"Living with a question mark": psychosocial experience of Portuguese young adults at risk for hereditary amyloid transthyretin amyloidosis with polyneuropathy.

This study is the first to explore the psychosocial experience of young Portuguese adults at genetic risk for hereditary amyloid transthyretin amyloidosis with polyneuropathy (hATTR-PN). The work focuses on the developmental peculiarities of their experience with the disease. Sixteen semi-structured interviews were conducted with young adults coming for pre-symptomatic testing (PST) at a single genetics outpatient center in Portugal. The data were analyzed qualitatively. The main findings suggest that four themes mark the psychosocial experience of the young adults interviewed. The first refers to the development of psychological representations, namely beliefs, mental representations, and social perceptions about hATTR-PN. The second regards the experienced and anticipated psychosocial impacts, namely, suffering, anxiety, and relief related to the disease. The third is related to using strategies such as performing PST, strategies focused on emotional regulation and the meaning of hATTR-PN, and social strategies to deal with these impacts over time. Finally, the fourth aspect concerns the perceived and expected support for the participants' needs provided by social contexts, that is, family and genetic counseling. In a period of life also marked by qualitatively different characteristics and developmental tasks from other life cycle stages (e.g., identity explorations, instability, and independent decision-making), experience with the disease can add psychosocial challenges to young adults at risk for hATTR-PN. Genetic counseling practices and health policies can be optimized to respond to the psychosocial needs of young adults. Future research should deepen the understanding of the psychosocial experience of individuals and families with late-onset hATTR-PN to improve the clinical response in this population.

Effects of a Mindfulness-Based Intervention for Teachers: a Study on Teacher and Student Outcomes.

Objectives: Teachers' stress can affect their occupational health and negatively impact classroom climate and students' well-being. This study aims to evaluate the proximal and distal effects of a mindfulness-based program, specially developed to promote teachers' social-emotional competencies (SEC), across teachers, classroom climates, and students' outcomes. Methods: The study followed a randomized trial design with two data collection points (pretest and posttest). Participants in the experimental group (EG) included 123 elementary school teachers, their 1503 students, and these students' parents (1494), while the control group (CG) comprised 105 elementary school teachers, their 947 students, and these students' parents (913). A mixed data collection strategy was used that included teachers' and students' (self-) report, observational ratings of teachers' classroom behaviors, and parents' reports on students. Results: After the intervention, EG teachers, compared to CG teachers, reported a significant increase in mindfulness and emotional regulation competencies, self-efficacy, and well-being and a decrease in burnout symptoms. Similarly, a significant improvement was found in EG teachers' classroom behaviors related to students' engagement. Additionally, significant improvements were also found in EG students' perceptions of the quality of their teachers' involvement in classroom relationships, self-reported effect, and social competencies perceived by their parents. Conclusions: These findings further the knowledge on the role played by mindfulness-based SEC interventions in reducing teachers' burnout symptoms and cultivating their SEC and well-being, in promoting a nurturing classroom climate and also in promoting the SEC and well-being of students. Supplementary Information: The online version contains supplementary material available at 10.1007/s12671-021-01635-3.

Disease-related Parenting Stress in the Post-treatment Phase of Pediatric Cancer.

Parenting stress is generally associated with poorer psychological adjustment in caregivers and children with chronic illness. Although parenting stress in pediatric cancer has been previously demonstrated, few studies have investigated this problem when treatments end. The present study aimed to describe disease-related parenting stress in the post-treatment phase of pediatric cancer, and to analyze the role of parents' age and education, family functioning, and perceived child vulnerability in predicting disease-related parenting stress. The study comprised 56 parents of children with cancer, in the post-treatment phase, who completed a clinical and demographic questionnaire, as well as the Pediatric Inventory for Parents, assessing parenting stress, the Child Perceived Vulnerability Scale, and the Family Adaptability and Cohesion Evaluation Scale-Version IV. Results revealed that the level of disease-related parenting stress in the post-treatment phase was still significant. Emotional stress scores were especially high, further showing that parents' concerns in this phase focus mainly on the long-term impact of the disease and treatments, involving intense feelings of fear and uncertainty. A model with four predictors was tested using regression analysis, which explained 57% of parenting stress variance. More specifically, findings indicated that parental age and education significantly predicted parenting stress, accounting for over one-third of the variance in this outcome. Family functioning and perceived child vulnerability explained an additional 18% of parenting stress. Findings of this study suggest that even when treatment ends, there is still the need for continued support in order to assist parents' ability to deal with the implications of having a child who had cancer. Importantly, special attention should be given in clinical practice to the family functioning and to parents' beliefs about their child's vulnerability.

The added value of narratives in the understanding of adolescent's experiences with diabetes

Evidence shows that living with diabetes during adolescence is a challenging expe-rience. Besides the disease and treatment implications, it is important to compre-hend how young people make sense of and manage their illness. Illness percep-tions have been associated with a range of physical and mental health outcomes in adolescents with chronic disease. In order to contribute to a better understanding of the adolescent's experiences with diabetes, this study aimed at1 describing ill-ness perceptions of young people with diabetes2; understanding whether and in what ways, an in-depth analysis of the adolescent's narratives, offers additional in-sight into their experience of living with diabetes. Participants were 32 adolescents with diabetes, aged 12 to 18 years, who com-pleted the Brief Illness Perception Questionnaire and wrote a text about "What it is like to have diabetes". Narratives were analysed with thematic analysis and illustrate how adolescents experience their disease, and the strategies adopted by them to maintain a sense of normalcy. Significant associations with the scores for illness perceptions were found, as for example, adolescents who reported a better understanding of their illness, eva-luated the experience of having diabetes as less restrictive (r = -0,445; p = 0.011). The use of narratives proved very informative on the adolescent's experiences with diabetes. For clinical interventions aimed to promote the adaptation of young people with diabetes, this study findings address the need to focus on normalizing their lives, and to promote more positive illness beliefs and coping strategies, to balance the restrictive impact that diabetes has on adolescent's lives

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Illness perceptions of adolescents with inflammatory bowel disease and the association with distress and well-being

Inflammatory Bowel Disease is one of the most common chronic diseases affecting children and adolescents. It requires a lifelong medical treatment, as well as the adoption of a healthy lifestyle. However, little is known about illness perceptions of adolescents suffering from IBD and how they relate to well-being measures. Aims were 1) to describe illness perceptions, distress and well-being of adolescents with IBD; and 2) to associate illness perceptions with distress and well-being of adoles-cents with IBD. Thirty-six adolescents aged 12 to 18, diagnosed with IBD, answered the Brief Illness Perception Questionnaire and distress and well-being items from the Health Behaviour in School-aged Children questionnaire. Overall the disease is perceived as benign. The majority of adolescents show some concerns about the disease but they feel a reasonable self-control over their illness and strongly believe in the benefits of treatment. Globally, adolescents showed positive perceptions of their health status and of their life. However, tired-ness, exhaustion and nervousness were referred as frequent symptoms. Significant correlations showed that higher threatening perception of illness was associated with an increased frequency of physical symptoms, of tiredness and exhaustion, of depression and nervousness and with less satisfaction with life (rs ranging from .331 to .587). All descriptive and correlational results were significantly stronger in adolescents with active disease compared to those in remission. Negative illness perceptions will likely trigger distress and malaise in adoles-cents with IBD. From the evaluation/comprehension of illness perceptions, it is pos-sible to plan interventions to change negative perceptions and illness outcomes

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Smoking Abstinence Twelve Months after an Acute Coronary Syndrome.

Studies on the cognitive working mechanism of smoking cessation in high-risk populations are few and much needed, and identifying long-term psychosocial factors to smoking cessation are relevant to improve intervention for cardiac patient groups. This longitudinal study followed patients who smoked and suffered an acute coronary syndrome from hospitalization to 12 months after clinical discharge. Questionnaires were administered to assess nicotine dependence, behavioral dependence, autonomous self-regulation, perceived competence, social support, anxiety, depressive symptoms and meaning in life at baseline, six months and twelve months after clinical discharge. The results showed that anxiety (F(2, 62) = 28.10, p < .001, η p 2 = .48) and depressive symptoms (F(2, 62) = 10.42, p < .001, η p 2 = .25) decreased over time, whereas meaning in life (F(2, 61) = 44.77, p < .001, η p 2 = .59) and social support increased (t(63) = -4.54, p < .001, 95% IC[-11.05, 4.29], η2 =.25). Smoking dependence was negatively predicted by change in perceived competence (B = -2.25, p = .011, 95% IC[.02, .60]) and positively by change in depressive symptoms (B =.37, p = .042, 95% IC[1.01, 2.05]) 12 months after clinical discharge. Nicotine dependence (t(17) = 2.76, p = .014, 95% IC[.39, 2.94], η2 =.31) and the number of cigarettes smoked per day (t(17) = 4.48, p < .001, 95% IC[5.49, 15.29], η2 =.54) decreased over time, whereas behavioral dependence increased among smokers (t(17) = -2.37, p = .030, 95% IC[-4.30, 2.54], η2 =.25). This study suggests that long term abstinence in cardiac patients may be enhanced by psychological interventions addressing perceived competence, depressive symptoms and behavioral dependence.

How chronic disease affects children's views on being ill and healthy: a comparative study.

BACKGROUND: Understanding children's views of illness and health is vital to a child-centred approach in patient education and care. Paediatric healthcare providers should incorporate children's views of health and illness to enable children and their families to participate in self-management plans and achieve better health outcomes. However, there is limited scientific knowledge regarding the views of children with specific diseases. METHOD: This comparative study investigated whether and in what ways the experience of having different chronic diseases influenced children's views of being ill and healthy. The participants were 82 children aged 8-13 years diagnosed with a chronic disease (31 had asthma, 27 had diabetes and 24 had cancer). A group of 81 healthy children participated as a comparison group. The 'draw-and-write' technique was used to collect the children's views, and the data were analysed using a previously validated coding system (inter-rater agreement of 93%) and subsequently quantified for the examination of any differences in relation to illness. RESULTS: Statistically significant differences were found in all dimensions of the children's conceptions of health and illness according to whether they had a chronic condition (effect sizes calculated with Cohen's d ranged from 0.35 to 1.22). Globally, the chronically ill children expressed a narrower definition of being healthy and ill than their healthy peers. Moreover, the comparison among the children with asthma, diabetes and cancer showed differences that seemed to reflect their specific experiences with their type of chronic disease and the associated treatments (effect sizes calculated with Eta-squared ranged from 0.07 to 0.25). CONCLUSIONS: This study's findings can be used to guide education and clinical services tailored to ill children suffering from different chronic conditions.

Smoking abstinence twelve months after an acute coronary syndrome

Studies on the cognitive working mechanism of smoking cessation in high-risk populations are few and much needed, and identifying long-term psychosocial factors to smoking cessation are relevant to improve intervention for cardiac patient groups. This longitudinal study followed patients who smoked and suffered an acute coronary syndrome from hospitalization to 12 months after clinical discharge. Questionnaires were administered to assess nicotine dependence, behavioral dependence, autonomous self-regulation, perceived competence, social support, anxiety, depressive symptoms and meaning in life at baseline, six months and twelve months after clinical discharge. The results showed that anxiety (F(2, 62) = 28.10, p < .001, ηp 2 = .48) and depressive symptoms (F(2, 62) = 10.42, p < .001, ηp 2 = .25) decreased over time, whereas meaning in life (F(2, 61) = 44.77, p < .001, ηp 2 = .59) and social support increased (t(63) = -4.54, p < .001, 95% IC[-11.05, 4.29], η2 =.25). Smoking dependence was negatively predicted by change in perceived competence (B = –2.25, p = .011, 95% IC[.02, .60]) and positively by change in depressive symptoms (B =.37, p = .042, 95% IC[1.01, 2.05]) 12 months after clinical discharge. Nicotine dependence (t(17) = 2.76, p = .014, 95% IC[.39, 2.94], η2 =.31) and the number of cigarettes smoked per day (t(17) = 4.48, p < .001, 95% IC[5.49, 15.29], η2 =.54) decreased over time, whereas behavioral dependence increased among smokers (t(17) = -2.37, p = .030, 95% IC[-4.30, 2.54], η2 =.25). This study suggests that long term abstinence in cardiac patients may be enhanced by psychological interventions addressing perceived competence, depressive symptoms and behavioral dependence (AU)

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The nature and dimensions of achievement goals: mastery, evaluation, competition, and self-presentation goals

The present study aimed to clarify the nature and dimensions of achievement goals and to examine structural differences in students' goals across school levels. Participants were 134 students from 5th and 6th grades, and 423 students from 7th to 9th grades. A variety of achievement goals were assessed, including mastery goals and several performance related goals representing three main dimensions: competition, self-presentation, and valence. Two alternative models were tested, using confirmatory factor analysis. For middle-school students a three factor model with presentation, competition, and simple evaluation/mastery goals, was found χ²(132, N = 134) = 160.9, p < .001; CFI = .94; RMSEA = .04, 95%CI [.02 - .06]. In the junior-high sample, one avoidance factor, one competition factor, and a simple evaluation/mastery factor, best fitted the data χ²(114, N = 423) = 269.8638 p < .001; CFI = .93; RMSEA = .06, 95%CI [.05 - .07] thus suggesting that distinct dimensions organize younger and older students' motivation. However, common to both grade levels was the existence of (a) separate but low incidence competition goals, and (b) simple evaluation goals, which encompass neither self-presentation nor competition, and are closely linked to mastery goals. Moreover, significant differences were found in the relative importance attached by students to the different types of goals (p < .001 for all comparisons), both at middle-school F(2, 266) = 220.98; p < .001; η2 = .624) and at junior-high school F(2, 820) = 464.4; p < .001; η2 = .531 (AU)

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Validation of the Glover-Nilsson Smoking Behavioral Questionnaire for the Portuguese population: a psychometric process.

OBJECTIVE: To validate the Portuguese version of the Glover-Nilsson Smoking Behavioral Questionnaire (GNSBQ). METHODS: This manuscript represents 2 studies. In the first, the free-translated Portuguese version of GNSBQ, currently in use, was administered to 124 healthy smokers for Confirmatory Factor Analysis (CFA). In the second, a forward-backward translation was developed to achieve a proper cultural and linguistic adaptation, which allowed creating a new Portuguese version of the GNSBQ. An Exploratory Factor Analysis (EFA) was then performed, including 120 healthy smokers who completed this new version. RESULTS: In the first study, the results from performing a CFA were not acceptable, although the scale was internally consistent. The second study showed that the new Portuguese version of GNSBQ presented reliability and 2 cor-related factors retrieved from the EFA. CONCLUSION: The new Portuguese version of the second study will contribute to an improved assessment of behavioral dependence in that population.

The nature and dimensions of achievement goals: mastery, evaluation, competition, and self-presentation goals.

The present study aimed to clarify the nature and dimensions of achievement goals and to examine structural differences in students' goals across school levels. Participants were 134 students from 5th and 6th grades, and 423 students from 7th to 9th grades. A variety of achievement goals were assessed, including mastery goals and several performance-related goals representing three main dimensions: competition, self-presentation, and valence. Two alternative models were tested, using confirmatory factor analysis. For middle-school students a three factor model with presentation, competition, and simple evaluation/mastery goals, was found χ²(132, N = 134) = 160.9, p < .001; CFI = .94; RMSEA = .04, 95%CI [.02 - .06]. In the junior-high sample, one avoidance factor, one competition factor, and a simple evaluation/mastery factor, best fitted the data χ²(114, N = 423) = 269.8638 p < .001; CFI = .93; RMSEA = .06, 95%CI [.05 - .07] thus suggesting that distinct dimensions organize younger and older students' motivation. However, common to both grade levels was the existence of (a) separate but low incidence competition goals, and (b) simple evaluation goals, which encompass neither self-presentation nor competition, and are closely linked to mastery goals. Moreover, significant differences were found in the relative importance attached by students to the different types of goals (p < .001 for all comparisons), both at middle-school F(2, 266) = 220.98; p < .001; η2 = .624) and at junior-high school F(2, 820) = 464.4; p < .001; η2 = .531.

Attachment and motivational strategies in adolescence: exploring links.

Within the framework of attachment theory and of motivation goal theory, this study explored the relation between quality of attachment strategies and quality of motivational strategies in a sample of young adolescents. Specifically, this study examined patterns of thoughts, behaviors, and emotions as they related to representations of attachment and motivational functioning in situations that challenge or threaten three psychological needs (emotional security, competence, and autonomy). Forty-four students, aged 11 to 14 years, responded to imagined stressful situations in order to: (a) assess attachment strategies; (b) identify and assess students' motivational strategies in stressful classroom circumstances; (c) assess motivational strategies of students with high and low control and agency beliefs; and (d) examine the relations between attachment and motivational strategies. Four distinct action patterns were identified: flexible action, rigid action, passive behavior, and disorganized behavior. Significant relations were found between control beliefs and motivational strategies, as well as a trend toward relations between attachment and motivational strategies, suggesting that secure adolescents show more constructive motivational strategies and less disorganized strategies when compared to insecure adolescents.