Estado emocional e satisfação com o suporte social após uma interrupção voluntária da gravidez

Dissertação de Mestrado apresentada no Instituto Superior de Psicologia Aplicada para obtenção de grau de Mestre na especialidade de Psicologia Clínica

Modeling the impact of social discrimination on the physical and mental health of portuguese gay, lesbian and bisexual people

Background: Despite growing acceptance of same-sex sexuality in Portugal, identity development of lesbian, gay and bisexual (LGB) individuals is still restricted by negative societal attitudes, which maintain the experience of stigmatization and discrimination. The purpose of this study is to document the frequency of discriminatory events experienced by sexual minorities and their association with indicators of physical and mental health in Portugal. Methods: A total of 610 LGB participants completed an online survey (mean age = 34.48, SD = 11.54). Most participants were single and self-identified as gay (73.8%). The survey included five categories of survey items: demographic information, social support, physical health, mental health, and discrimination experiences. Results: Physical and mental health results revealed that bisexual people were more likely to report higher levels of psychological distress than gay men. Overall, between one-fifth and one-fourth of the participants in this sample frequently felt the need to hide their sexual orientation to prevent discrimination experiences across the different settings. Regarding actual discrimination experiences, close to 20% reported having suffered from verbal abuse, followed by close to 10% who suffered from written threats, harassment, and physical threats. A hierarchical multiple regression analysis was performed to assess the effects of anticipated and actual discrimination on mental health. Possible confounding variables were added in the first block – age, sexual orientation, being in a relationship, body mass index, and HIV status. Anticipated and actual discrimination experiences were added in the second block. The first block of the analysis explained 6% of the overall variance, while the second block – discrimination experiences – explained an additional 17%. Conclusion: Portuguese culture and stigma/discrimination create discriminatory experiences which impact LGB people’s health. Unless policies are changed to allow for the acceptance of LGB people, they will continue to experience violence and discrimination as a result of homophobia.

A Social Cognitive Approach to Coping with Acculturative Stress in International Students

The present study employed a cross-sectional design to test a model of coping with acculturative stress in an international student sample. Drawing from Lent’s (2004) social cognitive model of restorative well-being, several direct and mediated paths were hypothesized to predict (negatively) acculturative stress and (positively) life satisfaction. Behavioral acculturation and behavioral enculturation (Kim & Omizo, 2006) were also examined as predictors of coping with acculturative stress among international students. Using a self-report survey, participants’ ratings of acculturative stress, life satisfaction, social support, behavioral acculturation, behavioral enculturation, and coping self-efficacy were assessed. The results revealed that the variables of the model explained 16% of the variance in acculturative stress and 27% of the variance in life satisfaction. A final model, including the use of modification indices, provided good fit to the data. Findings also suggested that coping self-efficacy was a direct predictor of acculturative stress, and that behavioral acculturation and coping self-efficacy were direct predictors of students’ life satisfaction. Limitations, future research, and practical implications are discussed.

The Effect of Supportive Social Interaction Priming on Children's Prosocial Comforing Responses to Distressed Others

The ability to sensitively care for others’ wellbeing develops early in ontogeny and is an important developmental milestone for healthy social, emotional, and moral development. One facet of care for others, prosocial comforting, has been linked with important social outcomes such as peer acceptance and friendship quality, underscoring the importance of determining factors involved in the ability to comfort. Although social support has been linked with a number of important social outcomes, no study has directly examined whether felt social support can foster children’s positive behavior toward others. The purpose of the current investigation was to use an experimental priming paradigm to demonstrate that felt social support a) enhances children’s ability to respond prosocially to the distress of others and b) decreases children’s expressions of personal distress when faced with the distress of another person. Participants were 94 4-year-old children (M = 53.56 months, SD = 3.38 months; 52 girls). Children were randomly assigned to either view pictures of mothers and children in close, personal interactions (supportive social interaction condition), happy women and children in separate pictures, presented side-by-side (happy control condition), or pictures of colorful overlapping shapes (neutral control condition). Each set of 20 pictures was presented in the context of a categorization computer game that participants played 4 times throughout the course of the study. Immediately following the first three computer games, children were given the opportunity to comfort someone who was distressed; twice it was the adult experimenter working with the child, and once it was an unseen infant crying over a monitor that participants had been trained to use. Comforting behaviors and distress/arousal were coded in 10-second time segments and yielded a global comforting score and a distress proportion score for each task. Results indicated that priming condition had no effect on either prosocial comforting behavior or expressions of personal distress. I discuss these null findings in light of the available literatures on priming mental representations in children and on prosocial comforting, and suggest some future directions for continued investigation in both fields.

Social and environmental determinants, household food insecurity

Food security is defined as a situation that exists when “all people, at all times, have physical and economic access to sufficient, safe and nutritious food to maintain a healthy and active life. It is a multilevel concept, which includes four main dimensions: availability related to food supply; accessibility in order to ensure the physical and economic access to food; adequacy to meet nutritional needs in quantity and quality while respecting individual food preferences and cultural issues (utilization); and, lastly, stability of the guarantee of food security over time. According to the food security definition, it is abroad concept where all these dimensions are largely affected by a considerable number of factors related to: public policies of different sectors, food production/industry/distribution food systems, marketing and advertising of food, social support networks and individual determinants related to food choice behaviour.

The Role of Attachment in a Social Cognitive Model of Social Domain Satisfaction in College Students

The study examined a modified social cognitive model of domain satisfaction (Lent, 2004). In addition to social cognitive variables and trait positive affect, the model included two aspects of adult attachment, attachment anxiety and avoidance. The study extended recent research on well-being and satisfaction in academic, work, and social domains. The adjusted model was tested in a sample of 454 college students, in order to determine the role of adult attachment variables in explaining social satisfaction, above and beyond the direct and indirect effects of trait positive affect. Confirmatory factor analysis found support for 8 correlated factors in the modified model: social domain satisfaction, positive affect, attachment avoidance, attachment anxiety, social support, social self-efficacy, social outcome expectations, and social goal progress. Three alternative structural models were tested to account for the ways in which attachment anxiety and attachment avoidance might relate to social satisfaction. Results of model testing provided support for a model in which attachment avoidance produced only an indirect path to social satisfaction via self-efficacy and social support. Positive affect, avoidance, social support, social self-efficacy, and goal progress each produced significant direct or indirect paths to social domain satisfaction, though attachment anxiety and social outcome expectations did not contribute to the predictive model. Implications of the findings regarding the modified social cognitive model of social domain satisfaction were discussed.

A experiência de Suporte Social em mulheres com cancro da mama

Dissertação de Mestrado apresentada ao Instituto Superior de Psicologia Aplicada para obtenção de grau de Mestre na especialidade de Psicologia Clínica.

Qualidade de vida, percepção de saúde, resiliência, auto-regulação e suporte social nos adolescentes portugueses com a doencça crónica

Tese de Doutoramento em Psicologia na área de especialidade Psicologia da Saúde

Functional Neuroimaging of the Social Regulation of Emotion in Schizophrenia

Negative symptoms in schizophrenia are characterized by deficits in normative experiences and expression of emotion. Social anhedonia (diminished pleasure from social experiences) is one negative symptom that may impact patients’ motivation to engage in meaningful social relationships. Past research has begun to examine the mechanisms that underlie social anhedonia, but it is unclear how this lack of social interest may impact the typically positive effects of social buffering and social baseline theory whereby social support attenuates stress. The present pilot study examines how social affiliation through hand holding is related to subjective and neural threat processing, negative symptoms, and social functioning. Twenty-one participants (14 controls; 7 schizophrenia) developed social affiliation with a member of the research staff who served as the supportive partner during the threat task. Participants displayed greater subjective benefit to holding the hand of their partner during times of stress relative to being alone or with an anonymous experimenter, as indicated by self-reported increased positive valence and decreased arousal ratings. When examining the effects of group, hand holding, and their interaction on the neurological experience of threat during the fMRI task, the results were not significant. However, exploratory analyses identified preliminary data suggesting that controls experienced small relative increases in BOLD signal to threat when alone compared to being with the anonymous experimenter or their partner, whereas the schizophrenia group results indicated subtle relative decreases in BOLD signal to threat when alone compared to either of the hand holding conditions. Additionally, within the schizophrenia group, more positive valence in the partner condition was associated with less severe negative symptoms, better social functioning, and more social affiliation, whereas less arousal was correlated with more social affiliation. Our pilot study offers initial insights about the difficulties of building and using social affiliation and support through hand holding with individuals with schizophrenia during times of stress. Further research is necessary to clarify which types of support may be more or less beneficial to individuals with schizophrenia who may experience social anhedonia or paranoia with others that may challenge the otherwise positive effects of social buffering and maintaining a social baseline.

Reabilitação psicomotora em contexto da saúde mental de adultos no centro de atividades ocupacionais, Casa do Sol do Centro de Apoio Social do Pisão, Santa Casa da Misericórdia de Cascais

O presente relatório refere-se às atividades, do estágio inserido no Ramo de Aprofundamento de Competências Profissionais do Segundo Ciclo, desenvolvidas no âmbito da Reabilitação Psicomotora em Saúde Mental. Estas práticas de estágio foram realizadas no Centro de Atividades Ocupacionais (CAO) – Casa Do Sol e no Centro de Apoio Social do Pisão (CASP). A Intervenção no CAO e no CASP foi dirigida a indivíduos adultos com perturbação psiquiátrica, de ambos os sexos, residentes e/ou utentes destes centros. Esta intervenção foi constituída pelas seguintes quatro etapas: 1ª Observação informal das aulas de expressão corporal, dos momentos de refeições, dos ateliês de carpintaria, jardinagem, artes plásticas e culinária; 2ª Reabilitação / Intervenção psicomotora (duração aproximada de 6 meses); 3ª Avaliação formal de alguns casos utilizando instrumentos de avaliação nomeadamente a Bateria Psicomotora de Vítor da Fonseca (BPM) e a Escala do Comportamento Adaptativo Verão Portuguesa de Sofia Santos e Pedro Morato (ECAP). 4ª Elaboração e Ajustamento do Plano Terapêutico.

Contributos para a adaptação e aferição de duas medidas de suporte social

"A perceção de suporte social familiar e dos amigos tem uma grande influência no desenvolvimento psicossocial saudável dos adolescentes. Desta forma, propusemo-nos adaptar e aferir para a população portuguesa as escalas de medida Perceção do Suporte Social da Família (PSS-Fam) e dos Amigos (PSS-Am) de Procidado e Heller (1983). Apresentamos os resultados obtidos a partir de uma amostra de 851 adolescentes com idades compreendidas entre os 11 e os 19 anos. Os resultados estão de acordo com os obtidos por Procidano e Heller (1983) que obtiveram uma solução com apenas um fator para cada escala. Os estudos psicométricos revelam, de forma global, bons índices de fiabilidade e validade dos instrumentos. Concluímos contribuindo com duas medidas adequadas para avaliar o suporte social percebido na população adolescente."

Host country nationals' support to expatriates:an investigation in Turkey

Using data from 243 executives in Turkey, we investigate the relationship(s) between perceived values similarity, in-group/out-group categorisation, interpersonal effect and Host Country National (HCN) willingness to offer role information and social support to expatriates. Results of this study confirm that HCNs are more likely to offer support to expatriates whom they categorise as in-group, as well as to those who they perceive as holding similar values. In addition, our data suggest that Turkish HCNs are more likely to offer support to Indian expatriates as compared to expatriates from the USA, and to expatriates who are assigned to work as their supervisors rather than to expatriate subordinates. We discuss implications of our findings for multinational corporations and suggest future research ideas.

Influência do suporte social e das estratégias de coping no stress dos cuidadores informais de idosos

Dissertação de Mestrado apresentada ao Instituto Superior de Psicologia Aplicada para obtenção de grau de Mestre na especialidade de Psicologia Clínica.

Apoio social, saúde mental e bem-estar em idosos institucionalizados e não institucionalizados

O apoio social e o bem-estar são variantes importantes para a saúde mental, em particular, quando se trata da população idosa. O presente estudo visa avaliar o apoio social, o bem-estar e a saúde mental em idosos não institucionalizados e institucionalizados. O método utilizado é o quantitativo, tendo sido realizado um estudo descritivo-correlacional, comparativo, transversal, com uma amostra de 100 idosos: 50 institucionalizados em lar e 50 não institucionalizados, mas que frequentam o centro de dia. Os instrumentos de recolha de dados foram a Escala de Bem-Estar Mental de Warwick-Edimburgh (WEMWBS); a Escala Continuum de Saúde Mental (MHC-SF); a Escala de Rede de Apoio Social de Lubben (LSNS-6); Questionário Sociodemográfico. Genericamente, os resultados demonstram que a maioria dos participantes apresenta níveis elevados de bem-estar, nomeadamente bem-estar emocional, bem-estar psicológico e bem-estar social, encontrando-se maioritariamente em flourishing. Relativamente ao apoio social, este evidencia-se como razoável ao nível da família e baixo ao nível dos amigos. Na análise da relação entre bem-estar, saúde mental e apoio social nos idosos em estudo, foram encontradas correlações estatisticamente significativas positivas entre todas estas dimensões, quer nos indivíduos não institucionalizados e quer nos institucionalizados. Assim, a relação positiva encontrada entre a maioria das variáveis consideradas permite concluir que o bem-estar, a saúde mental e o suporte social se encontram relacionados. Os idosos mais velhos, em particular os institucionalizados, são os que apresentam resultados mais baixos ao nível do bem-estar mental, emocional e suporte social.

Adesão ao tratamento em pacientes com depressão major: A influência da percepção de doença, suporte social, espiritualidade e do estado emocional

Este estudo teve como finalidade investigar a relação entre alguns factores psicossociais e a adesão terapêutica, utilizando como variáveis preditoras, as representações de doença, a ansiedade e depressão as previsões de suporte social, e a espiritualidade e como variáveis de resultado, a adesão ao regime terapêutico, através da avaliação da adesão à medicação. Pretendeu-se testar quatro hipóteses: (1) Prevê-se que as representações de depressão nas suas dimensões da consequências, duração e controlo pessoal e de tratamento, identidade, preocupação, emoções e compreensão da doença sejam preditores significativos da adesão ao tratamento medicamentoso; (2) Prevê-se que os níveis de ansiedade e depressão dos doentes depressivos estarão significativa e negativamente correlacionados com os níveis de adesão ao tratamento medicamentoso; (3) Prevê-se que os níveis de suporte social percebido estarão significativa e positivamente correlacionados com os níveis de adesão ao tratamento medicamentoso e (4) Prevê-se que os níveis de espiritualidade se encontrem significativa e positivamente correlacionados com os níveis de adesão ao tratamento medicamentoso. Tratou-se de um estudo transversal, com desenho correlacionai e foi desenvolvido num Hospital da Região do Alentejo, mais especificamente, num Departamento de Psiquiatria a saúde Mental, com uma amostra não aleatória de 15 pacientes com o diagnóstico de Depressão. Os resultados confirmaram parcialmente a primeira hipótese, sendo as representações de doença, nas suas dimensões controlo pessoal, controlo do tratamento e emoções preditores significativos da adesão (mais especificamente das alterações das doses da medicação). A segunda hipótese também foi confirmada parcialmente, sendo a depressão preditora da adesão (tanto na dimensão do esquecimento, quanto na alteração das doses da medicação). A terceira hipótese foi, também, parcialmente confirmada sendo a aliança fiável preditora significativa da adesão (na dimensão do esquecimento da toma da medicação). Por último, a quarta hipótese foi igualmente confirmada parcialmente sendo a esperança/optimismo preditora significativa da adesão (tanto na dimensão do esquecimento, quanto na alteração das doses da medicação). Nas análises exploratórias verificou-se a influência da variável sócio­ demográfico “sexo” nas representações cognitivas e também na depressão. A "idade" também demonstrou algum efeito nas alterações à medicação e nas provisões sociais. O "estado civil" mostrou efeito no aconselhamento e na oportunidade de prestação de valores. As variáveis clínicas também mostraram ter influência. O "tempo de doença" mostrou efeito significativo nas representações emocionais, nas crenças, esperança/optimismo e no esquecimento da medicação. A "duração do tratamento com medicação" mostrou efeito na compreensão da doença e no esquecimento da medicação. Por fim, são apresentadas algumas implicações da depressão, bem como algumas sugestões para estudos futuros. /ABSTRACT: This study aimed to investigate the relationship between some psychosocial factors and the adherence, using as predictor variables, the representations of illness, the anxiety and depression, the social support predictions, and spirituality, and as outcome variables, adherence to treatment regimen, through the assessment of medication adherence. lt was intended to test four hypotheses: (1) lt is expected that the depression representations in its dimensions of consequences, duration and personal control and treatment, identity, concern, emotions and disease understanding are significant predictors of adherence to therapy; (2) lt is expected that anxiety and depression levels in depressed patients are significantly and negatively correlated with the levels of adherence to therapy; (3) lt is expected that the levels of perceived social support are significantly and positively correlated with the levels of adherence to drug treatment and (4) lt is expected that the levels of spirituality are significantly and positively correlated with levels of adherence to therapy. This was a cross-sectional study with correlational design and was developed in one Hospital of the Alentejo Region, more specifically, in a Department of Psychiatry and Mental Health, with a non¬random sample of 15 patients diagnosed with depression. The results partially confirmed the first hypothesis, being the representations of disease, in its dimensions of personal control, treatment control and emotions, significant predictors of adherence (more specifically, of the changes in the doses of medication). The second hypothesis was also partially confirmed, with depression being a predictor of adherence {both in the extent of oblivion and in the changes of medication doses). The third hypothesis was also partially confirmed, being the trustable alliance a quite significantly reliable predictor of adherence {in the dimension of the medication oblivion). Finally, the fourth hypothesis was equally partially confirmed, being the hope/optimism significant predictor of adherence (both in the extent of oblivion and in changing doses of medication). ln exploratory analyzes, it was verified the influence of socio-demographic variable "sex" in the cognitive representations and also in depression. The "age" also had some effect on changes to medication and social provisions. The "marital status" had effect in the counseling and in the opportunity to provide values. The clinical variables also proved to have influence. "Time sickness" had a significant effect on emotional representations, beliefs, hope/optimism and medication oblivion. The "treatment duration with medication" had effect in the disease understanding and the medication oblivion. Finally, are presented some implications of depression as well as some suggestions for future studies.