Psychology and Health – Institute of Research and Advanced Training in Health Sciences and Technologies

GROUP LEADER | MAJOR INTERESTS | RESEARCH TEAM | CURRENT PROJECTS | RELEVANT PUBLICATIONS

Psychology and health header

GROUP LEADER
José Carlos Rocha | ORCID

MAJOR INTERESTS

The history of this group is based on a team that, in 1996, made the first steps for the organization of primary healthcare psychology services in northern Portugal, since 2007 have organized a research unit (UnIPSa) that has merged on a major effort on clinical and health sciences, being today a group of IINFACTS.
This group has a research focus on the bio-psycho-social connections of health, as the neuropsychological mechanisms underlying dysfunction, as the stress related to crisis or traumatic events effects on health and as the mental wellbeing correlates with health conditions, for example, cardiopathies, dementia and fetal abnormalities. The projects implemented in this group envisage the interception of research areas promoting original ideas to provide solutions, translating Psychology most advanced models and methods to practice. The focus on evidence-based research is a major drive of the group and we thrive to organize complex trials, epidemiological and correlation research on specific fields and problems with an intrinsically collaborative attitude to hospitals, primary healthcare centers and others research groups.

We aim to:

produce evidences on epidemiological, risk and protective, factors of mental outcomes of several health conditions, combining variables in complex predictive models;
build up instruments providing robust methods to access psychological variables of health, for outcome and risk/protective variables;
develop new approaches to prevent and treat mental health consequences of critical or chronic conditions:
implement pragmatic randomized controlled trials of new psychological approaches providing clear evidences for decision makers.

RESEARCH TEAM

PhD Students
Sofia Carreira | sofiajoaocarreira@gmail.com | ORCID

Volunteers
Gerly Gonçalves | gerlygoncalves@chaa.min-saude.pt |

CURRENT PROJECTS

Project POSOL-DERM-CESPU-2016: Characterisation of posologic instrution patterns in dermatology. | PI: Vera Almeida | Team: Vera Almeida, Carmen Maribel Teixeira, Ana Isabel Teixeira, Isabel Almeida, Sofia Magina, Tiago Torres | Funding Entity: CESPU | Period covered: 04-2016 to 03-2017

Project: Dementia and cognitive impairment | PI: Bruno Peixoto

Dementia and cognitive impairment makes up a serious worldwide problem. Dementia is at the top 10 of the leading causes of burden of disease in high-income countries. In Western Europe the prevalence of dementia for people aged over 60 it is estimated in 7.3% and the number of cases will increase up to 40% until 2030. International guidelines recommend keeping a surveillance attitude by using general cognitive screening tests in individuals with suspected cognitive impairments. This is especially relevant in primary care settings, where dementia and cognitive impairment are often under diagnosed because of the high number of patients by physician and the limits of the available instruments.

Aims:
-To characterize neurocognitive changes in aging and dementia;
– To develop and/ or adapt neurocognitive screening instruments for clinical use;
– To understand the contribution of clinical and sociodemographic variables to neurocognitive functioning and quality of life in several systemic pathologies

Project: Manipulation of Emotion in Virtual Reality Environments: Methodological Validation | PI: Luís Monteiro

The main objectives of this work were to test if it was possible to conciliate Virtual Reality techniques with the recording of neurophysiological data, and to develop and validate new methodological paradigms to study the psychobiology of emotion. Using Virtual Reality we were able to replace the subject’s passivity while viewing pictures with affective content for the properties of immersion and presence enabled by stimulation with virtual environments. We believe these are fundamental features of the stimuli that can increase the intensity of the emotional response of the subject and, therefore, mimicking the real life contingencies.
This empirical work was divided into four main studies. The first study consisted in selecting 3D stimuli similar to those used in the traditional methodological approach to study emotion. We selected 131 stimuli, which were normalized and validated using the Self-Assessment Manikin, in a sample of 214 healthy subjects. The results obtained were consistent with previous studies conducted with 2D stimuli, allowing the development of a Database of Affective 3D Pictures. Using stimuli contained in this database, we created three 3D Affective Induction Scenarios: a Pleasant scenario, composed by stimuli with high valence and arousal ratings; a Neutral scenario, composed by stimuli with intermediate values of valence and low values on arousal; and, finally, an Unpleasant scenario, composed by the stimuli with the lowest valence and higher arousal ratings. In the second study, we tested if the induction of emotions with 3D stimulation techniques caused more intense emotional responses than with 2D techniques. To that end we recorded behavioral and peripheral physiological measures associated with the visualization of the three Affective Induction Scenarios in two modalities (2D vs.. 3D). Results suggested that 3D visualization causes more intense emotional responses. The third study aimed at testing the interference of emotional information in the neurocognitive processing, through Event-related Potential analysis in a dual-task auditory oddball paradigm. Our results showed that emotional induction through 3D stimulation recruits more attentional resources than through 2D stimulation, causing a greater interference in the cognitive processing. Finally, in the fourth study, we presented indexes of brain activation obtained through Functional Magnetic Resonance Imaging (fMRI) when subjects were exposed to the Affective Induction Scenarios in two modalities (2D vs.. 3D). Results indicate that 3D visualization is associated to higher activation of the amygdala complex. With this work, we concluded that using 3D technology in emotional stimulation has potential to induce a greater emotional loading, which is translated in physiological, neurophysiological and behavioral indexes.

Project: Impact of Fetal Heart Maturity in Brain Development and in Neurocognitive Function in Adolescents and Younf Adults with Congenital Heart Disease Psychosocial Status, Psychiatric Morbidity and Quality of Life | PI: Maria Emília Guimarães Areias

Project: Postnatal Depression in Women and Men and its impact on the Development of Babies: Follow-up study | PI: Maria Emília Guimarães Areias

Project: Complex Posttraumatic stress in Angola and Portugal: veterans and civil population assessment | PI: José Rocha | Team: In collaboration with Marylène Cloitre

Angolan Civil War (1975-2002) had high impact on both civilian and military and was not studied envisaging clarification of long term effects, including Complex Posttraumatic Stress Disorder (C-PTSD). The general aim is to describe traumatic exposure and traumatic symptoms in both civilians and military, including PTSD, C-PTSD and Borderline Personality (BPD) symptoms 14 years after conflict. Also we aim to correlate this data with Posttraumatic growth and Attachment.
There will be two samples, one from Portugal with 100 participants and another from Angola with 150 participants using the new instrument to assess C-PTSD symptoms based on ICD-11 proposals.
PTSD and C-PTSD can be severe and highly dysfunctional disorders and there are particularly high frequencies on veterans from Angola. We discuss the need for specific assessment and intervention both civilians and militaries exposed to Angolan Civil War. Also raise awareness about traumatic stress associations with difficulties on human relationships. Another implication is related to Borderline symptoms association with traumatic events exposure.

Project: Prolonged grief and traumatic stress symptoms in psychiatric samples (suicide attempts and in schizophrenic patients) | PI: José Rocha | Team: In collaboration with Centro Hospitalar Vale do Tâmega e Sousa

The associations between traumatic-stress and borderline personality symptoms with suicidal ideation are well-known clinical and epidemiological evidences. Considering new developments on C-PTSD assessment, we aim to correlate specific complex traumatic symptoms with suicidal ideation in patients in the aftermath of suicidal attempt. Association between complex symptoms and history of traumatic exposure may clarify new needs for prevention, assessment and treatment. Also, there are strong epidemiological ties between early parents grief experiences with raised risk for schizophrenia which are still unexplained.
Target sample has 100 patients on follow-up routine assessment at least one week after a suicidal attempt. The instruments used were a Socio-demographical questionnaire, the Portuguese versions of ICD-11 Trauma Questionnaire, the Suicidal Ideation Questionnaire (QIS) and Life-events Checklist. Another sample of schizophrenic patients and caregivers will provide evidence for those symptoms on such a specific population.
Results describe exposure history in general and for specific events, PTSD, C-PTSD and BPD symptoms. Correlation have been pooled and the strongest relation was with exposure to traumatic events and QIS results (r=.34). Comparing results of ITQ with reference sample (healthy participants) results through t-test, there are significative more symptoms on participant with suicidal attempts.
Discussion on the relevance of traumatic history and screening of traumatic stress symptoms on the care to patients with suicidal attempts is provided, considering the limitations and future projects. Also, the projects will for the first time provide explanation for the connections between mother’s grief and high schizophrenia risk.

Project: IPG-C A scale for children’s grief symptoms: Portuguese version | PI: José Rocha | Team: In collaboration with Paul Boelen and Mariken Spuij (Utrecht University)

The Inventory of Prolonged Grief – Children (IPG-C) is a measure designed for children assessment of prolonged grief symptoms. The Portuguese version will have practice implications and will enable further research on such a complex and relevant theme for children mental health.
We aim to translate IPG-C and to verify its psychometric characteristics. To achieve these goals, we translated, blind back-translated, and achieved agreement between versions. Based on snow-ball sampling strategy, we included children with history of bereavement with ages between 8 and 12 years in northern Portugal. We used a sociodemographic questionnaire including loss-related variables, an instrument for traumatic exposure in children, IPG-C and CRIES-13 Portuguese versions.
We present the translated items, describe the general characteristics of the scale, the reliability analysis and factor analysis results. Also, present results of external validity study with bivariate analysis correlating results with CRIES-13.
The importance of grief symptoms in children assessment is emphasized, with special applicability in support organizations, healthcare systems and schools, considering its relevance on children well-being, mental health and academic achievement. The implications to practice, applicability on children screening and future research concerning children’s grief controversies and the need to pursue adolescent translation of this instrument are discussed.

Project: Decision attributes on non-invasive prenatal diagnosis: Portuguese sample on a large collaborative group | PI: José Rocha | Team: In collaboration with Melissa Hill (University College of London)

This project aims to compare the preferences of women and health professionals from different countries for key attributes of non-invasive and invasive prenatal tests for Down syndrome.
A questionnaire incorporating a discrete choice experiment was used to obtain participants’ stated preference for diagnostic tests that varied according to four attributes: accuracy, time of test, risk of miscarriage, and provision of information about Down syndrome only or Down syndrome and other conditions. Women and health professionals are being recruited from nine countries; the UK, Italy, Portugal, Iceland, Denmark, the Netherlands, Israel, Singapore and Canada. This project will focus on the Portuguese sample.
Preliminary analysis shows that differences between women’s and health professionals’ preferences are marked across countries. Furthermore, as there is significant variation in women’s preferences for testing between countries, approaches to implementation and service delivery may need to differ between countries. As all women place great emphasis on test safety when making decisions about prenatal testing, it is important that pre-test counselling for NIPT includes issues beyond safety and ensures women understand the possible implications of test results. Analysis of data from nine countries will be presented.

RELEVANT PUBLICATIONS

Areias MEG, Serra E, Caldas JC, Quintas J

.2014

. The Impact of Pain on Breast Cancer Patients Quality Life: Pain Associated Psychosocial Factors (Journal Article)

Journal of Psychiatry: Open Access, 17 (6), pp. 1000173, ISSN: 1994-8220.DOI: 10.4172/1994-8220.1000173.