Beyond fight or flight: The protective role of pre-pandemic meditation practice against anxiety and perceived stress.

The COVID-19 pandemic generated distinct mental health challenges, characterised by stress and anxiety due to its unpredictable duration and continuous threat. This study examined the role of meditation practice on anxiety symptoms and perceived stress, considering co-variables such as self-compassion, acceptance, awareness, brooding, lockdown duration, and sociodemographic characteristics. The study used a longitudinal design and data were collected through online surveys from April 2020 to January 2021 (at four different time points) and included 238 participants from Portugal (165 had prior experience with meditation practices, 73 were non-meditators) with a mean age of 43.08 years (SD = 10.96). Linear mixed models revealed that over time, during the lockdown, the non-meditators group demonstrated a greater increase of anxiety symptoms (ß = -0.226, SE = 0.06, p = 0.006) and perceived stress (ß = -0.20, SE = 0.06, p = 0.004), whereas the meditators group showed non-significant (p > 0.05) variations in anxiety and stress symptoms during the same period of time. The effect of meditation on anxiety symptoms was moderated by sex, days of lockdown, self-compassion, and acceptance. The effect of meditation on perceived stress was moderated by sex, years of education, days of lockdown, and levels of awareness. Additionally, the study explored the potential predictive effect of different meditation session lengths, indicating that longer meditation practices offered greater protection against an increase in anxiety symptoms. These findings highlight the importance of cultivating self-regulation skills and investing in preventive mental health strategies to promote well-being and autonomy. Mental health professionals should prioritise educating communities on evidence-based practices like meditation and compassion exercises to enhance overall health.

European Portuguese Version of the Game Addiction Scale-7: Factor Structure and Psychometric Properties.

INTRODUCTION: Game addiction (GA) can be described as a compulsive and excessive usage of computers or video games that causes emotional and or social problems. The current study tested the factor structure and psychometric properties of the European Portuguese Game Addiction Scale (GAS-7-PT) short version. METHODS: The sample encompassed 375 participants, 233 women (62.1%) and 142 men (37.9%), with a mean age of 21.71 (standard deviation = 5.82) years old. Participants completed a set of self-report measures online: the GAS-7-PT, the Scale of Involvement in Video Games and the Patient Health Questionnaire-4. RESULTS: Confirmatory factor analyses confirmed a biological sex invariant single-factor structure with a very good fit to the data. The GAS-7-PT showed good reliability and test-retest reliability. Correlations with related and unrelated measures suggested convergent validity, and partial correlation results pointed to incremental validity. Men showed significantly higher scores than women. CONCLUSION: The GAS-7-PT is a self-report instrument with suitable psychometric properties for clinical and research contexts. The availability of a European Portuguese version confirms the GAS-7 robust consistency and allows further cross-cultural clinical research.

Randomized controlled trial of an Acceptance and Commitment Therapy and compassion-based group intervention for persons with inflammatory bowel disease: the LIFEwithIBD intervention.

Objectives: This study tested the acceptability and efficacy of an Acceptance and Commitment Therapy and compassion-based intervention (LIFEwithIBD) in people with IBD through a two-arm RCT. Methods: Participants were recruited at the Gastroenterology Department of the Coimbra University Hospital between June and September 2019. Of the 355 patients screened, those who accepted to participate were randomly assigned to one of two conditions: experimental group (LIFEwithIBD; n = 25) or control group (waitlist; n = 29). Participants completed self-report measures at baseline (T0), post-intervention (T1), and 3-month (T2) and 12-month (T3) follow-ups. Intervention acceptability was assessed. Efficacy was examined using intent-to-treat ANCOVA at post-intervention after adjusting for baseline values of depressive, anxiety, and stress symptoms (primary outcomes). Linear mixed models for all longitudinal outcomes were also analysed. Inflammatory and disease biomarkers were determined at T0 and T3. Results: Acceptability results revealed a high level of satisfaction and perceived usefulness regarding the intervention. Both groups experienced a significant decrease in stress symptoms and IBD symptom perception at T1. No significant differences were observed at follow-up for the primary outcomes. The experimental group reported significantly lower Crohn's disease Symptom severity at T2 than the control group. Post-hoc analyses designed to mitigate floor effects revealed substantial treatment effects for the experimental group regarding anxiety symptoms. No significant differences were observed in clinical biomarkers from T0 to T3. Conclusion: The LIFEwithIBD intervention shows promising, although preliminary, benefits for managing disease activity and reducing anxiety symptoms in IBD patients with high severity of psychological distress.Clinical trial registration: https://www.clinicaltrials.gov/ct2/show/NCT03840707, identifier NCT03840707.

Fertility and fertility preservation knowledge in Portuguese women.

BACKGROUND: Knowledge about fertility and factors affecting it, for example, the impact of age, seem to be lacking, even in highly educated populations. The same applies to fertility preservation knowledge, pointing to the relevance of increasing fertility preservation awareness and education among young women. OBJECTIVE: To describe general fertility knowledge and factors affecting fertility, fertility preservation knowledge and attitudes, and the desire to access more information on this topic in a sample of reproductive-age Portuguese women. METHODS: The sample comprised 257 Portuguese women aged 18-45, mostly single and nulliparous. A questionnaire was developed explicitly for this study and disseminated through social media advertisements. RESULTS: Career building/development and financial stability were the more endorsed options for delaying childbearing, with 90 (35%) and 68 (26.5%), respectively. Most participants considered becoming a mother important (n = 185; 72%). More than halve provided an incorrect answer regarding the age range of women being more fertile (n = 132; 51.4%) and the age range of fertility decline (n = 168; 65.4%). Participants were aware of the influence of lifestyle and sexual health factors as well as the effect of age. Oocytes cryopreservation was the technique participants knew more (n = 206; 80.1%), but 177 (68.9%) showed no interest in using it. Most participants agreed that fertility and fertility preservation information should be provided during medical consultations or at school. CONCLUSIONS: More information regarding fertility and fertility preservation is relevant to ensure that more women can make informed decisions concerning their reproductive life.

The European Portuguese Version of the Determinants of Meditation Practice Inventory-Revised (DMPI-R).

Objectives: Meditation practice has beneficial effects on physical and mental health, and barriers to regular practice have been recognized. The Determinants of Meditation Practice Inventory (DMPI) was developed and recently revised (DMPI-R). DMPI-R is a 12-item self-report instrument encompassing four dimensions: low perceived benefit, perceived inadequate knowledge, perceived pragmatic barriers, and perceived socio-cultural conflict. The current study aimed to investigate the psychometric properties and factor structure of the European Portuguese version of the DMPI-R in a general population Portuguese sample (non-meditators). Methods: A sample comprising 154 participants completed a set of self-report measures online. Exploratory factor analysis (EFA) and parallel analyses were conducted to decide on the number of factors. Confirmatory factor analysis (CFA) was computed in an independent sample (N = 229). Three models were tested and compared. Reliability and validity were analyzed. Results: The EFA and parallel analysis revealed a four-factor structure. The three models tested showed a good fit to the data. Models' comparison pointed that the four-factor model, excluding item 10, was the one with the lower Expected Cross-Validation Index. The DMPI-R factors revealed adequate reliability and test-retest stability. The DMPI-R showed correlations with experiential avoidance and perspectives on meditation. No significant differences were found between men and women on the DMPI-R four factors. No significant associations with age and years of education were found. Conclusions: The European Portuguese version of DMPI-R is a reliable and valid self-report instrument to assess perceived barriers to meditation, contributing to expand research and support meditation instructors in improving meditation programs.

Corrigendum: The LIFEwithIBD Intervention: Study Protocol for a Randomized Controlled Trial of a Face-to-Face Acceptance and Commitment Therapy and Compassion-Based Intervention Tailored to People With Inflammatory Bowel Disease.

[This corrects the article DOI: 10.3389/fpsyt.2021.699367.].

Corrigendum: The LIFEwithIBD Intervention: Study Protocol for a Randomized Controlled Trial of a Face-to-Face Acceptance and Commitment Therapy and Compassion-Based Intervention Tailored to People With Inflammatory Bowel Disease.

[This corrects the article DOI: 10.3389/fpsyt.2021.699367.].

Nurturing compassion in schools: A randomized controlled trial of the effectiveness of a Compassionate Mind Training program for teachers.

OBJECTIVES: Schools are experiencing an unprecedented mental health crisis, with teachers reporting high levels of stress and burnout, which has adverse consequences to their mental and physical health. Addressing mental and physical health problems and promoting wellbeing in educational settings is thus a global priority. This study investigated the feasibility and effectiveness of an 8-week Compassionate Mind Training program for Teachers (CMT-T) on indicators of psychological and physiological wellbeing. METHODS: A pragmatic randomized controlled study with a stepped-wedge design was conducted in a sample of 155 public school teachers, who were randomized to CMT-T (n = 80) or a waitlist control group (WLC; n = 75). Participants completed self-report measures of psychological distress, burnout, overall and professional wellbeing, compassion and self-criticism at baseline, post-intervention, and 3-months follow-up. In a sub-sample (CMT-T, n = 51; WLC n = 36) resting heart-rate variability (HRV) was measured at baseline and post-intervention. RESULTS: CMT-T was feasible and effective. Compared to the WLC, the CMT-T group showed improvements in self-compassion, compassion to others, positive affect, and HRV as well as reductions in fears of compassion, anxiety and depression. WLC participants who received CMT-T revealed additional improvements in compassion for others and from others, and satisfaction with professional life, along with decreases in burnout and stress. Teachers scoring higher in self-criticism at baseline revealed greater improvements post CMT-T. At 3-month follow-up improvements were retained. CONCLUSIONS: CMT-T shows promise as a compassion-focused intervention for enhancing compassion, wellbeing and reducing psychophysiological distress in teachers, contributing to nurturing compassionate, prosocial and resilient educational environments. Given its favourable and sustainable effects on wellbeing and psychophysiological distress, and low cost to deliver, broader implementation and dissemination of CMT-T is encouraged.

Adaptation of the European Portuguese Version of the Nomophobia Questionnaire for Adolescents, Factor Structure and Psychometric Properties.

Nomophobia can be defined as a digital age phobia consisting of an excessive fear of being without a smartphone. Nomophobia negatively impacts physical and mental health, particularly in children and adolescents. This study aimed to test the factor structure and psychometric properties of the European Portuguese version of the Nomophobia Questionnaire for Adolescents (NMP-Q-A). Sample 1 comprised 338 adolescents (58.6% girls), with a mean age of 13.55 (SD = 2.07) years old, and was used to examine the factor structure of the NMP-Q-A, its psychometric properties and the association with other constructs. Sample 2 included 193 adolescents (53.9% boys), with a mean age of 13.61 (SD = 0.80) years old and was used to further test the NMP-Q-A factor structure. One higher-order factor with four lower-order factors structure revealed a good fit to the data in both samples. The NMP-Q-A showed good reliability, construct and concurrent validity. Girls showed higher nomophobia. Adolescents showing more nomophobia revealed more smartphone addiction and psychopathological symptoms and lower quality of life. The NMP-Q-A showed to be a valid and reliable measure to be used in clinical and educational settings.

The emotional impact of the Covid-19 pandemic in women facing infertility.

People facing infertility are inevitably affected by COVID-19 pandemic, having to delay their parental projects. This study aimed to explore the emotional impact (depression and anxiety symptoms and perceived stress) of the COVID-19 pandemic in Portuguese women pursuing assisted reproductive technology (ART). Results showed 67.4% of participants were in confinement but were dealing with it in a reasonably positive way. Women who continued to work at their workplace presented significantly higher levels of depressive and anxiety symptoms than those who stayed at home. No significant differences were found regarding depression and anxiety symptoms scores when comparing the current sample with an infertility reference sample and a community sample. Depressive and anxiety symptoms remained stable, but there was a significant decrease in perceived stress over the eight-week period. Although these findings do not suggest a worsening of psychological difficulties due to the COVID-19 pandemic, health professionals should be attentive to patients' long-term psychological consequences. It may be helpful to provide additional psychological support to women when restarting their ART treatments.

Psychological inflexibility in university students: the european portuguese version of the acceptance and action questionnaire-university students.

Psychological inflexibility is defined as a transdiagnostic mechanism characterized by rigid efforts to control psychological reactions to painful, undesirable, unpleasant internal experiences. The Acceptance and Action Questionnaire-University Students (AAQ-US) was designed to assess students' academic context-related psychological inflexibility. This study adapted the AAQ-US to Portuguese and examined its factor structure, validity, and reliability in a college student sample (sample 1: N = 262). Exploratory factor analysis and parallel analysis suggested a two-factor structure. A confirmatory factor analysis was conducted in a second sample to cross-validate the AAQ-US factor structure (sample 2: N = 260). One higher-order factor (psychological inflexibility) with two lower-order factors (cognitive fusion and experiential avoidance) revealed a very good fit to the data. The AAQ-US total and dimensions showed good reliability, convergent and incremental validity. Overall, the Portuguese version of the AAQ-US is a reliable and valid instrument for assessing context-specific psychological inflexibility in university students.

The LIFEwithIBD Intervention: Study Protocol for a Randomized Controlled Trial of a Face-to-Face Acceptance and Commitment Therapy and Compassion-Based Intervention Tailored to People With Inflammatory Bowel Disease.

Background: There is ample evidence of the high mental health burden caused by Inflammatory Bowel Disease (IBD). Several constructs such as experiential avoidance, cognitive fusion, shame, and self-criticism have recently emerged as potential intervention targets to improve mental health in IBD. Psychotherapeutic models such as Acceptance and Commitment Therapy and compassion-based interventions are known to target these constructs. In this protocol, we aim to describe a two-arm Randomized Controlled Trial (RCT) testing the efficacy of an ACT and compassion-focused intervention named Living with Intention, Fullness, and Engagement with Inflammatory Bowel Disease (LIFEwithIBD) intervention + Treatment As Usual (TAU) vs. TAU in improving psychological distress, quality of life, work and social functioning, IBD symptom perception, illness-related shame, psychological flexibility, self-compassion, disease activity, inflammation biomarkers, and gut microbiota diversity. Methods: This trial is registered at ClinicalTrials.gov (Identifier: NCT03840707, date assigned 13/02/2019). The LIFEwithIBD intervention is an adaptation to the IBD population of the Mind programme for people with cancer, an acceptance, mindfulness, and compassion-based intervention designed to be delivered in a group format. The LIFEwithIBD intervention's structure and topics are presented in this protocol. Participants were recruited at the Gastroenterology Service of the Coimbra University Hospital between June and September 2019. Of the 355 patients screened, 61 participants were selected, randomly assigned to one of two conditions [experimental group (LIFEwithIBD + TAU) or control group (TAU)] and completed the baseline assessment. Outcome measurement took place at baseline, post-intervention, 3- and 12-month follow-ups. Discussion: Results from this RCT will support future studies testing the LIFEwithIBD intervention or other acceptance and/or compassion-based interventions for IBD.

Assessing Nomophobia: Validation Study of the European Portuguese Version of the Nomophobia Questionnaire.

Nomophobia (no mobile phone phobia) can be defined as a situational phobia described by the fear of not having a smartphone available or being incapable of accessing the Internet. Based on these characteristics, the Nomophobia Questionnaire (NMP-Q) was designed, showing a four-factor structure and good psychometric characteristics. The current study intended to adapt the NMP-Q to European Portuguese (NMP-Q-PT) and test its factor structure and psychometric properties. Five hundred participants from the general population (convenience sampling) filled in the NMP-Q-PT, the Smartphone Addiction Scale-Short Version (SAS-SV) and the Depression, Anxiety, and Stress Scales (DASS-21). Three models were tested through confirmatory factor analysis. One higher order factor (global nomophobia) with four lower order factors revealed a good fit to the data. The NMP-Q-PT presented excellent consistency, construct and discriminant validity, as well as good concurrent and divergent validities. Overall, the NMP-Q-PT showed to be a reliable and valid instrument for measuring nomophobia.

Infertility-related stress and depressive symptoms - the role of experiential avoidance: a cross-sectional study.

Objective: The current study aimed to explore the mediating role of experiential avoidance in the relationship between infertility-related stress (impact of infertility in women's life and representations about the importance of parenthood) and depressive symptoms.Background: Infertility is a stress inducing condition presenting many challenges to individuals facing this diagnosis, particularly to the ones who decide to pursue medical treatment. One of its consequences may be the experience of depressive symptoms which have also been associated with increased infertility-related stress. Moreover, experiential avoidance, conceptualised as an emotion regulation process, has also been connected to psychopathological symptoms, particularly depressive symptoms.Methods: The sample consisted of 124 women presenting an infertility diagnosis who were pursuing medical treatment for fertility problems. Participants were recruited through the national patients' association website and completed the following self-report instruments: a sociodemographic and clinical questionnaire, the Acceptance and Action Questionnaire-II (AAQ-II), the Fertility Problem Inventory (FPI) and the Depression, Anxiety and Stress Scales 21 (DASS-21).Results: Results showed that representations about the importance of parenthood were associated with depressive symptoms indirectly, throughout the association with the impact of infertility in women's life and use of experiential avoidance.Conclusions: Experiential avoidance can be considered a relevant emotion regulation process to be targeted in psychological intervention programs for women facing infertility.

The Portuguese Version of the Hartford Geriatric Social Work Competency Scale II - Assessment Subscale: Factor Structure and Psychometric Properties.

The current study aimed to test the fit of the Portuguese version of the Hartford Geriatric Social Work Competency Scale II - Assessment subscale (GSWCS-A) and explore its factor structure and psychometric properties in a sample of 534 social workers working in the gerontology field. Confirmatory factor analysis showed that all items presented good factor loadings and that the single-component model fit the data well. The GSWCS-A showed very good internal consistency. Despite the existence of different theoretical perspectives on Social Work, which frame the required competencies for professional practice, the GSWCS-A Portuguese version revealed similitudes with studies conducted in other countries. Nevertheless, the different factor structures (single-component vs. bi-factorial) may indicate that different competencies are being emphasised in terms of professional training. To sum, the GSWCS-A may be a short and useful self-report instrument for addressing social workers' assessment competencies in the gerontology setting.

A 7-year follow-up study of the Mindfulness-Based Program for Infertility: Are there long-term effects?

The Mindfulness-Based Program for Infertility (MBPI) was developed for people facing infertility and proved effective in cultivating mindfulness skills, improving infertility self-efficacy, and decreasing depression, shame, entrapment, and defeat feelings. Fifty-five women attended the MBPI sessions and completed self-report measures of depression, anxiety, mindfulness, and experiential avoidance at post-MBPI (T1), 6-month follow-up (T2), and 7-year follow-up (T3). There were significant direct time effects regarding experiential avoidance (F = 3.81; p < 0.033; ηp 2  = 0.08), the mindfulness facets describing (F = 3.54; p = 0.037; ηp 2  = 0.13), acting with awareness (F = 6.87; p = 0.002; ηp 2  = 0.22), nonjudging of inner experience (F = 10.66; p < 0.001; ηp 2  = 0.31), and depressive symptoms (F = 4.85; p = 0.020; ηp 2  = 0.10). There was an increase in the describing facet from T1 to T3 (p = 0.036). The act with awareness facet increased from T1 to T2 (p = 0.010) and from T1 to T3 (p = 0.007), as well as the nonjudging of inner experience facet (T1 to T2 [p = 0.030] and T1 to T3 [p = 0.002]). Experiential avoidance decreased from T1 to T3 (p = 0.022) and depressive symptoms from T1 to T2 (p = 0.019). Post-MBPI scores were maintained at T2 and T3 concerning anxiety symptoms and the observing and no-reactivity mindfulness facets. There were long-term effects of MBPI on mindfulness and experiential avoidance. Moreover, therapeutic gains were maintained regarding depression and anxiety symptoms, independently of the reproductive outcome.

Experiential avoidance, self-compassion, self-judgment and coping styles in infertility.

OBJECTIVES: This study sought out to explore the existence of differences regarding emotion regulation processes (psychological inflexibility/experiential avoidance, self-judgment and self-compassion) and coping styles (emotional/detached, avoidant and rational) in three different groups of couples: 120 fertile couples (FG), 147 couples with an infertility diagnosis who were pursuing medical treatment for their fertility problem(s) (IG), and 59 couples with infertility applying for adoption (AG). STUDY DESIGN: Cross-sectional survey, using the couple as unit of analysis. MAIN OUTCOME MEASURES: Participants filled in paper-pencil questionnaires assessing coping styles, psychological inflexibility/experiential avoidance, self-judgment and self-compassion. RESULTS: IG couples, and particularly women, tend to use more experiential avoidance and self-judgment mechanisms and less emotional/detached coping style. When compared to FG couples, IG and AG couples tend to apply more avoidant coping strategies. AG couples showed higher self-compassion. CONCLUSIONS: Findings suggest that emotion regulation processes may be an important target in psychological interventions for patients dealing with infertility and with the demands of medical treatment.

The mediator role of emotion regulation processes on infertility-related stress.

The objective of this study is to investigate gender differences regarding the mediator role of self-compassion and self-judgment on the effects of external shame, internal shame, dyadic adjustment, on infertility-related stress. One hundred and sixty-two women and 147 men with a primary infertility diagnosis completed the following set of self-report measures: Others as Shamer, Experience of Shame Scale, Dyadic Adjustment Scale, Self-Compassion Scale, and Fertility Problem Inventory. Path analyses results revealed that in women self-compassion fully mediated the effect of internal shame on infertility-related stress and partially mediated the effect of dyadic adjustment on this variable, while external shame had only a direct effect. In men self-judgment fully mediated the effect of external and internal shame on infertility-related stress. Dyadic adjustment had only a direct effect on infertility-related stress. In conclusion, there is a distinct role of self-compassion and self-judgment on the relationship between shame and infertility-related stress in men and women. Such differences should be taken into account in psychological interventions with these patients. Future research is warranted to further support our results.

Mindfulness-Based Program for Infertility: efficacy study.

OBJECTIVE: To present and determine the impact of the Mindfulness-Based Program for Infertility (MBPI). DESIGN: Controlled clinical trial. SETTING: University research unit. PATIENT(S): Fifty-five infertile women completed the MBPI, and 37 infertile women were assigned to a control group. INTERVENTION(S): The MBPI includes 10 weekly sessions, in a group format, with a duration of about 2 hours each (men attend three sessions). MAIN OUTCOME MEASURE(S): Standardized measures of depression, state anxiety, entrapment, defeat, internal and external shame, experiential avoidance, mindfulness, self-compassion, and infertility self-efficacy were endorsed pre- and post-MBPI. RESULT(S): The MBPI group and the control group were shown to be equivalent at baseline. By the end of the MBPI, women who attended the program revealed a significant decrease in depressive symptoms, internal and external shame, entrapment, and defeat. Inversely, they presented statistically significant improvement in mindfulness skills and self-efficacy to deal with infertility. Women in the control group did not present significant changes in any of the psychological measures, except for a decrease in self-judgment. CONCLUSION(S): Increasing mindfulness and acceptance skills, as well as cognitive decentering from thoughts and feelings, seem to help women to experience negative inner states in new ways, decreasing their entanglement with them and thus their psychological distress. Data suggest that the MBPI is an effective psychological intervention for women experiencing infertility.

Measuring self-efficacy to deal with infertility: Psychometric properties and confirmatory factor analysis of the Portuguese version of the infertility self-efficacy scale.

This study explores the psychometric properties and factor structure of the Portuguese version of the Infertility Self-Efficacy Scale (ISE-P), using translation and back-translation of the original version; principal component analysis; confirmatory factor analysis (CFA); and internal consistency, and test-retest reliability analyses. A total of 287 participants (156 women and 131 men) seeking medical treatment were recruited from public and private fertility centers. CFA revealed that the single-component model fit the data well. The instrument showed excellent internal consistency, good test-retest reliability, and correlations with other mental health measures suggesting good convergent and discriminant validity. In conclusion, The ISE-P is a valid and reliable Portuguese-language measure of perceived self-efficacy to cope with infertility.