Sérgio Carvalho

Forms of self-criticising/attacking & self-reassuring scale: psychometric properties and normative study

BACKGROUND The Forms of Self-Criticising/Attacking & Self-Reassuring Scale (FSCRS, Gilbert, Clarke, Hempel, Miles, & Irons, 2004, Br. J. Clin. Psychology, 43, 31) is a self-report instrument that measures self-criticism and self-reassurance. It has shown good reliability and has been used in several different studies and in a range of different populations. The aim of this study was to explore its psychometric proprieties in a large clinical and non-clinical sample, to establish its reliability. In addition, to our knowledge, this is the first study to provide normative data to FSCRS. Differences in population scores will also be addressed. METHOD Data were collated from 12 different studies, resulting in 887 non-clinical participants and 167 mixed diagnosis patients who completed the FSCRS. RESULTS A confirmatory factor analysis shows that both in non-clinical and clinical samples, the three-factor model of FSCRS is a well-adjusted measure for assessing the two forms of self-criticism and a form of self-reassurance. Normative data for the scale are presented. Comparing the two populations, the non-clinical was more self-reassuring and less self-critical than the clinical one. Comparing genders, in the non-clinical population men were more self-reassuring and less self-critical than women. No significant gender differences were found in the clinical population. CONCLUSIONS Taken together, results corroborate previous findings about the link between self-criticism and clinical population, which stresses the need to both assess and address it in therapy. Results also confirm that FSCRS is a robust and reliable instrument, which now can aid clinicians and researchers to have a better understanding of the results, taking into account the norms presented. PRACTITIONER POINTS Practical implications The normative study of the FSCRS facilitates a better understanding of clinical and research results; The paper accounts for large clinical and non-clinical populations, which contribute to robust findings; Cautions Cultural and age differences should be carefully addressed; Generalizations to different psychopathologies deserve attention, as the clinical population considered here derived mainly from depressed participants.

Memories of Shame Experiences with Others and Depression Symptoms: The Mediating Role of Experiential Avoidance

BACKGROUND Shame experiences have been suggested to be related with psychopathological symptoms and with self-relevant beliefs. Recent studies also suggest that avoidant-focused strategies (e.g., rumination, thought suppression and dissociation) mediate the impact of shame memories and depression symptoms. However, experiential avoidance has been found to mediate the relation between early experience of abuse and psychopathological symptoms. Our goal was to test the mediating effect of experiential avoidance in the relation between both the nature of shame experiences at the hands of caregivers and the centrality of shame memories with others, and depression symptoms. METHOD Using structural equation modelling, we assessed the frequency and nature of recalled shame experiences at the hands of caregivers, the centrality of shame experiences with others throughout childhood and adolescence, experiential avoidance and depression symptomatology in 161 participants from general population. RESULTS Experiential avoidance mediates the impact of shame experiences with caregivers and depression symptoms. Experiential avoidance also mediated the association between the centrality of shame experiences with others and depression symptoms. CONCLUSION Our results suggest that shame memories with others do not per se impact on depression symptoms, but rather the unwillingness to experience them and the attempts to control them. Hence, our results emphasize the importance of addressing affect regulation processes such as avoidance when dealing with shame memories, particularly with patients who experience depression symptoms. KEY PRACTITIONER MESSAGE The recall of shame experiences with caregivers is associated with the experience of depression symptoms, even when these experiences are not perceived as central points to ones life identity and story. This seems to suggest a necessity to explore these experiences in a therapeutic setting. Our findings suggest that experiential avoidance is a key process through which these memories of shame experiences impact on depression symptomatology. Hence, it seems to be of great importance to reduce experiential avoidance and help people change the way they relate with these memories.

Body-Image Acceptance and Action Questionnaire: Its deleterious influence on binge eating and psychometric validation

Background/Objectives: This study aimed to explore the psychometric properties of BI-AAQ (Body-Image Acceptance and Action Questionnaire) and the body image psychological flexibility role as a mediator in a pervasive path towards binge eating in Brazilian samples. Method: This cross-sectional study was conducted in clinical (overweight or obese women currently in treatment for weight loss; n= 330) and non-clinical (general population; n= 682) groups of women. Results: BI-AAQ has one-factor structure, excellent internal consistency, ability to detect differences between groups and measurement invariance across samples. It was also negatively associated with self-compassion and positively associated with binge eating severity, drive for thinness and self-criticism. Conclusions: This study provides data confirming the robust psychometric properties of BI-AAQ in qualitatively different samples. Furthermore, an additional study conducted in a clinical sample of women with overweight or obesity revealed that body image psychological inflexibility has emerged as a partial and significant mediator of the effect of self-criticism and drive for thinness on binge eating severity.

Finding the link between internalized weight-stigma and binge eating behaviors in Portuguese adult women with overweight and obesity: The mediator role of self-criticism and self-reassurance

Please cite this article as: Lara Palmeira, José Pinto-Gouveia, Marina Cunha, Sérgio Carvalho , Finding the link between internalized weight-stigma and binge eating behaviors in Portuguese adult women with overweight and obesity: The mediator role of selfcriticism and self-reassurance. The address for the corresponding author was captured as affiliation for all authors. Please check if appropriate. Eatbeh(2017), doi: 10.1016/ j.eatbeh.2017.01.006

Incorporating psychoeducation, mindfulness and self-compassion in a new programme for binge eating (BEfree): Exploring processes of change

This study explores the efficacy of BEfree, a 12-session group intervention that integrates psychoeducation, mindfulness, compassion and value-based action, in a sample of overweight and obese women with binge eating disorder (N = 31). We used repeated measures analyses of variance and explored processes of change in binge eating and eating psychopathology. At post-intervention, participants decreased in binge eating severity, eating psychopathology, external shame, self-criticism, psychological inflexibility, body image cognitive fusion and increased self-compassion and engagement with valued actions. These results were maintained at 3- and 6-month follow-up. The changes in binge eating were mediated by the changes in the psychological processes promoted by BEfree.

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.

BEfree: A new psychological program for binge eating that integrates psychoeducation, mindfulness, and compassion

Background Binge eating disorder (BED) is associated with several psychological and medical problems, such as obesity. Approximately 30% of individuals seeking weight loss treatments present binge eating symptomatology. Moreover, current treatments for BED lack efficacy at follow‐up assessments. Developing mindfulness and self‐compassion seem to be beneficial in treating BED, although there is still room for improvement, which may include integrating these different but complimentary approaches. BEfree is the first program integrating psychoeducation‐, mindfulness‐, and compassion‐based components for treating women with binge eating and obesity. Objective To test the acceptability and efficacy up to 6‐month postintervention of a psychological program based on psychoeducation, mindfulness, and self‐compassion for obese or overweight women with BED. Design A controlled longitudinal design was followed in order to compare results between BEfree (n = 19) and waiting list group (WL; n = 17) from preintervention to postintervention. Results from BEfree were compared from preintervention to 3‐ and 6‐month follow‐up. Results BEfree was effective in eliminating BED; in diminishing eating psychopathology, depression, shame and self‐criticism, body‐image psychological inflexibility, and body‐image cognitive fusion; and in improving obesity‐related quality of life and self‐compassion when compared to a WL control group. Results were maintained at 3‐ and 6‐month follow‐up. Finally, participants rated BEfree helpful for dealing with impulses and negative internal experiences. Conclusions These results seem to suggest the efficacy of BEfree and the benefit of integrating different components such as psychoeducation, mindfulness, and self‐compassion when treating BED in obese or overweight women. Key Practitioner Message The current study provides evidence of the acceptability of a psychoeducation, mindfulness, and compassion program for binge eating in obesity (BEfree); Developing mindfulness and self‐compassionate skills is an effective way of diminishing binge eating, eating psychopathology and depression, and increasing quality of life in women with obesity; Integrating psychoeducation, mindfulness, and compassion seem to be effective in diminishing binge eating, with results maintained up to 6‐month postintervention.

Self-Criticism and Depressive Symptoms Mediate the Relationship Between Emotional Experiences With Family and Peers and Self-Injury in Adolescence

ABSTRACT Although the relationship between negative childhood experiences, peer victimization, depressive symptoms, and Non-Suicidal Self-Injury (NSSI) is widely recognized, the mechanisms involved are not fully understood, especially among adolescents. This study aims to test the mediating role of both self-criticism and depressive symptoms in the relationship between memories of negative or positive experiences, current peer victimization, and NSSI. The sample consists 854 Portuguese adolescents, 451 female and 403 male, with ages between 12 and 18 years (M = 14.89; SD = 1.79), from middle and secondary schools. Participants answered self-report measures. Results from path analysis showed that memories of negative experiences, the absence of positive memories with family in childhood and peer victimization indirectly impact on NSSI through self-criticism and depressive symptoms. In addition, these stressful experiences led to depressive symptoms through self-criticism. Lastly, the most severe form of self-criticism indirectly impacts on NSSI through depressive symptoms, even though it also has a strong direct effect. It suggests that negative experiences with parents and peer victimization, as well as the absence of positive memories with family, have a negative impact on NSSI when these experiences are linked with a sense of self-hatred and depressive symptoms.

Psychological distress, burnout and personality traits in Dutch anaesthesiologists

fentanyl patch for several weeks prior to her death. In this sense at least, the patient was not opioid nontolerant. Second, although we agree that the individual variation of tolerance is substantial, we were also quite surprised that a nonopioid-naı̈ve patient could commit suicide with her standard patch. This may be an effect of the quicker rate of increase in blood concentration by oral ingestion, rather than the absolute concentration. And third, given that chronic pain itself is an independent risk factor for suicide, withholding pain therapy in acute episodes of any sort is probably not a good idea and an aggressive multimodal approach – as emphasised by Ruan and colleagues – is warranted.

Mindfulness, selfcompassion, and depressive symptoms in chronic pain: The role of pain acceptance: CARVALHO et al.

OBJECTIVE(S) The aim of this study was to test a theory driven model in which pain acceptance (both pain willingness [PW] and activity engagement [AE]) mediates the relationships of mindfulness and selfcompassion with depressive symptoms, while controlling for pain intensity. METHODS A path analysis was conducted using AMOS software to test a meditational model in a sample of women with chronic musculoskeletal pain (N = 231). RESULTS Participants with higher levels of mindful awareness and selfcompassion presented lower levels of pain intensity and depressive symptoms, and higher levels of AE. PW did not significantly correlate with any variable in study. The mediation analysis showed that AE mediated the relationship between selfcompassion and depressive symptoms, independently from pain intensity. CONCLUSIONS These findings seem to corroborate the hypothesis that selfcompassion is rooted in a motivational system, as it seems to correlate with less depressive symptoms through increasing the engagement with valued actions despite experiencing pain.