The real relationship: the Portuguese version of the Real Relationship Inventory-Client form.

The Real Relationship is a relational construct that has influenced other constructs, like the working alliance, although empirically neglected. The development of the Real Relationship Inventory provides a reliable and valid way of measuring the Real Relationship in research and clinical applications. This study aimed to validate and explore the psychometric properties of the Real Relationship Inventory Client Form with a Portuguese adult sample in the context of psychotherapy. The sample includes 373 clients currently in psychotherapy or concluded recently. All clients completed the Real Relationship Inventory (RRI-C) and the Working Alliance Inventory. The confirmatory analysis revealed the same two factors in the RRI-C for the Portuguese adult population, Genuineness and Realism. The observation of the same factor structure suggests the cross-cultural value of the Real Relationship. The measure demonstrated good internal consistency and acceptable adjustment. A significant correlation was found between the RRI-C and the Working Alliance Inventory and significant correlations between the Bond and Genuineness and Realism subscales. The present study reflects on the RRI-C while also contributing to the importance of the Real Relationship in different cultures and clinical contexts.

Corrigendum: Illness perceptions of COVID-19 in Europe: predictors, impacts and temporal evolution.

[This corrects the article DOI: 10.3389/fpsyg.2021.640955.].

Illness Perceptions of COVID-19 in Europe: Predictors, Impacts and Temporal Evolution.

Objective: Illness perceptions (IP) are important predictors of emotional and behavioral responses in many diseases. The current study aims to investigate the COVID-19-related IP throughout Europe. The specific goals are to understand the temporal development, identify predictors (within demographics and contact with COVID-19) and examine the impacts of IP on perceived stress and preventive behaviors. Methods: This was a time-series-cross-section study of 7,032 participants from 16 European countries using multilevel modeling from April to June 2020. IP were measured with the Brief Illness Perception Questionnaire. Temporal patterns were observed considering the date of participation and the date recoded to account the epidemiological evolution of each country. The outcomes considered were perceived stress and COVID-19 preventive behaviors. Results: There were significant trends, over time, for several IP, suggesting a small decrease in negativity in the perception of COVID-19 in the community. Age, gender, and education level related to some, but not all, IP. Considering the self-regulation model, perceptions consistently predicted general stress and were less consistently related to preventive behaviors. Country showed no effect in the predictive model, suggesting that national differences may have little relevance for IP, in this context. Conclusion: The present study provides a comprehensive picture of COVID-19 IP in Europe in an early stage of the pandemic. The results shed light on the process of IP formation with implications for health-related outcomes and their evolution.

To Help or Not to Help? Prosocial Behavior, Its Association With Well-Being, and Predictors of Prosocial Behavior During the Coronavirus Disease Pandemic.

The coronavirus disease (COVID-19) pandemic fundamentally disrupted humans' social life and behavior. Public health measures may have inadvertently impacted how people care for each other. This study investigated prosocial behavior, its association well-being, and predictors of prosocial behavior during the first COVID-19 pandemic lockdown and sought to understand whether region-specific differences exist. Participants (N = 9,496) from eight regions clustering multiple countries around the world responded to a cross-sectional online-survey investigating the psychological consequences of the first upsurge of lockdowns in spring 2020. Prosocial behavior was reported to occur frequently. Multiple regression analyses showed that prosocial behavior was associated with better well-being consistently across regions. With regard to predictors of prosocial behavior, high levels of perceived social support were most strongly associated with prosocial behavior, followed by high levels of perceived stress, positive affect and psychological flexibility. Sociodemographic and psychosocial predictors of prosocial behavior were similar across regions.

Impact of COVID-19 pandemic on mental health: An international study.

BACKGROUND: The COVID-19 pandemic triggered vast governmental lockdowns. The impact of these lockdowns on mental health is inadequately understood. On the one hand such drastic changes in daily routines could be detrimental to mental health. On the other hand, it might not be experienced negatively, especially because the entire population was affected. METHODS: The aim of this study was to determine mental health outcomes during pandemic induced lockdowns and to examine known predictors of mental health outcomes. We therefore surveyed n = 9,565 people from 78 countries and 18 languages. Outcomes assessed were stress, depression, affect, and wellbeing. Predictors included country, sociodemographic factors, lockdown characteristics, social factors, and psychological factors. RESULTS: Results indicated that on average about 10% of the sample was languishing from low levels of mental health and about 50% had only moderate mental health. Importantly, three consistent predictors of mental health emerged: social support, education level, and psychologically flexible (vs. rigid) responding. Poorer outcomes were most strongly predicted by a worsening of finances and not having access to basic supplies. CONCLUSIONS: These results suggest that on whole, respondents were moderately mentally healthy at the time of a population-wide lockdown. The highest level of mental health difficulties were found in approximately 10% of the population. Findings suggest that public health initiatives should target people without social support and those whose finances worsen as a result of the lockdown. Interventions that promote psychological flexibility may mitigate the impact of the pandemic.

The role of weight perceptions and their impact on health and well-being: A multiple mediation model.

The present study analyses the role of weight distortion and weight self-criticism in explaining the relationship between actual weight and perceived health, well-being, body satisfaction and emotional eating. Eight hundred and six individuals were selected from a national study on nutrition. They were divided into two groups according to self-reported dieting. A questionnaire measuring the outcome variables was implemented. Weight distortion and self-criticism were calculated using actual, estimated and desired BMI. A multiple mediation model was estimated using structural equation modelling. A valid model was obtained in which weight self-criticism is a partial mediator of the relationship between weight and body satisfaction and a full mediator of the relationship between weight and emotional eating for the non-dieter group. For the dieter group, full mediation of weight self-criticism is observed in the relationships between weight and health, well-being and body satisfaction. For weight distortion, no mediation effect is found in either group. The results highlight the importance of weight perceptions in understanding the influence of body weight on several aspects of health and well-being. The type of weight perception is also relevant. A critical attitude towards weight is more determinant than the distortion in weight appraisal.

Routes for Specialization in Psychology throughout Europe.

The specialization of psychology helps to delineate fields in the practice of psychology. When establishing professional qualification criteria, associations seek to promote, in their members, scientific skills and knowledge considered fundamental for the practice of psychology in a given area. The present study reports on a survey of the member associations of the European Federation of Psychologists Associations (EFPA). The survey inquired about: (a) the initial requisites for entering the profession and (b) additional requisites for specialization. Of the 37 associations contacted, 14 replied and we retrieved the information of 12 associations from their official websites. The results indicate that specialization is widespread throughout Europe and is independent of the regulation of the profession. In almost half of the countries considered, the specialization process is completed in universities-it is frequently associated with the postgraduate level of the EuroPsy-and relies on conventional learning methods. The number of existing specialties in psychology is very high, but the traditional areas (clinical and health, education, and social/organizational) are more prevalent. The results are discussed in light of the advantages, but also the challenges posed by the specialization in psychology. A continuous model of the specialization of psychology is proposed with two stages: broad and advanced psychology areas.

Impact of economic crisis on the social representation of mental health: Analysis of a decade of newspaper coverage.

BACKGROUND: Mass media plays a fundamental role in how communities understand mental health and its treatment. However, the effect of major events such as economic crises on the depiction of mental health is still unclear. AIMS: This study aimed at analyzing representations of mental health and its treatment and the impact of the 2008 economic crisis. METHODS: In total, 1,000 articles were randomly selected from two newspapers from a period before and after the economic crisis. These articles were analyzed with a closed coding system that classified the news as good or bad news according to the presence of themes associated with positive or stigmatizing representations. RESULTS: The results show a positive representation of mental health and a negative representation of treatment. Furthermore, the economic crisis had a negative impact on the representation of mental health, but not on treatment. CONCLUSION: These findings suggest that the representation of mental health is multifaceted and may be affected differently in its dimensions. There is a need for stigma-reducing interventions that both account for this complexity and are sensitive to context and period.

Randomized controlled trial of an intervention to change cardiac misconceptions in myocardial infarction patients.

There is converging evidence that changing beliefs about an illness leads to positive recovery outcomes. However, cardiac misconceptions interventions have been investigated mainly in Angina or Coronary Heart Disease patients, and less in patients following Myocardial Infarction (MI). In these patients, cardiac misconceptions may play a role in the adjustment or lifestyle changes. This article reports a randomized controlled trial of an intervention designed to reduce the strength of misconceptions in patients after a first MI. The primary outcome was the degree of change in misconceptions and the secondary outcomes were: exercise, smoking status, return to work and mood (anxiety and depression). Patients in the intervention condition (n = 60) were compared with a control group (n = 67) receiving usual care. Both groups were evaluated at baseline and 4, 8 and 12 months after hospital discharge. There was a significant time-by-group interaction for the total score of cardiac misconceptions. Patients in the intervention group significantly decreased their total score of cardiac misconceptions at 4 months compared with the control group and this difference was sustained over time. Patients in the intervention group were also more likely to exercise at the follow-up period after MI than the control group. This intervention was effective in reducing the strength of cardiac misconceptions in MI patients and had a positive impact on health behaviour outcomes. These results support the importance of misconceptions in health behaviours and the utility of belief change interventions in promoting health in patients with Myocardial Infarction.

Characterization of readmissions at a Portuguese psychiatric hospital: an analysis over a 21 month period

Background and Objectives: The readmission rate has been considered as a promising variable to evaluate the efficacy of the mental health system. Considering the lack of literature on the subject in Portugal, it is important to characterize it further in order to validate its meaning as a variable. The aim of this analysis was to characterize readmissions to Júlio de Matos Hospital (JMH), in comparison with the single admissions. Methods: This analysis was made through the review of the clinical files of patients admitted over a period of 21 months. Results: Of the 3,225 patients admitted in this period, 1,276 (39.6%) were readmissions. Furthermore, a readmitted patient was admitted, on average, 2.6 times during the study timeframe. The results show a reduced social involvement, an increased prior institutionalization and an increased incidence of 'Schizophrenic Psychosis' and 'Abnormal Personalities' in the sub-group of repeated admissions. Conclusions: These findings are similar to those obtained in other European countries and strengthen the need for psychosocial and specific interventions at outpatient level. This analysis also shows the value of monitoring the relevant variables to tailor the intervention of the institutions (AU)

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