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.

Although functional recovery could be advocated as an achievable treatment goal, many effective interventions for the treatment of psychotic symptoms, such as antipsychotic drugs, may not improve functioning. The last two decades of cognitive and clinical research on schizophrenia were a turning point for the firm acknowledgment of how relevant social cognitive deficits and negative symptoms could be in predicting psychosocial functioning. The relevance of social cognition dysfunction in schizophrenia patients' daily living is now unabated. In fact, social cognition deficits could be the most significant predictor of functionality in patients with schizophrenia, non-redundantly with neurocognition. Emerging evidence suggests that negative symptoms appear to play an indirect role, mediating the relationship between neurocognition and social cognition with functional outcomes. Further explorations of this mediating role of negative symptoms have revealed that motivational deficits appear to be particularly important in explaining the relationship between both neurocognitive and social cognitive dysfunction and functional outcomes in schizophrenia. In this paper we will address the relative contribution of two key constructs-social cognitive deficits and negative symptoms, namely how intertwined they could be in daily life functioning of patients with schizophrenia.

AcknowledgementThe authors would like to acknowledge the valuable feedback of the team of psychologists who collaborated in the COMPASS validation study (Abstract Described as a contextual behavioural approach, Compassion-focused Therapy (CFT) aims at helping people develop compassionate relationships both with others and with the self. CFT has been used to promote recovery in psychosis with promising results. The development process of the Compassionate Approach to Schizophrenia and Schizoaffective Disorder (COMPASS) builds upon the available research on contextual behavioural approaches for psychosis. Its main framework is the affect regulation system's model and the compassion-focused therapy rationale as it was adapted for psychosis. Other theoretical and empirical influences are presented and innovations regarding CFT protocols for psychosis are highlighted. COMPASS is already being studied and details on the pilot study are provided. With further study and continuing improvement COMPASS has the potential to help foster recovery in psychosis.

Objective: This study aimed to develop and apply a brief (five-session) group-based intervention called Compassionate, Mindful and Accept-ing approach to Psychosis (CMAP) for patients diagnosed with paranoid schizophrenia. Methods: The intervention was based on three major approaches: the mindfulness framework adapted for psychosis with the proposed modifications for meditation work, the rationales from Acceptance and Commitment Therapy, and What is already known on this topic1 Contextual therapies aim at developing a more flexible response and more useful self-others and self-self relationships rather than eliminating symptoms.2 Acceptance, mindfulness, and compassion-based therapies for psychosis have shown promising results in several outcomes.3 To our knowledge, only one integrated treatment combining CAM exists and found promising results regarding acceptability, self-regulation, and affective symptoms. What this topic adds1 This study aimed at developing a brief and easy to implement intervention based on acceptance, mindfulness, and compassion for schizophrenia.2 Understanding of acceptability in sample of five patients: intervention seemed acceptable with subjective improvement of difficulties and coping.3 Potential benefits of this approach are illustrated through the results of two case studies: improvement in paranoid conviction and acting with awareness.Contextual cognitive behavioural therapy (CCBT; Hayes, Villatte, Levin, & Hildebrandt, 2011) emerged as a response to criticisms of the cognitive behaviour therapy model, where the function, not content per se, of internal events (including thoughts and images) were regarded as key to

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IntroductionThe Depression, Anxiety and Stress Scales are widely used in clinical and non-clinical populations, both in research and clinical settings. The need for briefer but valid and reliable instruments has motivated the reduction of the original 42-item scale to a short 21-version. On Portuguese samples, Pais-Ribeiro et al. (2004) found that the original 3-factor solution (stress, anxiety and depression) explained 50.35% of the variance and in an exploratory analysis; Xavier et al. (2015) presented a two factor solution and a modified three-factor solution with a sample of pregnant women, both with adequate factors’ reliability (< 0.70) and explaining above 50% of the variance.AimsBased on the previous results of factor analysis with Portuguese samples, the present study aimed to perform confirmatory factor analyses (using Mplus software) to evaluate which dimensional structure best fitted the data.MethodsThe sample comprised 234 students (78.2% female), between 18–26 years old (M = 20.55; SD = 1.66). Eighty-five percent of the participants were on their first three years of college education. Participants filled the Portuguese version of the DASS-21.ResultsOur results showed that the original 3-factor structure had the best model fit [χ2(186) = 475.465, P < 0.05; RMSEA = 0.082, 90% CI = 0.073–0.091; CFI = 0.918; TLI = 0.908; SRMR = 0.05]. Good reliability was found for all subscales (0.92 for stress, 0.87 for anxiety and 0.91 for depression subscale).ConclusionsThe DASS-21 is a reliable instrument that, with student populations, seems to have better performance when used with a 3-factor structure. Further research is needed to confirm this structure in Portuguese clinical samples.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Background: New treatment approaches for psychosis indicate that effective interventions require a therapeutic focus on emotional regulation, cognitive appraisals, and functioning. Efficacy of psychotherapeutic interventions' evaluation has changed from exclusively assessing symptom frequency/severity to a comprehensive and functional assessment of interference, functioning, and the relationship people have with symptoms. This shift led to new needs in clinical assessment. This study aimed to develop and submit to expert evaluation a new clinical interview for psychotic disorders which considers the new needs of the field.