Ana Galhardo

The impact of shame and self-judgment on psychopathology in infertile patients.

BACKGROUND Little is known about psychological processes of infertile couples pursuing medical treatment in comparison with fertile couples and adoption candidates who also suffer from infertility but are not seeking medical help. This study aims to contribute to a better understanding of these individuals in terms of psychological processes (such as external shame, internal shame and self-judgment) and their association with psychopathology, also attending to gender differences. METHODS One hundred control couples without known fertility problems [fertile group (FG)], 100 couples with an infertility diagnosis and pursuing medical treatment [infertile group (IG)], and 40 couples with an infertility diagnosis who are applying for adoption [adoption group (AG)] completed the instruments: Beck Depression Inventory, Spielberger State-Trait Anxiety Inventory, Others as Shamer, Experience of Shame Scale and the Self-compassion Scale. One-way analysis of variances were used to compare the three groups demographic and study variables. Pearson correlations and linear multiple regression analysis were performed to investigate the associations between shame, self-judgment, depression and anxiety. To explore gender differences, T-tests were used. RESULTS The IG group scored higher than FG and AG in measures of depression, anxiety, external shame, internal shame and self-judgment. In infertile couples, self-judgment, external shame and internal shame emerged as significant predictors of depressive symptomatology. Women with an infertility diagnosis tend to present higher levels of depressive and anxiety symptoms in comparison with fertile controls and adoption candidates. CONCLUSIONS This study highlights the importance of emotional regulation processes such as internal and external shame, and self-judgment, to the understanding of psychopathological symptomatology associated with infertility. Our results suggest that these issues should be addressed in a therapeutic context with these couples. Nevertheless, the heterogeneity of the infertile group, in what concerns different stages of medical diagnosis and treatment, might represent a limitation in the interpretation of our findings.

The Mediator Role of Emotion Regulation Processes on Infertility-Related Stress

The objective of this study is to investigate gender differences regarding the mediator role of self-compassion and self-judgment on the effects of external shame, internal shame, dyadic adjustment, on infertility-related stress. One hundred and sixty-two women and 147 men with a primary infertility diagnosis completed the following set of self-report measures: Others as Shamer, Experience of Shame Scale, Dyadic Adjustment Scale, Self-Compassion Scale, and Fertility Problem Inventory. Path analyses results revealed that in women self-compassion fully mediated the effect of internal shame on infertility-related stress and partially mediated the effect of dyadic adjustment on this variable, while external shame had only a direct effect. In men self-judgment fully mediated the effect of external and internal shame on infertility-related stress. Dyadic adjustment had only a direct effect on infertility-related stress. In conclusion, there is a distinct role of self-compassion and self-judgment on the relationship between shame and infertility-related stress in men and women. Such differences should be taken into account in psychological interventions with these patients. Future research is warranted to further support our results.

Mindfulness-Based Program for Infertility: efficacy study

OBJECTIVE To present and determine the impact of the Mindfulness-Based Program for Infertility (MBPI). DESIGN Controlled clinical trial. SETTING University research unit. PATIENT(S) Fifty-five infertile women completed the MBPI, and 37 infertile women were assigned to a control group. INTERVENTION(S) The MBPI includes 10 weekly sessions, in a group format, with a duration of about 2 hours each (men attend three sessions). MAIN OUTCOME MEASURE(S) Standardized measures of depression, state anxiety, entrapment, defeat, internal and external shame, experiential avoidance, mindfulness, self-compassion, and infertility self-efficacy were endorsed pre- and post-MBPI. RESULT(S) The MBPI group and the control group were shown to be equivalent at baseline. By the end of the MBPI, women who attended the program revealed a significant decrease in depressive symptoms, internal and external shame, entrapment, and defeat. Inversely, they presented statistically significant improvement in mindfulness skills and self-efficacy to deal with infertility. Women in the control group did not present significant changes in any of the psychological measures, except for a decrease in self-judgment. CONCLUSION(S) Increasing mindfulness and acceptance skills, as well as cognitive decentering from thoughts and feelings, seem to help women to experience negative inner states in new ways, decreasing their entanglement with them and thus their psychological distress. Data suggest that the MBPI is an effective psychological intervention for women experiencing infertility.

Measuring Self-Efficacy to Deal With Infertility: Psychometric Properties and Confirmatory Factor Analysis of the Portuguese Version of the Infertility Self-Efficacy Scale

This study explores the psychometric properties and factor structure of the Portuguese version of the Infertility Self-Efficacy Scale (ISE-P), using translation and back-translation of the original version; principal component analysis; confirmatory factor analysis (CFA); and internal consistency, and test-retest reliability analyses. A total of 287 participants (156 women and 131 men) seeking medical treatment were recruited from public and private fertility centers. CFA revealed that the single-component model fit the data well. The instrument showed excellent internal consistency, good test-retest reliability, and correlations with other mental health measures suggesting good convergent and discriminant validity. In conclusion, The ISE-P is a valid and reliable Portuguese-language measure of perceived self-efficacy to cope with infertility.

Child and adolescent mindfulness measure (CAMM): estudo das características psicométricas da versão portuguesa

The aim of this study is to present the Portuguese version of the Child and Adolescent Mindfulness Measure (CAMM) and examine its factorial structure and psychometric properties in a sample of 410 adolescents with mean age of 15.18 years. Results show that the CAMM is a single-factor self-report measure, presenting an adequate internal consistency (α = .80; CR = .85) and test-retest reliability (r = .46). Negative correlations were found with measures of depression, anxiety and psychological inflexibility. On the other hand, positive correlations were found with measures of social comparison. Even when psychological inflexibility effects (process associated with mindfulness) were controlled, the correlations were still significant. Overall, findings suggest that the CAMM is a reliable and valid measure for the assessment of mindfulness skills in children and adolescents.

Psychological Flexibility and Self-Compassion in Gay and Heterosexual Men: How They Relate to Childhood Memories, Shame, and Depressive Symptoms

ABSTRACT This study explores differences between men who are gay (n = 53) and men who are heterosexual (n = 52) regarding memories of shame events and of warmth and safeness experiences with parents during childhood and adolescence, self-compassion, psychological flexibility, internal shame, and depression. Also, it aims to explore whether psychological flexibility and self-compassion play a role in the association between these memories and internal shame and depressive symptoms. Results confirmed the mediating role of psychological flexibility and self-compassion. These findings suggest the appropriateness of promoting acceptance and self-compassion towards difficult memories in a therapeutic setting with men who are gay experiencing shame and depressive symptoms.

Psychological Adjustment to Lung Cancer: the Role of Self-compassion and Social Support

Introduction The impact of the diagnosis of an oncologic disease is well-known in terms of psychological adjustment and quality of life. On the other hand it is known that depressive symptoms may also overlap the physical symptoms of cancer and cancer treatment, which may interfere in their detection and appropriate treatment approach. Objectives The aim of the current study was to explore the relationship between psychological adjustment to lung cancer, self-compassion, social support and emotional negative states in patients with lung cancer. Method Fifty-five patients diagnosed with lung cancer (38 men and 17 women) with ages ranging from 44 to 87 years old participated in the study. A set of self-report instruments was used: the Mini Mental Adjustment to Cancer Scale (MiniMac), the Self-compassion Scale (SCS; Neff, 2003), the Social Support Satisfaction Scale (SSSS) and the Depression, Anxiety and Stress Scale (DASS-21). Results Significant correlations were found between psychological adjustment and emotion regulation strategies (self-compassion), social support and psychopathology. The predictive model for depressive symptomatology and psychological adjustment (as assessed by the helpless/hopeless dimension) includes mindfulness as a significant predictor. Regarding the predictive model for stress, the satisfaction level with support from friends revealed to be an important element. Conclusions Our findings suggest that these patients may benefit, in their therapeutic approach, from the development of this kind of strategies (new ways of relating themselves with their emotional experiences and quality of their social networks) in order to promote a better psychological adjustment to their clinical condition.

Social Anxiety in Adolescents: the Role of Early Negative Memories and Fear of Compassion

Introduction Social anxiety refers to the discomfort felt in situations of social interaction or performance and may be an especially intense emotion in adolescence due to characteristics and developmental tasks of this age group. Although it is a common emotion and has an adaptive function, it can also develop as a negative experience raising serious difficulties in school and social life of young people. Objectives This study analyses the contribution of childhood negative memories and fear of compassion in social anxiety in adolescence. Method Three hundred and twenty adolescents (186 boys and 134 girls) with ages ranging from 12 to 19 years old took part in the study. Participants completed the following self-report measures: Early Life Experiences Scale for Adolescents, Fear of Compassion Scale (FCS-A) and the Social Anxiety Scale for Adolescents (SAS-A). Results Significant gender differences were found regarding social anxiety, empathy and early unvalued experiences within the family. Age was only correlated with social anxiety. Social anxiety showed a significant and expected correlation with the study variables. The model including fear of compassionate feelings (from other and from oneself) and early unvalued experiences showed to be the best predictor of social anxiety. Conclusions This study integrates the contribution of less explored variables, as the fear of compassion and early negative memories, in the understanding of social anxiety in adolescents. Results suggest that these variables may have an important role and should be incorporated in psychological interventions for social anxiety in adolescence.

Experiential avoidance, self-compassion, self-judgment and coping styles in infertility

OBJECTIVES This study sought out to explore the existence of differences regarding emotion regulation processes (psychological inflexibility/experiential avoidance, self-judgment and self-compassion) and coping styles (emotional/detached, avoidant and rational) in three different groups of couples: 120 fertile couples (FG), 147 couples with an infertility diagnosis who were pursuing medical treatment for their fertility problem(s) (IG), and 59 couples with infertility applying for adoption (AG). STUDY DESIGN Cross-sectional survey, using the couple as unit of analysis. MAIN OUTCOME MEASURES Participants filled in paper-pencil questionnaires assessing coping styles, psychological inflexibility/experiential avoidance, self-judgment and self-compassion. RESULTS IG couples, and particularly women, tend to use more experiential avoidance and self-judgment mechanisms and less emotional/detached coping style. When compared to FG couples, IG and AG couples tend to apply more avoidant coping strategies. AG couples showed higher self-compassion. CONCLUSIONS Findings suggest that emotion regulation processes may be an important target in psychological interventions for patients dealing with infertility and with the demands of medical treatment.

EPA-1703 – Hope and well-being in the elderly

Introduction The concepts of well-being and hope are associated with life satisfaction. Public policies should include the promotion of quality of life in the elderly. Objectives The current study sought out to address the concepts of hope and well-being in the elderly, analysing the role of socio-demographic variables. It also aimed to characterize this population in terms of other quality of life indicators such as perception of general health status, loneliness and degree of activity. Method The sample included 130 elderly people, both from the community and institutionalized, with ages between 65 and 94 years old. Participants answered questions about socio-demographic data, quality of life indicators, cognitive functioning and measures of hope (HP; Snyder et al.; 1991), life satisfaction (SWLS; Diener et al, 1985), and positive and negative affect (PANAS; Watson, Clark, & Tellegen, 1998). Results The majority of participants perceived their health status as reasonable and mentioned feelings of loneliness. Only 20% considered themselves active. Men presented higher levels of hope when compared with women. Participants who were not institutionalized showed higher levels of hope and positive affect, considering themselves more active when compared to the ones living in nursing homes or attending day centres. Hope showed to be positively correlated with life satisfaction, positive affect, health status perception and degree of activity, and negatively correlated with negative affect. Negative affect showed to be correlated with the perception of loneliness. Conclusion This study enhances the importance of socio-demographic and psychological variables in the promotion of well-being in the elderly.