Marina Prista Guerra

Cognitive processing of emotions in anorexia nervosa

OBJECTIVE This study attempts to explore the cognitive processing of emotions in anorexia nervosa (AN), based on the study of emotions felt and the assessment of meta-emotional abilities. METHOD Eighty patients with AN and a control group of 80 healthy female participants were screened for anxiety, depression and alexithymia and completed an experimental task designed to analyse the emotional experience and meta-emotional abilities. RESULTS Despite presenting higher levels of alexithymia, participants with AN demonstrated they were able to imagine emotions in hypothetical situations and to identify and label them. The group of patients with AN revealed feeling more intense and internally based negative emotions in comparison with the control group, but this emotional pattern tends to occur in situations associated with food and weight. CONCLUSIONS Findings on meta-emotional abilities suggested no global deficit in emotional processing, but rather, specific sensitivities pertaining to situations relevant to AN.

Relação entre Sintomatologia Psicopatológica, Adesão ao Tratamento e Qualidade de Vida na Infecção HIV e AIDS

The study shows evidence of statistical association among psychopathological symptoms (BSI), treatment adherence (CEAT-VIH) and quality of life (WHOQOL-Bref) in 125 HIV-positive/AIDS patients followed at Porto Hospital (Portugal). The psychopathological symptoms present a negative correlation with treatment adherence and quality of life. On the other hand, adherence was positively correlated with quality of life. The model of adherence to the antiretroviral treatment using multiple regression analysis includes absence of psychopathological symptoms, an adherence behavior (i.e. to get the medication at the hospitals pharmacy) and the experience of side effects because of medication (R2 = 0.30). Besides, psychopathological symptoms have a mediation effect between adherence and quality of life in people with HIV/AIDS.

Alexithymia in anorexia nervosa: The mediating role of depression

The role of depression in the expression of alexithymia in anorexia nervosa (AN) has been controversially explained and several variables that may mask or increase the presence of emotional difficulties have scant examination in previous studies. This study aims to analyze the associations between alexithymia and state variables, such as age, BMI, illness duration, treatment duration, and medication status in AN participants, and to test the mediating role of depression in emotional difficulties. The Toronto Alexithymia Scale (TAS-20) and the Zung Self-Rating Depression Scale were administrated to 160 females: 80 participants with AN and 80 healthy controls. High levels of alexithymia were not a function of state variables. The mediating role of depression differed by the alexithymia dimension, with total mediation found for the TAS-DDF and partial mediation found for the TAS-DIF. Alexithymia is a relevant feature throughout the spectrum of AN and does not seem to be related to developmental maturation and some clinical features. Depression is probably the variable that best accounts for the variance in alexithymia, but is not a complete explanation for the known cognitive-affective disturbances in AN. Specific emotional competencies require scrutiny during psychiatric treatment.

The Psychological Adjustment of Children with Asthma: Study of Associated Variables

As part of a larger research project aimed to understand the impact of asthma in the psychological adjustment of children, this study focuses in the identification of factors associated with this process. The sample of this study consisted of 89 children, aged 8 to 12 with physician diagnosed asthma. To assess childrens adjustment, the Portuguese versions of the following instruments were used: School-age Temperament Inventory (McClowry, 1995) Schoolagers Coping Strategies Inventory (Ryan-Wenger, 1990); Pediatric Quality of Life Inventory - PedsQL (Varni, Seid & Kurtin, 2001); The Self-perception Profile for Children (Harter, 1985), Child Behavior Checklist (Achenbach, 1991); Social Skills Rating System (Gresham & Elliot, 1990). The results revealed that negative reactivity predicts the level of anxiety/depression, task persistence and perceived coping efficacy predicts social skills and that self-esteem is a significant predictor of the perceived quality of life. A significant proportion of shared variance was also found what seems to confirm the existence of multi-determination in the process of adjustment. The main conclusion is that two dimensions of temperament (negative reactivity and task persistence), as well as perceived coping efficacy and self-esteem, play a significant role in influencing the psychological adjustment of children with asthma.

Maternal Coping Strategies in Response to a Child’s Chronic and Oncological Disease: a Cross-Cultural Study in Italy and Portugal

A child’s oncological or chronic disease is a stressful situation for parents. This stress may make it difficult for appropriate management strategies aimed at promoting the child’s wellbeing and helping him or her cope with a disease to be adopted. In particular, this study focuses on the possible connections between the variable national cultural influences and the parental strategies used to cope with a child’s severe disease by comparing the experiences of Italian and Portuguese mothers. The study investigates differences and cross-cultural elements among the coping strategies used by Italian and Portuguese mothers of children with oncological or chronic disease. Two groups of mothers took part: 59 Italian mothers (average age 37.7 years; SD=4.5) and 36 Portuguese mothers (average age 39.3 years; SD=4.6). The tool used was the Italian and the Portuguese versions of the COPE inventory that measures five coping strategies: Social Support, Avoidance Coping, Positive Aptitude, Religious Faith and Humor, Active Coping. There were statistically significant differences between Portuguese and Italian mothers regarding Social Support (F(3, 94)=6.32, P=0.014, ɳ2=0.065), Religious Faith and Humor (F(3, 94)=20.06, P=0.001, ɳ2=0.18, higher values for Portuguese mothers) and Avoidance Coping (F(3, 94)=3.30, P=0.06, ɳ2=0.035, higher values for Italian mothers). Regarding child’s disease, the only statistically significant difference was in Religious Faith and Humor (F(3, 94)=7.49, P=0.007, ɳ2=0.076, higher values for mothers of children with chronic disease). The findings of specific cultural transversalities provide the basis for reflection on important factors emerging on the relationship between physicians and parents. In fact, mothers’ coping abilities may allow health workers involved in a child’s care not only to understand how parents face a distressful event, but also to provide them with professional support.

Prevalência da alexitimia na anorexia nervosa e sua associação com variáveis clínicas e sociodemográficas

objective: To analyze the prevalence of alexithymia in anorexia nervosa and its relationship with clinical and sociodemographic variables, such as, body mass index, anorexia nervosa duration, age, years of education and socioeconomic status. Methods: Two groups of female participants, between the ages of 13 and 34 years, were recruited. One group was composed of 80 participants with anorexia nervosa (AN Group) and the other consisted of 80 healthy participants (Control Group). The Portuguese version of the Toronto Alexithymia Scale – 20 items – was applied to both groups. results: The prevalence of alexithymia in the AN Group was 62.5% and 12.5% in the Control Group. The mean values of alexithymia (total score and factors) did

Treatment adherence and subjective well-being in HIV/AIDS infection

The aim of this study was to analyze the relationship between treatment adherence and subjective well-being (positive and negative affects and satisfaction with life) in HIV/AIDS infection. The empirical study was conducted at two Portuguese hospitals (Porto and Lisbon) with a sample of 197 outpatients diagnosed with HIV/AIDS attending the Infectology service and on antiretroviral medication, during a 6-month period (February–July 2009). All patients were asked for voluntary fulfillment of the questionnaire which recorded information on different socio-demographic variables. Clinical records were inspected in order to collect additional clinical information from the patients. The “Questionnaire to Assess Adherence to Antiretroviral Treatment-HIV” was used in order to assess the adherence degree in Portuguese version of Reis et al. The Portuguese versions of “Positive and Negative Affect Schedule” (PANAS) and the “Satisfaction with Life Scale” were used to measure subjective well-being. The study collected evidence on the positive correlation between therapeutic adherence (assessed by CEAT-VIH) and positive affect, as well as between adherence and satisfaction with life. Differences in therapeutic adherence and positive affect according to some clinical variables were also found. The multiplicity and the interaction of several determinants are being considered in the adjustment process during treatment for HIV/AIDS. The results may have implications for the psychological intervention directed at improving adherence to antiretroviral therapy.

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.

Life Satisfaction in Women With Breast Cancer1

It is well known that breast cancer carries many psychosocial consequences. For a deeper understanding of this topic, this study aims to analyze the relationship between life satisfaction, meaning in life, optimism, body image and depression in 55 women with breast cancer, organized into two groups: mastectomized and submitted to conservative surgery. The variables were characterized based on the results from the Auto-Actualizacao-SentidoVida [Self-Actualization-Life Meaning] sub-scale, the Escala de Otimismo [Optimism scale], the Body Image Scale, the Hospital Anxiety and Depression Scale and the Escala de Satisfacao com a Vida [Life satisfaction scale]. Meaning in life and optimism were positively correlated with life satisfaction. Higher depression and body image disturbance appeared associated with lower life satisfaction. Body image disturbance was higher in mastectomized women. It was concluded that women submitted to conservative surgery do not have more life satisfaction than mastectomized women, requiring equal attention in terms of preventing depression and promoting positive variables.Sabe-se que o cancro da mama acarreta consequencias psicossociais. Para aprofundar esta problematica este estudo teve como objetivo analisar a relacao entre satisfacao com a vida, sentido de vida, otimismo, imagem corporal e depressao em 55 mulheres com cancro da mama, organizadas em dois grupos: mastectomizadas e tumorectomizadas. Essas variaveis foram caracterizadas com base nos resultados da subescala Auto-Actualizacao-SentidoVida, da Escala de Otimismo, da Body Image Scale, da Hospital Anxiety and Depression Scale e da Escala de Satisfacao com a Vida. Sentido de vida e otimismo correlacionaram-se positivamente com satisfacao com a vida. Maiores indices depressivos e disturbio na imagem corporal apareceram associados a menor satisfacao com a vida. O disturbio na imagem corporal foi superior em mulheres mastectomizadas. Concluiu-se que as mulheres tumorectomizadas nao estao mais satisfeitas com a vida do que as mastectomizadas, necessitando de igual atencao em termos de prevencao da depressao e promocao de variaveis positivas.

The Epidemic of Anorexia Nervosa: Myth or Reality?

Anorexia nervosa (AN) is an eating disorder (ED) characterized by a severe weight loss due to inadequate food intake, and has associated significant medical and psychological sequelae (Bulik et al. 2005; Torres & Guerra, 2007). Despite the fact that AN was only recognized as a mental disorder during the 20th century, there are a great number of studies about this disease. A mixture of curiosity and concern justifies this attention given by both researchers and the community at large.