Emotion Regulation in Dementia Caregiving: The Role of Neuropsychiatric Symptoms and Attachment Orientation.

Family caregivers are usually the main source of support for persons living with dementia, being exposed to a loved one's suffering, which can lead to experiencing strong and negative emotions. This study aimed to identify factors capable of explaining individual differences in the way caregivers regulate their emotions. This cross-sectional study included 78 informal caregivers (M = 64.84 years; SD = 13.32) and 84 controls (non-caregivers) (M = 77 years; SD = 7.59). Neuropsychiatric symptoms (NPS), attachment orientations, and emotion regulation were measured using self-report scales. Caregivers of persons living with dementia used more expressive suppression in comparison to non-caregivers. NPS and attachment avoidance were associated with expressive suppression. Moderation analyses showed that NPS only predicted expressive suppression when attachment avoidance was low or medium. The present study showed that caregivers are more likely to suppress their emotions in the presence of NPS, especially those with lower/middle levels of attachment avoidance. Psychological interventions targeting emotion regulation should be offered especially to caregivers that face NPS of persons living with dementia and present lower/middle levels of attachment avoidance.

Emotion regulation and mental health among professionals of long-term care institutions for older adults: the mediating role of work engagement.

BACKGROUND: This study examined whether work engagement mediated the association between emotion regulation and mental health of professionals working in long-term care institutions for older adults in Brazil. PARTICIPANTS AND PROCEDURE: A cross-sectional study with a total of 104 professionals working in 13 long-term care facilities for the elderly in Brazil was conducted. Emotion regulation (expressive suppression and cognitive reappraisal), work engagement (vigor, dedication, and absorption), and mental health (depression, anxiety, and stress) were measured using self-report scales. Multiple mediation models were used to test the mediating role of engagement. RESULTS: Expressive suppression was associated with more vigor, which in turn was associated with less anxiety and stress; cognitive reappraisal was associated with more vigor, which in turn was associated with less anxiety and stress. No indirect effects were found for depression. CONCLUSIONS: Expressive suppression and cognitive reappraisal strategies to regulate emotions seem to be associated with more vigor in terms of resilience and persistence to deal with work demands in these professionals. These results seem to suggest that workers who are more capable of regulating their emotions (using both expressive suppression and cognitive reappraisal in a flexible way according to work demands) are more likely to be resilient, invest in their profession, and be persistent in the face of difficulties. This, in turn, contributes to protecting them from experiencing anxiety and stress.

Initial Psychological Reactions to COVID-19 of Middle Adolescents in Portugal.

In its early stage, the COVID-19 pandemic and the subsequent public health measures brought several challenges to people in general, with adolescents being one of the most affected groups. To assess the psychological reactions of Portuguese adolescents in that early phase of the COVID-19 pandemic, we conducted an online survey that was filled by a sample of 340 (67.6% female and 32.4% male) middle adolescents (aged 16 and 17 years). Using the Impact Event Scale-Revised and the Depression, Anxiety, and Stress Scale, we found that most participants reported a normal score for depression, anxiety, and stress. However, 47.1% reported some level of pandemic-related traumatic distress, and 25.6% reported high severity values. The girls' levels of depression, anxiety, stress, and traumatic distress were significantly higher than those of the boys. Regression models showed that gender, number of symptoms experienced in the past days, self-reported health status, and concern with family were significant predictors of these mental health indicators. Our findings underscore the need for future research on the long-term traumatic psychological impact of the COVID-19 pandemic in adolescents, and on the gender differences in this group. This will allow the development of strategies to identify and address at-risk adolescents, since the promotion of mental health and the prevention of pathology are imperative for the health of current and future generations.

Attachment Orientations and Family Functioning: The Mediating Role of Emotion Regulation.

Attachment insecurity has been found to be associated with poor family functioning. The mechanisms underlying this link, however, are less explored. This study examines the potential mediating role of emotion regulation in the association between attachment orientations and family functioning. Self-report scales measuring attachment, family functioning, and emotion regulation were administered to 132 adults (58% women; 57.63 years). Results showed that both attachment anxiety and attachment avoidance were associated with poor family functioning. Furthermore, emotion suppression, but not positive reappraisal, was found to partially mediate the association between attachment insecurity (both anxiety and avoidance) and perceived family functioning. Findings suggest that emotion regulation seems to play a role in the impact that attachment orientations may have on family functioning.

The Emotion Regulation Goals Scale: Advancing its psychometric properties using item response theory analysis.

OBJECTIVE: Emotion goals are considered paramount for influencing the initiation, maintenance, and cessation of emotion regulation. Recently, some authors developed an instrument to assess emotion goals-the Emotion Regulation Goals Scale (ERGS). METHOD: This study included two studies aimed to examine the psychometric properties of the ERGS in two Portuguese samples: 400 adults from the community (76% women; M age = 37.10) (Study 1) and 205 university students (80% women; M age = 21.72) (Study 2). RESULTS: Confirmatory factor analysis (CFA) and item response theory (IRT) analysis were used to examine the psychometric properties of the ERGS in the two samples. The CFA confirmed the five-factor structure of the 18-item ERGS, but the analyses of both studies suggested the elimination of two items given their lower loadings/low discrimination. CONCLUSIONS: A five-factor structure with 16 items was proposed, with good reliability and with evidence of construct validity with relevant constructs.

Exploratory study on the psychological impact of COVID-19 on the general Brazilian population.

The COVID-19 pandemic has become one of the main international concerns regarding its impact on mental health. The present study aims to investigate the prevalence of depression, anxiety, and stress symptoms, and behavioral aspects amidst the COVID-19 pandemic in a Brazilian population. An online survey was administered from May 22 to June 5, 2020 using a questionnaire comprising of sociodemographic information, the Depression, Anxiety, and Stress Scale (DASS-21), and the Coping Strategies Inventory. Participants comprised 3,000 people from Brazil's 26 states and the Federal District, with an average age of 39.8 years, women (83%), married (50.6%), graduates (70.1%) and employees (46.7%). Some contracted the virus (6.4%) and had dead friends or relatives (22.7%). There was more consumption of drugs, tobacco, medication, and food (40.8%). Almost half of participants expressed symptoms of depression (46.4%), anxiety (39.7%), and stress (42.2%). These were higher in women, people without children, students, patients with chronic diseases, and people who had contact with others diagnosed with COVID-19. The existence of a group more vulnerable to situations with a high stress burden requires greater attention regarding mental health during and after the pandemic. That said, it should be emphasized that these findings are preliminary and portray a moment still being faced by many people amid the pandemic and quarantine measures. Therefore, we understand that the magnitude of the impacts on mental health will only be more specific with continuous studies after total relaxation of the quarantine.

COVID-19 in Portugal: exploring the immediate psychological impact on the general population.

Like previous pandemics, the coronavirus disease 2019 (COVID-19) has direct and indirect effects, including in mental health. To evaluate the immediate psychological impact of COVID-19, we conducted an online survey in Portugal (24-27 March 2020), using the Impact of Event Scale-Revised (IES-R) and the Depression, Anxiety and Stress Scale (DASS-21). From the 10,529 participants (M = 31.33; SD = 9.73), 83.4% were women, had a mean age of 31.2 years, and 70.9% were active workers. Depression, anxiety, and stress were rated as moderate to severe in 11.7%, 16.9%, and 5.6% of the sample, respectively. Moreover, 49.2% of participants reported a moderate or severe psychological impact of the outbreak. Women, the unemployed, those with lower education, living in rural areas, and with flu-like symptoms or chronic disorders were risk factors. Further research is needed to identify vulnerable groups to better inform and adapt mental health policies and interventions.

Posttraumatic Growth After Childbirth in Women: A Systematic Review.

This systematic review aimed to synthesize and critically appraise research evidence on posttraumatic growth (PTG) and related factors within the perinatal context. PRISMA guidelines were followed. Five databases were searched from inception to February 2019 using relevant search terms. Of 121 abstracts identified, 13 studies were deemed eligible for inclusion. Data were extracted from each study regarding study sample characteristics, design, PTG measure, and main findings. Factors associated with PTG were divided into individual, event-related and contextual factors, as conceptualized by the functional-descriptive model of Tedeschi and Calhoun. Most individual consistent factors included age, personality and coping strategies; most event-related factors included premature birth and threat appraisal; finally, most contextual consistent factors included grandmothers' and spouses' emotional support. These factors highlight targets to the development of psychosocial interventions. Recommendations for future research are discussed.

Effects of supporting patients with dementia: A study with dyads.

PURPOSE: This study aimed to examine the factors associated with the development of higher burden in informal caregivers of patients with dementia, using dyadic data. DESIGN AND METHODS: Seventy-two dyads of patients with dementia and their informal caregivers were assessed, the former in terms of behavioral-psychological symptoms and autonomy, the latter in terms of burden and individual needs. FINDINGS: Caregivers at risk for developing higher burden are those who are female, whose care recipient present psychiatric symptoms and lower autonomy, and those who recognize the need for more information/support. PRACTICE IMPLICATIONS: Interventions should offer caregivers the tools to provide care, maintaining their psychological well-being. Interventions should target not only common aspects of caregiver burden but also the specificities of caring for a person with dementia.

Dyadic coping, marital adjustment and quality of life in couples during pregnancy: an actor-partner approach.

Objective: This study aimed to examine the impact of dyadic coping on the quality of life of couples during pregnancy and to explore the potential mediating role of marital adjustment on this association.Background: According to the systemic transactional model, pregnancy can be characterised as a situation of dyadic stress because it affects both members of the couple. However, the impact of dyadic coping on couples' quality of life during pregnancy is unexplored. Also, the potential mediating role of marital adjustment on this association remains understudied.Methods: Participants were 320 pregnant women and their partners (N = 640) who completed the Dyadic Coping Inventory, the Dyadic Adjustment Scale and the World Health Organisation Quality of Life instrument. Data were analysed using the actor-partner interdependence mediation model.Results: Results showed that there was an intrapersonal indirect effect of dyadic coping on quality of life through marital adjustment. Moreover, an interpersonal indirect effect was found with fathers' dyadic coping being associated with mothers' quality of life through mothers' marital adjustment.Conclusions: These findings highlight the importance of assessing dyadic coping strategies of couples during pregnancy and targeting them in the psychological support offered to couples as a way of improving their marital adjustment, and consequently, their quality of life.

Anxiety and depressive symptoms during pregnancy, perceived control and posttraumatic stress symptoms after childbirth: A longitudinal mediation analysis.

This longitudinal study evaluated the mediating role of sense of control during labour in the association between anxiety and depression levels during pregnancy and postpartum posttraumatic stress disorder symptoms. Participants were 57 women. Anxiety and depression were assessed during pregnancy; sense of control and childbirth-related posttraumatic stress disorder symptoms were collected 6-8 weeks after childbirth. Higher levels of anxiety and depression were associated with more postpartum posttraumatic stress disorder symptoms through lack of perceived control. For depression, this happened only for primiparous. Interventions targeting mechanisms enhancing perceptions/feelings of control should be offered to these women to prevent/minimize childbirth-related posttraumatic stress disorder.

Anxiety, depression, dyadic adjustment, and attachment to the fetus in pregnancy: Actor-partner interdependence mediation analysis.

Perinatal research has focused essentially on maternal outcomes leaving paternal outcomes unexplored. This cross-sectional study aimed to explore the intrapersonal and interpersonal effects of mothers' and fathers' anxiety and depressive symptoms on their own and their partners' antenatal attachment to the fetus. Additionally, it aimed to explore the mediating role of dyadic adjustment on these associations. Participants, 320 pregnant women and their partners, completed the Hospital Anxiety and Depression Scale, the Dyadic Adjustment Scale, and the Maternal and Paternal Antenatal Attachment Scale. Data were analyzed using the actor-partner interdependence mediation model. Mothers' (ß = -.16, p < .01) and fathers' depressive symptoms (ß = -.38, p < .001) were associated with their levels of antenatal attachment to the fetus. These relationships, however, were mediated by levels of dyadic adjustment (ß = -.08, p < .05; ß = -.09, p < .05, respectively). Fathers' anxiety symptoms were associated with their levels of antenatal attachment to the fetus (ß = .16, p < .05). This relationship was partially mediated by their levels of dyadic adjustment (ß = -.05, p < .05). Finally, fathers' depressive symptoms were associated with mothers' levels of antenatal attachment to the fetus through the mothers' dyadic adjustment levels (ß = -.06, p < .05). Results indicated that anxiety and depressive symptoms as well as lower levels of dyadic adjustment during pregnancy seem to negatively impact the levels of antenatal attachment to the fetus, especially for fathers. Results highlight the need to adopt a dyadic perspective to understand mothers' and fathers' outcomes during pregnancy. (PsycINFO Database Record (c) 2019 APA, all rights reserved).