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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.

APOLO-Teens is a Facebook-based psychological intervention aiming to optimize hospital treatment for adolescents with overweight/obesity. The present qualitative study aims to explore (1) how adolescents experienced participation in APOLO-Teens and (2) how parents perceived adolescents' participation. Sixteen adolescent–parent dyads were interviewed by telephone using semistructured guides. An inductive approach of thematic analysis was used to analyze data by two independent codifiers. The consensus was used to resolve differences in coding/themes, and two independent auditors reviewed the codes and the themes proposed. We identified four themes from adolescents' interviews, namely, expectations, perception of outcomes, participation in the intervention, and sharing of acquired knowledge. From parents' interviews, we identified five themes: expectations for son/daughter participation, perception of adolescents' outcomes, son/daughter participation, parental role, and use of social networks in intervention programs for adolescents. Both elements of the dyad indicated that adolescents' participation in APOLO-Teens contributed to favorable outcomes, further highlighting the use of online interventions to complement the hospital treatment of adolescents with overweight/obesity. Future studies should address the viewpoints of adolescents and parents in the design of Facebook-based interventions, namely, to implement tailored, shorter, less time-demanding interventions that favor engagement between participants and parental involvement., Foundation for Science and Technology, Grant/Award Numbers: 2020.01538.CEECIND, 2020.07384.BD, PTDC/PSI-GER/28209/2017, SFRH/BD/146470/2019

The quality of dyad interaction seems crucial to the client’s decision to drop out of psychotherapy. To characterize the client’s lack of change and the patterns of therapeutic collaboration in a dropout of psychodynamic therapy for Borderline Personality Disorder (BPD), we used the Therapeutic Collaboration Coding System (TCCS) to assess collaborative work and the Assimilation of Problematic Experiences Scale (APES) to rate client change. The software GridWare was used to characterize patterns of therapeutic collaboration and the R software to describe the client’s change. The dyad worked in a comfort zone for the client, with the therapist supporting the client’s problematic perspective and the client responding with Safety. The APES results showed that the client did not change, remaining in control through avoidance of thinking and discussing his problematic experience. Our results challenge the potential impact of therapists’ interventions on BPD clients’ comfort zones, suggesting that too much focus on their Therapeutic Zone of Proximal Development’s actual level might not be productive., La calidad de la interacción de la díada parece ser esencial para la decisión del cliente de abandonar la psicoterapia. Caracterizar la falta de cambio del cliente y los patrones de colaboración terapéutica en un abandono de una Terapia Psicodinámica para un Trastorno de Personalidad Borderline (TPB). Utilizamos el Sistema de Codificación de Colaboración Terapéutica (SCCT) para evaluar el trabajo colaborativo, y la Escala de Asimilación de Experiencias Problemáticas (EAEP) para calificar el cambio del cliente. Se utilizó el softwareGridWare para caracterizar patrones de colaboración terapéutica, y el softwareR para describir ecambio del cliente. La díada trabajó en una zona de confort para el cliente, el terapeuta apoyó la perspectiva problemática del cliente, y éste respondió con Seguridad. Los resultados de la EAEP mostraron que el cliente no cambió, mantuvo el control evitando reflexionar y comentar su experiencia problemática. Nuestros resultados desafían el impacto potencial de las intervenciones de los terapeutas en la zona de confort de los clientes TPB, sugiriendo que podría no ser productivo enfocarse demasiado en su nivel real de Zona Terapéutica de Desarrollo Próximo., This work was supported by the Brazilian National Council for Scientific and Tecnological Development (CNPq) [438534/2018-2]. This study was conducted at the Psychology Research Centre (CIPsi/UM), School of Psychology, University of Minho, partially supported by the Foundation for Science and Technology (FCT) through the Portuguese State Budget (UIDB/01662/2020). This study was also partially supported by the BIAL Foundation. / Este trabajo ha sido financiado por el Consejo Nacional Brasileño de Desarrollo Científico y Tecnológico (CNPq) [438534/2018-2]. Este estudio se realizó en el Centro de Investigación de Psicología (CIPsi/UM), Escuela de Psicología, Universidad de Minho, financiado parcialmente por la Fundación para la Ciencia y la Tecnología (FCT) a través del Presupuesto Estatal Portugués (UIDB/01662/2020). Este estudio también fue financiado parcialmente por la Fundación BIAL.

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., info:eu-repo/semantics/publishedVersion

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).

Worry is a phenomenon that is present in multiple psychopathologies. Given the widely accepted transdiagnostic role that worry plays in psychopathology, reliable measures for this construct are pivotal for clinical practice. The Penn State Worry Questionnaire (PSWQ) is one of the most widely used and established measures of worry in both clinical and non-clinical populations and it is accepted as a highly reliable measure. The present study aimed to examine the factor structure and psychometric properties of the PSWQ for the Portuguese population. The total sample consisted of 428 participants, 256 from the community, and 172 from the clinical population. Confirmatory factor analysis supported a model of one factor with a method factor containing the negatively worded items., This study was conducted at the Psychology Research Centre (PSI/01662), School of Psychology, 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 national funds (PIDDAC). Dr. Oliveira was also supported by the Portuguese Foundation for Science and Technology and the Portuguese Ministry of Science, Technology and Higher Education, through national funds, within the scope of the Transitory Disposition of Decree No. 57/2016, of 29 August, amended by Law No. 57/2017 of 19 July. Dr. Machado was supported, in part, 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); and by the Portuguese Foundation for Science and Technology and the Portuguese Ministry of Science, Technology and Higher Education (POCI-01-0145-FEDER-028145).

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.

Sudden gains (SG) are large and rapid symptom improvements experienced by clients that are related to positive effects on the outcome. However, little is known about why SGs happen or what are the mechanisms that underlie them. Ambivalence towards change is a client's variable related to outcome that has not been previously studied in the context of SGs. The main purpose of this study was to explore the role of ambivalence in the context of SGs. The sample consisted of 68 outpatients suffering from depression and/or anxiety disorders. The clients were treated using a manualized treatment for emotional disorders at an outpatient university-based clinic. SGs were detected with the Outcome Questionnaire 10.2. A 20.6% of the participants experienced a SG, occurring more frequently in session eight. The SG group presented lower levels of ambivalence and psychological symptoms at the end of the treatment when compared with non-SGs. Multilevel analysis suggested that the trajectory of ambivalence tends to be steeper in the SG group. The results suggest that SGs are associated with ambivalence and reinforce the idea that ambivalence resolution is closely related to treatment success., This study was conducted at the Psychology Research Centre (PSI/01662), School of Psychology, 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 national funds (PIDDAC). Dr. Oliveira was also supported by the Portuguese Foundation for Science and Technology and the Portuguese Ministry of Science, Technology and Higher Education, through national funds, within the scope of the Transitory Disposition of Decree No. 57/2016, of 29 August, amended by Law No. 57/2017 of 19 July. Dr. Machado was supported, in part, 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); and by the Portuguese Foundation for Science and Technology and the Portuguese Ministry of Science, Technology and Higher Education (POCI-01-0145-FEDER-028145).

Halochromism is the occurrence of a color change induced by a pH alteration. The main commercial classes of halochromic dyes are phthalides, triarylmethanes and fluorans, but other minor classes exist including styryl, merocyanines, indophenols and azobenzenes.1a The success of azobenzene dyes is due to their structural diversity, high molar extinction coefficient, and fastness properties in relation to light and washing fastness.1b Replacing one or both aryls with a heteroaryl offers broader structural diversity.1c In addition, the presence of basic sites, as well as H-bonding interactions, further affects the azo chromophore, leading to very different spectral properties. The synthesis of azopyrimidines and azopurines has long been known, and similarity to DNA nucleobases makes them promising candidates for applications in photopharmacology and biocompatible real-time information transmission. In a recent work, a novel method for the synthesis of a new class of azo-pyrimidines with both halochromic and antimicrobial properties has been developed to obtain compounds with an unusual pattern of substituents in the heteroaryl unity. The new synthetic approach starts from imidazole derivatives that are easily obtained from accessible commercial reagents.2 Preliminary results had suggested that these imidazole precursors easily evolve in the presence of oxygen leading to the in situ formation of highly colored products. These results motivated us to study the reactions of imidazole-based precursors in the presence of oxidants such as silver and copper salts. A very fast reaction occurred leading to azo imidazole intermediates that promptly reacted with secondary amines through a novel and unexpected rearrangement. Deep colored products were obtained, which were identified as azo-pyrimidines on the basis of NMR spectroscopy (including 1H RMN, D2O shake, 13C RMN, HMQC, HMBC and NOE techniques), mass spectroscopy, ATR-FTIR, melting point and elemental analysis data. Colorimetric studies have been performed by UV-Vis spectroscopy at variable pH values and in different solvents, revealing interesting halochromic properties. The antimicrobial activity of these new azopyrimidine dyes has been also evaluated and highly promising results were obtained. All the results will be presented and discussed., Fundação para a Ciência e a Tecnologia (FCT) for financial support through the Chemistry Research Centre of the University of Minho (UID/QUI/00686/2020) and CIIMAR (UIBD/04423/2020). This work was also supported under the projects MEDCOR (PTDC/CTM-TEX/1213/2020) and UID/CTM/00264/2019, and the PhD grant SFRH/BD/137668/2018.

The emergence of infectious diseases caused by new pathogens or multidrug-resistant (MDR) strains has been a global health threat over the last decades.1 These infections are among the most severe healthcare problems and have been associated to several deaths and heavy economic burden per year.2,3 The imidazole ring is present in several natural and synthetic molecules with biological activity namely on effective antimicrobial agents, which make it a vital anchor for the development of new therapeutic molecules in this field.4 Furthermore, amidrazones are known for their high reactivity thus being useful intermediates for the synthesis of compounds with a wide range of biological activities including antimicrobial. The amidrazone derivatives have been applied in different subjects of chemistry, specifically in the synthesis of azo molecules.5 In a previous work, novel imidazole-based 5-aminoimidazole-4-carboxamidrazones were prepared and exhibited potent antimicrobial activity against C. krusei and C. albicans.6 Further biological studies to elucidate the action mechanism revealed an interesting relationship between the antimicrobial activity and total intracellular ROS production by the yeasts.7 As these carboxamidrazones had previously evidenced a particular susceptibility to the presence of oxygen, all of these results combined prompted us to study the reactivity of 5-aminoimidazole-4-carboxamidrazones in the presence of different oxidant and antioxidant agents. Here, we present results of the electrochemical characterization by cyclic voltammetry to elucidate the oxidation mechanism of these compounds, and the results of the attempts performed to oxidize amidrazones in order to obtain the corresponding azoimidazoles. These products were fully characterized by NMR spectroscopy (including 1H RMN, D2O shake, 13C RMN, HMQC, HMBC and NOE techniques), mass spectroscopy, ATR-FTIR, melting point and elemental analysis. The antimicrobial activity of these new products has been also evaluated and highly promising results were obtained. All the results will be presented and discussed., Fundação para a Ciência e a Tecnologia (FCT) for financial support through the Chemistry Research Centre of the University of Minho (UID/QUI/00686/2020) and CIIMAR (UIBD/04423/2020). This work was also supported under the projects MEDCOR (PTDC/CTM-TEX/1213/2020) and UID/CTM/00264/2019, and the PhD grant SFRH/BD/137668/2018

[Excerpt] The concept of therapeutic responsiveness has been defined as the therapist’s attentive behavior being influenced by the evolving context, including client’s characteristics and emergent behavior (e.g., Elkin et al., 2014; Kramer & Stiles, 2015; Stiles et al., 1998; Stiles & Horvath, 2017). In this chapter, we approach the concept of therapeutic responsiveness at an immediate interactive context (Kramer & Stiles, 2015) based on the therapeutic collaboration model (TCM; E. Ribeiro et al., 2013).

Neste capítulo apresentamos a linha de apoio psicológico SOS COVID-19, da iniciativa da APsi-UMinho, criada com o propósito de responder às necessidades da co-munidade UMinho, emergentes no contexto da pandemia COVID-19. Com efeito, a literatura empírica tem demonstrado, a propósito do impacto psicológico de epidemias passadas e da pandemia COVID-19, que a comunidade estudantil universitária repre-senta um dos grupos de risco para o desenvolvimento de perturbação psicológica que merece particular atenção. Este conhecimento justifica o planeamento e implementa-ção de ações atempadas e dirigidas para intervenções em situações de crise e para a pre-venção do agravamento de problemas emergentes, que se descrevem neste capítulo

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

With this study, we aimed to describe the interaction within the therapeutic dyads involved in dropout cases of narrative therapy, once the quality of interaction in therapy appears to constitute a critical factor in clients’ decisions regarding its discontinuation. Seven dropout cases of narrative therapy, which were conducted by the same therapist, were analysed using the Therapeutic Collaboration Coding System. The coding procedure required two trained and independent judges along with an auditing process. Overall, the findings demonstrated that independent of the clients’ responses, the therapist tended to increase the challenging interventions and decrease the supporting interventions over time. In turn, the clients oscillated between having experiences of safety and experiences of intolerable risk. The results will be discussed in terms of their theoretical and empirical relevance in relation to clinical implications., Con este estudio se ha pretendido describir la interacción entre díadas terapéuticas en casos de abandono en terapia narrativa, una vez que la calidad de la interacción terapéutica parece ser un factor crítico en las decisiones de los clientes para abandonar sus procesos. Siete casos de abandono en terapia narrativa, acompañados por el mismo terapeuta, fueron analizados utilizando el Sistema de Codificación de la Colaboración Terapéutica. El procedimiento ha incluido la codificación de todas las sesiones de los casos por dos jueces independientes con formación sobre el sistema, así como su posterior auditoría. En general, los resultados mostraron que, independiente de las respuestas de los clientes, el terapeuta ha tendido a aumentar sus intervenciones de desafío y a reducir las de apoyo, a lo largo del tiempo. A su vez, los clientes oscilaron en presentar experiencias de seguridad y experiencias de riesgo intolerable. Los resultados serán debatidos de acuerdo con su relevancia teórica y empírica y sus implicaciones clínicas., This work was supported by the Portuguese Foundation for Science and Technology (FCT) under the PhD Grant with the reference SFRH/BD/82583/2011. This study was conducted at 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 through national funds, and co-financed by FEDER through COMPETE2020 under the PT2020 Partnership Agreement (POCI-01-0145-FEDER007653), 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

This study examined the therapeutic collaboration in a case of Life Design Counseling (LDC) with narrative change and positive career outcomes. The therapeutic collaboration-change model and correspondent coding system were used to intensively study the helping relationship throughout three sessions of LDC. The collaboration coding system enables the assessment of each therapeutic exchange within and outside of the client’s therapeutic zone of proximal development, defined as the space between the client’s actual therapeutic developmental level and his/her potential developmental level fomented by a collaborative relationship. Results show that in all sessions, counsellor and client worked mainly within the therapeutic proximal development zone, that is, they were able to interact collaboratively. The coding of the counsellor’s interventions throughout the counselling process was in accordance with the life-design framework. The collaborationchange model and coding system contributed to understand the process of change in LDC., info:eu-repo/semantics/publishedVersion

During infancy, cardiac vagal modulation has been associated with attentional and social engagement behaviors. While studies have shown that infants display a behavioral repertoire that enables them to interact with others by being able to regulate themselves in order to attend to and to discriminate emotional and social cues, vagal modulation to sensory stimuli and its association with behavioral outcomes at early ages remains to be addressed. In this study, we analyzed the cardiac vagal response of 1-month-old infants to two auditory stimuli intensities and whether vagal response was associated with social interactive and self-regulatory abilities. Therefore, we recorded cardiac and respiratory physiological responses in 28 infants using a Biopac System. Neurobehavioral assessment was performed using the Neonatal Behavioral Assessment Scale. We observed increased respiratory sinus arrhythmia (RSA) amplitude to both auditory stimuli intensities when compared to baseline. No intensity effect was found for the RSA response. Additionally, we observed that higher RSA amplitude to both auditory stimuli was positively correlated with adjusted self-regulatory behaviors, suggesting a convergence between multiple measures assessing infants’ state regulation. Results are discussed in light of 1-month-old infants’ auditory stimuli processing and its implications for regulatory behaviors and the emergent social-like behaviors., Foremost, we thank all the families and infants who participated in this study. 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 Maria de Gois-Eanes for all the help and knowledge and Santiago Galdo-Alvarez for the contributions to this study. Furthermore, we thank Associaç ~ao Viver a Ciencia for the Sim- ^ biontes prize in 2013. This work was supported by Fundaç~ao Bial (grant number 42/08) and financed by Fundaç~ao para a Ciencia e Tecnologia (FCT) under a PhD grand (reference SFRH/BD/68263/2010)., info:eu-repo/semantics/publishedVersion

First published online August 3, 2018, This case study explores the collaboration that occurs between therapist and client when reconceptualization innovative moments emerge. Reconceptualization innovative moments are exceptions to the problematic self-narrative that brought the client to therapy and are associated with successful psychotherapy. Reconceptualization innovative moments have two main components: a contrast between a past problematic facet and a current, more adjusted one (e.g., before I did/thought/felt X . . . , now, I do/think/feel Y) and an attribution for what allowed this transformation to occur (e.g., this was possible because I realized Z). The collaboration between therapist and client was analyzed using the Therapeutic Collaboration Coding System, which conceptualizes the relationship as collaborative or as noncollaborative. The majority of interactions in this case were clearly collaborative, with the therapist and client working inside the therapeutic zone of proximal development, which is typical of successful psychotherapy cases. Reconceptualization innovative moments begin with collaborative exchanges in which the therapist supported the problem and the client elaborated on the change afterward. Implications of these findings for change in psychotherapy are discussed., The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was 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 cofinanced by FEDER through COMPETE2020 under the PT2020 Partnership Agreement (POCI-01-0145-FEDER-007653)., info:eu-repo/semantics/publishedVersion

The aim of this study is to assess the factors that can influence the capability of a family to take care of an oncology patient in Palliative Care. It is a broad, qualitative and observational study, backed by the Grounded Theory and using the Focus Group technique. Meetings, separated into 2 focal groups, were held in the period from January to August 2009, with 13 relatives of patients with incurable cancer and progressive disease, who were being cared for in a Palliative Care Unit of an oncology hospital in northern Portugal. By analyzing the focal groups transcripts, 4 axes that carry factors (categories) that may condition the ability to be a caregiver could be identified: The practical axis (admission, technical assistance, social/health resources, palliative care, psychological support, relocation, home expenses), the relational axis (bonds, loss, privacy, intimacy, support to the caregiver, sharing), the internal experience axis (feelings, coping strategies, affection, suffering, death, psychological support), and the health condition axis (recovering, symptoms, information about the illness, vulnerability of the caregiver). A list of the identified indicators is of help in the holistic evaluation of the family, by enabling an early detection of traits that may be of risk to their caring capacity, determining the continuity of the palliative care and/or a possible discharge., El objetivo de este estudio fue evaluar los factores que pueden influir en la capacidad de que dispone una familia para cuidar de un paciente oncológico que requiere cuidados paliativos. Se trata de un estudio amplio, cualitativo y de observación, respaldado por la Teoría Fundamentada (Grounded Theory) y el uso de la técnica de grupos focales. En el periodo de enero a agosto de 2009 reunimos a 13 familiares de pacientes con enfermedad oncológica incurable y progresiva que estaban siendo atendidos por un servicio de cuidados paliativos de un hospital oncológico situado en el norte de Portugal, separados por 2 grupos focales distintos. Mediante el análisis de lo transcrito del grupo focal se identificaron 4 ejes que aportan factores (categorías), que pueden condicionar la capacidad de cuidar: el eje práctico (ingreso, asistencia técnica, recursos sociales/salud, cuidados paliativos, apoyo psicológico, traslado, gastos de la casa); el eje relacional (los vínculos, la pérdida, la privacidad, la intimidad, el apoyo al cuidador, compartir), el eje de experiencia interna (sentimientos, estrategias de afrontamiento, afecto, sufrimiento, muerte, apoyo psicológico), y la condición del eje de la salud (la recuperación, los síntomas, la información sobre la enfermedad, la vulnerabilidad del cuidador). La construcción de los indicadores identificados en la investigación pueden resultar muy útiles para detectar en una evaluación integral a la familia factores que pueden poner en riesgo la capacidad del grupo familiar para atender al paciente y asegurar la continuidad del manejo por Cuidados Paliativos., Investigación financiada por la Beca de Investigación de Isabel Levy-Asociación Portuguesa de Cuidados Paliativos, info:eu-repo/semantics/publishedVersion

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.

ObjectivesThe notion of intrapsychic conflict has been present in psychopathology for more than a century within different theoretical orientations. However, internal conflicts have not received enough empirical attention, nor has their importance in depression been fully elaborated. This study is based on the notion of cognitive conflict, understood as implicative dilemma (ID), and on a new way of identifying these conflicts by means of the Repertory Grid Technique. Our aim was to explore the relevance of cognitive conflicts among depressive patients.DesignComparison between persons with a diagnosis of major depressive disorder and community controls.MethodsA total of 161 patients with major depression and 110 non-depressed participants were assessed for presence of IDs and level of symptom severity. The content of these cognitive conflicts was also analysed.ResultsRepertory grid analysis indicated conflict (presence of ID/s) in a greater proportion of depressive patients than in controls. Taking only those grids with conflict, the average number of IDs per person was higher in the depression group. In addition, participants with cognitive conflicts displayed higher symptom severity. Within the clinical sample, patients with IDs presented lower levels of global functioning and a more frequent history of suicide attempts.ConclusionsCognitive conflicts were more prevalent in depressive patients and were associated with clinical severity. Conflict assessment at pre-therapy could aid in treatment planning to fit patient characteristics., info:eu-repo/semantics/publishedVersion

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

Objective: The Assimilation model argues that therapists should work responsively within the client's therapeutic zone of proximal development (TZPD). This study analyzed the association between the collaborative processes assessed by the Therapeutic Collaboration Coding System (TCCS) and advances in assimilation, as assessed by the Assimilation of Problematic Experiences Scale (APES). Method: Sessions 1, 4, 8, 12, and 16 of two contrasting cases, Julia and Afonso (pseudonyms), drawn from a clinical trial of 16-sessions emotion-focused therapy (EFT) for depression, were coded according to the APES and the TCCS. Julia met criteria for reliable and clinically significant improvement, whereas Afonso did not. Results: As expected, Julia advanced farther along the APES than did Afonso. Both therapists worked mainly within their client's TZPD. However, Julia's therapist used a balance of supporting and challenging interventions, whereas Afonso's therapist used mainly supporting interventions. Setbacks were common in both cases. Conclusions: This study supports the theoretical expectation that EFT therapists work mainly within their client's TZPD. Therapeutic exchanges involving challenging interventions may foster client change if they occur in an overall climate of safety., 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 article was supported by the Portuguese Foundation for Science and Technology (FCT) [grant number PTDC/PSI-PCL/103432/2008] (Decentering and change in psychotherapy, 2010-2013)., 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.