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MS is a heterogeneous entity that varies in its etiology, classification, clinical course and sequelae, and is included as part of the chronic diseases that cause limitations in many areas. This study aims to assess neuropsychological functions, anxiety and depression in patients with MS, and realize that these variables can be influenced by family functioning.
This study consists of a group of 25 individuals were women with diagnosis of Multiple Sclerosis (ages 25 to 58 years). Data collection was done through: a demographic questionnaire and clinical, a neuropsychological assessment battery (LNNB), a range of Hospital Anxiety and Depression Scale (HADS), and a questionnaire of family functioning (FACES-III). The results suggest that the group of patients evaluated present neuropsychological deficits in several areas, as well as depression and anxiety. They also suggest that there is a higher prevalence of neuropsychological deficits associated with a higher incidence of depressive symptoms and family dissatisfaction. Taken together, these results reveal an involvement of emotional and family functioning on neuropsychological functioning. As such, these factors should be considered in the implementation of intervention programs, both in terms of individual psychotherapy, or the level of family psychotherapy as well as in neuropsychological and psychosocial rehabilitation programs and these patients.
Two fundamental aspects of cultural intuitive conceptions of time's passage - cyclic and continuous temporality - are here related to clinical psychopathology of post-traumatic stress in Brazil. People with predominantly cyclical cultural perceptions of time tend to see life and death as part of an eternal movement. Severity and persistence of mental trauma are not directly related to the magnitude of the catastrophe or even of the traumatic experience, but rather to the way they pervade the mind and to the roles they represent on it. Modern culture tends to produce individuals prepared to a highly complex world, running in a frantic rhythm and under constant pressure. Nearly all events must be anticipated, planned or controlled, and obsessive traits tend to be facilitated. However, in catastrophic, unpredictable events, when nothing can be done, these full-schedule people may show frailty and despair.
Traditional communities seem capable to bear extremely high levels of aggression or suffering - in traumatic and catastrophic situations - without showing proportional signs of mental stress. While in the high social layers of modern communities an act of violence as an assault or rape may have serious and long lasting consequences, in everyday public hospital practice we come across victims of potentially traumatic events without any of the expected devastating effects on their mental life. Periodic dissociative rituals may have a role in their resilience.
Multiple Sclerosis (MS) is the most common demyelinating disease of the central nervous system and one that presents more neuropsychiatric manifestations.
The authors of this paper proposes to characterize psychological and psychopathologically a group of patients sent from Neurology to Psychiatry at St. João Hospital - Porto.
The initial group consisted of 48 patients (35 women and 13 men). Data collection was done through a semi-formant interview to obtain socio-demographic and clinical data. The psychological and psychopathological evaluation was made with the following tools: MMSE (Mini Mental State Examination), Raven, MOS SF-36 (Medical Outcomes Study 36-Item Short Form Health Survey), SCL-90 (Hopkins Symptoms Distress Checklist 90), HADS (Hospital Anxiety and Depression Scale), scale and EDSS (Expanded Disability Status Scale).
On this sample the median duration of disease was 11 years and the value of EDSS has an average of 2.49. The sample does not show significant levels of psychopathology. However the results suggest that the worse is the overall severity of MS (EDSS) and the greater the duration of illness, the worst seems to be general physical and emotional functioning. In this study, no associations were found between variables of MS and psychopathological findings. However cognitive dysfunction appears to worsen with the greatest severity of MS, as in other works.
To investigate in non-depressed perinatal women, whichBeck Depression Inventory-II (BDI-II) and Postpartum Postpartum DepressionScreening Scale (PDSS) scores and proportions of symptomatic items significantlydiffer through the perinatal period.
273 women were assessed with the Diagnostic Interviewfor Genetic Studies, BDI-II and the PDSS at the third trimester of pregnancy/T0(mean age =29.42±7.159 years; mean weeks gestation=32.6±3.61),three/T1, six/T2 and twelve/T3 months postpartum.
Significantlyhigher scores in T0 than in T1/T2/T3 and in T1 than in T2/T3 were found for: Total PDSS, Sleeping-Eating Disturbances, Emotional Liability, Total BDI-II andits dimension Somatic-Anxiety. Only T0 and T1/T2 didnot significantly differ in Anxiety/Insecurity, Mental Confusion, and Loss of Self. In Guilty/Shame only T1 was significantly higher than T3. Suicidalthoughts were significantly higher in T0 than T1 and lower in T1 than T2/T3.
Theproportions of symptomatic items systematically and significantly decreased fromT0 to T3 in changes of sleep, loss of interest in sex, feeling overwhelmed. Significantlyhigher symptomatic proportions in T0 than in all post-partum moments were foundfor: loss of energy, irritability, fatigue, changes in appetite, crying, indecisiveness and worthlessness (these last three also higher in T1 than inT3). Agitation was significantly higherin T1 than in T0. All the cognitive-affective symptoms from BDI-II and PDSSdid not differ.
From pregnancy to the twelfth month postpartum the depressivesymptomatology, particularly somatic-affective symptoms, significantlydecreased. However even for the women who are not clinically depressed, theperinatal period requires considerable psychological adjustment.
Factors associated with postpartum/PPT anxiety have been insufficiently investigated.
To identify correlates of PPT anxiety.
201 3-months postpartum women completed the Portuguese versions of Postpartum Depression Screening Scale (PDSS), Beck Depression Inventory/BDI-II, Profile of Mood States, Difficult Infant Temperament Questionnaire/DITQ, Multidimensional Perfectionism Scale and questions on sociodemographic variables, Lifetime history of insomnia/LTHD, Lifetime history of depressive symptomatology/LTHDS, Current insomnia, Health perception/HP, Stress perception/SP, Perceived social support/PSS, Quality of life/QOL, Health problem/complication postpartum, Sensibility to hormonal fluctuations, Type of delivery and Type of feeding. Postpartum anxiety was measured with the Anxiety/Insecurity (AI) subscale of the PDSS.
AI significantly correlated with LTHDS (rS=.32), LHI (rS=.18), Current insomnia (rS=.32), BDI-II (r=.76), SP (rS=.38), PSS (rS=.25), Perceived QOL (rS=.37), Health perception (rS=.29), Health problem in the postpartum (rS=.26), Negative Affect/NA (r=.66), Positive Affect/PA (r=.58), Conditional Acceptance/CA (r=.29) and DIT (r=.38) (all p< .01). Mean comparisons revealed that women with vs. without LHDS, with vs. without LTHI, good sleepers vs. with insomnia syndrome, high vs. low SP, low vs. high PSS, bad/very bad vs. good/very good QOL, bad/very bad vs. good/very good HP, high (< M+1DP) vs. low (>M-1DP) DIT, CA, NA and low vs. high PA had significantly higher mean scores in AI (all p< .01). Linear regression model composed of all correlated variables explained 53.7% of AI variance and showed that NA, PA and DIT are significant (p< .05) predictors of AI.
Our findings are in accordance with previous research and contribute to the progress on this topic.
Postpartum depressive symptomatology is highly prevalent and has negative impact in the entire family.
To identify correlates of postpartum depressive symptomatology.
201 3-months postpartum women completed the Portuguese versions of Postpartum Depression Screening Scale/PDSS, Profile of Mood States, Difficult Infant Temperament Questionnaire/DITQ, Multidimensional Perfectionism Scale and questions on sociodemographic variables (marital status, work status, educational level, parity), Lifetime history of insomnia/LTHD, Lifetime history of depressive symptomatology /LTHDS, Current insomnia, Sleep needs, Health perception/HP, Stress perception/SP, Perceived social support/PSS, Quality of life/QOL, Health problem/complication postpartum, Sensibility to hormonal fluctuations, Type of delivery and Type of feeding.
Total PDSS significantly correlated with LTHDS (rs=.35), LHI (rs=.22), Current insomnia (rs=.37), SP (rs=39), PSS (rs=.25), Perceived QOL (rs=.31), Health perception (rs=.28), Health problem or complication in the postpartum (rs=.16), Negative Affect/NA (r=.59), Positive Affect/PA (r=-.67), Conditional Acceptance/CA(r=.29) and DIT (r=.40) (all p< .01). Mean comparisons revealed that women with vs. without LHDS, with vs. without LTHI, good sleepers vs. with insomnia syndrome, high vs. low SP, bad/very bad vs. good/very good QOL, bad/very bad vs. good very good HP, high (< M+1DP) vs. low (>M-1DP) DIT, CA, NA and low vs. high PA had significantly higher mean scores in AI (all p< .01). Linear regression model composed of all correlated variables explained 53.9% of depressive symptomatology variance and showed that NA, PA, DIT and HP are significant (p< .05) predictors of AI.
These results are in line with previous findings and contribute to the progress on this topic.
We recently found that, in mice, independently of orosensory input, sucrose consumption is sufficient to condition the development of spout preferences and dopamine release in the ventral striatum.
To clarify if the appetitive behavioral and dopaminergic responses to the postingestive effects of calorie-containing sugars reflect preabsorptive or postabsorptive events.
To understand if endovenous injection of glucose is sufficient to condition spout preferences and dopamine release.
Measurements of the behavioural, metabolic and neurochemical effects of the administration of glucose solutions, enterically, and in the jugular (JV) or hepatic-portal (HPV) veins of rats.
High concentration glucose solutions administered in the JV were sufficient to condition spout preferences in a two-bottle behavioral task. Additionally, a low concentration glucose solution conditioned robust behavioral responses when administered in the HPV, but not the JV. Finally, using fast-scan cyclic voltammetry we found that, in accordance to behavioral findings, a low concentration glucose solution caused an increase of spontaneous dopamine release events in the nucleus accumbens shell when administered in the HPV, but not the JV.
The postabsorptive effects of glucose are sufficient to mimic the behavioral and dopaminergic responses that result from sugar consumption. Furthermore, glycemia levels in the HPV contribute more significantly for this effect than systemic glycemia, arguing for the participation of an intra-abdominal visceral sensor for glucose.
Watkins and Moulds (2005) adapted the Positive Beliefs aboutRumination Scale (PBRS; Papageorgiou and Wells, 2001) to reduce confounds with mood states. The items keep the meaningthat recurrent thinking about feelings would be helpful, but direct mentions ofrumination, depression and negative mood or events were omitted.
To investigate thepsychometric properties of the PBRS-Adapted Portuguese version.
Acommunity sample of 552 university students (425 girls; 80.3%; mean age=19.72±1.147) answered the Portuguesepreliminary version of the PBRS-A, and the validated Portuguese versions ofother self-reported questionnaires: Perseverative ThinkingQuestionnaire/PTQ-15; Repetitive Thinking Questionnaire/RNT-10; The Metacognitions Questionnaire-30/MCQ-30;Profile of Mood States/POMS. To study the temporal stability, 242 (207girls; 85.5%) respondents answered the MCQ-30 again after approximately six weeks.
The PBRS-A Cronbach alpha was 'very good” (a=.80). All the itemscontribute to the internal consistency. The test-retest correlation coefficientwas high, positive and significant (.64; p< .001); there was not significantdifference between test and re-test scores [25.89±5.384 vs. 24.64±5.444, t (218)=4.014,p=.114]. Following Kaiser and Cattel Scree Plot criteria, only one factor wasextracted, meaning that the scale is unidimensional.
PBRS-Asignificantly, positively and moderately correlated with RNT-10, PTQ-15, MCQ-30and all their dimensions (all r>.35;p<.01) as well as with all the negative mood states from POMS (all r@.20; p<.01).
The Portuguese version of PBRS-Ahas good reliability and validity. As a transdiagnostic measure, it could be veryuseful to assess individuals with several emotional disorders, both in clinicaland research contexts.
Postpartum depression (PPD) can occur through all the perinatal period and it is a public health problem. Positive and negative affect (at pregnancy and previous postpartum moments) are protective and risk factors for PPD. The Profile of Mood States (POMS) factor structure at pregnancy and three months postpartum has already been explored.
to explore the POMS factor structure at six and 12 months postpartum.
336 women (mean age=30,3; SD = 4,09; range=19-42 years) and 276 women (mean age=30,5; SD=3,99; range=19-41 years), respectively, filled in the Profile of Mood States (POMS), at six and 12 months postpartum.
A principal components analysis revealed, at six months postpartum, three components that explained 54,12% of the total variance: F1 Depression-Hostility (21 items; 39,5% explained variance/EV); F2 Anxiety-Anger/fatigue (14 items; 10,1% EV) and F3 Vigor-Activity (12 items; 4,8% EV); at 12 months postpartum, revealed also three components, that explained 46,16% of the variance: F1. Anxiety-anger/fatigue (13 items; explained 30,4% of the variance); F2. Depression-Hostility (6 items; 11,2% VE); F3. Vigor-Activity (14 items; 2,9% EV). At both postpartum moments, F1 and F2 can be summed to calculate Negative Affect (Cronbach Alpha, α=0,968 at six months and α=0,948 at 12 months). F3 corresponds to Positive Affect (α=0,863; α=0,875, respectively, at six months and 12 months).
The POMS factor structure at six and 12 months is robust, meaningful and can now be used to explore different aspects of the postpartum experience, at these postpartum moments.
There is growing literature regarding the controversial subject of the placement of early intervention in psychosis programs (EIP) in the psychiatric services network.
To review the literature concerning the different organizational models in early intervention in psychosis and their positioning with local psychiatric services.
To describe our community based early intervention program, integrated in a general adult psychiatry service. We intend to reflect about our experience, on the weaknesses and strengths of our service's model.
A non-systematic literature review about different models of service organization in early intervention in psychosis was performed, using Medline database and Google Scholar search-engine as well as reference textbooks.
The current debate is centered on whether EIP should be organized as autonomous services or integrated in broader psychiatric services.
The PSIC Programme is an assertive community-based programme for patients with a first psychotic episode. It was developed by the Psychiatric Department of Prof. Doutor Fernando Fonseca Hospital in 2001 through the cooperative use of the existing human and financial resources.
The integration of early intervention programs in general psychiatric services, allows for the delivery of specialized rehabilitative treatments while maintaining the continuity of care even after the critical period.
Early intervention programs encapsulate a new optimism within community mental health teams. Inevitably the high standards imported from early intervention, begin to be benchmarks for all services for psychotic individuals.
It has been shown that perfectionism constitutes a risk factor both for insomnia and postpartum depression.
To analyse the relationship between perfectionism, depressive symptoms and insomnia in the postpartum.
201 3-months postpartum women (M=12.27 ± .91 weeks postpartum) completed the Portuguese versions of Postpartum Depression Screening Scale (PDSS) and Multidimensional Perfectionism Scale (MPS). Three MPS dimensions derived by factorial analysis with data from this sample were used: Self-Oriented Perfectionism/SOP, Social Prescribed Perfectionism-Conditional Acceptance/SPP-CA and SPP-Others Highs Standards/OHS. Women also answered 5 questions about sleep, considering the previous month, based on which three insomnia groups were formed: Good Sleepers/GS (women without insomnia symptoms or daytime impairment); Insomnia Symptoms Group (women with at least one insomnia symptom but no daytime impairment); Insomnia Syndrome Group/ISG (women with at least one insomnia symptom and sleep related daytime impairment).
Insomnia and PDSS were correlated (r = .39, pr < .01). SOP was not correlated with insomnia neither with PDSS total score. SPP-CA was significantly correlated with insomnia and with PDSS (rr > .25, pr < .01). SPP-OHS was only significantly correlated with insomnia (r = .14, pr < .05). SPP-CA mean scores were significantly higher in ISG than in GS (23.45 ± 3.032 vs. 18.98 ± 8.81, p = 002). Considering insomnia as a quantitative variable, linear regression showed that SPP-CA (β = .20, p = .005) and PDSS (β = .17, p = .021) were both significant predictors of insomnia, explaining 8.7% of variance (pr < .001). The mediation analysis revealed that SPP-CA partially mediated the relationship between PDSS and insomnia (IC 95% .008-.005).
SPP-C is a relevant correlate of postpartum insomnia.
Knowledge about the mechanisms underlying the relationship between perfectionism and eating behaviors in overweight/obese women is very scarce.
To investigate the relationship between perfectionism, eating behaviors and affect in overweight women.
The Portuguese validated versions of the Eating Disorders Examination Questionnaire/EDEQ, the Multidimensional Perfectionism Questionnaire and the Profile of Mood States were administered to an outpatient sample of 276 women (Mean age = 43.85 ± 11.89; Mean BMI = 32.82 ± 5.43) attending a weight loss treatment in a public hospital.
Correlations between Social Prescribed Perfectionism/SPP and EDEQ total (T) and its dimensional scores (Weigh and Shape Concern and Dissatisfaction/WSCD, Eating Concern/EC, Restraint) were all moderate (r > .30) and significant (p > .001). Self-Oriented Perfectionism/SOP was also significantly correlated with EDEQ-T, WSCI and Restraint (r = .20). Positive affect/PA was negatively correlated and Negative affect/NA was positively correlated with all EDEQ dimensions (r > .25; p > .001). SPP, but not SOP, was significantly correlated with PA (r = −.27) and NA (r = .34). Participants with high (>M+SD) vs. low (< MSD) SOP and SPP had significantly higher means in EDEQ-T, WSCI, EC and Restraint (all p < .001). Linear regression showed that SPP, PA and NA were predictors of EDEQ-T and WSCI; SPP and NA were predictors of EC; NA was the unique predictor of Restraint (all p < .001). Controlling for NA/PA, SPP still being a significant predictor of all EDEQ, WSCD and EC, accounting for significant increments of variance (4.4%, 2.9% and 4.3%, respectively; p < .001).
As in studies with other type of samples, SPP is related to disordered eating in overweight women.
In comparison with postnatal depressive symptoms, few studies considered antenatal depressive symptoms risk factors/correlates.
In a multidimensional work our aim was to explore the associations/predictive role of lifetime and current pregnancy variables for antenatal depressive symptoms.
Two hundred and thirty six women (M = 30.5; SD =4.02; variation = 19-41), at the third pregnancy trimester were interviewed with the DIGS/OPCRIT (to make lifetime/current depression diagnoses) and answered a booklet about sociodemographic variables, lifetime/current insomnia, current stress perception, perception of being an anxious person, gynecological variables, past health perception and pregnancy health problems, among others. They filled in the Profile of Mood States to assess anxious symptoms, Negative and Positive affect and the Postpartum Depression Screening Scale (PDSS) to assess antenatal depressive symptoms at pregnancy. Women with a depression diagnosis (DSM-IV/ICD-10, n =5) and on sleep medication at pregnancy were excluded from the analyses.
We found significant associations between antenatal depressive symptoms (PDSS total score), current job situation, perception of being an anxious person, lifetime history of depression (DSM-IV/ICD-10), past health perception, health problems at current pregnancy, stress perception at pregnancy, lifetime and current insomnia, anxious symptoms at pregnancy, Negative and Positive affect. In an hierarquical multiple regression past health perception, negative affect, positive affect and current insomnia were significant predictors of antenatal depressive symptoms.
Past health perception, negative affect (anxious and depressive symptoms) and insomnia at current pregnancy seem to be risk factors/correlates for the outcome. Positive affect seems to work as a protective correlate.
Immigration involves significant changes in the psychosocial context, due to losses, relationship breakdowns, lack of social support, not feeling at home, novelty, discrimination, resettlement demands (occupation, language). These life stressors might lead to psychological distress, including depression.
To explore if there are differences in the prevalence of depression and depressive symptoms in immigrant and Portuguese women during the perinatal period.
The sample comprises 397 women. 348 (87.7%) of them were Portuguese and the remaining 49 (12.4%) were born in other Countries (5.8% Other/European, 3.8% African, 2.8% South America). They were both interviewed at the last trimester of pregnancy (T0) and at 3 months postpartum (T1), using the Diagnostic Interview for Genetic Studies, which allows CID-10 and DSM-IV diagnoses of depression. Both at T0 and T1, they also completed the Postpartum Depression Screening Scale (PDSS) to evaluate depressive symptoms.
Immigrants compared with Portuguese women did not differ in respect to a CID-10/DSM-IV depression diagnosis and in respect to PDSS total scores at T0 and T1. Being immigrant is associated with higher levels of passive suicidal ideation (death seem the only way out of this nightmare) (rs=.116, p<.05), feelings of loneliness (rs=.118, p<.05) and being overwhelmed by anguished (rs=.134, p<.01) at pregnancy and with feelings of being inadequate as a mother (rs=.128, p<.05) at the postpartum.
Being immigrant might contribute to higher levels of depressive symptoms during the perinatal period, including suicidal ideation. These findings have clinical implications, while working with immigrants.
The influence of socio-demographic characteristics, namely immigration, on the risk to develop schizophrenia is well known. However, the impact of these variables on its initial clinical presentation and long-term prognosis is less well established.
To compare socio-demographic characteristics, the clinical presentation of schizophrenia and other variables known to influence prognosis in immigrant and non-immigrant young patients (social performance, quality of life, psychopathology, therapeutic adherence, insight and premorbid adjustment).
A group of consecutive patients diagnosed with schizophrenia (ICD-10), aged 18 to 25, followed in our department's community-based early intervention in psychosis program were assessed using: ACECF short version for cognition, PANNS, WHOQOL short version for quality of life, ITAQ for insight, MARS for medication adherence, and PAS for pre-morbid adjustment. Information was also gathered on the following variables: gender, age, civil status, level of education, number of readmissions, and medication. The two groups (immigrants and non-immigrants) will be compared with the adequate statistical analysis.
Preliminary results demonstrated that the immigrant group showed significantly lower levels of attention and concentration, of medication adherence, and of risk of aggression compared to the non-migrant group. The two groups did not differ in any of the remaining variables studied. We are still waiting final results.
The results will contribute to a better understanding about the influence of the immigration status on the clinical picture of schizophrenia, and allow for the development of more comprehensive rehabilitative treatments.
The Beck Depression Inventory-II [BDI-II] (Beck et al., 1996) is the self-report instrument to depressive symptoms most widely used. A 2-factor structure is frequently obtained in clinical and nonclinical samples. Our group found an identical 2-factor solution in pregnant (3rd trimester) and postpartum women (3 months); the two factors were: Cognitive-Affective and Somatic-Anxiety (Bos et al., 2009).
To investigate the BDI-II factor structure in a sample of childbearing age women who were not pregnant or that did not have children in the last year and to compare the structure of depression symptoms experienced by women in the perinatal period versus outside the perinatal period.
120 non-perinatal women (students and employees at health and education institutions), aged 18-44 (M=29.42±7.159 years), currently or in the last year unpregnant, were asked to to fill in the BDI-II. A principal components analysis with Varimax rotation was performed.
The internal consistency coefficient Cronbach alpha (α) was of .82. Following the Kaiser and the Cattel's Scree Plot criteria, a two factors structure was selected, which explained 43.56% of the variance [EV]. Based on items content, Factor [F] 1 (EV=33.55%; a=.83) and F2 (EV=10.26%; a=.82) were respectively denominated’Somatic-Anxiety’ and’Cognitive-Affective’. The dimensions composition completely overlapped with the Bos et al. (2009) structure, obtained with perinatal women.
The BDI-II factorial structure in non-perinatal childbearing age women is robust and meaningful. Our results support the view that the structure of depressive symptoms does not differ between perinatal and non-perinatal women.
Decision capacity (DC) is a complex construct, whose assessment poses huge challenges to Liaison Psychiatrist (LP).
Assess factors related to DC in patients with somatic disorders admitted in medical and surgical departments of a general hospital.
Clinical records of patients who were submitted to a DC assessment at Hospital Fernando Fonseca (Portugal), from 1st January 2012 to 31st December 2014 were retrospectively analysed. Collected data were statistically analysed with SPSS®. Univariable analysis was performed, in order to determine factors related to DC.
Data from 35 patients subject to DC evaluation were considered, of whom 42.4% were considered unable to give consent to medical and/or surgical procedures. Most of these assessments were related to patients who refused treatment. Patients unable to decide were predominantly male and mainly affected by organic mental or neurocognitive disorders (P < 0.05). There were no statistical significant differences in the age of those considered able or unable to decide. After PL intervention, 40% of those considered unable to decide changed their decision. However, it was not significantly related to the ability to give consent.
Neurocognitive disorders are common diagnosis found in patients admitted in somatic departments with no DC. Frequent change in decision after LP intervention may reflect not only cognitive fluctuations, but also a possible influence of LP intervention on patients’ choices. Appropriate standardized measures are useful tools in assessing patients with cognitive impairment, reducing evaluation differences between professionals, and in order to increase LP decisions credibility.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Research has shown that PTSD is prevalent among firefighters and police forces and that Quality of Life (QoL) is seriously compromised in individuals suffering from PTSD. However, QoL studies with these professionals are scarce. This study results from a screening program held by the Portuguese Red Cross (PRC) aiming to analyze predictors of QoL. Participants were 95 firefighters and municipal police officers. They answered the Posttraumatic Stress Disorder Checklist (PCL-5) in order to evaluate the prevalence of PTSD symptoms, as well as measures of social support (3-Item Oslo Social Support Scale) and QoL (EUROHIS-QOL-8). From the results, there were no group differences regarding total PTSD, social support or QoL and 10% of participants reported enough symptoms to PTSD diagnostic. Social Support and PTSD explained 25% of QoL variance, PTSD symptoms explaining 10% (negative beta) and, in the second step, social support explained 15%. The results suggest that it would be important to include QoL as an outcome measure in clinical and research work in these populations, with special attention to PTSD and social support.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
We have recently found that Perfectionism and Perseverative Negative are both correlates of psychological distress/PD and that PNT mediates the relationship between perfectionism and PD (Macedo et al., 2015).
To investigate if perfectionism and PNT are prospectively associated to PD and if PNT is a longitudinal mediator between perfectionism and PD, controlling for perceived stress and gender.
A total of 227 university students (80.1% girls) filled in the Portuguese validated versions of Perseverative Thinking Questionnaire (PTQ), Multidimensional Perfectionism Cognitions Inventory (MPCI), Profile of Mood States and Perceived Stress Scale, with an additional item to evaluate perceived social support/PSS at T0 and after approximately one year (T1) (Mean months = 12.77 ± 1.137). Only variables significantly correlated with the outcomes (Tension/Anxiety at T1 and Depression at T1) were entered in the conditional process analysis. The moderating role of perceived support on the link between Concern over Mistakes (MPCI) and psychological distress and between PTQ total score and psychological distress (anxiety and depression separately) was examined via conditional process analyses.
The estimated models were significant (F = 4.257, P = .002; F = 6.476, P < .001) explaining 15.9% of tension-anxiety and 25.5% of depression variance. A significant conditional indirect effect of PTQ total score on psychological distress at average and higher levels of perceived support was found, in both models (anxiety and depression). On the contrary, the two models showed a non-significant conditional direct effect of Concern over Mistakes on psychological distress only at any level of perceived support.
PNT prospectively mediates the relationship between negative perfectionism and PD.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Real-world political discussions usually mix reason-giving and storytelling in complex ways, but the interplay between these practices remains essentially unexamined. This article builds a theoretical argument based on a systemic approach for investigating such forms of communication in institutionally organized forums and informal settings alike. It contends that generalizations should not be made about the role of giving reasons and telling stories for good deliberation. A distinctive analytical framework is developed for examining these practices when deliberation is high quality, low quality, or changing (high to low or low to high). Drawing on data about discussions on reducing the criminal responsibility age in Brazil in legislative public hearings and face-to-face groups, the analysis uncovers variations in the structure of reasons and stories and shifts in their functions in optimal and suboptimal moments of deliberation. By incorporating the pragmatic dimension of interactions into the analysis, this paper contributes to advancing comparative analyses in different contexts.