PCLI - Artigos em revistas internacionais
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- 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.
- Genetic differences in reactivity to the environment impact psychotic-like and affective reactivity in daily life neusPublication . Barrantes-Vidal, Neus; Torrecilla, Pilar; Mas-Bermejo, Patricia; Papiol, Sergi; Bakermans-Kranenburg, Marian J.; Rosa, Araceli; Kwapi, Thomas R.Background and Hypothesis: Consistent with diathesisstress models, psychosis research has focused on genetic moderation of adverse environmental exposures. In contrast, the Differential Susceptibility (DS) model suggests that the same genetic variants that increase risk-inducing effects of adverse experiences also enhance benefcial effects from positive experiences. This study examined whether individuals with high genetic susceptibility to the environment showed differential psychotic-like and affective reactivity in response to positive and negative events in daily life. Study Design: Experience sampling methodology assessed context (positive and stressful) and momentary levels of paranoia, psychotic-like experiences (PLE), and positive (PA) and negative affect (NA) in 217 non-clinical adults oversampled for schizotypy. Linear mixed models examined whether Polygenic Risk Scores of Environmental Sensitivity (PRS-ES) moderated the impact of current context on subsequent experiences. Study Results: PRS-ES moderated positive, but not stressful, context on subsequent levels of momentary paranoia, NA, and PA, but not PLE. Genetic and environmental (G × E) interactions indicated diathesis-stress at lower thresholds of PRS-ES, but a DS model at the highest threshold of the PRS-ES. Participants with elevated PRS-ES showed increased paranoia and NA and decreased PA in subsequent assessments when reporting low levels of positive situations, but also decreased paranoia and NA and increased PA when rating contexts as positive. Conclusions: Findings support the infuence of genetic sensitivity to the environment on psychotic-like and affective reactivity in daily life, particularly in response to positive contexts. This highlights the transdiagnostic protective role of positive experiences and informs ecological momentary interventions.
- Does deliberate practice surpass didactic training in learning empathy skills? A randomized controlled studyPublication . Larsson, Johannes; Werthén, David; Carlsson, Jan; Salim, Osame; Davidsson, Edvin; Vaz, Alexandre; Sousa, Daniel; Norberg, JoakimA large body of research identifies therapist expressed empathy as one of the most important predictors of psychotherapy outcome. Deliberate practice (DP) is an effective method to improve skills in many fields. We asked if DP also can be used to enhance the skill of expressing empathy. Objective: The aim was to compare the efficacy of DP to didactical learning methods (DLM) in enhancing the skill of empathic expression in students. Method: A repeated measures randomized controlled group design was used. Novice students (N ¼ 36) from psychologist-, medicine-, social work-, and nursing programs received two training sessions of either DP (n ¼ 21) or DLM (n ¼ 15). Participants’ skills in empathic expression were assessed with the Measure of Expressed Empathy (MEE) on three occasions: before the first, between, and after the last training session. Results: Participants in the DP-group showed improved empathic expression, whereas participants in the DLM-group did not. Conclusions: These findings suggest that DP is an effective training method for therapeutic skills such as empathic expression and holds implications for the future development of educational practices to incorporate active skill training methods.
- Genetic susceptibility to the environment moderates the impact of childhood experiences on psychotic, depressive, and anxiety dimensionsPublication . Barrantes-Vidal, Neus; Torrecilla, Pilar; Mas-Bermejo, Patricia; Papiol, Sergi; Bakermans-Kranenburg, Marian J.; Kwapil, Thomas R.; Rosa, AraceliBackground and Hypothesis: Consistent with diathesisstress models, psychosis research has focused on genetic moderation of adverse environmental exposures. In contrast, the Differential Susceptibility (DS) model suggests that the same genetic variants that increase risk-inducing effects of adverse experiences also enhance beneficial effects from positive experiences. This study examined whether individuals with high genetic susceptibility to the environment showed differential psychotic-like and affective reactivity in response to positive and negative events in daily life. Study Design: Experience sampling methodology assessed context (positive and stressful) and momentary levels of paranoia, psychotic-like experiences (PLE), and positive (PA) and negative affect (NA) in 217 non-clinical adults oversampled for schizotypy. Linear mixed models examined whether Polygenic Risk Scores of Environmental Sensitivity (PRS-ES) moderated the impact of current context on subsequent experiences. Study Results: PRS-ES moderated positive, but not stressful, context on subsequent levels of momentary paranoia, NA, and PA, but not PLE. Genetic and environmental (G × E) interactions indicated diathesis-stress at lower thresholds of PRS-ES, but a DS model at the highest threshold of the PRS-ES. Participants with elevated PRS-ES showed increased paranoia and NA and decreased PA in subsequent assessments when reporting low levels of positive situations, but also decreased paranoia and NA and increased PA when rating contexts as positive. Conclusions: Findings support the influence of genetic sensitivity to the environment on psychotic-like and affective reactivity in daily life, particularly in response to positive contexts. This highlights the transdiagnostic protective role of positive experiences and informs ecological momentary interventions.
- Maternal cognitive functioning and psychopathology predict quality of parent-child relationship in the context of substance use disorder: A 15-month longitudinal studyPublication . PORRECA, ALESSIO; DE CARLI, PIETRO; Filippi, Bianca; Bakermans-Kranenburg, Marian; van IJzendoorn, Marinus; SIMONELLI, ALESSANDRAThis longitudinal study aimed to investigate the role of maternal cognitive functioning and psychopathology in parent-child relationship quality during residential treatment for mothers with Substance Use Disorder (SUD), in order to identify factors that may enhance or limit intervention effects. We assessed cognitive functioning (Esame Neuropsicologico Breve-2 [ENB-2]) and psychopathology (Symptom Checklist-90 Revised [SCL-90-R]) in 60 mothers diagnosed with SUD (Mage = 30.13 yrs; SD = 6.79) at treatment admission. Parent-child relationship quality was measured during free-play interactions using the Emotional Availability Scales every three months from admission (Child Mage = 17.17m; SD = 23.60) to the 15th month of the residential treatment. A main effect of maternal psychopathology and an interaction effect of time and cognitive functioning were found. More maternal psychopathology predicted lower mother-child relationship quality. Mothers with higher cognitive functioning presented a better treatment trajectory, with an increase in mother-child relationship quality, whereas mothers with lower cognitive functioning showed a decrease in relationship quality after initial improvement. These findings suggest that maternal psychopathology and cognitive functioning may influence the treatment of parent-child relationships in the context of SUD, although causality is not yet established. Implications for assessment and intervention are discussed.
- Effects of a soft baby carrier on fathers’ behavior and hormones: A randomized controlled trialPublication . Verhees, Martine W. F. T.; Lotz, Anna M.; de Moor, Marleen H. M.; van IJzendoorn, Marinus H.; Fidder, Annabeth A. E. J.; Buisman, Renate S. M.; Bakermans-Kranenburg, Marian J.Increased father–infant physical contact may promote early paternal caregiving. This randomized controlled trial, preregistered on https://osf.io/qwe3a , tested the effects of a soft baby carrier intervention on fathers’ parenting behavior and hormonal levels. Eighty first-time fathers of 2- to 4-month-old infants were randomly assigned to a baby carrier intervention group (n = 41 fathers) or a control group receiving an infant seat (n = 39 fathers). Fathers were instructed to use the baby carrier or seat for 3 weeks. Fathers’ sensitive parenting behavior, involvement, salivary oxytocin and cortisol basal levels and reactivity to interacting with the infant were assessed at pre-test (on average 2 weeks before the intervention) and at post-test (on average 1 week after the intervention period ended). The results showed that the intervention did not enhance fathers’ sensitive parenting or involvement. Involvement operationalized as hours spent with the infant decreased over time for fathers in the carrier condition compared to fathers in the control condition. The baby carrier intervention had no effect on fathers’ basal oxytocin or cortisol levels, nor did it affect fathers’ oxytocin or cortisol reactivity to interacting with their infant. Our findings indicate that 3 weeks of using a baby carrier does not have immediate beneficial effects on fathers’ parenting behavior or hormonal functioning as assessed here. Future research may examine whether infant carrying has beneficial effects on the longer term or in different groups of fathers, and how fathers’ infant carrying affects their infants.
- 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.
- 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
- Memory reconsolidation in psychotherapy for severe perfectionism within borderline personalityPublication . Vaz, Alexandre; Ecker, BruceFor a case of severe perfectionism, comorbid with complex trauma symptomatology including suicidality, self-harming, and other markers of borderline personality, we demonstrate the use of the empirically confirmed process identified in memory reconsolidation (MR) research for the unlearning and nullification, or "erasure," of emotional and behavioral responses driven by learned expectations and mental models. MR has been proposed as a transtheoretical, unifying mechanism underlying profound psychotherapeutic change. The therapist (first author), under the second author's supervision, used a varied set of clinical skills woven together through a focus on the MR process.
- 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.