ObjectivesBesides increasing longevity, the ultimate goal of medical care is to improve patients’ enjoyment of life, a concept akin to happiness. This study examined the determinants of happiness and quality of life (QoL) in patients with rheumatoid arthritis (RA).MethodsIn this observational, cross-sectional study, patients were assessed on disease activity, disease impact, personality, QoL and happiness. Structural equation modelling estimation was used to analyse the associations between these dimensions, pursuing three hypotheses: H1—disease activity and perceived impact of disease are negatively associated with overall QoL and happiness in patients with RA; H2—‘positive’ personality traits are related to happiness both directly and indirectly through perceived disease impact; H3—happiness has a mediating effect in the relation between impact of disease and QoL.ResultsData from 213 patients were analysed. Results supported all driving hypotheses. Happiness was positively related to ‘positive’ personality and, to a lesser extent, negatively related to impact of disease. Impact of disease, in turn, was positively related to disease activity and mitigated by ‘positive’ personality traits. Impact of disease had a much stronger relation with QoL than with happiness. Happiness mitigated the negative effect of disease impact on QoL.ConclusionOptimisation of QoL and happiness of people with RA requires effective control of the disease process and also improvement of the disease impact domains. Personality seems to play a pivotal mediating role in these relations.
Objectives: 1) to evaluate diff erent attachment styles depending on the attachment figure; 2) to explore the association between experiential avoidance and paranoid ideation frequency; 3) to test a mediation model in which the impact of adult attachment on frequency of paranoid ideation occurs through experiential avoidance. Method: We assessed adult-attachment, experiential avoidance and paranoid ideation frequency in a sample of 37 (30 male and 7 female) outpatients and inpatients with a psychosis-spectrum diagnosis. Results: The anxiety attachment pattern was significantly higher in all attachment figures. We found that attachment anxiety (mother) was associated with both experiential avoidance and paranoid ideation. An association between experiential avoidance and paranoid ideation frequency was also found. Results show that experiential avoidance mediated the relationship between attachment anxiety and paranoid ideation frequency. Conclusion: Our study highlights the importance of addressing therapeutically the mechanisms people with psychosis use to cope with the internal experience elicited by insecure attachment styles, specifically experiential avoidance, and suggests the adequacy of acceptance and mindfulness-based therapies in promoting recovery for psychotic patients.
Background: The overactivation of the threat-defence system combined with an underdeveloped affiliative system has been emphasised as important in psychosis, usually leading to negative affect and impaired social functioning. Difficulties in feeling safe and content in relationships with others, common in individuals with psychotic symptoms, have been linked to two specific outputs of the threat-defence system: Paranoid ideation and external shame. This study sought to explore the associations between paranoid ideation, external shame, and social safeness.Methods: Participants diagnosed with psychotic disorders (N = 37) completed a series of self-report questionnaires.Results: Results showed a significant negative association between social safeness and external shame and frequency of paranoid ideation, while external shame was positively associated with both frequency and distress of paranoid ideation. Results revealed that the relationship between frequency of paranoid ideation and social safeness was mediated by external shame.Conclusions: These findings suggest that feelings of being inferior and subordinate in the eyes of others increases vulnerability to difficulties in social connectedness and safeness. Treatment for paranoid ideation could benefit from integrating strategies to help patients deal with shame.
Cognitive fusion refers to the dominance of verbal processes over behavior regulation, in detriment of being sensitive to contextual contingencies and pursuing valued life goals. It is a core process within Acceptance and Commitment Therapy and seems to have a crucial role in the development and maintenance of psychopathology.The first goal of this investigation was to explore the factor structure, factorial invariance and psychometrics of the Portuguese version of the Cognitive Fusion Questionnaire (CFQ). A multigroup confirmatory factor analysis attested the invariant one-dimensional factor structure of the CFQ across three samples from the general population (n = 408; n = 291; n = 101) with different demographic characteristics. Additionally, the CFQ showed to be a psychometrically robust and reliable measure.A second major goal was to investigate the convergent and incremental validity of this version of CFQ (n = 408).Convergent validity was explored and attested with several psychological indicators. Regarding incremental validity, the predictive power of depressive symptoms of cognitive fusion and three related processes, with origin in different conceptual frameworks, was tested. Results showed that even when the effects of decentering, mindfulness and metacognitions were controlled for, cognitive fusion consistently maintained a significant and unique predictive power over depressive symptoms. These findings suggest that these processes relate differentially and independently with depressive symptoms and, moreover, that cognitive fusion has a superior contribution to its explanation. Given the evidence that cognitive fusion plays an important role in the comprehension of depressive symptoms, conceptual and clinical implications were discussed.
IntroductionDepressive symptoms in pregnancy are risk factors for postpartum depression and associated to adverse child outcomes (Glover, 2014). Depressive symptoms decreases after participation in mindfulness and self-compassion based interventions for pregnant women (e.g. Goodman et al., 2014). However, apart from intervention trials, there are not studies on the relationship between mindfulness, self-compassion and depressive symptoms in pregnancy (Zoeterman, 2014).ObjectiveTo explore the association between mindfulness, self-compassion and depressive symptoms in pregnant women.MethodsFour hundred and twenty-seven pregnant women (mean age: 32.56 ± 4.785 years) in their second trimester of pregnancy completed a set of self-report questionnaires validated for pregnancy: Facets of Mindfulness Questionnaire-10 ([FMQ-10]; Azevedo et al., 2015; to evaluate Nonjudging of experience/NJ, acting with awareness (AA) and observing and describing (OD), Self-Compassion Scale ([SCS]; Bento et al., 2015; to evaluate self-kindness, self-judgment, common humanity [CH], isolation, mindfulness and over-identification [OD]) and Postpartum Depression Screening Scale-24 (PDSS-24; Pereira et al., 2013). Only variables significantly correlated with the outcomes were entered in the multiple regression models.ResultsFMQ-10 and SCS Total scores were both significant predictors of PDSS-24 (B = –0.294,–0.272). Derealization and failure predictors were NJ and Isolation (B = –0.234; 0.384); Suicidal ideation predictor was NJ, OD and isolation (B = –0.152;–0.115; 0.334); concentration difficulties and anxiety predictors were isolation and CH (B = 0.296;–0.201); Sleep difficulties predictors were AA and isolation (B = –0.199; 0.248) (all P < 0.05).ConclusionsMindfulness and self-Ccompassion dimensions, particularly nonjudging of experience, acting with awareness, observing and describing are protective correlates of antenatal depressive symptoms. Isolation is a correlate of PD in pregnancy.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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