The role of negative affect, rumination, cognitive fusion and mindfulness on depressive symptoms in depressed outpatients and normative individuals

This study examined the mediating effect of rumination, cognitive fusion and mindfulness, in the relationship between negative affect (NA) and depressive symptoms, and the differences between depressed outpatients and normative individuals. A cross-sectional design, employing validated questionnaires was used to measure NA, depressive symptoms, rumination, cognitive fusion and mindfulness in 140 participants (70 with Major Depressive Disorder, 57 female; 70 normative individuals, 44 female). Our tested model showed that cognitive fusion was the only significant mediator of the relationship between NA and depressive symptoms. Furthermore, our results showed that both rumination and mindfulness have a mediation effect in the relationship between NA and cognitive fusion. A partial metric invariance was indicated, allowing the identification of specific parameters that may be acting differently in the two samples. Our study showed that individuals high in NA, who repeatedly think about negative aspects of the self/situations, may become easily attached to literal content of thoughts and less sensitive to the contingencies of direct experience, which may increases their depressive symptoms. However, adopting a non-evaluative perspective of unwanted private experiences, seems to be central to achieve a psychological distance from their negative thoughts/feelings, and possibly a consequential decrease of depressive symptoms. As rumination, cognitive fusion, and mindfulness operate differently across depressed outpatients and normative individuals, a deeply understanding of their unique relations allow us to plane more effective interventions

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The Impact of Shame, Self-Criticism and Social Rank on Eating Behaviours in Overweight and Obese Women Participating in a Weight Management Programme.

Recent research has suggested that obesity is a stigmatised condition. Concerns with personal inferiority (social rank), shame and self-criticism may impact on weight management behaviours. The current study examined associations between social comparison (shame, self-criticism), negative affect and eating behaviours in women attending a community based weight management programme focused on behaviour change. 2,236 participants of the programme completed an online survey using measures of shame, self-criticism, social comparison, and weight-related affect, which were adapted to specifically address eating behaviour, weight and body shape perceptions. Correlation analyses showed that shame, self-criticism and social comparison were associated with negative affect. All of these variables were related to eating regulation and weight control (p < 0.001). Path analysis revealed that the association of shame, hated-self, and low self-reassurance on disinhibition and susceptibility to hunger was fully mediated by weight-related negative affect, even when controlling for the effect of depressive symptoms (p < 0.050 to p < 0.010). In addition, feelings of inadequacy and unfavourable social comparisons were associated with higher disinhibition and susceptibility to hunger, partially mediated through weight-related negative affect (p = 0.001). These variables were negatively associated with extent of weight loss during programme attendance prior to the survey, while self-reassurance and positive social comparisons were positively associated with the extent of weight loss prior to the survey (p < .050). Shame, self-criticism, and perceptions of inferiority may play a significant role in self-regulation of eating behaviour in overweight people trying to manage their weight.

Avaliação da Vergonha em Adolescentes: 'The Other as Shamer Scale' / Assessment of Shame in Adolescents: The 'Other as Shamer' Scale

RESUMO A vergonha, entendida como uma emoção autoconsciente, multifacetada e socialmente focada, desempenha um papel central na saúde mental dos indivíduos. Nos adolescentes, é também uma experiência frequente, sendo importante a sua avaliação para a investigação e prática clinica. Este estudo pretende validar uma medida breve de vergonha externa (Escala de Vergonha Externa - Versão breve para Adolescentes [OASB-A]). Participaram 834 adolescentes com uma média de 15 anos. O modelo final da OASB-A (8 itens), obtido por meio da Análise Fatorial Confirmatória, apresenta um bom ajustamento aos dados, invariância para o sexo, boa consistência interna e fidedignidade temporal adequada. As correlações com as experiências traumáticas de vergonha (IES-R) e sintomatologia psicopatológica (DASS-21) são significativas. A OASB-A é uma medida válida e econômica para avaliação da vergonha externa em adolescentes.

ABSTRACT Shame, as a self-conscious, multidimensional and socially focused emotion, plays a central role in the mental health of individuals. In adolescents, shame is also a frequent experience and its assessment is important for research and clinical practice. This study aims to validate a brief measure of external shame (Other as Shamer Scale - brief version for adolescents [OASB-A]). The participants were 834 adolescents with a mean age of 15 years. The final model of the OASB-A (8 items), obtained through CFA, presents a good fit to the data. The OASB-A shows a good internal consistency and an adequate temporal reliability. The OASB-A also reveals significant correlations with traumatic shame experiences (IES-R) and psychopathological symptoms (DASS-21). The OASB-A is an economic and reliable measure to assess external shame in adolescents.

[Eating disorders and type 1 diabetes: about 4 clinical reports]. / Doenças do comportamento alimentar e diabetes mellitus tipo 1.

Type 1 Diabetes mellitus is a chronic disease, often diagnosed in youth and associated with important psychological, familial and social disorders. Its intensive treatment with insulin and dietary changes is an extra stress factor in a stage of life already complicated. This vulnerability, coupled with low self-esteem and psychological factors typical of the youth, makes eating disorders twice as common in young girls with type 1 diabetes. The omission of insulin is the sole purging behavior used to lose weight, culminating in a poor glycemic control and increased acute and chronic complications. The treatment seeks to achieve specific objectives, depending on the associated psychiatric pathology. Because of its frequency, the clinician should be alert to early manifestations of this association. We present four clinical cases of young people with type 1 diabetes and eating disorders, which show the complexity of the approach and monitoring of these patients.

Disfunção erétil: Contributos para a sua compreensão à luz do modelo cognitivo de A. T. Beck

O presente artigo pretende dar um contributo no sentido de ajudar a compreender as disfunções sexuais em geral e a disfunção eréctil em particular à luz dos modelos cognitivos, utilizando como referência central a teoria cognitiva de A. T. Beck. Iremos proceder a uma revisão literária de todos os estudos e modelos de teor cognitivo aplicados ao domínio das disfunções sexuais e terminaremos com a apresentação das principais conclusões de um estudo empírico por nós elaborado (Nobre e Gouveia, 1999), cujos resultados nos permitem reequacionar a importância do papel dos factores de natureza cognitivo-afectiva hipotéticas sobre a conceptualização teorica desta disfunção e eventualmente sobre possíveis direccionamentos terapêuticos futuros(AU)