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- Ferreira, Cláudia, et al.
(författare)
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Randomized controlled trial of an Acceptance and Commitment Therapy and compassion-based group intervention for persons with inflammatory bowel disease : the LIFEwithIBD intervention
- 2024
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Ingår i: Frontiers in Psychology. - : Frontiers Media S.A.. - 1664-1078. ; 15
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: This study tested the acceptability and efficacy of an Acceptance and Commitment Therapy and compassion-based intervention (LIFEwithIBD) in people with IBD through a two-arm RCT.Methods: Participants were recruited at the Gastroenterology Department of the Coimbra University Hospital between June and September 2019. Of the 355 patients screened, those who accepted to participate were randomly assigned to one of two conditions: experimental group (LIFEwithIBD; n = 25) or control group (waitlist; n = 29). Participants completed self-report measures at baseline (T0), post-intervention (T1), and 3-month (T2) and 12-month (T3) follow-ups. Intervention acceptability was assessed. Efficacy was examined using intent-to-treat ANCOVA at post-intervention after adjusting for baseline values of depressive, anxiety, and stress symptoms (primary outcomes). Linear mixed models for all longitudinal outcomes were also analysed. Inflammatory and disease biomarkers were determined at T0 and T3.Results: Acceptability results revealed a high level of satisfaction and perceived usefulness regarding the intervention. Both groups experienced a significant decrease in stress symptoms and IBD symptom perception at T1. No significant differences were observed at follow-up for the primary outcomes. The experimental group reported significantly lower Crohn’s disease Symptom severity at T2 than the control group. Post-hoc analyses designed to mitigate floor effects revealed substantial treatment effects for the experimental group regarding anxiety symptoms. No significant differences were observed in clinical biomarkers from T0 to T3.Conclusion: The LIFEwithIBD intervention shows promising, although preliminary, benefits for managing disease activity and reducing anxiety symptoms in IBD patients with high severity of psychological distress.
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| 4. |
- Gregório, S, et al.
(författare)
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Cultivating Engagement with the Present Moment
- 2024
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Ingår i: International Handbook of Theoretical and Practical Foundations of Acceptance and Commitment Therapy. - Camaquã : Fênix Sefarad.
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Bokkapitel (refereegranskat)
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| 5. |
- Trindade, Ines, PhD, 1990-
(författare)
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Emotion regulation and chronic illness : The roles of acceptance, mindfulness and compassion in physical and mental health
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: Chronic illness is an increasingly predominant problem among the world population which vastly impacts on physical and mental health, quality of life and social functioning. Although chronic illnesses merit a long-term and complex response which would be ideally delivered by a multidisciplinary team of health professionals, most of the current healthcare for chronic illnesses still focus on acute episodes of illness. The third wave of cognitive and behavioural approaches on psychological problems, in particular mindfulness, Acceptance and Commitment Therapy, and evolutionary and compassion-based approaches have presented promising perspectives on behavioural medicine. Nevertheless, the efficacy of third wave interventions in improving well-being and mental health in chronic illness, although promising, is not yet clear. This doctoral dissertation aimed to contribute to a greater understanding of the psychological mechanisms that influence the vulnerability and persistence of psychological, social, and physical impairment in chronic illness. The role of verbal and emotion regulation processes aligned with third wave approaches’ conceptualizations of psychological problems in the comprehension of psychosocial and physical problems in chronic illness was thus explored in this dissertation. With this information, this thesis also aimed to develop, apply and test the efficacy of a new integrative acceptance, mindfulness, and compassion-based intervention for cancer.Methods: This dissertation includes 18 empirical studies with cross-sectional and longitudinal designs, including the development and test of efficacy of the MIND programme for cancer patients. The majority of these studies were conducted in samples of inflammatory bowel disease patients and breast cancer patients. Some studies also included individuals from the general population, as well as mixed samples of chronic patients. Generally, participants were recruited via internet or from hospital outpatient units. Data was collected through self-report measures and, in some specific studies, from medical records.Results: Overall, the studies revealed that: i) The Engaged Living Scale and its new shorter version (ELS-9), and the Committed Action Questionnaire are valid measures of engaged living and committed action for the Portuguese population. ii) The new chronic illness-specific measures – the Chronic Illness-related Shame Scale (CISS) and the Cognitive Fusion Questionnaire - Chronic Illness (CFQ-CI) – are robust and valid instruments that enable the assessment of chronic illness-related shame and chronic illness-related cognitive fusion, respectively. iii) The studied verbal and emotion regulation processes (cognitive fusion,experiential avoidance, self-criticism, fear of compassion from others, and lack of committed action) seem to be more important to the comprehension of psychosocial problems in chronic illness than physical symptomatology and contextual variables, and seem to mediate the effects of these variables, as well as the effects of chronic illness shame and body image dissatisfaction, on psychological, social, and physical health outcomes. Cognitive fusion and experiential avoidance in particular were identified as fundamental causal processes in the determination of the level of psychological health and perceived physical health in chronic patients. iv) The integration of acceptance, mindfulness, and compassion-based approaches in chronic illness seems to be feasible. The MIND programme for cancer patients presented a seemingly increased efficacy on the improvement of psychological health in relation to other mindfulness-based interventions in the context of breast cancer. Preliminary results suggested that the programme is a feasible, useful, accessible and cost-effective complement to the treatment of breast cancer.Conclusions: This dissertation clarifies the role of verbal and emotion regulation processes in chronic illness, presenting particularly innovative data in inflammatory bowel disease. The findings give support to the pertinence of acceptance, mindfulness, and compassion-based approaches, as well as their complementary integration, in behavioural medicine. The findings were integrated in a new transdiagnostic model for the comprehension of psychosocial and physical impairment in chronic illness. This dissertation provides new opportunities for future research, especially regarding the application of the MIND programme in other chronic illness populations.
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| 8. |
- Trindade, Ines, PhD, 1990-
(författare)
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When thoughts seem more than just thougths : body image-related cognitive fusion and its role in eating psychopathology
- 2013
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Recent studies have revealed that cognitive fusion underlies psychological inflexibility and, as result, a wide range of psychopathology as well. It is portrayed as the extent to which one gets caught up in the content of his or her thoughts while addressing them as if they were facts rather than an interpretation of reality. Concerning body image, cognitive fusion triggers the self-identification with perceptions, sensations and thoughts associated to physical appearance and has been accounted as a main feature in eating disorders. However, the impact of cognitive fusion particularly related to body image on eating psychopathology was yet little explored. Moreover, a measure that specifically assesses that construct was still to be created, contributing to the lack of studies in this area. The aim of the current work was, therefore, to develop and validate a measure of body image-related cognitive fusion (Cognitive Fusion Questionnaire – Body Image; CFQ-BI; Paper I) and to examine the role of such process in the relation between known related risk factors and eating psychopathological symptoms (Paper II). The present work involves several samples from the student and general populations. Self-report questionnaires were administered in order to measure the studies’ constructs. Results showed that the CFQ-BI is a short, robust and reliable measure, with satisfactory fit values, good convergent, divergent, temporal and discriminant reliabilities and an α = .97. Thereby, since the CFQ-BI presented very good psychometric features, a second study was conducted to explore body image-related cognitive fusion’s mediational role on the relationship of body dissatisfaction and social comparison through physical appearance towards eating psychopathology. Results showed that these relations were partially mediated by body image-related cognitive fusion. This thus suggests that the impact body dissatisfaction and unfavorable social comparisons through physical appearance have on eating difficulties rely on the degree to which one is fused with cognitions about his or her body image. Taken together, the results of the current work seem to present important insights for clinical practice and research in the field of eating psychopathology, contributing to a better assessment of body image-related cognitive fusion and to a greater understanding of its impact on body image and eating difficulties.
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