Using the Depression Anxiety Stress Scale 21 (DASS-21) across cultures

DASS-21 has been validated in a number of populations such as Hispanic adults, American, British and Australian. The findings show that the DASS-21 is psychometrically sound with good reliability and validity. It is clear from the literature that the DASS-21 is a well established instrument for measuring depression, anxiety and stress in the Western world. Nonetheless, the lack of appropriate validation amongst Asian populations continues to pose concerns over the use of DASS-21 in Asian samples. Cultural variation may influence the individual’s experience and emotional expression. Thus, when researchers and practitioners employ Western-based assessments with Asian populations by directly translating them without an appropriate validation, the process can be challenging. In summary, we have conducted a series of rigorous statistical tests and minimised any potential confounds from the demographic information. The advantages of this revised DASS-18 stress scale are twofold. First, the revised DASS-18 stress scale possessed fewer items, which resulted in a cleaner factorial structure. Second, it also had a smaller inter-factor correlation. With these justifications, the revised DASS-18 stress scale is potentially more suitable for the Asian populations.

Validation of an Australian sign language instrument of outcome measurement for adults in mental health settings

Objective: There are currently no adult mental health outcome measures that have been translated into Australian sign language (Auslan). Without a valid and reliable Auslan outcome measure, empirical research into the efficacy of mental health interventions for sign language users is unattainable. To address this research problem the Outcome Rating Scale (ORS), a measure of general functioning, was translated into Auslan and recorded on to digital video disk for use in clinical settings. The purpose of the present study was therefore to examine the reliability, validity and acceptability of an Auslan version of the ORS (ORS-Auslan). Method: The ORS-Auslan was administered to 44 deaf people who use Auslan as their first language and who identify as members of a deaf community (termed ‘Deaf’ people) on their first presentation to a mental health or counselling facility and to 55 Deaf people in the general community. The community sample also completed an Auslan version of the Depression Anxiety Stress Scale-21 (DASS-21). Results: t-Tests indicated significant differences between the mean scores for the clinical and community sample. Internal consistency was acceptable given the low number of items in the ORS-Auslan. Construct validity was established by significant correlations between total scores on the DASS-21-Auslan and ORS-Auslan. Acceptability of ORS-Auslan was evident in the completion rate of 93% compared with 63% for DASS-21-Auslan. Conclusions: This is the only Auslan outcome measure available that can be used across a wide variety of mental health and clinical settings. The ORS-Auslan provides mental health clinicians with a reliable and valid, brief measure of general functioning that can significantly distinguish between clinical and non-clinical presentations for members of the Deaf community.

The development and evaluation of a culturally affirmative counselling model for deaf clients in Australia

In Australia, there is only one, newly established, dedicated mental health service catering specifically for the signing *Deaf community. It is staffed by four part-time hearing professionals and based in Brisbane. There are currently no Deaf psychologists or psychiatrists and there is no valid or reliable empirical evidence on outcomes for Deaf people accessing specialised or mainstream mental health services. Further compounding these issues, is the fact that there are no sign language versions of the most common standardised mental health or psychological instruments available to clinicians in Australia. Contemporary counselling literature is acknowledging the role of the therapeutic alliance and the impact of 'common factors' on therapeutic outcomes. However, these issues are complicated by the relationship between the Deaf client and the hearing therapist being a cross-cultural exchange. The disability model of deafness is contentious and few professionals in Australia have the requisite knowledge and understanding of deafness from a cultural perspective to attend to the therapeutic relationship with this in mind. Consequently, Deaf people are severely disadvantaged by the current lack of services, resources and skilled professionals in the field of deafness and psychology in this country. The primary aim of the following program of research has been to propose a model for culturally affirmative service delivery and to provide clinicians with tools to evaluate the effect of their therapeutic work with Deaf people seeking mental health treatment. The research document is presented as a thesis by publication and comprises four specific objectives formulated in response to the lack of existing services and resources. The first objective was to explore the use of social constructionist counselling techniques and a reflecting team with Deaf clients, hearing therapists and an interpreter. Following the establishment of a pilot counselling clinic, indepth semi-structured interviews were conducted with two long-term clients following the one year pilot of this service. These interviews generated recommendations for the development of a new 'enriched' model of counselling to be implemented and evaluated in later stages of the research program. The second objective was to identify appropriate psychometric measures that could be translated into Australian Sign Language (Auslan) for research into efficacy, effectiveness and counselling outcomes. Two instruments were identified as potentially suitable; the Outcome Rating Scale (ORS), a measure of global functioning, and the Session Rating Scale (SRS), a measure of therapeutic alliance. A specialised team of bi-lingual and bi-cultural interpreters, native signers and the primary researcher for this thesis, produced the ORS-Auslan and the SRS-Auslan in DVD format, using the translation and back-translation process. The third objective was to establish the validity and reliability of these new Auslan measures based on normative data from the Deaf community. Data from the ORS-Auslan was collected from one clinical and one non-clinical sample of Deaf people. Statistical analyses revealed that the ORS-Auslan is reliable, valid and adequately distinguishes between clinical and non-clinical presentations. Furthermore, construct validity has been established using a yet to be validated sign language version of the Depression, Anxiety and Stress Scale-21 items (DASS-21), providing a platform for further research using the DASS-21 with Deaf people. The fourth objective was to evaluate counselling outcomes following the implementation of an enriched counselling service, based on the findings generated by the first objective, and using the newly translated Auslan measures. A second university counselling clinic was established and implemented over the course of one year. Practice-based evidence guided the research and the ORS-Auslan and the SRS-Auslan were administered at every session and provided outcome data on Deaf clients' global functioning. Data from six clients over the course of ten months indicated that this culturally affirmative model was an effective approach for these six clients. This is the first time that outcome data have been collected in Australia using valid and reliable Auslan measures to establish preliminary evidence for the effectiveness of any therapeutic intervention for clinical work with adult, signing Deaf clients. The research generated by this thesis contributes theoretical knowledge, professional development and practical resources that can be used by a variety of mental health clinicians in the context of mental health service delivery to Deaf clients in Australia.

Do cyberbullies suffer too? Cyberbullies' perceptions of the harm they cause to others and to their own mental health

While it is recognised that there are serious correlates for students who are victims of cyberbullying including depression, anxiety, lower self-esteem and social difficulties, there has been little research attention paid to the mental health of students who cyberbully. It is known that students who traditionally bully report they feel indifferent to their victims, showing a lack of empathy and that they themselves are at increased risk for psychosocial adjustment. However, there is scant research on the mental health associations of students who cyberbully or their awareness of their impact on others. The current study sought to ascertain from Australian students who reported cyberbullying others in years 6 to 12 (10-19 years of age), their perceptions of their mental health and the harm they caused to and the impact their actions had, on their victims. Most students who cyberbullied did not think that their bullying was harsh or had an impact on their victims. They reported more social difficulties and higher scores on stress, depression and anxiety scales than those students who were not involved in any bullying. The implications of these findings for the mental health of the cyberbullies and for psychologists in schools who assist them, are dis-cussed.

Depression and belongingness in general and workplace contexts : a cross-lagged longitudinal investigation

Belongingness has been linked to depression. Prior studies have been cross-sectional with few addressing distinct belongingness contexts. This study used structural equation modelling to investigate cross-lagged longitudinal relationships between general belonging, workplace belonging and depressive symptoms in a community sample of 221 working adults measured at two time points three months apart. Measures were: Sense of Belonging Instrument-Psychological (SOBI-P); Psychological Sense of Organizational Membership (PSOM); Depression Anxiety Stress Scales (DASS-21); Kessler Psychological Distress Scale (K10). General belonging was predicted more strongly by depressive symptoms than by baseline general belonging, suggesting that depressive symptoms not only linger but also influence future belongingness cognitions. Neither general nor workplace belonging longitudinally predicted depressive symptoms, however cross-sectional correlations were substantial. The concurrent path between general belongingness and depressive symptoms was strong. Results are consistent with daily process studies suggesting that reduced belongingness precipitates a rapid increase in depressive symptoms which influence longer term belongingness cognitions. Congruent with interpersonal descriptions of depression such as the social-cognitive interpersonal process model, results further suggest that belongingness cognitions are the proximal antecedent of a depressive response. Practitioners should monitor both a general sense of belonging as well as perceived relational value cues in specific contexts.

Psychological well-being status among medical and dental students in Makkah, Saudi Arabia: A cross-sectional study

Objectives Medical and dental students experience poor psychological well-being relative to their peers. This study aimed to assess the psychological well-being among medical and dental students in Saudi Arabia, identify the high-risk groups and assess the association between the psychological well-being and the academic performance. Methods In this cross-sectional study, 422 preclinical medical and dental students at Umm Al-Qura University, Saudi Arabia, were recruited to assess their depression, anxiety, stress, self-efficacy and satisfaction with life levels using 21-items Depression Anxiety Stress Scale (DASS-21), General Self-Efficacy (GSE) scale and Satisfaction With Life Scale (SWLS). Students’ academic weighted grades were obtained later. Descriptive statistics and univariate general linear model were used to analyse data. Results High levels of depression (69.9%), anxiety (66.4%) and stress (70.9%) were indicated, whereas self-efficacy (mean = 27.22, sd = 4.85) and life satisfaction (mean = 23.60, sd = 6.37) were within the normal range. Female medical students had higher psychological distress in contrast to dental students. In general, third-year students were more depressed and stressed in comparison with second-year students, except for stress among dental students. Moreover, all females had higher self-efficacy than males. Life satisfaction was higher within the second-year and high family income students. Depression was the only psychological variable correlated with the academic performance. Conclusion High levels of psychological distress were found. Female medical students had higher psychological distress than males, whereas male dental students had higher distress than female. Medical students at third year were more depressed and stressed. Dental students were more depressed in the third year, but more stressed in the second year. Attention should be directed towards reducing the alarming levels of depression, anxiety and stress among medical and dental students.

The impact of a self-development coaching programme on medical and dental students’ psychological health and academic performance: A randomised controlled trial

Background Psychological distress is well-documented worldwide among medical and dental students. Few studies have assessed the impact of self-development coaching programs on the students’ psychological health. The aim of the study was to evaluate the effect of a self-development coaching programme on the psychological health and academic performance of preclinical medical and dental students at Umm Al-Qura University, Saudi Arabia. Methods Four-hundred and twenty-two participants (n = 422, 20–22 years) fulfilled the study requirements and were invited into a parallel-randomised controlled trial that was partially blinded. Participants were stratified by faculty, gender, and academic year, and then randomised. A total of 156 students participated in the intervention group (IG) and 163 students participated in the control group (CG). The IG received the selfdevelopment programme, involving skills and strategies aimed to improve students’ psychological health and academic performance, through a two-day workshop. Meanwhile, the CG attended an active placebo programme focussing on theoretical information that was delivered through a five-hour workshop. Both programmes were conducted by the same presenter during Week 1 of the second semester of the 2012–2013 academic year. Data were gathered immediately before (T1), one week after (T2) and five weeks (T3) after the intervention. Psychological health was measured using the Depression Anxiety Stress Scale (DASS-21), the General Self-Efficacy (GSE), and the Satisfaction With Life Scale (SWLS). Academic performance was measured using students’ academic weighted grades (WG). Student cognitive and emotional perceptions of the intervention were measured using the Credibility/Expectancy Questionnaire (CEQ). Results Data from 317 students, who completed the follow ups, were analysed across the three time periods (IG, n = 155; CG, n = 162). The baseline variables and demographic data of the IG and CG were not significantly different. The IG showed short-term significant reductions in depression and anxiety in compared to CG from T1 to T2. The short-term changes in stress, GSE and SWLS of the IG were not significantly different from those of the CG. While both groups showed a significant change on most of the psychological variables from T1 to T3, no significant differences were found between the groups in this period. In addition, no significant difference was found in WG between the IG and CG after the intervention. No harms relevant to the intervention were reported. Conclusion The investigated self-development coaching programme showed only a short-term improvement on depression and anxiety compared with an active control. There was no effect of the intervention on academic performance.

Caraterização da Saúde Mental numa população jovem do concelho da Póvoa de Varzim

Dissertação apresentada à Universidade Fernando Pessoa como parte dos requisitos para a obtenção do grau de Mestre em Psicologia, ramo de Psicologia Clínica e da Saúde

Establishing a population-based patient-reported outcomes study (PROMs) using national cancer registries across two jurisdictions: The Prostate Cancer Treatment, your experience (PiCTure) study

Objective: To establish an international patient-reported outcomes (PROMs) study among prostate cancer survivors, up to 18 years postdiagnosis, in two countries with different healthcare systems and ethical frameworks. Design: A cross-sectional, postal survey of prostate cancer survivors sampled and recruited via two population-based cancer registries. Healthcare professionals (HCPs) evaluated patients for eligibility to participate. Questionnaires contained validated instruments to assess health-related quality of life and psychological well-being, including QLQ-C30, QLQPR-25, EQ-5D-5L, 21-question Depression, Anxiety and Stress Scale (DASS-21) and the Decisional Regret Scale. Setting: Republic of Ireland (RoI) and Northern Ireland (NI). Primary outcome measures: Registration completeness, predictors of eligibility and response, data missingness, unweighted and weighted PROMs. Results: Prostate cancer registration was 80% (95% CI 75% to 84%) and 91% (95% CI 89% to 93%) complete 2 years postdiagnosis in NI and RoI, respectively. Of 12 322 survivors sampled from registries, 53% (n=6559) were classified as eligible following HCP screening. In the multivariate analysis, significant predictors of eligibility were: being ≤59 years of age at diagnosis (p<0.001), short-term survivor (<5 years postdiagnosis; p<0.001) and from RoI (p<0.001). 3348 completed the questionnaire, yielding a 54% adjusted response rate. 13% of men or their families called the study freephone with queries for assistance with questionnaire completion or to talk about their experience. Significant predictors of response in multivariate analysis were: being ≤59 years at diagnosis (p<0.001) and from RoI (p=0.016). Mean number of missing questions in validated instruments ranged from 0.12 (SD 0.71; EQ-5D-5L) to 3.72 (SD 6.30; QLQ-PR25). Weighted and unweighted mean EQ-5D-5L, QLQ-C30 and QLQ-PR25 scores were similar, as were the weighted and unweighted prevalences of depression, anxiety and distress. Conclusions: It was feasible to perform PROMs studies across jurisdictions, using cancer registries as sampling frames; we amassed one of the largest, international, population-based data set of prostate cancer survivors. We highlight improvements which could inform future PROMs studies, including utilising general practitioners to assess eligibility and providing a freephone service.

Prevenção do mal-estar através da motivação e criatividade dos colaboradores: um estudo realizado com artistas

A criatividade e a motivação dos colaboradores são características fundamentais para a inovação e para o empreendedorismo. No entanto, não têm sido realizados estudos empíricos que esclareçam as relações que se estabelecem entre a criatividade e a saúde mental no domínio organizacional. De uma forma geral, a literatura parece sugerir que os profissionais que trabalham no meio artístico apresentam uma maior criatividade, mas também que revelam uma maior vulnerabilidade em termos de saúde mental. O presente trabalho tem como objetivo principal compreender se a criatividade e a motivação de profissionais do mundo artístico podem ajudar a prever a sua saúde mental, sendo esta avaliada através de três indicadores de mal-estar (stress, ansiedade e depressão). Foram utilizados instrumentos já existentes para avaliar a criatividade (EPC), a motivação intrínseca (IMQ) e os três indicadores de mal-estar – stresse, ansiedade e depressão (DASS-21). A amostra era constituída por 50 profissionais do meio artístico em Portugal. Foi possível verificar a existência de uma relação significativa entre a criatividade e a motivação profissional. Verificou-se ainda que a relação entre os três indicadores de mal-estar e a criatividade, por um lado, e a motivação intrínseca, por outro, é sempre negativa, embora na análise dos efeitos conjuntos da criatividade, da motivação e das variáveis sócio-demográficas, apenas a criatividade contribua de forma significativa para menores níveis de ansiedade. A criatividade parece poder ser protetora em relação à saúde mental dos colaboradores, contribuindo para a prevenção de situações de mal-estar no trabalho.

O Papel das Memórias Positivas Precoces nos Estilos de Vinculação e Estados Emocionais Negativos dos Adolescentes

Objetivos: A literatura científica tem mostrado que as experiências precoces na infância, nomeadamente as relacionadas com sentimentos de ameaça ou de segurança desempenham um papel fundamental no desenvolvimento emocional e social posterior. O presente estudo apresenta os seguintes objetivos: 1) Adequar e analisar as propriedades psicométricas da escala de memórias precoces de calor e segurança (EMWSS) à população de adolescentes, garantindo, uma medida confiável do constructo em estudo; 2) Examinar o impacto das memórias precoces de calor e segurança nos estilos de vinculação; 3) Explorar a relação entre as memórias positivas precoces e indicadores de desajustamento psicológico (sintomas de depressão, ansiedade e stress). Método: A amostra é constituída por 651 adolescentes (330 rapazes e 321 raparigas) com idades compreendidas entre os 12 e os 19 anos a frequentarem o ensino básico e secundário do ensino regular. Foram completados 3 instrumentos de auto - resposta que avaliaram as memórias precoces de calor e segurança (EMWSS), vinculação (AQ) e sintomas de ansiedade, depressão e stress (DASS-21). Resultados: A EMWSS evidenciou uma boa consistência interna, uma estrutura fatorial unidimensional, uma excelente estabilidade temporal e uma boa validade discriminante. As memórias precoces de calor e segurança mostraram uma correlação moderada negativa com os sintomas de ansiedade, depressão e stress e uma adequada validade discriminante relativamente à qualidade de vinculação. Os adolescentes classificados com o estilo de vinculação segura evidenciaram significativamente mais memórias positivas de infância, que os jovens com um estilo de vinculação insegura (ambivalente ou evitamento). Conclusões: À semelhança dos estudos realizados com adultos, a EMWSS parece ser uma escala útil na prática clínica com adolescentes, revelando excelentes características Memórias Positivas Precoces, Estilos de Vinculação e Estados Emocionais Negativos 6 psicométricas. Este estudo mostrou igualmente como as memórias emocionais precoces (de calor e segurança) diferem em função da qualidade de vinculação (segura/insegura).

O Impacto das Experiências de Vergonha nos Adolescentes

A presente investigação pretendeu ver cumpridos três dos seus principais objectivos: 1) Adequar e analisar os instrumentos de avaliação em adolescentes, garantindo, medidas confiáveis dos constructos em estudo; 2) Examinar o impacto das experiências de vergonha, verificando se estas podem funcionar como acontecimentos determinantes e centrais na formação da identidade do adolescente; 3) Explorar a relação entre as experiências de vergonha e sintomas de desajustamento psicológico (sintomas de depressão, ansiedade e stress). A amostra é constituída por 397 jovens (190 rapazes e 207 raparigas), com idades compreendidas entre os 12 e os 18 anos (M= 14,91) a frequentar o ensino básio e secundário do sistema regular de ensino. Para além do CES que foi objecto de uma análise mais detalhada, preencheram igualmente os seguintes questionários: ISS, OAS e DASS-21. Os resultados obtidos mostram que indivíduos cujas memórias de vergonha se tornaram pontos de referência na sua identidade, tendem a manifestar valores mais elevados de vergonha externa e vergonha interna. Verificou-se também que indivíduos que apresentam centralidade das memórias de vergonha evidenciam maior vulnerabilidade à sintomatologia psicopatológica, nomeadamente depressão, ansiedade e stress. Por fim, constatou-se que tanto a vergonha externa, como a vergonha interna em adolescentes se apresentam correlacionadas com a psicopatologia. No entanto, a vergonha interna surge mais associada à depressão que a vergonha externa, que se correlaciona mais com a ansiedade e o stress. No que respeita à adaptação das escalas CES, OAS e ISS para a população adolescente, verificou-se que apresentaram boas qualidades psicométricas. Podemos concluir com a nossa investigação, que tal como na população adulta, os adolescentes que experienciaram memórias de vergonha que se tornaram centrais na sua identidade e história de vida, tendem a manifestar níveis mais elevados de vergonha externa e interna. Por outro lado, encontram-se também mais propensos a desenvolver sintomatologia psicopatológica, como a depressão, ansiedade e stress.

Cyberbullying: estudo da prevalência de comportamentos de cyberbullying e sua relação com vivências de vergonha e estados emocionais negativos

Objectivos: O presente estudo tem como principal objectivo avaliar a prevalência dos comportamentos de cyberbullying, analisando a influência de variáveis sóciodemográficas, e, compreender a sua relação com as vivências de vergonha interna e externa e com os estados emocionais negativos, particularmente a depressão, a ansiedade e o stress. Método: Para a recolha de dados recorreu-se a uma mostra de adolescentes (N=131) a frequentar o 3º ciclo do ensino básico, com idades compreendidas entre os 12 e os 18 anos (M= 13,76; DP= 1,25). O protocolo de avaliação foi constituído por um questionário psicossocial desenvolvido especificamente para este estudo e por um conjunto de medidas fidedignas para avaliar o cyberbullying (CBQ e CBQ-V), a vergonha interna (ISS), vergonha externa (OAS) e os estados emocionais negativos (DASS-21). Resultados: Os nossos dados revelaram que 76 adolescentes (58%) exerceram um qualquer comportamento de cyberbullying (com um predomínio dos rapazes), enquanto 50 adolescentes (38,2%) já foram vítimas de um qualquer comportamento de cyberbullying (com igual proporção entre rapazes e raparigas). Manter lutas e discussões online, usando insultos mediante mensagens electrónicas foi o comportamento praticado mais frequente (30,5%), enquanto o ser removido intencionalmente de um grupo online foi o comportamento sofrido mais frequente (16,1%). A idade e os anos de reprovações mostraram uma associação positiva com os comportamentos de agressão por cyberbullying. Foi ainda analisada a sobreposição entre a execução e a vitimização de comportamentos de cyberbullying, tendo sido discriminados quatro grupos de adolescentes: só agressores (adolescentes que apenas exerceram comportamentos de agressão), só vítimas (apenas sofreram comportamentos de cyberbulling), vítimas e agressores (adolescentes que são simultaneamente agressores e vítimas), e nem vítimas nem agressores (adolescentes que não exerceram nem sofreram qualquer comportamento de cyberbullying). Os resultados evidenciaram que quanto maior a frequência de comportamentos de agressão por cyberbullying, maior a vergonha interna e maior os níveis de stress demonstrados. Por sua vez, quanto maior a frequência de vitimização por cyberbullying, maior a vergonha interna e externa, bem como maior os níveis de ansiedade e stress. Conclusão: Devido a complexidade do fenómeno cyberbullying e seu recente surgimento, serão necessários mais estudos, particularmente longitudinais, para compreender a relação antecedente e/ou consequentes aos comportamentos de cyberbullying entre estados emocionais negativos e as experiências de vergonha. / Objectives: The present study has as main objective to assess the prevalence of cyberbullying behaviours, analyzing the influence of socio demographic variables, and, understand its relationship to the experiences of internal and external shame and negative emotional states, particularly depression, anxiety and stress. Method: For data collection we used a sample of adolescents (N=131) attending the 3rd cycle of basic education, aged between 12 and 18 years (M=13,76; SD=1,25). The evaluation protocol consisted of a psychosocial questionnaire developed specifically for this study and a set of reliable measure to assess cyberbullying (CBQ and CBQ-V), internal shame (ISS), external shame (OAS) and the emotional states negative (DASS-21). Results: Our data indicate that 76 adolescents (58%) exerted any conduct of a cyberbullying (with a predominance of boys), while 50 adolescents (38,2%) had been victims of cyberbullying behaviour of any one (with an equal ratio of boys and girls). Keep fighting and discussions online, through e-mails using insults behaviour was practiced more often (30,5%), while being intentionally removed a group of online behaviour is seen more frequently (16,1%). The age and years of failures were positively associated with the behaviours of aggression by cyberbullying. Was further examined the overlap between enforcement and victimization of cyberbullying behaviours, having been discriminated four groups of adolescents: only aggressors (adolescents who have had only aggressive behaviour), only victims (only suffered cyberbullying behaviours), victims and aggressors (adolescents who are both perpetrators and victims), and neither victims nor aggressors (adolescents who did not exercise any behaviour or suffered cyberbullying). Results showed that the higher the frequency of aggression by cyberbullying behaviour, the greater shame and internal stress levels demonstrated. In turn, the higher the frequency of cyberbullying victimization, the greater the shame internal and external, as well as higher levels of anxiety and stress. Conclusion: Due to the complexity of the phenomenon cyberbullying and its recent emergence, further studies are needed, particularly longitudinal, to understand the relationship between antecedent and/or consequential to cyberbullying behaviours between negative emotional states and experiences of shame.

Vergonha e Solidão na Doença Mental Crónica: contributo de um estudo exploratório

Este estudo pretende explorar a natureza da vergonha, enquanto vivência emocional, e a sua relação com a solidão nos doentes mentais crónicos. Foi avaliada a vergonha interna e externa, a solidão, e estados emocionais negativos, nomeadamente a depressão, ansiedade e stress. Nesta investigação participaram 41 utentes com diagnóstico de perturbação mental. Para avaliar as variáveis psicológicas pretendidas foi utilizada a Escala de Vergonha Interna (ISS), a Escala de Vergonha Externa (OAS), A Escala de Solidão UCLA e a Escala de Depressão, Ansiedade e Stress (DASS-21). Os resultados indicaram que os doentes mentais da nossa amostra apresentam maiores níveis de vergonha comparativamente à população geral. São as mulheres que apresentam valores mais elevados de vergonha interna, enquanto os divorciados apresentam maiores índices de vergonha externa e de solidão. Os doentes que têm uma actividade laboral manifestam menores níveis de solidão e de depressão. Quanto mais elevadas as habilitações literárias dos participantes, menor é o nível de ansiedade. No estudo de comparação entre doentes institucionalizados e não-institucionalizados, verificou-se que os primeiros apresentam níveis significativamente mais elevados de ansiedade, não se distinguindo relativamente à percepção de solidão e de vergonha (interna e externa). A análise da relação entre as variáveis evidenciou que os valores de vergonha interna e de solidão estavam associados de forma positiva e elevada à depressão e de forma moderada à ansiedade e stress. Não obstante as limitações reconhecidas, o presente estudo contribuiu para um melhor conhecimento dos estados emocionais negativos nos doentes mentais. / This study aims to explore the nature of shame, while emotional experience and its relationship with loneliness in the chronic mentally ill. We evaluated the internal and external shame, loneliness, and negative emotional states, including depression, anxiety and stress. 41 users participated in this investigation with a diagnosis of mental disorder. To assess the psychological variables was intended to use Internal Shame Scale (ISS), the Foreign Shame Scale (OAS), the UCLA Loneliness Scale and the Scale for Depression, Anxiety and Stress (DASS-21). The results indicated that the mentally ill in our sample have higher levels of shame compared to the general population. They are women who have higher levels of internal shame, while the divorced have higher rates of external shame and loneliness. Patients who have a work activity demonstrate lower levels of loneliness and depression. The higher the educational level of participants, the lower the level of anxiety. In the comparative study of institutionalized patients and non-institutionalized, it was found that the former have significantly higher levels of anxiety, not distinguishing relation to the perception of loneliness and shame (internal and external). The analysis of the relationship between the variables showed that the values of internal shame and loneliness were positively associated with depression and high and moderately to anxiety and stress. Despite the recognized limitations, this study contributes to a better understanding of negative emotional states in the mentally ill.

A Solidão e o Auto-Conceito na Idade Adulta e Velhice

Neste estudo propomo-nos estudar as possíveis diferenças existentes entre a idade adulta e a velhice ao nível da solidão e do auto-conceito. Analisámos o papel de variáveis psicossociais específicas e de variáveis psicológicas, como a depressão, ansiedade, stresse e estilos de coping, sobre a solidão, bem como qual o conjunto de variáveis que melhor prediz a solidão. A solidão e o auto-conceito constituem constructos relevantes na vida do ser humano nas mais variadas formas, interagindo com um grande leque de domínios pessoais e desempenhando um papel importante na compreensão da psicopatologia. Nesta investigação participaram 222 sujeitos, com idades compreendidas entre 35 e 90 anos de idade. Para avaliar as variáveis psicológicas pretendidas foi utilizada a Escala de Solidão da UCLA, o Inventário Clínico de Auto-conceito, a Escala de Depressão, Ansiedade e Stresse (DASS-21) e o Questionário de Estratégias de Coping (CSQ). Os resultados indicaram que os indivíduos em idade adulta e na velhice não diferem na experiência de solidão, embora apresentem diferenças significativas ao nível de autoconceito, com os idosos a revelarem um pior auto-conceito. São os indivíduos com um trabalho doméstico, com menor escolaridade, com uma relação conjugal pouca satisfatória, com um nível sócio-económico baixo, com uma saúde pobre e sem suporte social que apresentam valores mais elevados de solidão. Na análise da acção conjunta das variáveis, o auto-conceito e os estilos de coping revelaram-se os melhores preditores da solidão. Não obstante as limitações reconhecidas, o presente estudo contribuiu para um melhor conhecimento desta realidade na população portuguesa adulta e idosa.