A Systematic Review on Intervention Treatment in Pathological Gambling.

Over the last century, there has been a growing interest in researching pathological gambling, particularly in industrialized nations. Historically, gambling was widely perceived as morally questionable, condemned by religious groups. However, contemporary concerns have shifted towards the health repercussions of gambling disorders and broader societal impacts like increased crime and money laundering. Governments, aiming to mitigate social harm, often regulate or directly oversee gambling activities. The global surge in legal gambling has resulted in a substantial rise in its prevalence, popularity, and accessibility in the last two decades. This paper provides a comprehensive overview of global research on interventions for pathological gambling. Through a systematic search on platforms such as EBSCO, PubMed, and Web of Science, 13 relevant records were identified. The revised findings indicate a heightened occurrence of behavioral addictions, linking them to the early onset of gambling issues and their severe consequences. The research emphasizes the active role that clients play in the process of self-directed change and therapy. Therapists recognizing clients as both catalysts for change and potential obstacles can enhance their effectiveness. A common source of resistance arises when clients and therapists are in different stages of the change process, underlining the importance of therapists aligning with clients' readiness for change. Recognizing the urgent need for a better understanding of this problem in adolescents, this study emphasizes the necessity to tailor prevention and treatment plans based on gender and age-specific requirements.

Portuguese Version of the Watching TV Series Motives Questionnaire: what does this have to do with Loneliness? A Bidirectional Relationship

The objective of this study was twofold: to validate the Watching TV Series Motives Questionnaire (WTSMQ) for the Portuguese population and to understand its relationship with loneliness. WTSMQ was validated through an exploratory factor analysis (EFA) and a confirmatory factor analysis (CFA). Besides, multi-group CFAs according to gender were conducted having been tested four levels of measurement invariance: configural, metric, scalar, and error variance. Several multiple linear regressions were carried out to estimate the relationship between sociodemographics, series preferences, loneliness and watching TV series motives. Results showed that the Portuguese version of WTSMQ presents good psychometric properties and that configural and metric were achieved, but not scalar and error variance invariance providing some evidence that the WTSMQ operates similarly in males and females. Results also showed that gender, age, TV series preferences, and loneliness contribute to explain different dimensions of Watching TV Series Motives. Also, sociodemographic variables, TV series preferences and WTSMQ subscales explain loneliness. The relationship between the motives for binge-watching and loneliness is bidirectional; sociodemographic variables and series preferences that explain those motives and loneliness overlap. Implications for tracking problematic Binge-watching situations are discussed. (AU)

Measurement Invariance of the Multidimensional Jealousy Scale and Quality of Relationships Inventory (Friend).

The aim of this study is to measure the invariance of the Multidimensional Jealousy Scale (MJS) and of the Quality of Relationships Inventory (Friend) (QRI-F) across gender, age, education, and being in a romantic relationship in a Portuguese sample (N = 662). A confirmatory factor analysis was performed to test the fit of different potential factor structures. The results pointed out that both MJS and QRI-F were most suitable if represented by three first-order factors correlated between them. Results from multi-group analyses suggested there was factorial invariance for these structures across groups, suggesting that the MJS and the QRI-F provide, respectively, an assessment of romantic jealousy and quality of relationship that are equivalent across gender, age, education, and being in a romantic relationship. The study established the strong psychometric properties of its instruments, validating reliability and convergent and discriminant validity, thereby bolstering the research's overall credibility. Additionally, cognitive jealousy is primarily influenced by heightened conflict values, with education, relationship status, and gender moderating the associations between QRI-F dimensions and MJS behavioral and cognitive jealousy. The research offered in-depth perspectives on jealousy, underscoring its diverse manifestations across demographic variables and illuminating the complexities within the dynamics of friendships.

Being Female and in a Romantic Relationship Enhances the Association between Satisfaction with Love Life and Capacity to Love.

This study aims to evaluate if the relation between love life satisfaction, assessed by the satisfaction with love life scale (SWLLS), and capacity to love, assessed by the capacity to love inventory (CTL-I), is moderated by gender and by being or not in a romantic relationship, in a Portuguese sample. To this end, the adaptation and validation of CTL-I for this population were carried out through an exploratory factorial analysis (EFA) followed by a Robust Maximum Likelihood (MLR) confirmatory factorial analysis (CFA). A multi-group analysis for measurement invariance depending on being in a romantic relationship or not was assessed. The model's reliability was also evaluated. The associations between SWLLS and CTL-I were tested by correlations, regressions and moderations. At last, differences between means and distributions concerning sociodemographic variables were determined. The results showed that a good model fit for the Portuguese version of the CTL-I was found, as well as good psychometric properties. Results also showed that satisfaction with love life contributes to explaining the capacity to love and all its dimensions, and that gender and being in a romantic relationship moderate the association between love life satisfaction and the capacity to love. Being female and being in a romantic relationship make the relationship between love life satisfaction and the capacity to love stronger and more meaningful.

Pro-Environmental Behavior and Climate Change Anxiety, Perception, Hope, and Despair According to Political Orientation.

The main objective of this paper is to assess pro-environmental behavior, climate change anxiety, perception, hope, and despair in different political orientations. Our specific aims included to assess the validity of all the instruments used; to assess whether the factor structure of the scales were valid across political orientations; to evaluate their reliability; to assess differences concerning age, gender, and political orientation; to learn the variables that explain pro-environmental behavior; and to evaluate the moderating role of climate change perception, despair, and hope in the relationship between climate change anxiety and pro-environmental behavior. Confirmatory factor analyses (CFAs), multi-group CFAs (to calculate measurement invariance), multiple linear regressions, and moderations were performed. Results showed that pro-environmental behavior and climate change hope achieved the four assessed levels of invariance across different political orientations; climate change anxiety achieved the first three levels of invariance; and climate change perception and climate change despair achieved configural invariance. Climate change anxiety, personal experience with climate change, and climate change perception (total, reality, and consequences) presented higher values for the left political orientation than for the right or the center. Climate change anxiety variables contributed most to explaining pro-environmental behaviors. Hope, despair, and climate change perception (consequences) moderated the relationship between climate change anxiety and pro-environmental behavior. These results open up new avenues for investigation, specifically to understand why high levels of anxiety lead to more pro-environmental behaviors.

Dark Personality Traits and Online Behaviors: Portuguese Versions of Cyberstalking, Online Harassment, Flaming and Trolling Scales.

The main objective of this study is to assess moderation effects of online behaviors between personality traits and addiction to Internet. To this end, four instruments were validated for Portuguese version through confirmatory factor analysis and exploratory factor analysis (Study 1) Multiple regression analysis was applied to examine the personality predictors of specific online behaviors while controlling for gender and age; and moderation effects were assessed (Study 2). Results showed good psychometric properties for the four validated scales. Machiavellianism is positively associated with all the dimensions of this study. Psychopathy is positively associated with total Cyberstalking, Cyberstalking Control, Flaming and Trolling. Narcissism is positively associated with all the dimensions, except Online Harassment and Flaming. Machiavellianism is positively associated with Addiction to Internet through Cyberstalking, Flaming and Trolling. Psychopathy is positively associated with Addiction to Internet through Cyberstalking Control and Flaming. Narcissism is also positively associated with Addiction to Internet through Cyberstalking and Trolling. This study demonstrates that dimensions of the dark triad of personality play an important role in Internet addiction through online behaviors. The results of this study have theoretical and practical implications: on the one hand, they reinforces the findings of other studies showing that dimensions of the dark personality triad play an important role in Internet and social network addition, contributing to the literature; and, on the other hand, on a practical level, they allow to conduct awareness campaigns in communities, schools, and work to understand that one can be exposed to unpleasant situations due to behaviors that some people with personality traits of Machiavellianism, narcissism and/or psychopathy that may cause problems affecting the mental, emotional and psychological health of others.

Minding the gap: The moderating role of education between subjective health and social life perception and Internet use time

Introduction: Internet addiction results in intense and frequent use. There is a gap in the literature in relation to the unawareness of problematic Internet use (PIU) in predicting Internet use time (IUT). Objective: To identify sociodemographic/psychological variables contributing and moderating IUT. Participants: 1,270 participants of the European Social Survey (EES), Round 8. Instruments: EES variables assessing Internet use (IU), health perception, well-being, social life, and sociodemographic variables, underlying the construct. Results: Age, education, sources of household income, social activities compared to others of the same age and subjective general health explain IU per day; and age, years of education, domicile and socially meeting with other people with whom to discuss intimate matters explain IU per week. Education was found to be a significant moderator in the relationship between subjective general health and IU per week; and in the relationship between socially meeting with other people and IU per day. Discussion: Maladaptive IU, when the perception of health is worse, and adaptive IU, when the perception of social life is better, are both suggested, depending on education. Conclusions: These findings point to the need to study IUT involving educational level, keeping in mind that what may be PIU at one educational level may not be the case at another.

Introdução: O vício da Internet traduz-se numa utilização intensa e frequente. Existe uma lacuna na literatura sobre o desconhecimento dos preditores do uso problemático da Internet (PIU) do tempo de utilização da Internet (IUT). Objetivo: Identificar as variáveis sociodemográficas/psicológicas que contribuem e moderam o IUT. Participantes: 1270 participantes da European Social Survey (EES), Round 8. Instrumentos: Variáveis ESS que avaliam a utilização da Internet (IU), perceção de saúde, bem-estar, vida social e variáveis sociodemográficas, sub jacentes ao construto. Resultados: Idade, escolaridade, fontes de renda familiar, atividades sociais em comparação com outras da mesma idade e saúde geral subjetiva explicam IU por dia e idade, anos de escolaridade, domicílio, convívio social com outras pessoas e quem para discutir assuntos íntimos explicam IU por semana. A escolaridade mostrou-se um moderador significativo na relação entre saúde geral subjetiva e IU por semana; e na relação entre encontro social com outras pessoas e IU por dia. Discussão: IU desadaptativa, quando a perceção de saúde é pior, e IU adaptativa, quando a perceção de vida social é melhor, dependem da escolaridade. Conclusões: Os resultados sugerem o estudo do IUT de acordo com o nível educacional, pois o que pode ser um PIU num nível educacional pode não ser noutro.

Self-Care Practices with Psychedelics - A Qualitative Study of Users' Perspectives.

This article explores the psychedelic experience from the users' point of view and through the lens of self-care, a concept within the domain of health and well-being. In a time of renewed interest in psychedelic-assisted psychotherapy, we aim to contribute to a better understanding of these substances by exploring their role in different settings. A phenomenological approach was used in this study. We conducted semi-structured interviews with 19 psychedelic users and inquired about the relationship between their experiences and self-care. Analysis of the interview data was based on inductive content analysis. Most participants reported using psychedelics with self-care intentions in ceremonial, recreational, or private settings. Self-perception and existential meaningfulness were identified as the main mechanisms of self-care. Participants also mentioned difficult experiences and adversities that impair self-care. The results suggest that for some people, the use of psychedelics may be experienced as part of a self-care process and may improve self-care abilities in naturalistic settings.

Photo-Phytotherapeutic Gel Composed of Copaifera reticulata, Chlorophylls, and k-Carrageenan: A New Perspective for Topical Healing.

Chronic wound healing represents an impactful financial burden on healthcare systems. In this context, the use of natural products as an alternative therapy reduces costs and maintains effectiveness. Phytotherapeutic gels applied in photodynamic therapy (PDT) have been developed to act as topical healing medicines and antibiotics. The bioactive system is composed of Spirulina sp. (source of chlorophylls) and Copaifera reticulata oil microdroplets, both incorporated into a polymeric blend constituted by kappa-carrageenan (k-car) and F127 copolymer, constituting a system in which all components are bioactive agents. The flow behavior and viscoelasticity of the formulations were investigated. The photodynamic activity was accessed from studies of the inactivation of Staphylococcus aureus bacteria, the main pathogen of hospital relevance. Furthermore, in vivo studies were conducted using eighteen rabbits with dermatitis (grade III and IV) in both paws. The gels showed significant antibiotic potential in vitro, eliminating up to 100% of S. aureus colonies in the presence or absence of light. The k-car reduced 41% of the viable cells; however, its benefits were enhanced by adding chlorophyll and copaiba oil. The animals treated with the phytotherapeutic medicine showed a reduction in lesion size, with healing and re-epithelialization verified in the histological analyses. The animals submitted to PDT displayed noticeable improvement, indicating this therapy's viability for ulcerative and infected wounds. This behavior was not observed in the iodine control treatment, which worsened the animals' condition. Therefore, gel formulations were a viable alternative for future pharmaceutical applications, aiming at topical healing.

Dark Tourists: Profile, Practices, Motivations and Wellbeing.

This work aims to address whether knowing what dark tourism is (or not) impacts rumination on sadness, self-hatred, hostility, psychological vulnerability, and tourist wellbeing, as well as practices and motivations for dark tourism. A quantitative approach, based on a survey of 993 respondents, reveals that women and more educated participants know more about dark tourism; people who know what dark tourism is have visited more Holocaust museums, sites of human tragedy and natural disasters, concentration camps, and prisons; show more curiosity, need to learn and understand, and need to see morbid things. A model was found showing that gender, age, know/do not know dark tourism, and motivations (curiosity, the need to learn, the need to understand, and pleasure) explained 38.1% of a dark tourism practice index. Most findings also indicate that rumination on sadness, self-hatred, hostility, and psychological vulnerability are associated with darker practices. Greater wellbeing was not found in participants who knew in advance what dark tourism was. Interestingly, participants who visit tragic human sites present higher values in hostility and tourist wellbeing than those who do not. In summary, people who visit more dark places and score higher on negative personality characteristics have higher values of tourist wellbeing.

Quality of Life in Women With Breast Cancer Receiving Chemotherapy and the Moderating Role of Cortisol.

BACKGROUND: Quality of life (QoL) is severely affected by breast cancer (BC) and its treatment, particularly chemotherapy treatment. Psychological morbidity, illness perceptions, and self-efficacy for coping are important variables that impact QoL during the treatment of BC. The impact of cortisol on QoL has been poorly studied. OBJECTIVE: The aim of this study was to identify the contributing variables to QoL in women with BC receiving adjuvant chemotherapy, as well as the moderating role of cortisol in the relationship between treatment adverse effects and QoL. METHODS: This cross-sectional study included 112 women with BC undergoing chemotherapy who answered the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire, the Supplementary Questionnaire Breast Cancer Module, the Illness Perception Questionnaire, the Cancer Behavior Inventory-Brief Version, and the Hospital Anxiety and Depression Scale. In addition, salivary cortisol concentrations were also assessed. RESULTS: The strongest contributor to lower QoL was treatment adverse effects. The illness perception and the cancer stage also contributed to a lower QoL. Nadir cortisol moderated the relationship between adverse effects and QoL. CONCLUSION: Breast cancer chemotherapy and illness perceptions, even at the beginning of treatment, showed a great impact on QoL. IMPLICATIONS FOR PRACTICE: It is important during chemotherapy to assess women's illness perceptions, as well as their stress levels to help women cope with the stress associated with treatment adverse effects. Monitoring cortisol is important as cortisol moderated the relationship between adverse effects and QoL. For those women struggling with stress, a reference to a mental health provider is warranted.

The indirect effect of body image on distress in women with breast cancer undergoing chemotherapy.

BACKGROUND: This study assessed the indirect effect of body image in the relationship between illness duration, optimism, coping strategies and psychological distress as well as the moderator role of being or not submitted to surgery and type of surgery, in women with breast cancer undergoing chemotherapy. PARTICIPANTS AND PROCEDURE: This cross-sectional study included eighty-seven women with breast cancer undergoing chemotherapy, who answered instruments that assessed sociodemographic and clinical issues, optimism, coping, concerns with body image and psychological distress. Bayesian statistics were performed to test the indirect effect model that included also the moderator effects. RESULTS: Lower optimism, lower use of humor, and higher denial and illness duration predicted lower body image and higher distress. Longer illness duration was associated with higher distress. Body image had an indirect effect in the relationship between optimism and distress; between denial coping and distress; between humor coping and distress and between illness duration and distress. Being submitted to surgery but not the type of surgery was a moderator in the indirect effect model. CONCLUSIONS: Body image is critical to psychological distress. Future interventions for women with breast cancer should consider body image as a target, in order to promote adaptive coping strategies specially when women have had surgery.

Quality of Life in Caregivers of Type 2 Diabetes Patients After Patient's Surgery: a Path Analysis.

BACKGROUND: Type 2 diabetes Mellitus is a chronic disease, and one of its complications may result in amputation. The goal of this study was to evaluate the impact of psychosocial variables, over time, on quality of life (QoL) of caregivers of patients (N = 110) who had undergone a recent amputation. METHOD: A longitudinal design was employed: (T1) 1 month after the patient's surgery; (T2) 7 months after; and (T3) 10 months after. Burden Assessment Scale, Family Assessment Device, Revised Impact of Events Scale, Family Disruption from Illness Scale, and Short Form Health Survey were used. A path analysis model was tested. RESULTS: Burden, perception of family functioning, and traumatic symptoms at T1 showed a positive impact on the perception of family functioning, at T2. Traumatic symptoms, at T1, predicted traumatic symptoms at T2 being also a mediator between those symptoms (T1) and physical QoL (T3). Physical and traumatic symptoms, at T1 predicted physical symptoms, at T2 affecting both mental and physical QoL (T3), being also a mediator in these relationships. Burden (T1) also had a direct effect on mental QoL (T3) and at T2 had an impact on physical QoL (T3) mediating also the relationship between burden/physical symptoms at T1 and physical QoL, at T3. CONCLUSION: Intervention should focus on physical and traumatic symptoms as well as burden since they were both mediators regarding mental and physical QoL.

Community perceptions surrounding Lisbon's first mobile drug consumption room.

Portugal's first Mobile Drug Consumption Room (MDCR) has been operating for over three years in two Lisbon neighborhoods. This qualitative study first creates a baseline understanding of community perceptions concerning the acceptability of and expectations surrounding drug consumption rooms in the communities of intervention. Then, at least six months after the initial interviews, it determines how these perceptions changed and what changes participants perceive in the neighborhoods. Findings highlight widespread acceptance of the MDCR among participants. One of the participants' priorities related to the MDCR was to lessen the visibility of public consumption, a change some participants perceived in the neighborhood. While in the first round of data collection participants primarily conceptualized the MDCR as a service for People Who Use Drugs (PWUD), in the follow-up round, they reported changes in the community.

Psychological Factors Explaining Perceived Impact of COVID-19 on Travel.

This cross-sectional study aims to determine the psychological factors that contribute to the perceived impact of COVID-19 on travel using a convenience sample (N = 1122) from the general population to whom instruments assessing the perception of the COVID-19 pandemic's impact on travel, anxiety, fear, phobia, risk perception, and stress were applied. The participants were mainly female (65.6%), had not attended university, and who were professionally active, with a mean age of around 30-years-old (M = 31.91, SD = 13.76, Min = 18, Max = 81). The perceived impact of COVID-19 on travel correlates with all of the psychological variables, mainly in terms of the emotional fear of COVID-19. Together with the perceived risk of COVID-19, social phobia due to COVID-19, and COVID-19 stress contamination, these variables explain 20% of the perceived impact of COVID-19 on travel variance. The relationship between COVID-19 stress socio-economic consequences and the perception of the pandemic's impact on travel is moderated by the emotional perceived risk of COVID-19. Fear and perception of this risk explain the impact of the COVID-19 on travel in pandemic times, suggesting that the psychological impact of fear and anxiety induced by the pandemic needs to be handled as a public health priority.

Associations between Cues of Sexual Desire and Sexual Attitudes in Portuguese Women.

Sexuality is defined as a multidimensional experience that involves genital, mental, and bodily components. It is also assumed as a basic condition inherent to the human existence that encourages the search for love, intimacy, sex, and proximity to others. The main objective of this study is to assess the relationship between cues of sexual desire and sexual attitudes in Portuguese women. This is a cross-sectional study with 804 Portuguese women to whom the protocol was applied. It included an informed consent, a sociodemographic questionnaire, a questionnaire related to intimacy, a scale of sexual attitudes, and the scale of cues of sexual desire. The protocol was applied via Google Forms due to the current pandemic situation (COVID-19). Differences were found in sexual attitudes and the cues of sexual desire in terms of sociodemographic characteristics, as well as in terms of women's intimacy. Significant correlations were found between the brief sexual attitudes scale (BSAS) and the cues of sexual desire scale (CSDS). Age, sexual orientation, relation nature, sexual practices, visual proximity cues, erotic explicit cues, and sensory explicit cues explain, altogether, 25% of the total sexual attitudes. Additionally, age, sexual orientation, the relation's nature, sexual practices, visual proximity cues, emotional bonding cues, romantic implicit cues, erotic explicit cues, and sensory explicit cues explain, altogether, 30% of the permissiveness. Sexual attitudes are developed under the influence of sociodemographic variables, variables related to women's intimacy, and cues of sexual desire, which are new data in the study of sexual attitudes and have implications at the level of gender issues.

Preliminary Validation Study of the Intrinsic Religious Motivation Scale and the Centrality of Religiosity Scale for the Portuguese Population.

Religion is a construct widely present in most people's lives. Religious motivations, either intrinsic or extrinsic, as well as religious centrality, are crucial aspects of religion. In the Portuguese population, there are no validated instruments to assess these aspects of religion. Accordingly, this study intends to validate the Intrinsic Religious Motivation Scale (IRMS) and the Centrality of Religiosity Scale (CRS) for the Portuguese population. This is a validation study whose sample consists of 326 participants (73.1% women) from the general population. Exploratory and confirmatory factor analyses were carried out and the correlations between the constructs and self-compassion were determined to assess the convergent and divergent validity. The results obtained confirm the existence of models adjusted to the population, allowing us to conclude that the instruments are reliable for assessing the studied constructs. The validation of the IRMS and CRS for the Portuguese population is of outstanding importance, as it provides researchers in the field with valid instruments and psychometric qualities to carry out research within religion and religiosity.

Portuguese Version of COVID-19 Perceived Risk Scale and COVID-19 Phobia Scale: Psychometric Properties.

The COVID-19 pandemic scenario has a psychological impact on individuals and society. A higher level of perceived risk concerning COVID-19 has been found when compared to other potential health threats. A misperception of risk in contrast with the real risk may lead people to develop disruptive cognitive, affective, or behavioral responses to the COVID-19 pandemic, namely, coronaphobia. Validated instruments are needed to evaluate such responses. This work aims to validate the COVID-19 Perceived Risk Scale (C19PRS) and the COVID-19 Phobia Scale (C19PS) in the Portuguese population. The two scales were translated from English to Portuguese using the back-translation technique. The cultural adaptation was framed in the context of establishing the validity and reliability of the instruments. In two studies, C19PRS and C19PS were validated for the adult Portuguese population (N = 1122; women = 725 (64.6%); mean age of 31.91 years old) through exploratory factorial analysis, followed by a confirmatory factorial analysis. Convergent validity was calculated by composite reliability (CR) and average variance extracted (AVE) values. Discriminant validity was assessed by square roots of the AVE values and their comparison with the C19PRS and C19PS dimensions' cross-correlations. Both C19PRS and C19PS present a good adjustment model and solid reliability and validity and have significant correlations with fear of COVID-19 and COVID-19 anxiety scales.

Validation and Psychometric Properties of the Portuguese Version of the Coronavirus Anxiety Scale (CAS) and Fear of COVID-19 Scale (FCV-19S) and Associations with Travel, Tourism and Hospitality.

The aim of this study is to determine the anxiety and fear related to coronavirus disease 2019 (COVID-19) and their associations with travel, tourism and hospitality, in the Portuguese population. The Coronavirus Anxiety Scale (CAS) and Fear of COVID-19 Scale (FCV-19S) were validated for the Portuguese population and correlations with issues related to travel, tourism and hospitality were established. CAS and FCV-19S presented a good adjustment model and solid reliability and validity. Correlations between CAS and FCV-19S and the perception of the impact of COVID-19 in travel, tourism and hospitality were found. Participants considered that COVID-19 mainly affected their holidays and leisure time. However, the strongest correlation established was between total FCV-19S and emotional fear FCV-19S and the fear of attending hotel facilities. The Portuguese versions of CAS and FCV-19S are reliable psychological tools to assess anxiety and fear in relation to COVID-19 for the general population. The use of hotel facilities is the most threatening issue related to travel, tourism and hospitality. The results suggest that hotels should invest in hygiene and safety measures that allow users to regain confidence in hotel equipment.

Traumatic stress as a mediator of quality of life and burden in informal caregivers of amputees due to diabetic foot: a longitudinal study.

BACKGROUND: Type 2 diabetes mellitus (DMT2) is frequently associated with complications that can lead to lower limb amputation, being the second major cause of amputation. The amputee becomes dependent on caregivers, who are often unprepared for this new role and face many challenges. Care-giving influences several dimensions of the caregiver's life. This study evaluates the mediating role of traumatic stress in the relationship between caregiver perceived stress and burden/quality of life (QoL) taking also into consideration the duration of caregiving and whether the caregiver receives help in caregiving tasks, in informal caregivers of amputees due to diabetic foot over a 10 month period. PARTICIPANTS AND PROCEDURE: The sample consisted of 110 informal caregivers of amputees due to diabetic foot with type 2 diabetes. This longitudinal study evaluates, at three time points, the mediating role of traumatic stress in the relationship between perceived stress and burden/quality of life considering the duration of caregiving and whether the caregiver received help and social support in caregiving tasks. RESULTS: The results showed that the duration of caregiving, help in caregiving and caregiver stress (T1) predicted traumatic stress seven months (T2) after patients' amputation; and traumatic stress (T2) predicted mental QoL and burden, 10 months later (T3). CONCLUSIONS: This study emphasizes the importance of intervention in caregivers at the beginning of caregiving, to improve mental QoL and decrease the burden, ten months after amputation.