PCLI - Artigos em revistas internacionais
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- Assessment of change in psychoanalysis : Another way of using the change after psychotherapy scalesPublication . Pires, António Augusto Pazo; Gonçalves, João; Sá, Vânia; Silva, Andrea Manuela Melo; Sandell, RolfA systematic method is presented whereby material from a full course of psychoanalytic treatment is analyzed to assess changes and identify patterns of change. Through an analysis of session notes, changes were assessed using the CHange After Psychotherapy scales (CHAP; Sandell 1987a), which evaluate changes in five rating variables (symptoms, adaptive capacity, insight, basic conflicts, and extratherapeutic factors). Change incidents were identified in nearly every session. Early in the analysis, relatively more change incidents related to insight were found than were found for the other types of change. By contrast, in the third year and part of the fourth year, relatively more change incidents related to basic conflicts and adaptive capacity were found. While changes related to symptoms occurred throughout the course of treatment, such changes were never more frequent than other types of change. A content analysis of the change incidents allowed a determination of when in the treatment the patient's main conflicts (identified clinically) were overcome. A crossing of quantitative data with clinical and qualitative data allowed a better understanding of the patterns of change.
- Autobiographical memories in major depressive disorderPublication . Cláudio, Victor; Aurélio, João Garcez; Machado, Paulo Manuel Pinto Pereira AlmeidaThe objective of this research was to study the relation between the processing and recall of information in major depressive disorder. An autobiographical memory task was applied to 42 subjects with a diagnosis of major depressive disorder, 28 subjects with a diagnosis of panic disorder and 51 subjects without any psychological disorder. We used clinical scales for the evaluation of depression and anxiety. The results of the three groups, and both assessment periods of depressed subjects, were compared. The results indicate the existence, in severely depressed subjects, of a bias in processing and recalling negative information. We associate this situation to the existence of negative contents in selfschemas and processing and recall of information consistent with these schema contents. Based on the obtained results, we consider that the onset and maintenance of depression is more related to the information encoding and recall processes, controlled by the self’s negative schemas, than with negative thoughts.
- Balancing motherhood and drug addiction: The transition to parenthood of addicted mothersPublication . Silva, Sofia Alves da; Pires, António A. Pazo; Guerreiro, Cristina; Cardoso, AntóniaThis is a study about balancing motherhood and drug addiction, during the transition to parenthood. Few studies have dealt with the parental experience of drug-addicted mothers. The participants included 24 drug-addicted mothers, on methadone, with ages 25-42 and with children 1-32 months of age. Semi-structured interviews were conducted and analyzed according to Grounded Theory. The mothers' main concern was the ambivalence they felt towards pregnancy/motherhood and drug addiction, which was associated with strong feelings of guilt. Confronted with this ambivalence their maternal role becomes merely functional. They focus on providing the basic care to the child, but show little willingness to talk or play. Social support, especially from the partner seems to have a positive role.
- Components of multiple health behaviour change interventions for patients with chronic conditions: A systematic review and meta-regression of randomized trialsPublication . Silva, Carolina C.; Presseau, Justin; Allenb, Zack van; Dinsmore, John; Schenk, Paulina; Moreto, Maiara; Marques, Marta M.Interventions addressing more than one health behaviour at a time could be an efficient way of intervening to manage chronic conditions. Within a systematic review of multiple health behaviour change (MBHC) interventions, we identified key components of interventions in patients with chronic conditions, assessed how they are linked to theory, behaviour change techniques implemented, and evaluated their impact on intervention effectiveness. Studies were identified by systematically searching five electronic databases. Subgroup analyses and metaregressions were conducted to analyse the association between intervention components and behavioural changes. In total, 61 studies were included spanning different chronic conditions (e.g., cardiovascular conditions, type 2 diabetes). Most interventions sought to change behaviours simultaneously (72%), often targeting the ‘physical activity, diet and smoking’ cluster of behaviours (33%), and were not theory informed (55%). A total of 36 behaviour change techniques were identified, most commonly goal setting behaviour and self-monitoring of behaviour. Subgroup analyses indicated that MHBC interventions delivered entirely face-to-face might not be as effective for physical activity outcomes, and not using goal setting (behaviour) might be more effective for smoking cessation outcomes. Metaregressions indicated that a longer intervention duration may work best to achieve better physical activity outcomes. This review provides a comprehensive understanding of interventions and contributes to the field of MHBC by facilitating data-driven insights for future optimisation and dissemination.
- Criterion and construct validity of the Beck Depression Inventory (BDI-II) to measure depression in patients with cancer: The contribution of somatic itemsPublication . Almeida, Sílvia; Camacho, Marta; Barahona-Corrêa, J. Bernardo; Oliveira, José; Lemos, Raquel; Da Silva Rodrigues, Daniel; da Silva, Joaquim Alves; Baptista, Telmo Mourinho; Grácio, Jaime; Oliveira-Maia, Albino J.Background/Objective: Screening for depression in patients with cancer can be difficult due to overlap between symptoms of depression and cancer. We assessed validity of the Beck Depression Inventory (BDI-II) in this population. Method: Data was obtained in an outpatient neuropsychiatry unit treating patients with and without cancer. Psychometric properties of the BDI-II Portuguese version were assessed separately in 202 patients with cancer, and 376 outpatients with mental health complaints but without cancer. Results: Confirmatory factor analysis suggested a three-factor structure model (cognitive, affective and somatic) provided best fit to data in both samples. Criterion validity was good for detecting depression in oncological patients, with an area under the ROC curve (AUC) of 0.85 (95% confidence interval [CI], 0.760.91). A cut-off score of 14 had sensitivity of 87% and specificity of 73%. Excluding somatic items did not significantly change the ROC curve for BDI-II (difference AUCs = 0.002, p=0.9). A good criterion validity for BDI-II was also obtained in the non-oncological population (AUC = 0.87; 95% CI 0.810.91), with a cut-off of 18 (sensitivity=84%; specificity=73%). Conclusions: The BDI-II demonstrated good psychometric properties in patients with cancer, comparable to a population without cancer. Exclusion of somatic items did not affect screening accuracy
- A cross-cultural perspective on psychological determinants of chronic fatigue syndrome: A comparison between a portuguese and a dutch patient samplePublication . Marques, Marta Moreira; De Gucht, Véronique; Leal, Isabel Pereira; Maes, StanBackground Few studies focus on cross-cultural differences in Chronic fatigue syndrome (CFS). Purpose This study aimed to (1) compare fatigue severity and impairment, somatic complaints, psychological distress, and quality of life (QoL) in a population of Portuguese and Dutch patients; (2) explore the differential contribution of behavioral and cognitive determinants of fatigue severity; and (3) investigate the relation between fatigue severity and somatic complaints on one hand and QoL on the other in both populations. Method Eighty-five female patients from Portugal (Mean age0 47.54) and 167 female CFS patients from The Netherlands (Mean age044.93) participated in the study. All participants were surveyed for demographic and clinical characteristics, fatigue severity, somatic symptoms, psychological distress, (physical and psychological) QoL, physical activity, behavior regulation patterns, and illness representations. Results Cross-cultural differences were found in relation to working status, duration of fatigue symptoms, psychological distress, somatic complaints, and psychological QoL. Although behavioral characteristics and illness representations were significantly associated with fatigue severity in both Portuguese and Dutch patients, there were important differences in the determinants of CFS. Moreover, higher levels of fatigue and severity of other somatic complaints were related to poor QoL. Conclusions These findings show cross-cultural similarities and differences in clinical characteristics and psychological determinants of CFS that are important in view of diagnosis and treatment.
- Das relações entre espontaneidade, saúde e doençaPublication . António José C. A. GonzalezApós enquadramento do termo "espontaneidade", é explorada a definição dada a este por J. L. Moreno. Segue-se uma apresentação do "Spontaneity Assessment Inventory" (SAI) e sua versão revista (SAI-R), desenvolvidos por David Kipper e colaboradores, bem como de alguns dos resultados obtidos em estudos que correlacionaram os resultados nestes inventários com diversos outros construtos ligados à saúde e aos diversos tipos de sintomatologias e sofrimentos de ordem psíquica e física. Por fim, o autor apresenta um conjunto de investigações levadas a cabo por colaboradores, correlacionando os resultados obtidos com a versão portuguesa do SAI-R e diversas outras variáveis associadas ao bem-estar, à autoestima, às variáveis de personalidade, à presença de doenças ou indicadores do foro psicossomático, como psoríase e lúpus, e à impulsividade.
- Desarrollo personal en grupo con mayores a través de técnicas de expresión corporal y psicodrama: Un estudio de casoPublication . Pedroso de Lima, Margarida; Gonzalez, António José C. A.La tendencia al aumento de la población de edades superiores a los 65 años supone simultáneamente preocupaciones y desafíos. De estos se derivan los esfuerzos llevados a cabo para mantener la calidad de vida de esta población, reforzar las estructuras informales y comunitarias de apoyo a los mayores y combatir los prejuicios relativos al envejecimiento, que condicionan el tipo de intervenciones a desarrollar. En este artículo se presentarán los resultados de una experiencia terapéutica con un grupo de personas de edades comprendidas entre los 70 y los 91 años. La intervención ha durado 6 meses y se han utilizado, además de técnicas verbales, técnicas de expresión corporal y psicodramáticas. La evaluación, para la cuál se utilizó el EASY CARE (sistema rápido de evaluación del bienestar físico, mental y social del mayor) y las opiniones de los propios implicados, ha revelado un aumento de la calidad de vida percibida por los mayores y el desarrollo de algunas habilidades cognitivas. También se ha notado la disminución de los niveles de depresión y de incapacidad funcional. Estos resultados sugieren la importancia de este tipo de intervención en el desarrollo de la calidad de vida y en la prevención de su deterioro, en las poblaciones de edad avanzada. ------ ABSTRACT ------ Older people are living longer and staying healthier and more active much later in life. This fact brings up problems and challenges. Namely, how to maintain the quality of life, how to provide opportunities of self development, improvement and, finally, how to address the prejudices related to the aging process that foster difficulties in the developing interventions. In this article we present the results of a therapeutic experience with a group of persons with ages between 70 and 91 years old. The duration of the intervention was one year and included verbal, corporal expression and psicodramatic techniques. The results where assessed applying the EASY CARE (a tool for integrating the assessment of a service user’s physical, mental and social well-being) and the subjective view of the people involved. The results indicated enhancement of the quality of life and of the cognitive abilities of the subjects in our sample. These outcomes suggest the importance of this kind of intervention for the promotion of the quality of life of the aged.
- Development and validation of the facilitative interpersonal skills scale for clientsPublication . Santos, João M.; Barata, Matilde; Rathenau, Sara; Amaro, Inês; Vaz, Alexandre; Sousa, Daniel; Severino, Margarida; Taveira, Mafaldapsychotherapist development, psychotherapy expertise, statistical methodology, test development, therapist effects1| INTRODUCTION The role of the therapist in psychotherapy research has a controversial history. The widespread focus on investigating specific treatment protocols for specific psychological disorders made the study of individual differences among therapistsalong‐neglected research topic (e.g., Beutler et al.,2004;Castonguay&Hill,2017). However, despite the historicallygreater emphasis on randomized controlled trials to understand differences between specific treatment models, researchhas consistently shown thattherapistscontribute more to therapy outcomes than the type of treatment or level ofadherence to a particular protocol (Wampold & Imel,2015). It seems that therapist effects can explain 5%–9% of theoutcome variance (Baldwin & Imel,2013). These results overshadow the 0%–1% variability attributable to specifictreatment models (Miller et al.,2013; Wampold & Imel,2015).The existing literature suggests that the therapeutic alliance is one of the best predictors of clinical outcomes identified to date, along with the therapist's ability to convey empathy (Nor cross &Lambert,2019; Nor cross & Wampold,2019; Wampold & Imel,2015). The therapeutic alliance is described by Bordin (1979) as a collaborative relationship intended to overcome the client's suffering. This relation shipe incompasses three important aspects: (a) agreement on the goals of the treatment, (b) agreement on thetasks, and (c) the development of a mutual bond betweentherapist and client. The therapeutic alliance isconsidered a common factor or a nonspecific factor in psychotherapy. These factors include therapeuticqualities (such as empathy and the therapist's ability to be persuasive and to create compelling expectations)foundintherapistsandprofessionalsacrosstherapeutic approaches and helping professions (Frank &Frank,1993).Commonfactorsaresubjecttovariousdefinitionswhichposessomechallengestocontrolledexperimental research (Anderson & Patterson,2013). Following the need to measure and operationalizethese factors, Anderson and Patterson (2013) created the facilitative interpersonal skills (FIS) rating scale,which assesses several relational therapist skills relevant to therapeutic effectiveness (Anderson &Patterson,2013). These skills play an important role in the ability to develop and maintain a solid therapeutic alliance and might go beyond the therapist's use of a particular treatment model or technique(Wampold & Imel,2015).The FIS rating scale (Anderson & Patterson,2013)isaperformance‐based measure of eight therapist interpersonalskills, namely verbal fluency, emotional expression, persuasiveness, warmth/positive regard, hopefulness, empathy, alliancebond capacity, and alliance–rupture–repair responsiveness. This measure was designed for the assessment of thetherapist's performance by an external observer. More specifically, it evaluates participants' responses to a performance‐based task where they provide therapeutic responses to standardvideostimulithatportraychallenging psychotherapeuticevents. In these clips, one actor/actress plays the role of a client explaining a certain problem to which the participantshave to respond in a therapeutic manner as if they were in session. The FIS‐in session (FIS‐IS) rating scale (Uhlin,2011)isan adaptation of the original FIS ratingscale applied to actual recorded or observed therapy sessions. Similarly to theoriginal FIS, an external coder rates the therapist's performance. Our goal is to create a new FIS scale (the FIS‐clientversion [FIS‐C]) where clients evaluate their therapists' performance.Anderson et al. (2009) found that therapists' observer‐rated FIS predicted those therapists' real‐lifeclinical outcomes. Subsequent studies confirmed that FIS scores predicted outcome and alliance (Anderson,Crowley, et al.,2016; Anderson, McClintock, et al.,2016) and that these skills were trainable throughdeliberate practice(Anderson et al.,2020;Rousmaniereetal.,2017). The effects of observer‐rated therapist 2|SANTOS ET AL.
- Directed forgetting in major depressionPublication . Cláudio, Victor; Noronha, Maria; Balola, Michele FerreiraBasing ourselves upon the cognitive processing and recall of information, we studied directed forgetting in a sample of individuals diagnosed with major depressive disorder. The sample consisted of 30 such subjects and also included 15 subjects diagnosed with panic disorder and 30 subjects without a psychopathological disorder. The depressed subjects were evaluated on two occasions three months apart. We used a series of clinical scales and a Directed Forgetting Task. The results indicated that the instruction to forget was effective for the three groups. Depressed subjects showed a bias towards negative information in the processing and recall of information in depressed subjects. In addition, a self-characterisation task showed a devalued sense of self in the depressed subjects. Overall, our findings suggest that, in depressed subjects, positive characterisations do not resonate in a sufficiently strong self to have an impact on information recall.