Joana Coutinho

Versão portuguesa da escala de dificuldades de regulação emocional e sua relação com sintomas psicopatológicos

CONTEXTO: As dificuldades de regulacao emocional estao presentes em varios quadros psicopatologicos, sendo necessario o recurso a um instrumento que as possa medir adequadamente. OBJECTIVOS: Fazer a adaptacao para o portugues da Escala de Dificuldades de Regulacao Emocional e analisar as suas qualidades psicometricas. Um segundo objectivo do estudo era o de explorar a associacao entre as dimensoes da DERS e sintomas psicopatologicos especificos. METODO: A escala original foi traduzida para o portugues e preenchida por uma amostra de 324 sujeitos que tambem preencheram o Inventario Breve de Sintomas. RESULTADOS: Os resultados revelam uma estrutura factorial muito semelhante a da versao original, bons valores de estabilidade temporal, de consistencia interna (Cronbachs α = ,93) e bons niveis de validade externa com o BSI. A analise realizada com o subgrupo de 115 sujeitos que compuseram a amostra clinica revelou que os individuos com psicopatologia apresentam mais dificuldades de regulacao emocional do que os individuos normais. Por meio da analise de correlacao entre as diferentes subescalas da DERS e do BSI, verificamos que as subescalas Estrategias e Objectivos apresentam o valor mais elevado de associacao com todos os sintomas psicopatologicos. DISCUSSAO: Esses resultados sugerem que essas duas dimensoes sao transversais as varias perturbacoes psicopatologicas e poderiam, por isso, ser incluidas em intervencoes psicologicas focadas na capacidade de regulacao emocional.CONTEXTO: As dificuldades de regulacao emocional estao presentes em varios quadros psicopatologicos, sendo necessario o recurso a um instrumento que as possa medir adequadamente. OBJECTIVOS: Fazer a adaptacao para o portugues da Escala de Dificuldades de Regulacao Emocional e analisar as suas qualidades psicometricas. Um segundo objectivo do estudo era o de explorar a associacao entre as dimensoes da DERS e sintomas psicopatologicos especificos. METODO: A escala original foi traduzida para o portugues e preenchida por uma amostra de 324 sujeitos que tambem preencheram o Inventario Breve de Sintomas. RESULTADOS: Os resultados revelam uma estrutura factorial muito semelhante a da versao original, bons valores de estabilidade temporal, de consistencia interna (Cronbachs α = ,93) e bons niveis de validade externa com o BSI. A analise realizada com o subgrupo de 115 sujeitos que compuseram a amostra clinica revelou que os individuos com psicopatologia apresentam mais dificuldades de regulacao emocional do que os individuos normais. Por meio da analise de correlacao entre as diferentes subescalas da DERS e do BSI, verificamos que as subescalas Estrategias e Objectivos apresentam o valor mais elevado de associacao com todos os sintomas psicopatologicos. DISCUSSAO: Esses resultados sugerem que essas duas dimensoes sao transversais as varias perturbacoes psicopatologicas e poderiam, por isso, ser incluidas em intervencoes psicologicas focadas na capacidade de regulacao emocional.

The Big Five default brain: functional evidence

Recent neuroimaging studies have provided evidence that different dimensions of human personality may be associated with specific structural neuroanatomic correlates. Identifying brain correlates of a situation-independent personality structure would require evidence of a stable default mode of brain functioning. In this study, we investigated the correlates of the Big Five personality dimensions (Extraversion, Neuroticism, Openness/Intellect, Agreeableness, and Conscientiousness) and the default mode network (DMN). Forty-nine healthy adults completed the NEO-Five Factor. The results showed that the Extraversion (E) and Agreeableness (A) were positively correlated with activity in the midline core of the DMN, whereas Neuroticism (N), Openness (O), and Conscientiousness (C) were correlated with the parietal cortex system. Activity of the anterior cingulate cortex was positively associated with A and negatively with C. Regions of the parietal lobe were differentially associated with each personality dimension. The present study not only confirms previous functional correlates regarding the Big Five personality dimensions, but it also expands our knowledge showing the association between different personality dimensions and specific patterns of brain activation at rest.

Default mode network dissociation in depressive and anxiety states

The resting state brain networks, particularly the Default Mode Network (DMN), have been found to be altered in several psychopathological conditions such as depression and anxiety. In this study we hypothesized that cortical areas of the DMN, particularly the anterior regions - medial prefrontal cortex and anterior cingulate cortex - would show an increased functional connectivity associated with both anxiety and depression. Twenty-four healthy participants were assessed using Hamilton Depression and Anxiety Rating Scales and completed a resting-state functional magnetic resonance imaging scan. Multiple regression was performed in order to identify which areas of the DMN were associated with anxiety and depression scores. We found that the functional connectivity of the anterior portions of DMN, involved in self-referential and emotional processes, was positively correlated with anxiety and depression scores, whereas posterior areas of the DMN, involved in episodic memory and perceptual processing were negatively correlated with anxiety and depression scores. The dissociation between anterior and posterior cortical midline regions, raises the possibility of a functional specialization within the DMN in terms of self-referential tasks and contributes to the understanding of the cognitive and affective alterations in depressive and anxiety states.

Neurosciences, empathy, and healthy interpersonal relationships: recent findings and implications for counseling psychology.

In this article, we define the construct of empathy and its relevance for counseling psychology. The importance of deficits in empathic processes for most of the psychological disorders is presented within the context of the social brain hypothesis (Frith, 2007). We provide a review of empirical research about the neural correlates of empathy in terms of both the central and peripheral nervous system. We present recent evidence on the cortical and subcortical regions involved in different dimensions of empathy-emotional contagion, cognitive and emotional empathy, and self-regulation. Regarding the autonomic correlates of empathy, we present evidence about the correlates of sympathetic arousal associated with empathic processes and review data supporting the idea of the physiological linkage or synchrony as indicator of empathy in interpersonal relationships. The implications of these findings for counseling psychology, particularly for the psychotherapist-client relationship and for context of intimate relationships or couples therapy, are discussed.

Comparing Two Methods of Identifying Alliance Rupture Events

This study compared two methods of detecting ruptures in therapy sessions, a procedure based on a self-report measure, the Working Alliance Inventory (WAI), and an observational Rupture Resolution Rating System (3RS). We anticipated that the 3RS would detect more ruptures than the WAI. We examined the longitudinal data of 38 patient-therapist dyads in a cognitive-behavioral therapy condition. The sample included cases that did not complete treatment (dropped cases) as well as good-outcome and poor-outcome cases. At the end of each session, patients completed the WAI self-report questionnaire. Six judges were trained to observe and detect the occurrence of ruptures, and then rated 201 videotaped sessions. Longitudinal statistical models were applied to the data retrieved from the WAI questionnaires completed by patients. We found discrepancies in the ability of the two methods to detect rupture events with the observational 3RS detecting more ruptures than the WAI. Thus, the use of observational systems for the detection of alliance ruptures is crucial for effectively assessing the quality of the therapeutic alliance over the course of treatment. Furthermore, observational systems proven to detect ruptures can be used to improve clinical practice and training of new clinicians.

Brain correlates of pro-social personality traits: a voxel-based morphometry study

Of the five personality dimensions described by the Big Five Personality Model (Costa and McCrae 1992), Extraversion and Agreeableness are the traits most commonly associated with a pro-social orientation. In this study we tested whether a pro-social orientation, as expressed in terms of Extraversion and Agreeableness, is associated with a specific grey matter phenotype. Fifty-two healthy participants underwent magnetic resonance imaging (MRI) and completed the NEO-Five Factor Inventory (NEO-FFI), a self-report measure of the Big Five personality traits. Voxel-based morphometry (VBM) was used to investigate the correlation between brain structure and the personality traits of Agreeableness and Extraversion. We found that Extraversion was negatively correlated with grey matter density in the middle frontal and orbitofrontal gyri while Agreeableness was negatively correlated with grey matter density in the inferior parietal, middle occipital and posterior cingulate gyri. No positive correlations were found. These results suggest that pro-social personality traits seem to be associated with decreases in grey matter density in more frontal regions for Extraversion, and more posterior regions for Agreeableness.

Volumetric Alterations in the Nucleus Accumbens and Caudate Nucleus in Bulimia Nervosa: A Structural Magnetic Resonance Imaging Study

OBJECTIVE Bulimia nervosa (BN) is an eating disorder characterized by recurrent episodes of binge eating and inappropriate compensatory behaviors (such as purging, fasting, or excessive exercise) to prevent weight gain. BN has been associated with deficits in inhibitory control processes. The basal ganglia specifically, the nucleus accumbens (NAc) and the caudate nucleus (CN) are part of the frontostriatal circuits involved in inhibitory control. The main goal of this study was to investigate the presence of morphological alterations in the NAc and the CN in a sample of patients diagnosed with BN. METHOD Forty-one female participants, 21 diagnosed with BN and 20 healthy matched controls (HC), underwent a structural magnetic resonance imaging (MRI) acquisition and clinical assessment. The NAc and the CN were manually segmented using the software Slicer 3D. RESULTS The results reveal a significant volumetric decrease in the CN and a preserved NAc volume in BN compared to the control group. DISCUSSION These findings suggest a contributory role of the caudate nucleus part of the dorsal striatum in the psychopathology of BN.

Differential activation of the default mode network in jet lagged individuals

Long-term exposure to transmeridian flights has been shown to impact cognitive functioning. Nevertheless, the immediate effects of jet lag in the activation of specific brain networks have not been investigated. We analyzed the impact of short-term jet lag on the activation of the default mode network (DMN). A group of individuals who were on a transmeridian flight and a control group went through a functional magnetic resonance imaging acquisition. Statistical analysis was performed to test for differences in the DMN activation between groups. Participants from the jet lag group presented decreased activation in the anterior nodes of the DMN, specifically in bilateral medial prefrontal and anterior cingulate cortex. No areas of increased activation were observed for the jet lag group. These results may be suggestive of a negative impact of jet lag on important cognitive functions such as introspection, emotional regulation and decision making in a few days after individuals arrive at their destination.

The development of therapeutic collaboration in a good outcome case of person-centered therapy

This paper explores the development of therapeutic collaboration in Person-Centered Therapy (PCT). It presents a good outcome case – “Mary” – selected from York I Depression Study, treated with PCT. The study examined how therapist and client worked together throughout the therapy, using the Therapeutic Collaboration Coding System (TCCS). The TCCS assumes that effective therapeutic collaboration occurs within the client’s therapeutic zone of proximal development (TZPD), defined as the distance between the actual and the potential client’s developmental level. It consists of a transcript-based method by which therapist’s interventions and client’s responses are analyzed on a moment-to moment basis. Two independent trained judges coded 15 sessions of this case, using the TCCS. Results showed that the therapeutic dyad worked most of the time within the client’s TZPD, thus suggesting a collaborative pattern throughout the therapy process. In addition, the results showed that the client proactively interacted with the therapist, moving forward in her TZPD.

Alterations of the default mode network connectivity in obsessive-compulsive personality disorder: a pilot study

Obsessive-compulsive personality (OCPD) disorder is characterized by a pattern of excessive self-control, perfectionism and behavioral and cognitive rigidity. Despite the fact that OCPD is the most common personality disorder in the general population, published studies looking at the brain correlates of this disorder are practically nonexistent. The main goal of this study was to analyze the presence of brain alterations in OCPD when compared to healthy controls, specifically at the level of the Default Mode Network (DMN). The DMN is a well-established resting state network which was found to be associated with psychological processes that may play a key role in OCPD (e.g., self-awareness, episodic future thinking and mental simulation). Ten individuals diagnosed with OCPD and ten healthy controls underwent a clinical assessment interview and a resting-state functional magnetic resonance imaging (fMRI) acquisition. The results show that OCPD patients presented an increased functional connectivity in the precuneus (i.e., a posterior node of the DMN), known to be involved in the retrieval manipulation of past events in order to solve current problems and develop plans for the future. These results suggest that this key node of the DMN may play an important role in the pathophysiology of OCPD.