HEPPI: a randomized controlled trial of the efficacy of a cognitive-emotional intervention for homebound older adults.

OBJECTIVES: This randomized controlled trial aimed to assess the efficacy of the Homebound Elderly People Psychotherapeutic Intervention (HEPPI), a home-delivered cognitive-emotional intervention, among the homebound older population presenting with mild cognitive impairment and depressive or anxiety symptoms. METHODS: Participants were randomly assigned either to the intervention group or the treatment-as-usual group and completed baseline, post-intervention, and three-month follow-up assessments. Changes in episodic memory and symptoms of depression and anxiety were the primary outcomes. Secondary outcomes included changes in global cognition, attentional control, subjective memory complaints, functional status, and quality of life. Data were analyzed on an intention-to-treat basis employing a linear mixed models approach. ClinicalTrials.gov identifier: NCT05499767. RESULTS: Compared with the treatment-as-usual group, the HEPPI group reported significant immediate improvement in cognition, mood, and daily functional performance. Positive effects of HEPPI were maintained over the follow-up phase only in depressive symptomatology, perceived incapacity to perform advanced instrumental activities of daily living, and self-reported emotional ability. A significant impact of the intervention on the subjective memory complaints level was observed only three months after the intervention. CONCLUSIONS: This study suggests that HEPPI may be a promising home-delivered cognitive-emotional intervention to help homebound older adults improve their mental health.

Homebound Elderly People Psychotherapeutic Intervention (HEPPI): study protocol for a randomized controlled trial / Intervenção psicoterapêutica com adultos idosos confinados no domicílio: protocolo para um ensaio clínico randomizado controlado

Objective: To present the study protocol for the Homebound Elderly People Psychotherapeutic Intervention (HEPPI), a home-delivered cognitive-emotional intervention aimed at homebound older adults with mild cognitive impairment and depression and/or anxiety symptoms. Methods: A two-arm, open-label, parallel-group randomized controlled trial will be conducted to compare the effects of HEPPI with treatment as usual. Homebound older adults will be recruited from the community through contact with their health care networks in mainland Portugal. All participants will complete baseline, post-intervention, and 3-month follow-up assessments. Primary outcomes will be changes in episodic memory and depression and anxiety symptoms. Secondary outcomes will include changes in general cognition, attentional control, subjective memory complaints, quality of life, functional status, and loneliness. Relevance: The availability of evidence-based home-delivered non-pharmacological interventions meeting the cognitive and emotional needs of the homebound older population could improve their access to mental health care resources and increase their mental health and quality of life.

Objetivo: Apresentar o protocolo do estudo da Homebound Elderly People Psychotherapeutic Intervention (HEPPI), uma intervenção cognitivo-emocional, realizada no domicílio, dirigida a adultos idosos confinados no domicílio com declínio cognitivo leve e sintomatologia depressiva e/ou ansiógena. Métodos: Será realizado um ensaio clínico randomizado, controlado e aberto, com o objetivo de comparar os efeitos da intervenção HEPPI com um grupo de tratamento usual. Os idosos confinados no domicílio serão recrutados na comunidade, em Portugal continental, por meio de contato com sua rede de prestação de cuidados de saúde. Todos os participantes serão avaliados em três momentos: pré-intervenção, pós-intervenção e três meses depois da intervenção. As alterações na memória episódica e na sintomatologia depressiva e ansiógena serão os desfechos primários, já os secundários serão constituídos pelas alterações no funcionamento cognitivo geral, controle atencional, queixas subjetivas de memória, qualidade de vida, capacidade funcional e solidão. Relevância: A disponibilidade de intervenções não farmacológicas em domicílio com evidência empírica, que atendam às necessidades cognitivas e emocionais dos adultos idosos confinados no domicílio, poderá facilitar o seu acesso a recursos de saúde mental, bem como melhorar sua saúde mental e qualidade de vida.

Effectiveness of Mindfulness-Based Relapse Prevention in Individuals with Substance Use Disorders: A Systematic Review.

OBJECTIVES: This systematic review aimed to understand the current state of the art about the effectiveness of mindfulness-based relapse prevention (MBRP) on individuals with substance use disorders (SUD), taking into account not only SUD variables (e.g., cravings, frequency of use) but also other relevant clinical variables (e.g., anxiety and depressive symptoms, quality of life). METHODS: A comprehensive search of electronic databases was conducted to identify studies that investigate MBRP interventions on individuals with SUD. Studies that met the inclusion criteria were synthesized and assessed using systematic review methods. RESULTS: Thirteen studies were included in the present review. The methodological quality of the included studies was moderately strong. Nine studies (69.2%) used the traditional 16 h MBRP program. Six studies (46.1%) chose to use a co-intervention treatment ranging from the treatment as usual (TAU) to cognitive behavioral therapy. All but one study indicated that their interventions produced positive effects on at least one addiction outcome measure. None of the interventions were evaluated across different settings or populations. CONCLUSIONS: Despite some heterogeneity regarding the type of MBRP program used, results support the effectiveness of these interventions in the SUD population, especially in reducing cravings, decreasing the frequency of use, and improving depressive symptoms.

Análise das qualidades psicométricas da versão portuguesa do Inventário de Avaliação da Espontaneidade (SAI-R) / Analysis of the psychometric qualities of the portuguese version of the Spontaneity Assessment Inventory (SAI-R) / Análisis de las cualidades psicométricas de la versión portuguesa del Inventario de Evaluación de la Espontaneidad (SAI-R)

A espontaneidade e as suas ligações à saúde mental e ao bem-estar são uma componente central quer na teoria quer na prática do psicodrama, e a literatura especializada associa a presença de patologia à falta de espontaneidade. Neste artigo, elencam-se alguns dos resultados obtidos em estudos em língua inglesa do SAI-R e apresentam-se os estudos da sua validação para a população portuguesa. Na validação do SAI-R para o contexto português, foi confirmada a estrutura fatorial com 719 sujeitos, distribuídos em duas amostras independentes. Os participantes tinham idades entre os 18 e os 69 anos. Por fim, foram testadas a fiabilidade compósita e a validade convergente, bem como a validade do tipo critério em duas amostras independentes (n 1ªamostra =348 e n 2ªamostra =371). Apesar de serem necessários mais estudos com populações clínicas, o SAI-R apresenta-se como um instrumento curto e válido para aplicar em contextos clínicos e não clínicos quando se pretende avaliar a espontaneidade (AU).

Spontaneity and its connections to mental health and wellbeing are a central theme in both the theory and practice of psychodrama, and the specialized literature sometimes even associates the presence of pathology with a lack of spontaneity. In this article, we list some of the results obtained in studies with the English-language version of the spontaneity scale and present its validation studies for the Portuguese population. We verified a factorial structure with 719 subjects, divided into two independent samples in the validation of the SAI-R for the Portuguese context. Participants had an age range of 18 to 69 years old. Furthermore, composite reliability, convergent validity, and cross validity were tested in two other independent samples (n sample1 =348 and n sample2 =371). Although further studies with clinical samples are needed, the SAI-R presents itself as a short and valid instrument to apply in clinical and non-clinical settings when assessing spontaneity (AU).

La espontaneidad y sus vínculos con la salud mental y el bienestar son una componente central tanto en la teoría como en la práctica del psicodrama, y la literatura especializada asocia la presencia de patología con la falta de espontaneidad. En este artículo se enumeran resultados obtenidos con la versión inglesa del SAI-R y se presentan estudios para su aplicación en la población portuguesa. En la validación del SAI-R para el contexto portugués, se confirmó la estructura factorial con 719 sujetos, distribuidos en dos muestras independientes. Los participantes tenían entre 18 y 69 años. Finalmente, se probaron la confiabilidad compuesta y la validez convergente, así como la validez cruzada en las dos muestras independientes (n muestra 1 = 348 y n muestra2 = 371). Aunque son necesarios más estudios con poblaciones clínicas, el SAI-R se presenta como un instrumento breve y válido para ser aplicado en contextos clínicos y no clínicos en la evaluación de la espontaneidad (AU).

NEO-FFI: Psychometric properties of a short personality inventory in Portuguese context / NEO-FFI: Propriedades psicométricas de um inventário reduzido de personalidade no contexto português

The aim of this study was to assess the psychometric properties (validity and reliability) of the Portuguese adaptation of the NEO Five-Factor Inventory (NEO-FFI) and to compare the obtained structure to the original North American version. The methods of analysis used for cross-validation of the factorial structure were the Principal Axis Factoring (PAF) and the Confirmatory Factor Analysis (CFA). PAF reproduced the original structure of NEO-FFI and CFA revealed a satisfactory fit of single-factor models for the five dimensions. The reliability analysis showed high values of internal consistency which are congruent with previous international adaptations of the NEO-FFI. Multidimensional analysis showed significant main effects of gender and academic qualifications on personality using age as covariant. The findings suggest that the Portuguese version of the NEO-FFI is a reliable instrument to measure the five dimensions of personality. (AU)

O objetivo deste estudo foi avaliar as propriedades psicométricas (validade e fidelidade) da adaptação portuguesa do NEO-FFI e comparar a estrutura obtida com a versão original americana. Como métodos para a validação cruzada da estrutura fatorial foram usados a Análise Fatorial de Eixos Principais (PAF) e uma Análise Fatorial Confirmatória (CFA). A PAF reproduziu a estrutura original do NEO-FFI e a CFA revelou modelos uni-factoriais de ajustamento satisfatório para cada uma das cinco dimensões. A análise de fidelidade revelou elevados valores de consistência interna, congruentes com as adaptações prévias internacionais do NEO-FFI. A análise multidimensional revelou efeitos principais significativos do género e das qualificações académicas na personalidade, usando a idade como co-variante. Os resultados sugerem que a versão portuguesa do NEO-FFI é um instrumento fiável para medir as cinco dimensões da personalidade. (AU)