Treating Affect Phobias: Therapeutic Alliance as a Moderator of the Emotional Experience Effect on Outcomes

Psychodynamic-oriented psychotherapies have demonstrated their efficacy in emotional disorders’treatment. However, it remains unclear what are the specific mechanisms accounting for change. Inpsychodynamic psychotherapeutic models as the Affect Phobia Therapy (APT), emphasis is placedon therapeutic relationship and the ability of clients to regain adaptive contact with their emotions.Specifically, it is argued that there must be a high therapeutic alliance for the emotions’ exposure tolead to positive outcomes. This exploratory study aimed to examine whether the level of therapeuticalliance (high vs. low) moderates the contribution of emotional experience to outcomes. Twenty-sixclients (65% females; Mage= 25; SD= 7.26) with depressive and/or anxiety symptoms undergoing apsychodynamic psychotherapy on a university counselling centre were included. After each weeklysession, clients answered measures of therapeutic alliance, emotional experience, and outcomes(Psychological Well-Being and Subjective Discomfort). Data were analysed using Hierarchical LinearModels for longitudinal data. Results indicated that effect of emotional experience on outcomesdepends on levels of therapeutic alliance. In clients with low therapeutic alliance, higher levelsof emotional experience contributed to a decrease in Psychological Well-Being and an increasein Subjective Discomfort across sessions. In clients with higher levels of alliance, both outcomesdecreased significantly between sessions, regardless of the emotional experience effect. Our findingshighlight that it is important to consider that exposure to adaptive emotions may have adverse effectswhen a strong alliance is not established (AU)

Reasons for Living Inventory for Young Adults: Psychometric Properties Among Portuguese Sample.

A main protective factor against suicide in young adults is their reasons for living; therefore, suicide risk screening should consider these reasons. However, few psychometric instruments assess reasons for living, and none have been adapted for young adults in Portugal. Thus, we assess the psychometric characteristics of the Reasons for Living Inventory for Young Adults-II (RFL-YA-II) in participants (n = 936; Mage = 21.77; SD = 2.88) from Portugal. Participants answered measures concerning suicidal ideation, depression, hopelessness, and positive and negative affect. The results of an exploratory factorial analysis replicated the original 4-factor model of the RFL-YA-II, and a confirmatory factorial analysis indicated satisfactory indices. In terms of reliability and convergent, discriminant, and concurrent validity, our results are consistent with previous research. Moreover, our results indicate that the RFL-YA-II is a valid and reliable instrument to study the protective factors against suicidal behavior in Portuguese young adults, and should thus be integrated into preventive strategies.

Eye-Tracking Evidence of a Maintenance Bias in Social Anxiety.

BACKGROUND: The mechanisms and triggers of the attentional bias in social anxiety are not yet fully determined, and the modulating role of personality traits is being increasingly acknowledged. AIMS: Our main purpose was to test whether social anxiety is associated with mechanisms of hypervigilance, avoidance (static biases), vigilance-avoidance or the maintenance of attention (dynamic biases). Our secondary goal was to explore the role of personality structure in shaping the attention bias. METHOD: Participants with high vs low social anxiety and different personality structures viewed pairs of faces (free-viewing eye-tracking task) representing different emotions (anger, happiness and neutrality). Their eye movements were registered and analysed for both whole-trial (static) and time-dependent (dynamic) measures. RESULTS: Comparisons between participants with high and low social anxiety levels did not yield evidence of differences in eye-tracking measures for the whole trial (latency of first fixation, first fixation direction, total dwell time), but the two groups differed in the time course of overt attention during the trial (dwell time across three successive time segments): participants with high social anxiety were slower in disengaging their attention from happy faces. Similar results were obtained using a full-sample, regression-based analysis. CONCLUSION: Our results speak in favour of a maintenance bias in social anxiety. Preliminary results indicated that personality structure may not affect the maintenance (dynamic) bias of socially anxious individuals, although depressive personality structures may favour manifestations of a (static) hypervigilance bias.

Estimation of the collective dose in the Portuguese population due to medical procedures in 2010.

In a wide range of medical fields, technological advancements have led to an increase in the average collective dose in national populations worldwide. Periodic estimations of the average collective population dose due to medical exposure is, therefore of utmost importance, and is now mandatory in countries within the European Union (article 12 of EURATOM directive 97/43). Presented in this work is a report on the estimation of the collective dose in the Portuguese population due to nuclear medicine diagnostic procedures and the Top 20 diagnostic radiology examinations, which represent the 20 exams that contribute the most to the total collective dose in diagnostic radiology and interventional procedures in Europe. This work involved the collaboration of a multidisciplinary taskforce comprising representatives of all major Portuguese stakeholders (universities, research institutions, public and private healthcare providers, administrative services of the National Healthcare System, scientific and professional associations and private service providers). This allowed us to gather a comprehensive amount of data necessary for a robust estimation of the collective effective dose to the Portuguese population. The methodology used for data collection and dose estimation was based on European Commission recommendations, as this work was performed in the framework of the European wide Dose Datamed II project. This is the first study estimating the collective dose for the population in Portugal, considering such a wide national coverage and range of procedures and consisting of important baseline reference data. The taskforce intends to continue developing periodic collective dose estimations in the future. The estimated annual average effective dose for the Portuguese population was of 0.080±0.017 mSv caput(-1) for nuclear medicine exams and of 0.96±0.68 mSv caput(-1) for the Top 20 diagnostic radiology exams.