkiewicz et al. 2013). The Body Image Concerns During Pregnancy (Uçar et al. 2018) was developed to measures this cognitive-emotional variable in pregnancy. Objectives To analyze the psychometric properties of the Portuguese adapted (both for pregnancy and postpartum) version of the Body Image Concerns during the Perinatal Period (BICPP), namely its construct validity and the internal consistency. Methods A sample of 346 women recruited through social media and Family Health Units, assessed in the second trimester of pregnancy (mean gestational age=28.11±7.67 weeks) and after delivery (baby’s age 4.37±2.87 months), completed a survey including the Portuguese BICPP. The total sample was randomly divided into two sub-samples: sample A (n=173) was used to perform an exploratory factor analysis/EFA; sample B (n=173) to perform a confirmatory factor analysis/CFA. Results EFA resulted in four components. CFA revealed that the second-order model with four factors presented good fit indexes (X2/df=2.4141; CFI=.9195; GFI=.948; TLI=.9028; GFI=.8181; RMSEA=.0807). BICPP Cronbach alphas was α=.936; for F1 Concern about future weight and image, F2 Concern with the new body image, F3 Social avoidance and concern and F4 Concern with appearance were .922, .930, .809, .807, respectively. Conclusions This psychometric study provides evidence for the validity and reliability of the Portuguese version of BIC-Perinatal Period, which will be used in an ongoing research project on the relationship between eating, depressive and anxiety disorders in the perinatal period. Disclosure of Interest None Declared

Introdução: A canábis constitui a substância ilícita com maior prevalência de consumo ao longo da vida em Portugal. Apesar do seu uso medicinal pelas suas propriedades antieméticas tem sido reconhecida uma entidade clínica paradoxal – o síndroma de hiperemese por canabinoides (SHC) – caracterizada pelo consumo crónico de canabinoides (habitualmente diário), episódios cíclicos de náuseas e vómitos refratários a terapêuticas convencionais e o recurso a banhos quentes compulsivos para alívio sintomático. Descrição do caso: Mulher de 36 anos, com múltiplas idas aos cuidados de saúde primários por queixas de náuseas e vómitos cíclicos, ainda em investigação. Recorreu ao serviço de urgência (SU) por queixas de epigastralgias, náuseas e vómitos com três dias de evolução. Realizou estudo complementar que não revelou alterações de relevo. Administrada medicação antiemética e pantoprazol com reduzida melhoria das queixas. Durante a permanência no SU foi encontrada por diversas vezes a tomar duches quentes, solicitando recorrentemente para o fazer, afirmando que era a única medida que aliviava as suas queixas. Adicionalmente apurou-se ainda história de consumo crónico de canabinoides, levando à hipótese diagnóstica de SHC. Comentário: É comum registar-se um atraso importante no diagnóstico desta síndroma e associar-se frequentemente à realização de diversos exames complementares de diagnóstico (ECD), terapêuticas e internamentos hospitalares. Assim, procurou-se sensibilizar a comunidade médica para a SHC, enquanto diagnóstico diferencial de vómitos recorrentes difíceis de tratar, em indivíduos com história de consumo de canabinoides. O presente relato de caso visa promover o conhecimento sobre a SHC, possibilitando a sua atempada identificação e adequada abordagem terapêutica.

The COVID‐19 pandemic generated distinct mental health challenges, characterised by stress and anxiety due to its unpredictable duration and continuous threat. This study examined the role of meditation practice on anxiety symptoms and perceived stress, considering co‐variables such as self‐compassion, acceptance, awareness, brooding, lockdown duration, and sociodemographic characteristics. The study used a longitudinal design and data were collected through online surveys from April 2020 to January 2021 (at four different time points) and included 238 participants from Portugal (165 had prior experience with meditation practices, 73 were non‐meditators) with a mean age of 43.08 years (SD = 10.96). Linear mixed models revealed that over time, during the lockdown, the non‐meditators group demonstrated a greater increase of anxiety symptoms (β = −0.226, SE = 0.06, p = 0.006) and perceived stress (β = −0.20, SE = 0.06, p = 0.004), whereas the meditators group showed non‐significant (p > 0.05) variations in anxiety and stress symptoms during the same period of time. The effect of meditation on anxiety symptoms was moderated by sex, days of lockdown, self‐compassion, and acceptance. The effect of meditation on perceived stress was moderated by sex, years of education, days of lockdown, and levels of awareness. Additionally, the study explored the potential predictive effect of different meditation session lengths, indicating that longer meditation practices offered greater protection against an increase in anxiety symptoms. These findings highlight the importance of cultivating self‐regulation skills and investing in preventive mental health strategies to promote well‐being and autonomy. Mental health professionals should prioritise educating communities on evidence‐based practices like meditation and compassion exercises to enhance overall health. [ABSTRACT FROM AUTHOR]

The current study examines the mediating role of fears of compassion (for others, from others, for self) between self-compassion and social safeness in a sample of Portuguese women with chronic pain (CP). The recruitment (N = 107) was conducted online and participants responded to a set of self-report questionnaires aimed to assess socio-demographic and medical data, as well as self-compassion, fears of compassion, social safeness, pain intensity, pain-related functional impairment and depressive symptoms. A theory-driven mediational model was built in which fears of compassion mediate the relationship between self-compassion and social safeness, while controlling for pain intensity, functional impairment and depressive symptoms. This was tested using the SPSS macro PROCESS. Results suggest that the relationship between self-compassion and social safeness was mediated by fears of receiving compassion from others, but not by fears of giving compassion to others nor fears of self-compassion. These results yield relevant information to better understand how women with CP experience social safeness and connectedness, with promising clinical implications., Author(s): Sérgio A. Carvalho [sup.1] , José Pinto-Gouveia [sup.1] , David Gillanders [sup.2] , Paula Castilho [sup.1] Author Affiliations: (1) grid.8051.c, 0000 0000 9511 4342, Cognitive-Behavioural Research Centre (CINEICC), Faculty [...]

Research has questioned whether it is feasible to assess psychosocial variables through web-based recruitment methods. Previous literature on IBD focused exclusively on testing differences on psychosocial scores and did not test the invariance between types of recruitment on the relationships between variables. The aim of the present study is thus to analyse structural invariance between internet-recruited and hospital-recruited groups of IBD patients on a mediation model with theoretical basis on previous studies (experiential avoidance as possible mediator of the association between IBD symptomatology and psychopathology). The internet sample included 137 IBD patients recruited through a patients association, and the hospital sample comprised 66 IBD patients. Structural equation modelling was used; a multiple-group comparison was conducted to examine model invariance between samples. Although the internet sample presented higher levels of experiential avoidance and psychopathological symptoms compared to the hospital sample, the relationships between these variables were invariant across groups. Experiential avoidance partially mediated the impact of IBD symptomatology on levels of stress, anxiety, and depression symptoms in a similar way for online respondents and hospital-recruited patients. This is a new finding that argues for the validity of web-based research methods., Author(s): Inês A. Trindade [sup.1] , Laurie Keefer [sup.2] , Francisco Portela [sup.3] , Cláudia Ferreira [sup.1] , José Pinto-Gouveia [sup.1] Author Affiliations: (1) grid.8051.c, 0000 0000 9511 4342, CINEICC [...]

This article aims to adapt and validate the Risk-Taking and Self-Harm Inventory for Adolescents (RTSHIA) in Portuguese. Results confirm the 2-factor structure originally proposed (risk-taking and self-harm). Both dimensions presented an adequate internal reliability and temporal stability. Convergent validity and sociodemographic differences are analyzed. Preventive and clinical implications are discussed.

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., Author(s): Sérgio A. Carvalho [sup.1] [sup.2] , Ana Xavier [sup.1] [sup.3] , David Gillanders [sup.4] , José Pinto-Gouveia [sup.1] , Paula Castilho [sup.1] Author Affiliations: (1) grid.8051.c, 0000 0000 9511 [...]

Background: Spider venoms induce different physio-pharmacological effects by binding with high affinity on molecular targets, therefore being of biotechnological interest. Some of these toxins, acting on different types of ion channels, have been identified in the venom of spiders of the genus Phoneutria, mainly from P. nigriventer. In spite of the pharmaceutical potential demonstrated by P. nigriventer toxins, there is limited information on molecules from venoms of the same genus, as their toxins remain poorly characterized. Understanding this diversity and clarifying the differences in the mechanisms of action of spider toxins is of great importance for establishing their true biotechnological potential. This prompted us to compare three different venoms of the Phoneutria genus: P. nigriventer (Pn-V), P. eickstedtae (Pe-V) and P. pertyi (Pp-V). Methods: Biochemical and functional comparison of the venoms were carried out by SDS-PAGE, HPLC, mass spectrometry, enzymatic activities and electrophysiological assays (whole-cell patch clamp). Results: The employed approach revealed that all three venoms had an overall similarity in their components, with only minor differences. The presence of a high number of similar proteins was evident, particularly toxins in the mass range of ~6.0 kDa. Hyaluronidase and proteolytic activities were detected in all venoms, in addition to isoforms of the toxins Tx1 and Tx2-6. All Tx1 isoforms blocked Nav1.6 ion currents, with slight differences. Conclusion: Our findings showed that Pn-V, Pe-V and Pp-V are highly similar concerning protein composition and enzymatic activities, containing isoforms of the same toxins sharing high sequence homology, with minor modifications. However, these structural and functional variations are very important for venom diversity. In addition, our findings will contribute to the comprehension of the molecular diversity of the venoms of the other species from Phoneutria genus, exposing their biotechnological potential as a source for searching for new active molecules.

Cognitive fusion refers to the dominance of verbal processes over behavior regulation, in detriment of being sensitive to contextual contingencies and pursuing valued life goals. It is a core process within Acceptance and Commitment Therapy and seems to have a crucial role in the development and maintenance of psychopathology. The first goal of this investigation was to explore the factor structure, factorial invariance and psychometrics of the Portuguese version of the Cognitive Fusion Questionnaire (CFQ). A multigroup confirmatory factor analysis attested the invariant one-dimensional factor structure of the CFQ across three samples from the general population (n = 408; n = 291; n = 101) with different demographic characteristics. Additionally, the CFQ showed to be a psychometrically robust and reliable measure. A second major goal was to investigate the convergent and incremental validity of this version of CFQ (n = 408). Convergent validity was explored and attested with several psychological indicators. Regarding incremental validity, the predictive power of depressive symptoms of cognitive fusion and three related processes, with origin in different conceptual frameworks, was tested. Results showed that even when the effects of decentering, mindfulness and metacognitions were controlled for, cognitive fusion consistently maintained a significant and unique predictive power over depressive symptoms. These findings suggest that these processes relate differentially and independently with depressive symptoms and, moreover, that cognitive fusion has a superior contribution to its explanation. Given the evidence that cognitive fusion plays an important role in the comprehension of depressive symptoms, conceptual and clinical implications were discussed., Author(s): José Pinto-Gouveia [sup.1], Alexandra Dinis [sup.1], Sónia Gregório [sup.1], Ana Margarida Pinto [sup.2] Author Affiliations: (1) grid.8051.c, 0000 0000 9511 4342, Center for Research in Neuropsychology and Cognitive Behavioural [...]

Background: Non-suicidal self-injury (NSSI) is a serious and alarming phenomenon during adolescence. There is a need for understanding the intrapersonal variables that might contribute to the maintenance of these self-injurious behaviors. Objective: This study aims to concurrently compare intrapersonal variables between adolescents with and without a lifetime history of NSSI, and to longitudinally test whether NSSI over lifetime history predicts 6-months NSSI through self-criticism and depressive symptoms among Portuguese adolescents with a self-reported history of NSSI. Methods: Adolescents (N = 418, 12-19 years-old) from middle and secondary schools completed self-report questionnaires to assess self-criticism (particularly, the most severe form: hated self), depressive symptoms, and the frequency of NSSI in two points in time over the 6-months interval. Results: Adolescents who reported a lifetime history of NSSI tend to experience greater harsh and persecutory criticism towards themselves and elevated depressive symptoms than adolescents without a history of NSSI. Results from path analysis showed that lifetime NSSI predicts subsequent NSSI, and this association is mediated by self-hatred and depressive symptoms among adolescents with lifetime NSSI. Conclusions: Findings suggest that NSSI is maintained through a sense of self-focused on hatred and disgust feelings and depressive symptoms.

Non-suicidal self-injury (NSSI) in adolescence is a serious public health problem. Although self-compassion is a protective factor of mental health difficulties in adult populations, its potential impact on adolescence remains scarcely explored. Therefore, we aimed to test whether self-compassion can mitigate the impact of daily peer hassles and depressive symptoms on NSSI. The participants were 643 adolescents (51.6% female) with ages between 12 and 18 years, from middle and secondary schools. Self-report questionnaires were used to measure daily peer hassles, depressive symptoms, self-compassion and NSSI. Daily peer hassles were positively correlated with depressive symptoms and NSSI. Self-compassion was inversely associated with daily peer hassles and depressive symptoms and NSSI. Path analysis showed that self-compassion had a moderator effect on the association between depressive symptoms and NSSI. Results suggest that self-compassion can be a protective process, as it may buffer against the impact of depressive symptoms on NSSI. This study presents preventive and clinical implications for educators and therapists working with adolescents.

Introduction: The Copenhagen Burnout Inventory was developed to overcome what some authors have proposed as potential limitations of existing burnout measures. Specifically, the Copenhagen Burnout Inventory measures the main component of burnout (i.e. exhaustion) in three domains: personal-, work- and patient-related. Additionally, some authors have argued the necessity to have available a global burnout index. Material and Methods: This study followed a cross-sectional design in a sample of Portuguese physicians (n = 1348). A confirmatory factor analyses was conducted and the Copenhagen Burnout Inventory´s three-factor structure was tested. In addition, a model with a 2nd order factor was tested with the goal of achieving a one-factor structure that would allow a global burnout index. Results: The confirmatory factor analyses showed a good model fit for both the three-factor and one-factor model, having the latter a significant better fit. The Copenhagen Burnout Inventory showed good psychometric properties for both structures, with good reliability according to Chronbach`s alphas and average variance extracted between factors. The Copenhagen Burnout Inventory I was statistically and positively correlated with depression, anxiety and stress symptoms, as well as rumination, and negatively correlated with life satisfaction. Discussion: The current study shows that the Copenhagen Burnout Inventory is a psychometrically valid measure of burnout in Portuguese physicians, and contributes with an instrument able to produce a global index of burnout. This measure provides comprehensive information on different dimensions associated with the development of burnout, as well as presents a global burnout score. Results show that participants who had more burnout also presented higher levels of depressive, anxiety and stress symptoms, as well as present more ruminative thinking, and less life satisfaction. Conclusion: The Copenhagen Burnout Inventory is a psychometrically valid measure of burnout that allows for exploratory studies on the overall level of exhaustion, thus making it possible the comparison between groups in a way that is not restricted to occupation specific aspects.