Body understanding measure for pregnancy scale (BUMPs): Cross-cultural adaptation and psychometric properties among Brazilian pregnant women.

The Body Understanding Measure for Pregnancy Scale (BUMPs) is a scale developed and validated for British pregnant women to assess body satisfaction during pregnancy. The aim of this study was to perform a cross-cultural adaptation and verify the psychometric properties of BUMPs for Brazilian adult pregnant women. The cross-cultural adaptation was performed using translation, back-translation, expert committee, expert analysis, and pre-testing, which showed easy comprehension by pregnant women. Psychometric analyses were evaluated in a sample of 618 pregnant women (31.08 ± 4.94 years old). Exploratory and confirmatory factor analyses resulted in 19 items and three factors, with satisfactory fit indices. BUMPs presented an invariant measurement across white vs. nonwhite women and across the three gestational trimesters. BUMPs showed good indicators of convergent, internal consistency, and test-retest reproducibility validity. It was concluded that the Brazilian version of BUMPs has adequate psychometric properties for Brazilian pregnant women, being an excellent instrument for analyzing body satisfaction in this population, facilitating additional investigations into these constructs.

Acceptability and Feasibility of a Mindfulness Intervention Delivered via Videoconferencing for People With Parkinson's.

Mindfulness-based group therapy is a rapidly growing psychological approach that can potentially help people adjust to chronic illness and manage unpleasant symptoms. Emerging evidence suggests that mindfulness-based interventions may benefit people with Parkinson's. The objective of the paper is to examine the appropriateness, feasibility, and potential cost-effectiveness of an online mindfulness intervention, designed to reduce anxiety and depression for people with Parkinson's. We conducted a feasibility randomized control trial and qualitative interviews. Anxiety, depression, pain, insomnia, fatigue, impact on daily activities and health-related quality of life were measured at baseline, 4, 8, and 20 weeks. Semi-structured interviews were conducted at the end of the intervention. Participants were randomized to the Skype delivered mindfulness group (n = 30) or wait-list (n = 30). Participants in the mindfulness group were also given a mindfulness manual and a CD with mindfulness meditations. The intervention did not show any significant effects in the primary or secondary outcome measures. However, there was a significant increase in the quality of life measure. The incremental cost-effectiveness ratio was estimated to be £27,107 per Quality-Adjusted Life Year gained. Also, the qualitative study showed that mindfulness is a suitable and acceptable intervention. It appears feasible to run a trial delivering mindfulness through Skype, and people with Parkinson's found the sessions acceptable and helpful.

Self-blame attributions in relatives of people with recent-onset psychosis: Associations with relatives' distress and behavioural control.

OBJECTIVES: There is evidence that self-blame is an important predictor of distress and depression in relatives of people with long-term psychosis, but there is limited research investigating the nature and correlates of self-blame in relatives of people with recent-onset psychosis. Self-blame motivates a tendency to engage with others and to repair wrongdoings; it might be that such cognitions also impact on relatives' behaviours towards the patient. This study examined the association between self-blame and psychological distress, and tested the prediction that greater self-blame would be associated with more behavioural control attempts to patients in a sample of relatives of people with recent-onset psychosis. METHODS: Statements pertaining to self-blame and behavioural control were extracted and rated from 80 interviews with relatives, who also completed the General Health Questionnaire-28. Content analysis was used to examine the nature of self-blame attributions. Regression analyses were used to explore the links between self-blame attributions and distress, and between self-blame and behavioural control in this recent-onset population. RESULTS: Higher levels of self-blame were associated with more behavioural control attempts, and self-blame predicted relatives' behavioural responses when adjusting for the contribution of control attributions. Self-blame was also linked with distress, but did not emerge as an independent predictor in multivariate analysis. Most relatives who blamed themselves did so for not overseeing their family member's mental health problems properly or for perceiving themselves generally as poor carers. CONCLUSIONS: This study extends findings related to self-blame to a population of relatives of people with recent-onset psychosis and highlights the possible role of blaming cognitions in promoting interpersonal engagement through behavioural control. PRACTITIONER POINTS: Self-blaming beliefs were linked with increased distress in relatives of people with recent-onset psychosis; Increased self-blame was associated with more behavioural control attempts; Most relatives blamed themselves for not overseeing their family member's mental health problems properly, and for perceiving themselves generally as poor carers. The cross-sectional study design limits inferences about causality.

Expressed Emotion and behaviourally controlling interactions in the daily life of dyads experiencing psychosis.

While research using Experience Sampling Methodology (ESM) suggests that, in general, contact with relatives or friends may be protective for psychotic experiences, contact with high-Expressed Emotion (high-EE) relatives can have adverse consequences for patients. This study investigated whether contact with high-EE relatives, and relatives' behaviourally controlling interactions (BCI) are related to patients' symptoms and to both patients' and relatives' affect when measured using structured diary assessments in the course of everyday life. Twenty-one patients experiencing psychosis and their closest relatives provided synchronized self-reports of symptoms (patients only), affect, dyadic contact and BCI over a 6-days period. Relatives' EE was obtained from Camberwell Family Interviews. Multi-level modeling showed that patients' reports of relatives taking control of them and helping them were associated with increased patient negative affect and symptoms. Relatives' self-reports of nagging, taking control and keeping an eye on the patient were related to fluctuations in relatives' affect. No evidence was found for the moderating effect of EE status on the association between dyadic contact and affect or, in the case of patients, symptoms. When measured using an ecologically valid methodology, momentary behaviourally controlling interactions within dyads experiencing psychosis can impact on patients' affect and symptoms.

The influence of thought control on the experience of persecutory delusions and auditory hallucinations in daily life.

Attempts to control or suppress thoughts are often unsuccessful and may even lead to an increase in the unwanted content. Intrusive thoughts and thought control are influential in the experience of psychosis, although recent findings have arisen from non-clinical samples and data tend to be retrospective in nature. The current study utilised repeated momentary assessments (experience sampling methodology) delivered as part of participants' daily routine to examine the associations between thought control and the experience of persecutory delusions and auditory hallucinations. The findings revealed that thought control was related to the subsequent severity and distress in relation to psychotic symptoms. Moreover, most of these effects persisted over two subsequent monitoring timepoints, although their size was diminished. These findings add weight to models of psychosis that include a role for thought control, and also highlight opportunities for targeted momentary interventions. Future work might seek to elucidate which specific aspects of thought control are important, alongside the use of more multifaceted measures of psychotic experiences.

Expressed emotion, types of behavioural control and controllability attributions in relatives of people with recent-onset psychosis.

PURPOSE: High expressed emotion (high-EE), as compared with low-EE, relatives of patients with long-term psychosis may behave in a more controlling manner towards patients. Furthermore, higher levels of behavioural control have been associated with higher relapse rates. We investigated in a recent-onset sample, the extent to which high-EE relatives engage in controlling behaviours and attribute the patient's illness to factors within patient's control. Furthermore, we examined whether criticism/hostility and emotional overinvolvement (EOI) were, respectively, associated with two types of behavioural control (termed 'direct influencing' and 'buffering'). We also investigated if controlling behaviours or attributions were better relapse predictors than EE. METHOD: Measures of EE, controllability attributions and behavioural control and its subtypes ('direct influencing' and 'buffering') were derived from Camberwell Family Interviews with 80 relatives of recent-onset psychosis patients. 'Direct influencing' attempts denote any behaviour intending to coerce the patient; while 'buffering' attempts refer to any behaviour aiming to take control or do things for the patient. RESULTS: High-EE relatives perceived patients as having more control over their illness and were more inclined to attempt to control patients' behaviour than low-EE relatives. Furthermore, high-EE-critical relatives used more direct influencing attempts, and high-EE-EOI relatives used more buffering attempts, but behavioural control was not associated with relapse in this recent-onset sample. CONCLUSIONS: These findings may help us to understand the development of EE in recent-onset psychosis families. Acknowledging and integrating relatives' attributional and behavioural patterns in designing and delivering clinical and familial early interventions should prove beneficial in meeting the needs of this specific population.

Staff-patient relationships and outcomes in schizophrenia: the role of staff attributions.

We investigated associations between staff-patient relationships and outcomes in a randomised controlled trial of motivational interventions for drug and alcohol misuse in schizophrenia. Participants were 204 patients and their care co-ordinators. We assessed relationship status (positive versus neutral) and staff attributions of control using Five Minute Speech Samples collected at baseline. We examined associations between this baseline data and symptoms at 12-months follow-up. We found that dyads with positive relationships at baseline had significantly less symptoms at 12-months compared to those dyads with neutral relationships. As predicted, care co-ordinators with positive relationships were less likely to attribute patients' problems as being within their control. The findings highlight the potentially important role of positive staff-patient relationships in outcomes. Our findings are also in line with the hypothesis that staff attributions may contribute to the development of more positive relationships.