APPsyCI - Artigos em revistas científicas internacionais
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- Adaptation of the eco-anxiety scale to adult Portuguese native speakers: a validity and reliability studyPublication . Ferrajão, Paulo; Torres, Nuno; Martins, Amadeu QuelhasEco-anxiety is a multidimensional construct that includes emotional, behavioral and cognitive manifestations related to potential environmental calamities. There is a need to adapt and validate measures that evaluate eco-anxiety into Portuguese using a multi-trait approach. This study examined the psychometric properties of the Hogg Eco-Anxiety Scale (HEAS) in adult Portuguese speakers (18–83 years old). Data were collected on the Portuguese adaptation of the HEAS, environmental identity and psychological symptoms, and sociodemographic data. The construct validity of the HEAS was subsequently examined through exploratory and confirmatory factor analysis. The factorial structure of the original scale was the best explanation of the sample data. The scale showed good internal consistency and presented measurement invariance for both sex and age groups. The global score of the HEAS and the dimensions of emotional and behavioral symptoms were moderately associated with clinical symptoms. Females and younger participants presented higher levels of eco-anxiety apart from rumination symptoms. The results suggest the suitability of the HEAS as a valid measure to evaluate the different signs of eco-anxiety among adult Portuguese native speakers.
- Bereavement support guidelines for caregivers in palliative care: A scoping reviewPublication . Coelho, Alexandra; Albuquerque, Sara; Neto, David DiasPalliative care teams’ support practices for bereavement vary substantially. Clinical guidelines are needed to promote concerted, evidence-based intervention. The goal of the present study is to identify and synthesize the principles and clinical guidelines that ensure best practices in bereavement support for family caregivers accompanied in palliative care. A scoping review was conducted based on a systematic search of articles in academic databases (EBSCO, PsycINFO, PubMed, Web of Science, Psychology and Behavioral Sciences Collection, Scopus) and Google (2010–2024). The review included articles focused on the principles, guidelines, and clinical recommendations for bereavement support for adult family caregivers in palliative care. Quality appraisal of guidelines was conducted using the AGREE II instrument. Of the 1,489 references identified, 20 documents were included, mostly governmental or institutional norms and clinical guidelines from gray literature. Quality appraisal revealed gaps in evidence selection, resource implications, updates and monitoring criteria. Eight fundamental principles were identified, from which several clinical guidelines were derived, organized according to the moments of assessment and intervention throughout the bereavement process, including pre and post-death period: (1) organizing support for the family caregiver; (2) assessing needs and establishing a care plan; (3) ensuring information and support for the family caregiver; (4) preparing for death; (5) support at the time of death; and (6) bereavement support post-death. In addition to universal support and information measures, regular assessment procedures should be adopted for timely referrals based on individual needs.These guidelines cover the temporal variation of care and the multidimensional and multiple-actor nature of palliative care. Implementing these guidelines and evaluating their impact will allow for the standardization of best practices and improve the quality of bereavement support in palliative care.
- Bridging genetic insights with neuroimaging in Autism Spectrum Disorder — A systematic reviewPublication . Vilela, Joana; Rasga, Célia; Santos, João Xavier; Martiniano, Hugo; Marques, Ana Rita; Oliveira, Guiomar; Vicente, Astrid Moura; Maria Rasga, CéliaAutism Spectrum Disorder (ASD) is an early onset neurodevelopmental disorder characterized by impaired social interaction and communication, and repetitive patterns of behavior. Family studies show that ASD is highly heritable, and hundreds of genes have previously been implicated in the disorder; however, the etiology is still not fully clear. Brain imaging and electroencephalography (EEG) are key techniques that study alterations in brain structure and function. Combined with genetic analysis, these techniques have the potential to help in the clarification of the neurobiological mechanisms contributing to ASD and help in defining novel therapeutic targets. To further understand what is known today regarding the impact of genetic variants in the brain alterations observed in individuals with ASD, a systematic review was carried out using Pubmed and EBSCO databases and following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. This review shows that specific genetic variants and altered patterns of gene expression in individuals with ASD may have an effect on brain circuits associated with face processing and social cognition, and contribute to excitation–inhibition imbalances and to anomalies in brain volumes.
- Bridging the gap: Environmental health literacy as key to adolescent well-being and sustainable behaviorsPublication . Matos, Margarida Gaspar de; Branquinho, Cátia; Domingos, Leonor; Guedes, Fábio Botelho; Cerqueira, Ana; Gaspar, TaniaAdolescents who possess environmental health literacy are more equipped to handle the effects of the environment on their health. This study uses data from Portugal’s 2022 HBSC survey to investigate the environmental health literacy (EHL) of teenagers. The Environmental Health Literacy Scale (EHLS) was verified by confirmatory component analysis. Within the framework of an ecosystem, this study investigates factors related to health and well-being. There are 7355 adolescents in the sample. EHLS_Social Norms and participation in volunteering activities were found to be significant predictors of EHL_Knowledge, which explained 25.2% of the variance in the final model. EHLS_Social Norms and EHLS_Knowledge accounted for 42.9% of the variance in EHL_Behaviors, while school grade was adversely connected with pro-environmental behavior. While actions and knowledge were major positive predictors, gender and school grades showed negative relationships, and EHL_Social Norms accounted for 46% of the variance. This study establishes a valid measure of environmental health literacy in adolescents, informing science education strategies and public health interventions.
- Bullying, mental health, and the moderating role of supportive adults: A cross-national analysis of adolescents in 45 countriesPublication . Kim, Samuel Seunghan; Craig, Wendy Marion; King, Nathan; Bilz, Ludwig; Cosma, Alina; Michal, Cosma; Qirjako, Gentiana; Matos, Margarida Gaspar De; Augustine, Lilly; Šmigelskas, Kastytis; Pickett, William; Gaspar de Matos, MargaridaObjectives: Relationships with supportive adults during adolescence may be a protective factor that lowers the risks associated with bullying. The current study aimed to examine the moderating role of supportive adults in the associations between bullying involvement (in-person and cyber) and mental health problems (psychological symptoms and low life satisfaction). Methods: Data from 45 countries and regions taking part in the 2017/18 Health Behaviour in School-Aged Children study (N = 230,757) were used. Multivariable Poisson regression models were used to estimate relative risks of bullying on mental health. Effect estimates were compared across the number of supportive adults to examine a possible cumulative protective effect of relationships with supportive adults. Results: Bullying involvement was consistently associated with poor mental health across the 45 countries. Risk of mental health problems associated with bullying involvement was greatest among students reporting relationships with multiple supportive adults. This was true for all indicators of bullying involvement.Conclusion: Bullying remains a prevalent and harmful experience for youth worldwide. Merely having supportive adults is not sufficient in protecting youth from experiencing the mental health risks associated with bullying.
- Changes in cannabis consumption during the global COVID-19 lockdown: The International COVISTRESS StudyPublication . Salles, Juliette; Yrondi, Antoine; Marhar, Fouad; Andant, Nicolas; Dorlhiac, Raimundo Avilés; Binh, Quach; Jiao, Jiao; Antunes, Samuel; Ugbolue, Ukadike Chris; Guegan, Julien; Karine, Rouffiac; Pereira, BrunoIntroduction: COVID-19 lockdown measures have been sources of both potential stress and possible psychological and addiction complications. A lack of activity and isolation during lockdown are among the factors thought to be behind the growth in the use of psychoactive substances and worsening addictive behaviors. Previous studies on the pandemic have attested to an increase in alcohol consumption during lockdowns. Likewise, data suggest there has also been a rise in the use of cannabis, although it is unclear how this is affected by external factors. Our study used quantitative data collected from an international population to evaluate changes in cannabis consumption during the lockdown period between March and October, 2020. We also compared users and non-users of the drug in relation to: (1) socio-demographic differences, (2) emotional experiences, and (3) the information available and the degree of approval of lockdown measures.Methods: An online self-report questionnaire concerning the lockdown was widely disseminated around the globe. Data was collected on sociodemographics and how the rules imposed had influenced the use of cannabis and concerns about health, the economic impact of the measures and the approach taken by government(s).Results: One hundred eighty two respondents consumed cannabis before the lockdown vs. 199 thereafter. The mean cannabis consumption fell from 13 joints per week pre-lockdown to 9.75 after it (p < 0.001). Forty-nine respondents stopped using cannabis at all and 66 admitted to starting to do so. The cannabis users were: less satisfied with government measures; less worried about their health; more concerned about the impact of COVID-19 on the economy and their career; and more frightened of becoming infected in public areas. The risk factors for cannabis use were: age (OR = 0.96); concern for physical health (OR = 0.98); tobacco (OR = 1.1) and alcohol consumption during lockdown (OR = 1.1); the pre-lockdown anger level (OR = 1.01); and feelings of boredom during the restrictions (OR = 1.1).Conclusion: In a specific sub-population, the COVID-19 lockdown brought about either an end to the consumption of cannabis or new use of the drug. The main risk factors for cannabis use were: a lower age, co-addictions and high levels of emotions.
- Correlates of active commuting to school among portuguese adolescents: An ecological model approachPublication . Loureiro, Nuno; Loureiro, Vânia; Grao-Cruces, Alberto; Martins, João; Matos, Margarida Gaspar de; Gaspar de Matos, MargaridaActive commuting to and from school can be an important contribution to improving health in adolescents. This study aimed to analyze the influence of multilevel variables of the ecological model in the active commuting of a representative sample of Portuguese adolescents. The 2018 Health Behaviour in School-Aged Children questionnaire was applied to 5695 adolescents with an average age of 15.5 years old (SD ± 1.8), 53.9% of whom were girls. The associations were studied by applying chi-square tests and multivariate logistic regression models. In this study, 36.5% of the participants reported walking or cycling to school. Active commuting to school was directly associated with age (OR = 1.2; p < 0.05), strong family support (OR = 1.2; p < 0.05), a moderate to low financial level of the family (OR = 1.3; p < 0.05) and living near the school (OR = 2.4; p < 0.05). The results revealed that an adolescent’s choice to travel to and from school using an active mode of transportation increased with strong family support. As a result, promotion campaigns should consider the adolescent’s family context.
- Diaphragm ultrasound for muscle strength assessment: A systematic literature reviewPublication . Leote, Joao; Monteiro, Margarida; Rocha, Cláudia; Rodrigues, Carolina; Pereira, Marco; Antunes, Maria Luz; Dias, Hermínia; Antunes, Maria da LuzObjective: To assess if diaphragmatic ultrasound (DU) reflects diaphragmatic muscle strenght when compared to respiratory tests and neurophysiological studies. Methods: A systematic literature review was conducted on adults undergoing DU, compared to any respiratory or neurophysiological technique. The search strategy was applied in PubMed, Scopus, and Web of Science, and the analysis was conducted using the PRISMA methodology. Three eligibility assessment stages were performed: title, abstract, and full-text reading. The risk of bias was evaluated using the RoB 2.0, ROBINS-I, and Newcastle-Ottawa Scale tools. Results: Out of 155 identified articles, 25 were selected for full-text review (14 nonrandomised studies, 8 case-control studies, and 3 randomised studies). The overall risk of bias was moderate, with the main biases related to population selection and intervention assessment. Twenty-three articles used maximal inspiratory pressure easurement as a comparator which showed a weak-to-moderate correlation, significant in 10 studies, with diaphragmatic excursion. Three studies reported a weak association between diaphragmatic thickening and sniff pressure. Five articles reported a concordant correlation between iaphragmatic thickening and compound muscle action potential amplitude, significant only in one study. Conclusion: The variability of results obtained across different pathologies does not support the use of DU alone to predict diaphragmatic muscle strength
- Effectiveness of empower-grief for relatives of palliative care patients: Protocol for an exploratory randomized controlled trial.Publication . Neto, David Dias; Coelho, Alexandra; Albuquerque, Sara; Silva, Ana Nunes da; PsychOpenBackground: Grief reactions of relatives of palliative care patients are seldom addressed. Most interventions focus on Prolonged Grief Disorder (PGD) and not on its prevention. This is particularly relevant in palliative care, in which death is the result of a difficult period of a terminal illness, making caregivers particularly vulnerable to psychological distress. The purpose of the present exploratory trial is to test the efficacy of a selective intervention (Empower-Grief) for the initial problematic grief reactions and to study potential predictors of adherence and efficacy. Method: This is an exploratory Randomized Controlled Trial (RCT) studying Empower-Grief compared with Treatment as Usual (TAU). Participants will be relatives or caregivers of palliative and oncological patients with initial indicators of risk of developing PGD and will be randomly allocated to Empower-Grief and TAU. Participants will be assessed prior, at the end and six months after the intervention. The primary outcome considered will be symptoms of PGD. The assessment includes measures of anxiety and depression, coping, attachment, psychological flexibility, posttraumatic growth, social support and therapeutic alliance. Results: The trial is ongoing. Forty-four participants will be invited to participate. Conclusion: This study addresses the need for the development of empirically grounded and feasible interventions aimed at dealing with initial problematic reactions in grief, exploring potential predictors and possible venues for personalizing intervention and understanding the mechanism through which these interventions operate.
- Empower-grief for relatives of cancer patients: Implementation And findings from an exploratory randomized controlled trialPublication . Dias Neto, David Manuel; Coelho, Alexandra; Silva, Ana Nunes; Garcia-Marques, Teresa; Albuquerque, SaraGrief reactions among relatives of palliative care patients are often overlooked, with most interventions targeting Prolonged Grief Disorder (PGD) rather than its prevention. Few interventions have been developed for individuals at risk. This study aimed to evaluate the efficacy of Empower-Grief, a selective intervention designed to address early problematic grief reactions and to explore predictors of its effectiveness. This exploratory randomized controlled trial (RCT) compared Empower-Grief with Treatment as Usual (TAU) among relatives or caregivers of palliative and oncological patients at risk of developing PGD. A total of 46 participants were assessed at baseline, post-intervention, and six months later. The primary outcome was PGD symptoms, with additional measures including anxiety, depression, coping strategies, attachment style, psychological flexibility, post-traumatic growth, social support, and therapeutic alliance. The final analyses indicate equivalence between Empower-Grief and TAU, suggesting that both interventions yielded comparable outcomes in reducing PGD symptoms and associated psychological distress. The initial symptoms and therapeutic alliance were predictors of the results in both post- and follow-up moments. This study contributes to the evidence on grief interventions in palliative care, highlighting the importance of structured support for bereaved caregivers. While Empower-Grief demonstrated comparable effectiveness to TAU, its lower intensity, ease of training, and application make it a promising treatment option.