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Repositório Institucional do Ispa-Instituto Universitário
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What factors do young people define as determinants of their well-being? Findings from the improve the youth project
Publication . Kleszczewska, Dorota; Dzielska, Anna; Michalska, Agnieszka; Branquinho, Cátia; Gaspar, Tania; Gaspar de Matos, Margarida; Mazur, Joanna
Background: The UN has recognised well-being as a main goal of The Global Strategy for Women’s, Children’s and Adolescents’ Health (2016–2030).
Objective: The aim was to identify the areas of mental health that are the most significant to teenagers.
Material and methods. The mixed-method approach was applied. Quantitative research included adolescents aged 11–15 years (6,026 in Portugal; 4,545 in Poland). HBSC study results (2013/2014) were analysed in terms of the following variables: self-rated health, life satisfaction (Cantril Ladder, KIDSCREEN-10 Index), and psychosomatic complaints (SCL scale). Focus workshops took place in 2018, with 72 teenagers aged 14 to 16.
Results: 16.6% of the Polish participants and 12.7% of the Portuguese participants were concerned about their health. Polish participants were less satisfied with their life [KIDSCREEN score: 25.48 for Poland (SD=6.39), and 29.96 (SD=6.03) for Portugal]. Both nations associated mental health (MH) with the family setting and relationships with friends. An additional association among Portuguese teenagers involved social issues, whereas Polish adolescents were more focussed on relationships with various people in their environment, as well as on experiencing issues at school and in the family.
Conclusions: Adolescent MH is determined by stress, environmental pressure and high expectations. The viewpoints of adolescents are the most valuable source of knowledge for specialists, researchers and youth institutions, who can benefit greatly from taking advantage of this resource.
Luszczynska, A., Szczuka, Z., Abraham, C., Baban, A., Brooks, S., Cipolletta, S., Danso, E., Dombrowski, S. U., Gan, Y., Gaspar, T., De Matos, M. G., Griva, K., Jongenelis, M. I., Keller, J., Knoll, N., Ma, J., Miah, M. a. A., Morgan, K., Peraud, W., . . . Wolf, H. (2021). The interplay between strictness of policies and individuals’ self-regulatory Efforts: Associations with Handwashing During the COVID-19 Pandemic. Annals of Behavioral Medicine, 56(4), 368–380. https://doi.org/10.1093/abm/kaab102
Publication . Luszczynska, Aleksandra; Szczuka, Zofia; Abraham, Charles; Baban, Adriana; Brooks, Sydney; Cipolletta, Sabrina; Danso, Ebrima; Dombrowski, Stephan U; Gan, Yiqun; Gaspar, Tania; Gaspar de Matos, Margarida; Griva, Konstadina; Jongenelis, Michelle I; Keller, Jan; Knoll, Nina; Ma, Jinjin; Miah, Mohammad Adbdul Awal; Morgan, Karen; Peraud, William; Quintard, Bruno; Shah, Vishna; Schenkel, Konstantin; Scholz, Urte; Schwarzer, Ralf; Siwa, Maria; Taut, Diana; Tomaino, Silvia C M; Vilchinsky, Noa; Wolf, Hodaya
Patterns of protective health behaviors, such as handwashing and sanitizing during the COVID-19 pandemic, may be predicted by macro-level variables, such as regulations specified by public health policies. Health behavior patterns may also be predicted by micro-level variables, such as self-regulatory cognitions specified by health behavior models, including the Health Action Process Approach (HAPA).This study explored whether strictness of containment and health policies was related to handwashing adherence and whether such associations were mediated by HAPA-specified self-regulatory cognitions.
Methods
The study (NCT04367337) was conducted among 1,256 adults from Australia, Canada, China, France, Gambia, Germany, Israel, Italy, Malaysia, Poland, Portugal, Romania, Singapore, and Switzerland. Self-report data on cross-situational handwashing adherence were collected using an online survey at two time points, 4 weeks apart. Values of the index of strictness of containment and health policies, obtained from the Oxford COVID-19 Government Response Tracker database, were retrieved twice for each country (1 week prior to individual data collection).
Across countries and time, levels of handwashing adherence and strictness of policies were high. Path analysis indicated that stricter containment and health policies were indirectly related to lower handwashing adherence via lower self-efficacy and self-monitoring. Less strict policies were indirectly related to higher handwashing adherence via higher self-efficacy and self-monitoring
Conclusions: When policies are less strict, exposure to the SARS-CoV-2 virus might be higher, triggering more self-regulation and, consequently, more handwashing adherence. Very strict policies may need to be accompanied by enhanced information dissemination or psychosocial interventions to ensure appropriate levels of self-regulation.
Open-label placebo treatment in chronic low back pain: A randomized controlled trial
Publication . Cláudia Carvalho; Joaquim Machado Caetano; Lidia Cunha; Paula Rebouta; Ted J. Kaptchuk; Irving Kirsch
This randomized controlled trial was performed to investigate whether placebo effects in chronic low back pain could be harnessed ethically by adding open-label placebo (OLP) treatment to treatment as usual (TAU) for 3 weeks. Pain severity was assessed on three 0- to 10-point Numeric Rating Scales, scoring maximum pain, minimum pain, and usual pain, and a composite, primary outcome, total pain score. Our other primary outcome was back-related dysfunction, assessed on the Roland–Morris Disability Questionnaire. In an exploratory follow-up, participants on TAU received placebo pills for 3 additional weeks. We randomized 97 adults reporting persistent low back pain for more than 3 months' duration and diagnosed by a board-certified pain specialist. Eighty-three adults completed the trial. Compared to TAU, OLP elicited greater pain reduction on each of the three 0- to 10-point Numeric Rating Scales and on the 0- to 10-point composite pain scale (P < 0.001), with moderate to large effect sizes. Pain reduction on the composite Numeric Rating Scales was 1.5 (95% confidence interval: 1.0-2.0) in the OLP group and 0.2 (−0.3 to 0.8) in the TAU group. Open-label placebo treatment also reduced disability compared to TAU (P < 0.001), with a large effect size. Improvement in disability scores was 2.9 (1.7-4.0) in the OLP group and 0.0 (−1.1 to 1.2) in the TAU group. After being switched to OLP, the TAU group showed significant reductions in both pain (1.5, 0.8-2.3) and disability (3.4, 2.2-4.5). Our findings suggest that OLP pills presented in a positive context may be helpful in chronic low back pain.
Cyberbullying em Portugal durante a pandemia: 2ºconfinamento
Publication . António, Raquel; Guerra, Rita; Moleiro, Carla
A utilização de plataformas digitais está associada a diversos benefícios (e.g., aumento do bem-estar pessoal), mas o cyberbullying é um dos riscos mais comuns associados à mesma. O cyberbullying consiste na utilização da tecnologia para assediar, ameaçar ou vitimizar outra pessoa de forma repetida e intencional. Este tipo de bullying realizado através de meios digitais pode acontecer em qualquer lugar e a qualquer hora, para além dos portões das escolas; possibilita o anonimato do/a agressor(a) e pode gerar diversos efeitos
negativos nas vítimas, como ansiedade.
Em 2020, um estudo realizado em Portugal relativo ao 1º período de
confinamento obrigatório e de ensino à distância revelou que 61% dos jovens afirmavam ter sido vítimas de cyberbullying e que oito em cada dez foi testemunha deste tipo de comportamento online[1]. Em Portugal, o relatório EU Kids Online 2019, que inquiriu jovens entre os 9 e 17 anos, revelou que o cyberbullying predomina sobre o bullying tradicional (presencial). Mais de um quinto dos que sofre deste tipo de agressão indicou que esta ocorre várias vezes por mês, através de chamadas, mensagens ou por outra via.
Durante o período de confinamento decorrente da pandemia da Covid-19, vários especialistas alertam para o facto de milhões de crianças e jovens terem sido afectadas pelo fecho de escolas, passando a ter aulas e socializar mais online, deixando-as mais vulneráveis e expostas a serem vítimas de cyberbullying.
A principal contribuição deste estudo é analisar a frequência de cyberbullying em jovens portugueses durante o 2º período de confinamento obrigatório decorrente da pandemia do coronavírus, ou seja, entre janeiro e abril de 2021.
Será a relação terapêutica suficiente? O papel de tarefas e ruturas em psicoterapia
Publication . Ribeiro, Pedro Rodrigues; Neto, David Dias
Research shows that the therapeutic relationship consistently has a moderate, positive impact on the efficacy of psychotherapy and on change. However, there is ongoing discussion about the association between the relationship and techniques in the change process, with evidence that techniques have a positive impact on both the process and the relationship. At the same time, we see an increase in the influence of identifying and repairing ruptures as a relational task and a contribution to the quality of the relationship and the efficacy of therapy. The purpose of this work is to determine whether the therapeutic relationship is sufficient and to examine the roles of techniques and ruptures in the therapeutic process, thereby expanding theoretical and empirical knowledge.
In the first study, we propose a different view of the Therapeutic Relationship by integrating the Real Relationship, Therapeutic Alliance, and Client’s Attachment to Therapist in a sample of 373 adults in individual therapy. Using an exploratory principal components analysis, the results show a five-component structure, illustrating different patients’ needs and perspectives on the relationship, as well as the therapist's perceptions of the relationship and their interactions with patients. We conclude with implications for research and clinical practice.
In the second study, we question the role and weight of techniques in the Therapeutic Alliance, in individual therapy. Based on the literature, we conducted a systematic review analyzing 53 articles, organized by specific therapeutic strategies and their relative weight in the alliance. Results show a total of 37 techniques: 14 had a positive impact on the alliance’s effect size, and 23 didn’t affect the alliance’s effect size, illustrating that techniques can affect the alliance and the process outcome. We conclude with implications for research and clinical practice.
In the third study, we proceeded with the analysis of a 19-session brief intervention with an adult patient in individual therapy in a case study context. Using a reflexive thematic analysis methodology, this analysis is grounded in our perspective on the therapeutic relationship and in the identification and repair of ruptures in the alliance. The results show themes related to the patient’s specific needs, the therapist's techniques, and a set of alliance ruptures, indicating a good partnership throughout the intervention and an openness and flexibility to repair ruptures in the relationship. We conclude with implications for research and clinical practice.
The contributions of these studies and works allow us to say that, regarding therapeutic process and change, the therapeutic relationship influences the change in interaction with techniques and rupture repair. We conclude with suggestions for the next steps that, ultimately, can contribute to enhancing therapists’ training and research in the field of psychotherapy.