How do early affiliative memories explain body image shame? A 12-month longitudinal study in adolescent girls.

OBJECTIVE: This study aimed to explain adolescent girls' body image shame across a 12- month longitudinal design, and its relationship with early parental memories of warmth and safeness and fear of receiving compassion from others. DESIGN AND METHODS: Participants included 231 adolescent girls, who completed self-report measures at three different periods: baseline (W1), 6-month follow-up (W2), and 12-month follow-up (W3). Descriptive and correlational analyses were performed, and differences between participants at the different waves were explored through repeated measures ANOVA. A cross-lagged panel model tested the mediational effect of fears of receiving compassion on the association between early affiliative memories (W1) and body image shame (W3). RESULTS: ANOVA results found significant differences throughout time in memories of warmth and safeness (tending to diminish) and in body image shame (tending to rise). Correlation analysis revealed that all variables were significantly associated in the expected directions, across the three waves. Finally, path analysis revealed that early affiliative parental memories (in W1) had a direct effect on body image shame (in W3), through the fear of receiving compassion from others (in W2), accounting for 85% of body image shame's variance (W3). CONCLUSIONS: These findings indicate that the lack of early affiliative memories often leads to the development of defensive mechanisms such as fears of receiving compassion from others which in turn can foster isolation and distant relationships, enhancing feelings of inferiority and inadequacy, which in female adolescents can emerge centered on body image - body image shame. This study further highlights the importance of prevention and intervention strategies based on compassion to specifically target fears of receiving compassion from others, in adolescent girls dealing with feelings of inferiority and shame regarding their body.

Factors Associated with Prospective Acceptability and Preferences for Unified Transdiagnostic Cognitive-Behavioral Treatments and Group Therapy in the Portuguese General Population.

Group transdiagnostic cognitive-behavioral therapy (CBT) offers a promising solution for limited mental health access in Portugal. Understanding barriers to patient adherence is crucial for successful implementation. This study aimed to characterize the prospective acceptability and preferences for unified transdiagnostic CBT and group therapy in the Portuguese general population and explore their correlates. A sample of 243 participants (18-88 years old), recruited online, completed an online survey collecting information on sociodemographic and clinical characteristics, acceptability of transdiagnostic CBT treatments, specifically of Unified Protocol (UP), acceptability of group therapy, therapeutic format preferences, beliefs about group therapy and help-seeking attitudes. Most participants were receptive to and perceived as useful both unified transdiagnostic CBT and group therapy. Overall, participants presented significantly more favorable attitudes than unfavorable attitudes toward unified transdiagnostic CBT and group therapy (p < .001). Multivariate analyses revealed that (1) favorable attitudes toward transdiagnostic treatments were negatively associated with being employed and positively associated with living in an urban area, and higher efficacy scores; (2) unfavorable attitudes toward transdiagnostic treatments were positively associated with being married/cohabitating and negatively associated with vulnerability scores; (3) being female, living in an urban area, and higher efficacy and myth scores emerged as positive predictors of favorable attitudes toward group therapy; and (4) efficacy and vulnerability scores and help-seeking propensity emerged as negative predictors of unfavorable attitudes toward group therapy. These findings highlight the importance of delineating strategies to increase knowledge and acceptance of unified transdiagnostic CBT and group therapy in the Portuguese population, addressing specific individual characteristics.

The Associations Between Physician-Patient Communication and Adjustment Outcomes of Patients and Physicians: A Systematic Review and Meta-Analysis of Correlations.

Physician-Patient communication (PPC) has been linked to patient adjustment outcomes. However, conflicting results have been reported and previous systematic reviews showed some methodological weaknesses. It has also been suggested that PPC is related to physicians' own adjustment outcomes. This systematic review aims to explore and synthesize the associations between PPC and both patient and physician adjustment outcomes. A systematic search was conducted primarily in five databases and 11.488 non-duplicated articles were identified. Forty-five studies met the eligibility criteria and data extraction was performed for sample characteristics, PPC measurement, adjustment outcomes under examination and main outcomes. The observed results showed that the majority of the included studies were cross-sectional, assessed PPC by proxy-report and reported an overall positive association with patients' adjustment outcomes. None of the studies examined the association between PPC and physicians' adjustment outcomes. Thirty-three studies were meta-analyzed and showed a positive and significant association between PPC and patients' adjustment outcomes (r = .16). Due to the small number of studies included in the meta-analysis, the heterogeneity was high. Subgroup analysis could not identify sources for heterogeneity. Research on the associations between PPC and physicians' own adjustment outcomes is warranted. Future studies should be rigorous in defining clear PPC definitions, directionality of communication processes, and study design.

A blended psychological intervention for postpartum depression: acceptability and preferences in women presenting depressive symptoms.

OBJECTIVES: To evaluate the acceptability of and preferences for a blended psychological intervention (combining face-to-face sessions and web-based interventions) for the treatment of postpartum depression among Portuguese women presenting depressive symptoms and to explore the factors associated with its acceptability. BACKGROUND: Despite its high prevalence and the existence of effective treatment, still few women seek professional help for postpartum depression, demanding for new treatment formats, such as blended interventions. METHODS: Women (n = 235) presenting postpartum depressive symptoms (EPDS>9) completed an internet survey assessing sociodemographic and clinical information, depressive symptoms, e-health literacy and the acceptability of and preferences for a blended intervention for postpartum depression. RESULTS: Most of the participants considered a blended intervention for postpartum depression to be useful and would be available to use it. Women reported significantly more advantages than disadvantages in regard to this treatment format. Married women, employed, with younger babies and with less severe depressive symptoms had a higher likelihood of finding a blended intervention useful. Higher educational levels increased the likelihood of being available to obtain a blended treatment. Most participants preferred an equal distribution of content across face-to-face and online sessions. Approximately one-third of the sample preferred a 75% face-to-face/ 25% online proportion. Most of the women preferred a duration of 45-60 minutes for face-to-face sessions and 30-45 minutes for online sessions. CONCLUSION: Our findings support and inform the development of blended psychological treatments for postpartum depression, according to women's preferences, and highlight the prioritisation of this format according to women's characteristics.

Affiliative interactions and body and eating-related difficulties in adolescent girls: The effects of fears of compassion and feelings of social safeness.

The need to examine the associations between emotion regulation and mental health and well-being among adolescents is increasingly recognized. Adolescence is a critical time characterized by increased vulnerability towards emotional struggles and difficulties, especially related with body image and eating behaviours. Thus, it seems particularly important to analyse the processes and mechanisms underlying the relationships between several risk factors (such as the lack of early affiliative memories) and body and eating-related difficulties, in this specific developmental phase. The current study intended to examine whether early affiliative memories are significantly associated with body and eating-related difficulties (i.e., body image shame and eating psychopathology severity), and whether this association is mediated by lower feelings of social safeness and increased levels of fears of receiving compassion from others. This cross-sectional study was conducted with 231 adolescent girls from the community, aged between 12 and 18, who completed self-report measures. Data were examined through descriptive and correlational statistics, and the adequacy of the model was performed via path analysis. Path analysis results revealed that fears of receiving compassion from others and low feelings of social safeness mediated the relationship between early affiliative memories and body and eating-related difficulties. The path model accounted for the variances in the following way: 27% of feelings of social safeness; 23% of fears of receiving compassion from others; 28% of body-image shame; and 54% of eating psychopathology severity, revealing a very good fit. These findings emphasize the relevance of assessing and working on potential processes underlying the adoption of disordered body and eating attitudes and behaviours, not only but especially in female adolescents with scarce recall of early affiliative experiences with close ones.

Profiles of women with postpartum depressive symptoms: A latent profile analysis using the Edinburgh Postnatal Depression Scale factors.

OBJECTIVES: To examine the multidimensionality of symptoms assessed with the Edinburgh Postnatal Depression Scale (EPDS) and to identify and characterize the profiles of women with Postpartum Depression (PPD) symptoms. METHODS: A sample of 487 Portuguese postpartum women with clinically relevant depressive symptoms participated in this cross-sectional online study. Confirmatory factor analysis was conducted to analyze the factor structure of the EPDS. A latent profile analysis based on the EPDS factors was conducted. Differences in sociodemographic characteristics and risk factors between profiles were explored. RESULTS: Three EPDS factors were confirmed: depression, anxiety, and anhedonia. Based on these dimensions, three profiles with different symptom severities were found: mild anxious-depressive symptoms; severe PPD symptoms; and moderate anxious-depressive symptoms. CONCLUSION: Identifying profiles of women with PPD symptoms according to the EPDS factors allows to understand the distinct paths of development of PPD and can inform the development of tailored interventions.

Quality of Life of Children and Adolescents with Short Stature: The Twofold Contribution of Physical Growth and Adaptive Height-Related Cognitive Beliefs.

This study aimed to examine the health-related quality of life (HrQoL), coping, height-related beliefs, and social support of children/adolescents with short stature, the sociodemographic, clinical, and psychosocial variables associated with HrQoL, and the moderating role of sociodemographic and clinical variables on the associations between psychosocial variables and HrQoL. 114 Portuguese children/adolescents with short stature, aged 8-18 years old, completed the Quality of Life in Short Stature Youth questionnaire and the Satisfaction with Social Support Scale. Regression analyses explained 54% of the variance of HrQoL, with significant main effects of current height deviation and height-related beliefs, and a significant interaction effect between beliefs and diagnosis. Results suggest that a multidisciplinary therapeutic approach, not only focused on hormone treatment to boost physical growth, but also including psychosocial interventions focused on the modification of height-related beliefs, may contribute to improve the HrQoL of pediatric patients with short stature.

The powerful effect of body image inflexibility on the explanation of eating psychopathology severity.

PURPOSE: Feelings of shame and social comparison focused on physical appearance have been identified as important risk factors for the engagement in disordered eating behaviours. Further, recent studies have emphasized the role of body-image psychological (in)flexibility in the association between several risk factors and eating psychopathology. The current study intended to explore, in two different path models, the effects of external shame, physical appearance-related social comparison, and body image inflexibility on the explanation of eating psychopathology severity. METHODS: This study follows a cross-sectional design and was conducted in a sample of 776 emerging-adult women, aged between 18 and 28, who completed an online battery of self-report measures. Path analyses were conducted using a structural equation modeling. RESULTS: Model 1's results showed that external shame and unfavourable social comparison based on physical appearance directly accounts for 26% of the variance in disordered eating. In turn, when body image inflexibility is introduced as a mediator in the relationship presented in Model 1, variance in disordered eating increases to 60% (Model 2). These results suggest that both external shame and unfavourable physical appearance-related social comparison have an impact on disordered eating behaviours. However, when body image inflexibility is introduced, the mentioned relationships change and reveal that psychological inflexibility is a significant mediator of these associations. CONCLUSION: These findings seem to demonstrate that body image inflexibility is a key process for the engagement in disordered eating, so the promotion of psychological flexibility focused on one's body is crucial for the prevention and treatment of disordered eating behaviours and attitudes. LEVEL OF EVIDENCE: Level IV: Cross-sectional study.

Self-compassion and mindful parenting among postpartum mothers during the COVID-19 pandemic: The role of depressive and anxious symptoms.

Self-compassion is an important psychological skill that may facilitate the adoption of a mindful way of parenting, especially during the COVID-19 pandemic. However, the association between these constructs may be explained by several variables, such as maternal psychopathological symptoms, with a well-established interference in parenting. This study aimed to compare mothers who experienced and mothers who did not experience a negative emotional impact of the COVID-19 pandemic on self-compassion, mindful parenting, postpartum depressive symptoms (PPDS) and postpartum anxious symptoms (PPAS). We also explored whether mothers' self-compassion was associated with mindful parenting and whether this relationship may be mediated by PPDS and PPAS. A sample of 977 Portuguese mothers of infants aged between zero and six months completed an online survey between December 2020 and January 2021, a period of major pandemic-related restrictions. The survey included several self-report questionnaires that assessed sociodemographic, clinical, and COVID-19 information, self-compassion, mindful parenting, PPDS and PPAS. Mothers who reported having felt that the pandemic had a negative emotional impact during their postpartum period (79.5%) presented lower levels of self-compassion and mindful parenting, and higher levels of PPDS and PPAS. Regarding the mediation model, higher levels of self-compassion were related to higher levels of mindful parenting, and this association was mediated by lower levels of PPAS. These results highlight the relevance of mothers' self-compassion for helping them feel less anxious and to adopt a mindful way of parenting in the postpartum period, particularly during the pandemic. Compassion-based interventions may be particularly important in reducing PPAS and promoting mindful parenting and should be available to postpartum mothers, especially during, but also beyond the pandemic.

The relationship between dyadic coping and dyadic adjustment among HIV-serodiscordant couples.

Living within an HIV-serodiscordant relationship has been recognized as a stressful experience for both HIV-infected and HIV-uninfected partners. However, no study has examined the association between dyadic coping (DC) and dyadic adjustment of such couples. In this study, we analysed the association between DC (positive, negative, and common DC) and dyadic adjustment (consensus, satisfaction, cohesion) among HIV-serodiscordant couples, considering individual and cross-partner effects. This cross-sectional study included a sample of 44 HIV-serodiscordant different-sex couples, in a relationship for an average of 16.46 years. The self-reported measures included the Dyadic Coping Inventory and the Revised Dyadic Adjustment Scale. For HIV-infected partners, their own common DC was significantly associated with cohesion, and a cross-partner effect of common DC on satisfaction was found. For HIV-uninfected partners, individual effects of common DC on all dyadic adjustment subscales and a cross-partner effect of common DC on cohesion were found. Additionally, their own and their HIV-infected partners' negative DC were significantly associated with cohesion and satisfaction, respectively. These findings suggest that the perception of common DC has a particularly important role in explaining the different components of dyadic adjustment of both partners facing HIV-serodiscordancy, whereas negative DC is linked to the adjustment of HIV-uninfected partners.

The Children's Revised Impact of Event Scale: Dimensionality and Measurement Invariance in a Sample of Children and Adolescents Exposed to Wildfires.

Natural disasters are potentially traumatic events due to their disruptive nature and high impact on social and physical environments, particularly for children and adolescents. The present study aimed to examine the psychometric properties of the Children's Revised Impact of Event Scale (CRIES-13) in a sample of Portuguese children and adolescents exposed to a specific type of natural disaster (i.e., wildfire). The sample was recruited at six school units of the Central region of Portugal following wildfires in the summer of 2017 and included children and adolescents without a clinical diagnosis of a psychopathological condition associated with exposure to the traumatic event (i.e., nonclinical sample, n = 486) and those with a clinical diagnosis of a trauma- and/or stress-related disorder (i.e., posttraumatic stress disorder [PTSD], adjustment disorder, separation anxiety disorder, or grief; clinical sample, n = 54). Confirmatory factor analyses indicated that a two-factor model (i.e., Intrusion/Arousal and Avoidance) provided a better fit than a three-factor model (i.e., Intrusion, Arousal, and Avoidance) and was found to be invariant across gender and age groups. The CRIES-13 showed good reliability for all subscales, with Cronbach's αs > .79. Higher CRIES-13 scores were associated with poorer health and well-being and more internalizing and externalizing problems. The clinical sample presented with significantly higher CRIES-13 scores than the nonclinical sample, ηp 2 = .13. These results contribute to the cross-cultural validation of the CRIES-13 and support its use as a reliable and valid measure for assessing posttraumatic symptoms in children and adolescents.

How psychological inflexibility mediates the association between general feelings of shame with body image-related shame and eating psychopathology severity?

Adolescence is considered a transitional stage characterized by several physical, psychological and social changes. During this period, there is an increased propensity for the emergence of emotional difficulties, especially those related to body image and eating attitudes and behaviours. In particular, shame has been pointed out as a key risk factor for body image and eating-related difficulties. However, research seems to be scarce regarding this association in adolescent samples. Therefore, the current study aimed to explore whether psychological inflexibility impacts the association between general feelings of shame with body image-related shame and eating psychopathology severity. The study was conducted with 226 adolescent girls from the community, aged between 12 and 18, who completed self-report measures. Path analysis indicated that higher levels of external shame were associated with more externalized and internalized body image shame and also with greater engagement in disordered eating behaviours. Furthermore, the model demonstrated that these relationships were mediated by increased levels of psychological inflexibility. The tested model accounted for a total of 30% and 22% of externalized and internalized body image variances, respectively, and 51% of the variance of disordered eating behaviours. These findings appear to suggest that in adolescent girls, body shame and disordered eating may emerge as defensive and maladaptive strategies to cope with general feelings of inferiority, particularly in the presence of psychological inflexibility. Also, this study highlights the importance of assessing and working underlying maladaptive processes in this association, mainly in adolescents with high levels of shame.

Mothers' psychopathology symptoms and mindful parenting in the postpartum period: The role of parental reflective functioning.

Postpartum psychopathology has an adverse impact on parenting behaviors and, consequently, on the mother-infant relationship. This study aimed to explore whether the relationship between maternal anxiety and depression symptomatology in the postpartum period and the ability of mothers to adopt a mindful parenting approach is indirect and can be explained by parental reflective functioning. Two hundred ninety five Portuguese mothers of infants aged up to 12 months completed self-report measures assessing anxiety/depression symptoms, mindful parenting, and parental reflective functioning. Mothers who reported clinically significant anxious and/or depressive symptomatology levels (21%) showed lower levels of mindful parenting and of certainty about the mental states as well as higher levels of prementalizing modes of mental states than mothers with normal symptomatology levels. An indirect effect of depressive symptomatology on mindful parenting through the two dimensions of parental reflective functioning and a direct effect of anxious symptomatology on mindful parenting were found. The results suggest that parental reflective functioning is an important explanatory mechanism of the relationship between depressive symptomatology and mindful parenting, as well as that anxious symptomatology is directly associated with mindful parenting. This study suggests that reducing anxious and depressive symptoms in the postpartum period can promote reflective and mindful parenting skills.

La sicopatología posterior al parto tiene un impacto adverso sobre las conductas de crianza y, consecuentemente, sobre la relación madre-infante. Este estudio se propuso explorar si la sintomatología materna de ansiedad/depresión en el período posterior al parto se asocia con la más débil habilidad de la madre para adoptar un acercamiento consciente a la crianza y si esta relación es indirecta y la explica el funcionamiento reflexivo del progenitor. Doscientas noventa y cinco madres portuguesas de infantes de edad hasta los 12 meses completaron medidas de auto reporte para evaluar los síntomas de ansiedad/depresión, la crianza consciente, así como el funcionamiento reflexivo del progenitor. El 21% de las madres reportaron niveles de sintomatología de ansiedad y/o depresión clínicamente significativos. Estas madres mostraron niveles más débiles de una crianza consciente y de certeza acerca de los estados mentales y niveles más fuertes de modos mentales de mentalización previa que las madres con niveles normales de sintomatología. Encontramos un efecto indirecto de sintomatología depresiva sobre la crianza consciente a través de dos dimensiones del funcionamiento reflexivo del progenitor y un efecto directo de sintomatología de ansiedad sobre la crianza consciente. Los resultados sugieren que el funcionamiento reflexivo del progenitor es un mecanismo importante de explicación de la relación entre la sintomatología depresiva y la crianza consciente, como también la sintomatología de la ansiedad está directamente asociada con la crianza consciente. Este estudio sugiere que reducir los síntomas de ansiedad y depresión en el período posterior al parto puede promover las habilidades de una crianza reflexiva y consciente.

La psychopathologie postpartum a un impact négatif sur les comportements de parentage et par conséquent sur la relation mère-bébé. Cette étude s'est donnée pour but d'explorer si la symptomatologie anxiété/dépression maternelle durant la période postpartum est liée à une moindre capacité des mères à adopter une approche attentive au parentage et si cette relation est indirecte et expliquée par le fonctionnement parental de réflexion. 295 mères portugaises de bébés âgés de 0 à 12 mois ont rempli des mesures d'auto-évaluations évaluant les symptômes d'anxiété/dépression, le parentage attentif, et le fonctionnement parental de réflexion. 21% des mères ont fait état de niveaux cliniquement élevés de symptomatologie anxieuse et/ou dépressive. Ces mères ont fait preuve de niveaux moins élevés de parentage attentif et de certitude sur les états mentaux et de niveaux plus élevés de mode de pré-mentalisation que les mères avec des niveaux normaux de symptomatologie. Un effet indirect de symptomatologie dépressive sur le parentage attentif à travers deux dimensions de fonctionnement de réflexion maternelle et un effet direct de symptomatologie anxieuse sur le parentage attentif ont été trouvés. Les résultats suggèrent que le fonctionnement de réflexion parentage est un mécanisme important d'explication de la relation entre la symptomatologie dépressive et le parentage attentif. Ils suggèrent également que la symptomatologie anxieuse est directement liée au parentage attentif. Cette étude suggère que la réduction des symptômes anxieux et dépressifs durant la période post-partum peut promouvoir des capacités de parentage de réflexion et d'attention.

Ineffective Pregnancy Prevention During Adolescence: Assisting Healthcare Providers in Portugal With Individualized Risk Assessment.

In this study, we describe the relative contributions of and interactions between individual risk factors associated with ineffective pregnancy prevention among female adolescents in Portugal. Our sample consisted of 856 sexually experienced female adolescents (10-19 years) who did not intend to become pregnant. Of these, 379 were pregnant, and the residual (477) had never been pregnant. We used classification tree analysis to describe the interplay among a set of established sociodemographic, familial, reproductive, and relationship factors as predictors of ineffective pregnancy prevention. The tree model showed good predictive properties. Seven profiles predicted one-half to all the cases of ineffective pregnancy prevention. Ineffective pregnancy prevention was predicted by adolescents' grade level and different combinations of variables, specifically female age, age at the time of first sexual intercourse, religious beliefs, place of residence, maternal pregnancy before age 20, household structure in childhood, and partner's age difference. According to our findings, limiting assessments to the cumulative presence of risk factors may be insufficient to accurately identify adolescents at elevated risk of unwanted pregnancy, as the impact of any given risk factor may vary according to other factors. Our findings may contribute to the development of a risk assessment tool that may support healthcare providers' efforts to provide individualized risk assessment for adolescent patients and, thus, to better support pregnancy prevention.

Postpartum Depression in the Portuguese Population: The Role of Knowledge, Attitudes and Help-Seeking Propensity in Intention to Recommend Professional Help-Seeking.

Professional help-seeking for postpartum depression is very uncommon, despite its adverse effects. However, women's support network can have an important role in the professional help-seeking behaviour. This study aimed to characterize the intentions to recommend professional help-seeking for postpartum depression in the Portuguese population, as well as to analyse its determinants. A cross-sectional internet survey including 621 people of general population was conducted. Participants reported a high intention to recommend professional help-seeking for postpartum depression. Greater knowledge about postpartum depression, lower stigma and high perceived utility of mental health help-seeking were associated with high intention to recommend professional help-seeking for PPD, both directly and indirectly, through less negative attitudes towards postpartum depression and higher help-seeking propensity. Education campaigns are needed to increase knowledge and to promote positive attitudes towards postpartum depression in the general population. Moreover, the results highlight the importance of implementing strategies aimed at reducing the stigma associated to help-seeking, of increasing the perception of utility of mental health services and of including the women's support network in perinatal care to facilitate their help-seeking process.

Psychometric Properties of the Portuguese Version of the Child Post-traumatic Cognitions Inventory in a Sample of Children and Adolescents Following a Wildfire Disaster.

This study aimed to examine the psychometric properties of the Child Post-Traumatic Cognitions Inventory (CPTCI) in a sample of Portuguese children and adolescents, following the exposition to a wildfire disaster. The sample included 533 children and adolescents living in regions exposed to the wildfire disaster (non-clinical sample: n = 483; clinical sample: n = 50). The short form of the instrument (CPTCI-SF) including two correlated factors ('Sense of Disturbing and Permanent Change' and 'Sense of Being a Fragile Person in a Scary World') showed good model fit and was invariant across gender and age-groups. Good internal consistency (> .70) was found, and higher CPTCI scores were associated with poorer adjustment indicators. The clinical sample presented significantly higher CPTCI scores than the non-clinical sample. These results contribute to the cross-cultural validation of the CPTCI and support the adequacy of its short form as a reliable and valid measure to be used with Portuguese children and adolescents.

Sociodemographic, sexual, and reproductive variables associated with pregnancy among adolescents from low socioeconomic background.

Adolescent pregnancy remains a public health concern in both developed and developing countries. Portugal and Brazil represent some of the best examples of this phenomenon. The present study aimed to identify sociodemographic, sexual, and reproductive health-related variables associated with adolescent pregnancy among students from low socioeconomic backgrounds in both countries. The sample included 984 female adolescents, among whom 215 became pregnant. Living with a partner and lack of information about sex and contraception from the family were the best explicative factors for pregnancy occurrence in both countries. Country-specific variables were also identified. Our results may contribute to developing global preventive interventions, addressing the school as an ideal setting for primary intervention and considering culture-specific characteristics of high-risk populations.

Cognitive correlates of women's postpartum depression risk and symptoms: the contribution of dysfunctional beliefs and negative thoughts.

Background: Despite the extensive research on interpersonal and clinical risk factors for postpartum depression (PPD), there is a paucity of research on the potential role of cognitive variables (dysfunctional beliefs and negative thoughts) as correlates of PPD symptoms.Aims: This exploratory study aimed to understand the cognitive processes of women at a higher risk (i.e. presenting well-established interpersonal and clinical risk factors) for PPD by: (a) comparing women's dysfunctional motherhood-related beliefs and frequency of automatic thoughts, as a function of their levels of PPD risk and symptoms; (b) examining the cognitive correlates of PPD symptoms, controlling for the presence of well-established risk factors.Method: A cross-sectional internet survey comprising 441 postpartum women was conducted.Results: Women presenting high-risk for PPD showed more dysfunctional motherhood-related attitudes (p < 0.001), more frequent negative thoughts (p < 0.001) and less frequent positive thoughts (p < 0.001) than low-risk women. More dysfunctional beliefs related to maternal responsibility, more frequent negative thoughts related with personal maladjustment and with the metacognitive appraisal of the thoughts' content, and less frequent positive thoughts were found to be significantly associated with PPD symptoms.Conclusion: The inclusion of cognitive variables in risk assessment and preventive efforts for PPD may hold potential to increase its clinical efficacy.

Do 8- to 18-year-old children/adolescents with chronic physical health conditions have worse health-related quality of life than their healthy peers? a meta-analysis of studies using the KIDSCREEN questionnaires.

PURPOSE: This meta-analytic review aimed to estimate the magnitude of health-related quality of life (HrQoL) impairments, as assessed by the KIDSCREEN questionnaires, both self- and parent-reported, in 8- to 18-years-old children/adolescents with chronic health conditions. METHODS: To identify studies using the KIDSCREEN questionnaires, three electronic databases (PubMed, PsycINFO, EBSCOhost Psychology & Behavioral Sciences) were searched. The final search (February 14-15, 2018) revealed 528 non-duplicated articles, of which 23 papers (21 studies) directly compared the HrQoL of pediatric patients to community/healthy controls and were included in the meta-analysis. Pooled mean differences (MD) with 95% CIs were estimated using the inverse-variance random-effects method. RESULTS: Of the 21 studies, 16 used self-reports, one used parent-reports and four adopted a multi-informant approach. Self-reported data were retrieved from 20 studies (4852 cases/28,578 controls), and parent-reported data were retrieved from four studies (511 cases/433 controls). Pediatric patients presented significant HrQoL impairments in the domains of physical well-being (MD = - 4.84, 95% CI - 6.44/- 3.24 for self-reports; MD = - 6.86, 95% CI - 10.42/- 3.29 for parent-reports) and peers and social support (MD = - 1.29, 95% CI - 2.25/- 0.34 for self-reports; MD = - 3.90, 95% CI - 5.28/- 2.52 for parent-reports), compared to community/healthy peers. Between-studies heterogeneity was explained by diagnostic categories, instrument version and informants. CONCLUSIONS: The identification of significant HrQoL impairments among pediatric patients, specifically in the physical and social domains, highlights the importance of routine psychosocial assessment and intervention in primary pediatric healthcare services. Specific recommendations include the use of profile measures, both self- and parent-reports, and the prioritization of oncology, endocrinology and neurology services.

Psychometric properties of the European Portuguese version of the Perceived Risk of HIV Scale in the general population and HIV-uninfected partners from sero-different couples.

BACKGROUND: Perceived risk of HIV plays an important role in the adoption of protective behaviours and HIV testing. However, few studies have used multiple-item measures to assess this construct. The Perceived Risk of HIV Scale (PRHS) is an 8-item measure that assesses how people think and feel about their risk of HIV infection. This cross-sectional study aimed to assess the psychometric properties (reliability and validity) of the European Portuguese version of the PRHS, including the ability of this scale to discriminate between individuals from the general population and HIV-uninfected partners from sero-different couples on their perceived risk of HIV infection (known-groups validity). METHODS: This study included 917 individuals from the general population (sample 1) to assess the psychometric properties of the PRHS. To assess the known-groups validity, the sample comprised 445 participants from the general population who were in an intimate relationship (sub-set of sample 1) and 42 HIV-uninfected partners from sero-different couples (sample 2). All participants filled out a set of questionnaires, which included a self-reported questionnaire on sociodemographic information, sexual behaviours, HIV testing and the PRHS. Sample 1 also completed the HIV Knowledge Questionnaire - 18-item version. RESULTS: The original unidimensional structure was reproduced both in exploratory and confirmatory factor analyses, and the PRHS demonstrated good reliability (α = .78; composite reliability = .82). The differential item functioning analyses indicated that the items of the PRHS, in general, did not function differently for men and women or according to HIV testing. Significant associations with sexual risk behaviours and HIV testing provided evidence for criterion validity. The known-groups validity was supported. CONCLUSIONS: The PRHS is a suitable scale in the evaluation of the perceived risk of HIV, and its psychometric characteristics validate its use in the Portuguese population. Furthermore, the present study suggests that interventions improving individuals' HIV risk perceptions may be important since they were associated with different sexual behaviours and the likelihood of HIV testing.