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Rhodopseudomonas palustris is an alphaproteobacterium with impressive metabolic versatility, capable of oxidizing ferrous iron to fix carbon dioxide using light energy. Photoferrotrophic iron oxidation is one of the most ancient metabolisms, sustained by the pio operon coding for three proteins: PioB and PioA, which form an outer-membrane porin–cytochrome complex that oxidizes iron outside of the cell and transfers the electrons to the periplasmic high potential iron–sulfur protein (HIPIP) PioC, which delivers them to the light-harvesting reaction center (LH-RC). Previous studies have shown that PioA deletion is the most detrimental for iron oxidation, while, the deletion of PioC resulted in only a partial loss. The expression of another periplasmic HiPIP, designated Rpal_4085, is strongly upregulated in photoferrotrophic conditions, making it a strong candidate for a PioC substitute. However, it is unable to reduce the LH-RC. In this work we used NMR spectroscopy to map the interactions between PioC, PioA, and the LH-RC, identifying the key amino acid residues involved. We also observed that PioA directly reduces the LH-RC, and this is the most likely substitute upon PioC deletion. By contrast, Rpal_4085 demontrated significant electronic and structural differences from PioC. These differences likely explain its inability to reduce the LH-RC and highlight its distinct functional role. Overall, this work reveals the functional resilience of the pio operon pathway and further highlights the use of paramagnetic NMR for understanding key biological processes.

An 18-item Portuguese-language version of the CompACT scale has recently been proposed for the Portuguese population. This study aims at conducting the first Confirmatory Factor Analysis of the Portuguese CompACT in participants from two different samples (community adults and women in the post-partum period; total N = 1090). Given that the CompACT had yet to be subjected to gender invariance testing, the present study also presents an invariance analysis between male and female community participants. The measurement invariance of the Portuguese CompACT between community and post-partum women was also examined. The current study additionally explored the scale’s relationships with theoretically relevant outcomes associated in the literature with psychological flexibility. Results showed that the three-factor correlated model of the Portuguese CompACT was an adequate fit for the data taken from the complete sample, with most items presenting statistically and practically significant loading values. The Portuguese CompACT presented acceptable to good internal consistencies for all factors - Openness to Experience (OE), Behavioral Awareness (BA), and Valued Action (VA). Full measurement invariance was found, with results further indicating that community women presented lower scores in BA than community men, and that women in the post-partum period scored higher than community women in BA and VA, and lower in OE. The three subscales of the Portuguese CompACT, that underpin the overarching construct of psychological flexibility, demonstrated different patterns of association from one another with various aspects of individual functioning. Although those associations were in the expected directions with flexibility being associated with lower distress, some forms of psychological flexibility assessed by the CompACT were not significantly associated with measures of positive affect or resilience. This result underscores the difficulty of measuring psychological flexibility as a single construct, as it comprises a number of sub-component processes. Further implications of findings are discussed.

This study aimed to examine the role of decentering and committed action as mediators of the link of external and internal shame with psychological health, in people with a chronic disease diagnosis (n = 223) and without chronic disease (n = 230). Participants with chronic disease presented higher levels of both external and internal shame. Path analysis results showed that these variables seem to be negatively linked to psychological health and that their effects on this outcome seem to be reduced by the mechanisms of decentering and committed action. The tested model explained 56% of psychological health's variance and was invariant across groups. This study emphasizes the importance of taking a decentered stance towards internal experiences and behaving accordingly to one's personal values on psychosocial functioning, independently of disease status. These results may have particular relevance to individuals with high levels of shame.

The aim of this longitudinal study was to examine changes in COVID-19 and illness-related perceptions, gastrointestinal symptoms, coping, catastrophising, psychological distress, and QoL during the COVID-19 pandemic. A total of 831 adults with a gastrointestinal condition completed an online questionnaire at baseline (May—October 2020). Of those, 270 (32.5%) participants (85.2% female, mean age = 47.3 years) provided follow-up data (March—May 2021). Repeated-measures multiple analysis of variance and a cross-lagged panel model were used to test the study hypotheses. Gastrointestinal symptoms and COVID-19 perceptions at follow-up were strongly predicted by their baseline values, while illness perceptions were predicted by baseline gastrointestinal symptoms. Cross-lagged relationships indicated a reciprocal relationship between gastrointestinal symptoms and psychological distress. Moreover, gastrointestinal symptoms had substantial predictive utility, strongly predicting future gastrointestinal symptoms, and to a lesser extent, more negative illness perceptions, greater psychological distress, and greater use of adaptive coping strategies across time.

Acceptance and Commitment Therapy (ACT) has been widely tested for chronic pain, with demonstrated efficacy. Nevertheless, although there is meta-analytical evidence on the efficacy of face-to-face ACT, no reviews have been performed on online ACT in this population. The aim of this meta-analysis is to determine the efficacy of online ACT for adults with chronic pain, when compared with controls. PubMed, PsycINFO, CENTRAL, and Web of Knowledge were searched for randomized controlled trials (RCTs) of online-delivered ACT for chronic pain. Effects were analyzed at post-treatment and follow-up, by calculating standardized mean differences. Online-delivered ACT was generally favored over controls (5 RCTs, N = 746). At post-treatment, medium effects for pain interference and pain acceptance, and small effects for depression, mindfulness, and psychological flexibility were found. A medium effect for pain interference and acceptance, and small effects for pain intensity, depression, anxiety, mindfulness, and psychological flexibility were found at follow-up. ACT-related effects for pain interference, pain intensity, mindfulness, and anxiety increased from post-treatment to follow-up. Nevertheless, the current findings also highlight the need for more methodologically robust RCTs. Future trials should compare online ACT with active treatments, and use measurement methods with low bias. Perspective This is the first meta-analytical review on the efficacy of online ACT for people with chronic pain. It comprises 5 RCTs that compared online ACT with active and/or inactive controls. Online ACT was more efficacious than controls regarding pain interference, pain intensity, depression, anxiety, mindfulness, and psychological flexibility.

This study aimed to investigate the associations between the different abuse types, and gastrointestinal (GI) and extraintestinal symptom severity in irritable bowel syndrome (IBS), and possible mediators of these relationships.We assessed sexual and physical abuse in childhood and adulthood with the Drossman and Leserman abuse questionnaire, whereas GI and extraintestinal symptoms were assessed with the Gastrointestinal Symptom Rating Scale and the Symptom Check List-90 Revised. General linear models with bootstrapping tested the mediating role of depressive symptoms, anxiety symptoms, and GI-specific anxiety and rectal pain threshold. A path model analysis testing all relationships simultaneously was also performed.Among our 186 patients with IBS, an overall history of abuse (i.e., at least one type) was found in 37%. The effects of child and adult sexual abuse on GI symptom severity were fully mediated by GI-specific anxiety and rectal pain threshold (F = 21.540, R2 = 0.43, and F = 22.330, R2 = 0.44, respectively; p.001 for both). The effect of adult sexual abuse and child physical abuse on extraintestinal symptom severity was fully mediated by GI-specific anxiety, depressive symptoms, and rectal pain threshold, whereas the effect of child sexual abuse was partially mediated (F = 14.992, R2 = 0.28; F = 15.065, R2 = 0.30; and F = 18.037, R2 = 0.32, respectively; p.001 for all). When analyzed in a single path model, child sexual abuse and adult physical abuse only had a direct effect on extraintestinal symptom severity, whereas child physical abuse had an indirect effect through depressive symptoms.Abuse is associated with increased GI and extraintestinal symptom severity in IBS. These associations are mediated by levels of GI-specific anxiety, depressive symptoms, and rectal sensitivity.

This study aimed to explore the association between perceived isolation and symptoms of distress in people with GI disorders at the time of the pandemic; and to examine factors which moderate this relationship. This online cross-sectional survey was advertised in May–September 2020 via patient organisations and associated social media. Overall, 831 people (82% female, mean age 49 years) from 27 countries participated. A significant relationship between social isolation and psychological distress was noted (r = .525, p

A robust scale capable of assessing illness-related experiential avoidance (EA) in any given medical condition is currency lacking. Further, there is no available measure that assesses EA related to illness behaviours, i.e., actions and/or reactions in relation to feeling unwell that have the purpose of defining one’s state of health and obtaining physical or emotional relief from perceived or actual illness. This study intends to fill this significant gap by presenting the development and psychometric test of a measure of EA related to illness behaviour, the Illness Behaviour Avoidance Scale (IBAS). A total of 370 Portuguese adults with chronic illness participated in the study. The structure and validity of the IBAS was tested through an Exploratory Factor Analysis (EFA; n = 185), a Confirmatory Factor Analysis (CFA; n = 185), and reliability analyses. The IBAS presented a 7-item unifactorial structure, with good global (CMIN/DF = 2.08; CFI = 0.97; TLI = 0.94; SRMR = 0.04; RMSEA = 0.08, p = 0.139) and local adjustments (SRWs 0.56–0.73; SMCs 0.31–0.53). It also presented a good internal consistency (with αs = 0.82), and construct and discriminant validity. The IBAS appears to be a significant improvement from the use of previous EA measures in illness contexts. This scale can provide a measurement of whether the behavioural response to any given condition is a manifestation of EA.

BACKGROUND: Irritable bowel syndrome patients report reduced disease-specific quality of life (IBSQOL). Factors of potential relevance for QOL include gastrointestinal (GI), psychological, and somatic symptoms, demographics, and GI motor and sensory abnormalities. OBJECTIVE: The aim of our study was to evaluate the relative importance of these factors on the different IBSQOL dimensions. METHODS: We included irritable bowel syndrome (IBS) patients who completed validated questionnaires to assess QOL, stool form and frequency, GI symptom severity, psychological distress, GI-specific anxiety, sense of coherence, and overall somatic symptom severity. Patients also underwent tests for oroanal transit time and rectal sensitivity. The nine dimensions of IBSQOL and their average (overall IBSQOL) were used as outcome variables, and factors associated with these were assessed using general linear models. RESULTS: We included 314 IBS patients (74% female, mean age 36.3 ± 12.2 years). Higher stool frequency, GI and overall somatic symptom severity, psychological distress, and GI-specific anxiety were independently associated with reduced overall IBSQOL, with the model explaining 60% of the variance (p

Graphic abstract Iron is a fundamental element for virtually all forms of life. Despite its abundance, its bioavailability is limited, and thus, microbes developed siderophores, small molecules, which are synthesized inside the cell and then released outside for iron scavenging. Once inside the cell, iron removal does not occur spontaneously, instead this process is mediated by siderophore-interacting proteins (SIP) and/or by ferric-siderophore reductases (FSR). In the past two decades, representatives of the SIP subfamily have been structurally and biochemically characterized; however, the same was not achieved for the FSR subfamily. Here, we initiate the structural and functional characterization of FhuF, the first and only FSR ever isolated. FhuF is a globular monomeric protein mainly composed by α-helices sheltering internal cavities in a fold resembling the “palm” domain found in siderophore biosynthetic enzymes. Paramagnetic NMR spectroscopy revealed that the core of the cluster has electronic properties in line with those of previously characterized 2Fe–2S ferredoxins and differences appear to be confined to the coordination of Fe(III) in the reduced protein. In particular, the two cysteines coordinating this iron appear to have substantially different bond strengths. In similarity with the proteins from the SIP subfamily, FhuF binds both the iron-loaded and the apo forms of ferrichrome in the micromolar range and cyclic voltammetry reveals the presence of redox-Bohr effect, which broadens the range of ferric-siderophore substrates that can be thermodynamically accessible for reduction. This study suggests that despite the structural differences between FSR and SIP proteins, mechanistic similarities exist between the two classes of proteins. Supplementary Information The online version contains supplementary material available at 10.1007/s00775-021-01854-y.

In paramagnetic metalloproteins, longitudinal relaxation rates of 13C′ and 13Cα nuclei can be measured using 13C detected experiments and converted into electron spin-nuclear spin distance restraints, also known as Paramagnetic Relaxation Enhancement (PRE) restraints. 13C are less sensitive to paramagnetism than 1H nuclei, therefore, 13C based PREs constitute an additional, non-redundant, structural information. We will discuss the complementarity of 13C PRE restraints with 1H PRE restraints in the case of the High Potential Iron Sulfur Protein (HiPIP) PioC, for which the NMR structure of PioC has been already solved by a combination of classical and paramagnetism-based restraints. We will show here that 13C R1 values can be measured also at very short distances from the paramagnetic center and that the obtained set of 13C based restraints can be added to 1H PREs and to other classical and paramagnetism based NMR restraints to improve quality and quantity of the NMR information.

The aim of this study was to develop and validate the Athletes’ Perceptions of the Coach-related Critical Attitudes Scale (APoCCAS), using three independent samples of Portuguese adult athletes. In the first stage, the items were developed to assess athletes’ perceptions of coach-related critical attitudes and the items’ factorial structure were explored via a principal components analysis. In a second stage, the findings of Principal Components Analysis were confirmed and cross-validated using confirmatory factor analysis with two independent samples of athletes. The development of a pool of items resulted in a 10-item with a unifactorial structure. This scale presented high internal consistency, adequate convergent validity, and presented a negative association with self-reassurance and positive associations with self-criticism, anxiety, and depressive symptoms. The APoCCAS demonstrated to be a short and reliable measure of the athletes’ perceptions regarding coach-related critical attitudes and seems to be useful for practice and research fields in clinical sport psychology. By highlighting the associations between the athletes’ perception of coach-related critical attitudes and mental health indicators, this study could create a space to alert coaches towards the effect of their attitudes on athletes’ mental health.

Background Although several studies have reported the impact of fears relating to COVID-19 on several chronic illness populations, there are few studies focused on gastrointestinal (GI) conditions. The aim was to compare how fear of COVID-19 is manifested in people living with Inflammatory Bowel Disease (IBD) compared to other GI conditions; and, how fear of COVID-19 is manifested across different demographic backgrounds (employment status, education level and country of residence) among IBD respondents using a large international sample. Methods Participants with a GI condition (≥18years of age) were recruited from 22 countries through a web-based questionnaire. Demographic, clinical, and psychosocial information was collected in relation to the COVID-19 pandemic. An adaptation of the scale developed for IBD by Trindade & Ferreira (2020) measuring fear of COVID-19 (FoC; original items 1–9) and GI specific fear of COVID-19 (GI-FoC; new items 10–14) was used. Results In 831 participants (312 IBD), there were no significant differences in FoC between IBD and other GI conditions; whilst significant increases in GI-FoC were found in IBD respondents (mean [SD]: 13.5 [5.5] vs. 10.9 [5.0], p being at increased risk of getting COVID-19; and being at increased risk of death if they got COVID-19. Among IBD respondents, persons on sick leave had significantly more general FoC than those who were employed, and significantly more GI-FoC compared to the employed or respondents outside of the labour market (Figures 1a and 1b). Persons living in a rural setting had significantly more general FoC and GI-FoC (Figures 2a and 2b). These persons were fearful of contracting COVID-19, having contact with someone with respiratory symptoms, having contact with healthcare professionals, going outside, meeting people, having contact with someone who was in contact with an infected person, having contact with someone infected with COVID-19, and that their IBD means being at increased risk of death if they got COVID-19. There were no differences in general FoC and GI-FoC according to educational background. However, respondents with higher education were less afraid of dying from COVID-19. Conclusion Respondents with IBD are more afraid of the consequences of COVID-19 due to their disease compared to other GI diseases; especially, persons on sick leave or persons living in a rural setting. Persons with higher education were less afraid of dying from COVID-19. These findings should be taken into consideration to personalise the support health-care providers can offer in mitigating fear related to COVID-19 in IBD patients.

The enhancement of nuclear relaxation rates due to the interaction with a paramagnetic center (known as Paramagnetic Relaxation Enhancement) is a powerful source of structural and dynamics information, widely used in structural biology. However, many signals affected by the hyperfine interaction relax faster than the evolution periods of common NMR experiments and therefore they are broadened beyond detection. This gives rise to a so-called blind sphere around the paramagnetic center, which is a major limitation in the use of PREs. Reducing the blind sphere is extremely important in paramagnetic metalloproteins. The identification, characterization, and proper structural restraining of the first coordination sphere of the metal ion(s) and its immediate neighboring regions is key to understand their biological function. The novel HSQC scheme we propose here, that we termed R2-weighted, HSQC-AP, achieves this aim by detecting signals that escaped detection in a conventional HSQC experiment and provides fully reliable R2 values in the range of 1H R2 rates ca. 50–400 s−1. Independently on the type of paramagnetic center and on the size of the molecule, this experiment decreases the radius of the blind sphere and increases the number of detectable PREs. Here, we report the validation of this approach for the case of PioC, a small protein containing a high potential 4Fe-4S cluster in the reduced [Fe4S4]2+ form. The blind sphere was contracted to a minimal extent, enabling the measurement of R2 rates for the cluster coordinating residues.

High potential iron–sulfur proteins (HiPIPs) are a class of small proteins (50–100 aa residues), containing a 4Fe–4S iron–sulfur cluster. The 4Fe–4S cluster shuttles between the oxidation states [Fe4S4]3+/2+, with a positive redox potential in the range (500–50 mV) throughout the different known HiPIPs. Both oxidation states are paramagnetic at room temperature. HiPIPs are electron transfer proteins, isolated from photosynthetic bacteria and usually provide electrons to the photosynthetic reaction-center. PioC, the HIPIP isolated from Rhodopseudomonas palustris TIE-1, is the smallest among all known HiPIPs. Despite their small dimensions, an extensive NMR assignment is only available for two of them, because paramagnetism prevents the straightforward assignment of all resonances. We report here the complete NMR assignment of 1H, 13C and 15N signals for the reduced [Fe4S4]2+ state of the protein. A set of double and triple resonance experiments performed with standardized parameters/datasets provided the assignment of about 72% of the residues. The almost complete resonance assignment (99.5% of backbone and ca. 90% of side chain resonances) was achieved by combining the above information with those obtained using a second set of NMR experiments, in which acquisition and processing parameters, as well as pulse sequences design, were optimized to account for the peculiar features of this paramagnetic protein.

CFQ-CI was previously developed and preliminarily validated in a study with a single online-recruited inflammatory bowel disease (IBD) sample. The current study presents a further validation of CFQ-CI in four different samples of patients with chronic health conditions: a sample of 82 women with breast cancer, an online-recruited mixed sample of 100 people with cancer, a sample of 69 people with IBD, and an online-recruited mixed chronic illness sample of 93 participants. Confirmatory Factor Analyses, multi-group, reliability, and differences analyses were conducted. Results indicated that the scale is a robust unidimensional 7-item measure of chronic illness-related cognitive-fusion, with excellent reliability and structural validity across the four studied samples and in both paper-pencil- and online-based collection methods. Measurement invariance was not established across the samples, suggesting that CFQ-CI does not appear tofunction equivalently across different illness diagnoses. This study confirms CFQ-CI as a robust, adequate, and simple measure of chronic illness-related cognitive fusion that can be used in different behavioural medicine research and clinical contexts. As the scale does not seem to present measurement invariance, comparing scores between different illness groups is not recommended.

Major life events have been positively associated with depression symptoms. Although psychological flexibility has been associated with adaptive coping skills and negatively linked with depression ...

Objective In accordance to ACT theory, psychological inflexibility may influence the well-known link between learned helplessness and depression symptomatology. This exploratory preliminary study aims to analyse whether psychological flexibility moderates the relationship between these variables. Methods A community sample of 84 Portuguese participants (30 men and 54 women), with a mean age of 33.98 (SD = 11.05), completed the LHS, CompACT, and DASS-21. The moderating effect of psychological flexibility on the relationship between learned helplessness and depression symptomatology was calculated using the PROCESS computation macro. Results The interaction term between learned helplessness and psychological flexibility was significant (b = −0.01, SE = 0.00, p Discussion Higher psychological flexibility seems to be protective for depression symptomatology, in particular for those individuals who experience higher levels of learned helplessness. Individuals who are most likely to struggle with learned helplessness are potentially those who could benefit the most of an intervention targeting psychological flexibility as a way to ameliorate depressive symptomatology. Future studies with larger and clinical samples are required to confirm these preliminary findings.

Although there is some evidence on the efficacy of mindfulness-based interventions in improving health and psychological outcomes in women with breast cancer, further research is needed to understand these findings’ clinical significance. Furthermore, Acceptance and Commitment Therapy (ACT) intervention studies on breast cancer are scarce, and no compassion-based intervention has been tested for cancer patients. Given the complementarity and compatibility of mindfulness practice, ACT, and Compassion Focused Therapy, the current study combined these approaches to develop an integrative intervention specifically adapted to cancer patients, the Mind programme. Participants were recruited at the Radiotherapy Service of the Coimbra University Hospital (CHUC) and were assigned to one of two groups: the experimental group (Treatment As Usual + Mind Programme (8 weekly sessions and homework assignments) – n = 15) and the control group (Treatment As Usual – n = 17). There was a 100% retention on the experimental group, during the intervention. The effect size for psychological health (g = 0.79) was particularly noteworthy, suggesting that the intervention presented benefits that are comparable to mindfulness only-based interventions. The experimental group also improved on physical health (g = 0.16), quality of social relationships (g = 0.42), depression symptoms (g = −0.42), and stress (g = −0.32). Participants reported it was important for them to take part in the programme, and that it improved the way they deal with difficulties. Results indicate that the Mind programme may be a useful complement to the medical treatment of breast cancer and support the combination of acceptance, mindfulness, and compassion-based components in this context. Having an accessible and integrative psychological programme for people with cancer may significantly help improving quality of life and mental health in this population. Further implications are discussed.

O presente artigo objetiva analisar a extradição à luz dos princípios de cooperação jurídica internacional previstos no Novo Código de Processo Civil. Para tanto, inicialmente, faz-se necessária a abordagem do conceito de extradição, vislumbrada como medida de cooperação internacional, bem como as exigências legais da Lei 13.445/2017 (Lei de Migração). Aliás, a abordagem da lei de migração é de suma importância por ter revogado o Estatuto do Estrangeiro, até então norma responsável por ditar as regras a serem observadas nos casos em concreto sobre a extradição. Na verdade, muito antes da abordagem do assunto principal, mister analisar os requisitos legais da nova lei que aborda a extradição, uma vez que sua análise é primordial para a chegada do tema sobre princípios, que são bases primordiais de análise de qualquer decisão sobre extradição. Em seguida, o artigo enumera os princípios próprios da cooperação internacional previstos no Novo Código de Processo Civil, diretamente ligados ao instituto da extradição, e também os compara ao Código Modelo de Cooperação Interjurisdicional para Ibero- -América, proposto como norte de adequação dos Estados-Membros quando o assunto é cooperação internacional, como o próprio nome diz. Por fim, o artigo estabelece um paralelo entre os princípios diretrizes da Lei de Migração, vislumbrando-se tudo isso em um caso em concreto, utilizando o método lógico-dedutivo.

Objetivo: O presente estudo teve como objetivo testar o potencial efeito mediador da autocompaixão e da ação comprometida na relação entre vergonha e sintomatologia depressiva, em pessoas sem e com diagnóstico de doença física crónica. Adicionalmente, foram exploradas as diferenças em relação a essas variáveis entre os dois grupos. Métodos: A amostra foi constituída por 453 participantes (223 com e 230 sem diagnóstico de doença física crónica), os quais responderam numa plataforma online a um protocolo de medidas de autorrelato de vergonha, autocompaixão, ação comprometida e sintomas depressivos. Resultados: Os participantes com diagnóstico de doença crónica apresentaram níveis significativamente (p < 0,05) superiores de vergonha e sintomatologia depressiva, e níveis inferiores de ação comprometida, comparativamente aos participantes sem doença física crónica. Contudo, não foram encontradas diferenças significativas entre os dois grupos relativamente às competências autocompassivas. As análises de correlação revelaram que a vergonha se associa negativamente à autocompaixão e ação comprometida e positivamente á sintomatologia depressiva, tanto no grupo sem como no grupo com diagnóstico de doença física crónica. Os resultados da path analysis indicaram que sentimentos de vergonha têm um impacto significativo, explicando 41% da variância da sintomatologia depressiva, parcialmente via menores níveis de autocompaixão e de ação comprometida. Os resultados da análise multigrupos demonstraram que o modelo testado é plausível nos dois grupos em estudo. Conclusões: Este estudo parece fornecer importantes contributos para a compreensão do impacto protetor das competências autocompassivas e da adoção de ações comprometidas para a saúde mental, tanto para pessoas sem como com diagnóstico de doença física crónica. De facto, os resultados sugerem que estes processos de regulação emocional são importantes mecanismos mediadores da relação entre vergonha e sintomas depressivos. Finalmente, estes dados parecem suportar o desenvolvimento de abordagens mais eficazes para a promoção da saúde psicológica para pessoas sem e com doença crónica.

Irritable Bowel Syndrome (IBS) negatively influences mental and physical quality of life (QoL), but factors that explain this impact are still unclear. Increasing evidence has associated IBS severity, psychological distress, somatic symptoms, and gastrointestinal (GI)-specific anxiety with QoL in IBS. The aim of this study is to further explore these associations and to analyze potential mediating factors.A total of 1017 IBS patients (69.3% female, mean age 40.6 years) who completed a QoL measure (SF-36) were included in this study. A proportion of these participants (N = 183; 72.7% female, mean age 41.7), who additionally completed psychological distress, somatic symptoms, and GI-specific anxiety measures, was included in the mediation analysis. This analysis was conducted via structural equation modelling to identify factors of importance for generic QoL, using a cross-sectional design.IBS patients reported lower QoL than what is observed in the general population, in particular regarding role limitations caused by health and emotional functioning, vitality, and social functioning. Female patients scored lower than male patients on most QoL dimensions. The effects of IBS severity on mental and physical QoL were mediated by GI-specific anxiety. In addition to GI-specific anxiety, depressive symptoms were also of importance for mental QoL, and somatic symptom severity for physical QoL.QoL is reduced in patients with IBS and GI-specific anxiety, depressive symptoms, and somatic complaints are particularly important for this outcome. Future trials should test the efficacy of psychological interventions specifically targeting these factors in improving QoL in IBS.

Objectives Evidence shows that Acceptance and Commitment Therapy (ACT) is an empirically supported psychological approach for chronic pain (CP) management. Although self-compassion is not explicitly a target of ACT, it seems to be one mechanism of change in ACT for CP. However, research is lacking on the benefits of including explicit self-compassionate exercises in ACT for CP. The current study pilot tested a Compassionate ACT 8-session group program (COMP.ACT; n=9), as well as an ACT-only 8-session group program (ACT; n=7), in a sample of women with CP. Methods The current study follows a quasi-experimental design, and conducts Reliable and Significant Change analyses comparing pre- to post-intervention scores of self-report measures. Results No differences were found between conditions at baseline, nor between completers and drop-outs. Although preliminary, results showed COMP.ACT led to greater clinical improvements in depression and anxiety, while ACT led to greater improvements in stress and uncompassionate self-responding. Reliable and Significant Change analysis showed that some participants improved significantly (in psychopathological symptoms, valued living and uncompassionate self-responding) in both conditions, while the majority did not change significantly. Conclusions More research is needed to conclude whether explicit self-compassion exercises are useful in ACT for CP. Limitations and implications are further discussed.

The aim of this cross-sectional study was to use an extended common sense model (CSM) to evaluate the impact of fear of COVID-19 on quality of life (QoL) in an international inflammatory bowel disease cohort. An online study involving 319 adults (75% female, mean (SD) 14.06 (15.57) years of symptoms) completed the Gastrointestinal Symptom Rating Scale, Brief Illness Perceptions Questionnaire, Fear of Contracting COVID-19 Scale, Brief-COPE, Depression, Anxiety and Stress Scale, and the EUROHIS-QOL. The extended CSM had an excellent fit (χ

Objective The COVID-19 pandemic has had a significant impact on mental health across the globe. People living with a chronic gastrointestinal (GI) disorder might be particularly at risk of mental health complications given higher rates of comorbid anxiety and depression compared to the healthy population. As GI disorders affect up to 40% of the population worldwide, this international collaborative study seeks to evaluate the extent of the impact of the COVID-19 pandemic on GI symptoms specifically and more generally on the well-being of those living with chronic GI conditions. Methods A longitudinal survey with three time points (baseline, 6-month, and 12-month) will be conducted online. Adult participants with GI disorders from multiple countries will be recruited via patient associations, social media advertising, utilizing snowball sampling. Participants will be invited to complete a battery of questionnaires including demographic and health parameters, and measures of gastrointestinal symptoms, fear of COVID-19, perceived impact of COVID-19, illness perceptions, coping, depression, anxiety, stress, catastrophizing, and quality of life, using validated measures where available. Statistical analyses will include univariate descriptive models, multivariate models utilizing regression, mediation, and moderation, and latent growth models. Conclusions This project may present novel information to the field of psychogastroenterology and may provide crucial information regarding the areas of impact for individuals with GI disorders during and following the pandemic. Further, this information can guide healthcare providers and patient associations on how to target support related to the pandemic mental health sequelae for these patients.

The need for a transnational validation is imperative at the stage of development of the CompACT, a self-report measure of psychological flexibility. This study aimed to translate, validate and test the factor structure of the Portuguese version of the CompACT and to conduct a measurement invariance analysis comparing the scale's performance in Portuguese and UK samples. Results from an Exploratory Factor Analysis demonstrated that the Portuguese version of the CompACT statistically performed better without 5 items from the Openness to Experience subscale. The 18-item Portuguese-adapted CompACT presented significant correlations in the expected directions and with the expected magnitudes with AAQ-II, CFQ-7, MAAS, CAQ-8, and DASS-21. Partial metric invariance was demonstrated between the Portuguese-adapted 18-item CompACT and the original CompACT in a UK sample. The non-correspondence between responses to these versions may be due to differences between the Portuguese and British cultures. This study contributes with the adaptation of the original CompACT to the Portuguese language and with the refinement of this instrument to an 18-item measure of psychological flexibility, that appears to be adequate for use in Portuguese samples. The lack of complete metric invariance of the CompACT found across the Portuguese and UK samples highlights the importance of psychometrically analyzing psychological instruments before use in cultural contexts distinct from the one targeted in the measure's original validation study.

Considering that self-criticism is an important process in the development and maintenance of depression, and taking into account the stigma associated with inflammatory bowel disease (IBD), the present study aimed to analyse whether self-criticism exacerbates the relationships of depression symptoms with IBD symptomatology and chronic illness-related shame. The sample included 53 ambulatory IBD patients (66% females) with ages from 18 to 65. Moderation analyses were conducted using structural equation modelling. Self-criticism exacerbated the associations of depression with IBD symptoms (b = 0.01; standard error [SE] = 0.00; Z = 3.73; P < .001) and illness shame (b = 0.02; SE = 0.01; Z = 2.40; P = .016). For the same level of IBD symptomatology or chronic illness-related shame, those individuals who present more feelings of inadequacy towards the self, experience more symptoms of depression. This exacerbation effect is stronger when IBD symptomatology and chronic illness-related shame are more intense. A high self-critical IBD patient may view the illness and/or symptomatology as a flaw or error that should be self-corrected. Physicians and other health professionals should be attentive to these pathological mechanisms and should attempt to alleviate them. It may be beneficial to refer high self-critical patients to psychological care.

An extensive body of research has showed the impact of major life events on depressive symptoms. However, the underlying psychological processes that contribute to this association are still unclear. The present study aims to explore the mediating role of external shame and fears of receiving compassion on the associations of the number of major life events and their appraisals by the individual with depressive symptoms. Participants were 400 Portuguese-speaking adults from the general population (121 men and 279 women) with ages between 18 and 65 years, that completed self-report measures. Correlation analysis showed significant and positive associations between the number of major life events that occurred in the previous year and the positive and negative appraisal of such events, external shame, fears of receiving compassion, and depressive symptoms. Path analysis revealed that external shame and fears of receiving compassion fully mediated the effects of number of life events on depressive symptoms. Furthermore, results showed a direct effect of negative appraisal of major life events on depressive symptoms. This study sheds light on the psychological processes that may underlie the relationship between the cumulative number of major life events and depressive symptoms. Specifically, it suggests that the occurrence of major life events can impact on depressive symptoms when associated with feelings of shame and fears of receiving compassion from others.

This study aimed to explore, through structural equation modelling, experiential avoidance and committed action’s effects on the association between anxiety and psychological quality of life and whether this relationship presents significant differences across a sample of 115 college students with chronic illness and a sample of 232 students without illness. Students with chronic illness presented higher levels of anxiety and experiential avoidance and lower levels of quality of life. The association between anxiety and psychological quality of life was partially explained by experiential avoidance and committed action. This path model was shown to be invariant between the two groups of students.

This study aims to (a) explore individual differences in women with chronic pain (CP) in regard to pain intensity, functional impairment, cognitive fusion, and depressive symptoms and (b) longitudinally test whether cognitive fusion is a significant predictor of depression symptoms, while controlling for pain intensity and functional impairment, over a 12-month period. This study follows a longitudinal design and was conducted in a sample of 86 women with CP who responded to an online battery of questionnaires in three equally spaced assessment moments. In order to explore the growth trajectory of variables of interest, latent growth curve models were examined. Also, correlation analyses were conducted between demographic and illness-related variables and depressive symptoms, as well as between all variables in all assessment moments. Cognitive fusion and functional impairment (but not pain intensity) were significantly associated with baseline levels of depressive symptoms. Cognitive fusion significantly predicted the growth trajectory of depressive symptoms, whereas pain intensity and functional impairment did not. No demographic (age, marital status, education, socio-economic) nor illness-related variables (number of CP diagnoses, duration of CP, taking medication) were associated with depressive symptoms at any point. These results suggest that the trajectory of depressive symptoms in women with CP is not predicted by the intensity of pain nor pain-related functional impairment, but rather by the tendency to get entangled with internal experiences (e.g., thoughts, emotions, and physical sensations), which may or may not be related to pain-specific contents. Clinical implications are discussed.

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.