Palmeira, Lara

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Lara Palmeira


Lara Sofia Nascimento Palmeira, Licenciada em Psicologia, Mestre em Psicologia Clínica e da Saúde e Doutorada em Psicologia pela Universidade de Coimbra. Concluiu o seu doutoramento em 2017 intitulado “When weight stigma gets under the skin: The development of Kg-Free: A new integrated acceptance, mindfulness, and compassion-based group intervention” onde investigou a eficácia de uma intervenção centrada na aceitação, atenção plena, e autocompaixão para mulheres com excesso de peso e obesidade. A sua investigação tem-se focado na aplicação das terapias cognitivo-contextuais de 3ªgeração (por exemplo, ACT, CFT, Mindfulness), mais especificamente sobre o papel das estratégias de regulação emocional no estigma e no bem-estar em pessoas com diversos problemas de saúde e também na implementação e teste de eficácia das intervenções grupais baseadas na aceitação, na compaixão e na atenção plena na promoção da saúde e bem-estar de diferentes populações. Afiliação: IJP - Instituto Jurídico Portucalense. DPE - Departamento de Psicologia e Educação.

Projetos de investigação

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IJP - Instituto Jurídico Portucalense
O Instituto Jurídico Portucalense (IJP) é um centro de investigação em ciências jurídicas que tem como objetivo principal promover, apoiar e divulgar a investigação científica nessa área do saber produzida na Universidade Portucalense e nos Institutos Politécnicos de Leiria e de Lisboa, suas parceiras estratégicas.

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  • PublicaçãoAcesso Aberto
    The Three-Factor Eating Questionnaire-R21: A confirmatory factor analysis in a Portuguese sample
    2020 - Duarte, Patrícia; Pinto-Gouveia, José; Palmeira, Lara
    The Three-Factor Eating Questionnaire (TFEQ) is one of the most widely used instruments to study different eating behaviors. It measures three types of eating behaviors namely: cognitive restraint, uncontrolled eating and emotional eating. The present study aims to evaluate the factor structure and reliability of the Portuguese version of the TFEQ-R21, using a confirmatory factor analysis (CFA). The sample includes 468 participants from the general population, with ages ranging from 18 to 60 years. Results from the CFA confirmed the TFEQ-R21 three-factor structure and the model revealed an acceptable fit to the data (χ2(186) = 443.211, p < 0.001; χ2/df = 2.329; CFI = 0.933; TLI = 0.925; RMSEA = 0.054; SMRS = 0.053). Multigroup analysis results support strong measurement invariance across genders. Furthermore, all three dimensions presented adequate psychometric properties. Overall, results support that the Portuguese version of the TFEQ-R21 is a useful, reliable and robust instrument to assess relevant eating behaviors.
  • PublicaçãoAcesso Aberto
    Southampton mindfulness questionnaire: Confirmatory factor analysis and psychometric properties across portuguese clinical and non‐clinical samples
    2021-08-15 - Martins, Maria João; Marques, Cristiana C.; Guiomar, Raquel; Castilho, Paula; Xavier, Ana; Palmeira, Lara
    Objectives Southampton Mindfulness Questionnaire (SMQ) is one of the available instruments to assess mindfulness and has been described as particularly suited for clinical populations. The original study of the SMQ conceptualized it as having four facets, but yielded a single factor structure. The aim of this study was to confirm the SMQ factor structure and examine its psychometric properties in clinical and non-clinical Portuguese samples. Methods The community sample comprised 243 participants, ranging from 18 to 77 years. Additionally, to assess sensitivity, two distinct samples were used: individuals with meditation experience (n = 30) and a clinical sample (43 individuals with psychosis). Factor structure, reliability, validity, and sensitivity analyses were performed. Results Confirmatory factor analyses of the SMQ seem to support one overarching mindfulness construct containing four facets, revealing an acceptable fit through a parceling method. Significant correlations were obtained between SMQ and another mindfulness measure, and also with measures of cognitive fusion, and positive and negative affect. Results also indicated significant differences in SMQ non-judging facet between meditators and non-meditators and clinical samples. Conclusions The results indicate that although the SMQ has shown adequate reliability and validity, some limitations to the measure have been found. Further studies are needed, particularly with clinical samples, to determine how the current SMQ version could be improved and whether it should be revised.
  • PublicaçãoAcesso Aberto
    The longitudinal impact of psychological flexibility and compassion on mother-baby bonding: Care4mmmies study protocol [comunicação oral]
    2023-03-30 - Mateus, Vera; Palmeira, Lara; Xavier, Ana; Silva, Joana Ribeiro da; Vagos, Paula
    Becoming a mother is a life-changing event that is often experienced in a positive way, but may also encompass great vulnerability and uncertainty, with the potential to hinder the mother’s well-being and foster disorganization, particularly for women with attachment difficulties dealing with a difficult infant. Risk factors to the quality of mother-infant emotional bonding are well documented, whereas research into the mothers’ protective and modifiable factors is scarcer. Psychological flexibility and compassion are adaptive emotional regulation strategies that have been linked to the wellbeing and mental health in diverse populations. The current work intends to present the Care4mommies project, which aims to examine whether prenatal maternal compassion (towards others and the self) and psychological flexibility play a protective role in the development of postpartum mother-infant bonding over time and whether this effect remains relevant regardless of mothers’ attachment style and infant temperament. Participants will be pregnant women to be assessed between 22 and 30 weeks of gestation (T0) and when the infant is three (T1) and nine months old (T2). Participants will respond to an online survey that includes sociodemographic information and questionnaires about their compassion and psychological flexibility to be completed at all three assessments. In addition, mothers’ own attachment style will be reported during pregnancy, and infant temperament and mother-infant bonding questionnaires will be administered at T1 and T2. Recruitment will take place through social media advertising, colleagues and acquaintances of the research team members, and family health units attending pregnant women. Data will be analysed using a structural equation modelling approach. Overall, we expect that higher levels of mother’s compassion and psychological flexibility will predict higher quality of mother-infant bonding. In addition, we expect that the impact of less adaptive maternal attachment styles and infant difficult temperament on mother-infant bonding will be moderated by mother’s compassion and/or psychological flexibility. Finally, we expect mother-infant bonding at T2 to be predicted by mothers’ attachment style, compassion and psychological flexibility, infant temperament, and mother-infant bonding previously assessed. The study findings will clarify whether mothers’ compassion and psychological flexibility may be protective for mother-infant bonding, which can inform future studies in designing and testing specific parental interventions to promote a secure mother-infant bond in the postpartum period.
  • PublicaçãoAcesso Restrito
    Online compassion focused therapy for overeating (CFT-OE): Feasibility and acceptability pilot study
    2023-12-21 - Marques, Cristiana; Castilho, Paula; Rodrigues, Dírcea; Mayr, Andreas; Soares Pina, Tiago; Pereira, Ana Telma; Castelo-Branco, Miguel; Goss, Kenneth; Palmeira, Lara
    Objective: This pilot study aims to investigate the feasibility, acceptability and potential effectiveness of online Compassion Focused Therapy for overeating (CFT-OE). Method: Eighteen Portuguese women seeking treatment for overeating enrolled in this study, and 15 participants completed the CFT-OE. This was a single-arm study. Participants were assessed at pre- and post-intervention and 3-month follow-up. All participants completed measures assessing binge eating, cognitive restraint, uncontrolled eating, emotional eating, general eating psychopathology, general and body shame, self-criticism, self-compassion and fears of self-compassion. Results: The treatment attrition rate was 16.7%, which is relatively low compared to other similar online interventions. Participants gave positive feedback on the program and indicated they would recommend it to people with similar difficulties. CFT-OE improved self-compassion and reduced eating psychopathology symptoms, general and body shame, self-criticism and fears of self-compassion. Clinical significance analysis showed that the majority of participants were classified as in recovery in all measures at post-intervention and 3-month follow-up. Discussion: Preliminary results suggest that the online CFT-OE program is an acceptable and feasible intervention. Results also suggest that CFT-OE is beneficial for the treatment of women with difficulties with overeating. A future randomized controlled trial is necessary to establish the effectiveness of the CFT-OE.
  • PublicaçãoAcesso Aberto
    Development of a theory and evidence-based digital intervention tool for weight loss maintenance: The NoHoW Toolkit [preprint]
    2020-10-21 - Marques, Marta; Matos, Marcela; Mattila, Elina; Encantado, Jorge; Duarte, Cristiana; Teixeira, Pedro; Stubbs, James; Sniehotta, Falko; Ermes, Miikka; Harjumaa, Marja; Leppänen, Juha; Välkkynen, Pasi; Silva, Marlene; Ferreira, Cláudia; Carvalho, Sérgio; Horgan, Graham; Lilienthal Heitmann, Berit; Evans, Elizabeth; Palmeira, António; Palmeira, Lara
    Background: Many weight loss programs show short-term effectiveness, but subsequent weight loss maintenance is difficult to achieve. Digital technologies offer promising means to delivering behaviour change approaches at low cost and on a wide scale. The NoHoW project was a European Commission H2020-funded project aimed to develop, test, and evaluate a digital Toolkit designed to promote successful long-term weight management. The Toolkit was tested in an 18-month large-scale international 2 x 2 factorial (motivation and self-regulation versus emotion regulation) randomised controlled trial, conducted in overweight/obese adults who lost ≥5% of their body weight in the preceding twelve months before enrolment into the intervention. Objective: This paper describes the development of the NoHoW Toolkit focusing on the logic models, content and specifications, and results from user testing. Methods: The Toolkit was developed using a systematic approach including (1) development of the theory-based logic models, (2) selection of behaviour change techniques, (3) translation of these techniques into a digital web-based app (NoHoW Toolkit components), (4) technical development, (5) user evaluation and refinement of the Toolkit. Results: The Toolkit included a set of web-based tools and inputs from digital tracking devices (smart scales and activity trackers), with modules targeting weight, physical activity, and dietary behaviours. The final Toolkit was comprised of 34 sessions, distributed through 15 modules, providing active content over a 4-month period. The motivation and self-regulation arm consisted of 8 modules (17 sessions), the emotion regulation arm was presented with 7 modules (17 sessions), and the combined arm received the full Toolkit (15 modules, 34 sessions). The sessions included a range of implementations, such as videos, testimonies, and questionnaires. Further, the Toolkit contained 5 specific data tiles for monitoring weight, steps, healthy eating, mood and sleep. Conclusions: A systematic approach to the development of digital solutions based on theory, evidence, and user testing, may significantly contribute to the advancement of the science of behaviour change and improve current solutions for sustained weight management. Testing the Toolkit using a 2x2 design provided a unique opportunity to examine the effect of motivation and self-regulation and emotion regulation separately, as well as the effect of their interaction in weight loss maintenance.
  • PublicaçãoAcesso Aberto
    The Me and the Us of Emotions: a cluster-randomized controlled trial of the feasibility and efficacy of a compassion-based social– emotional learning program for children
    2023-11-01 - Menezes, Paulo; Patrão, Bruno; Mendes, Sofia; Tavares, Marta; Xavier, Ana; Palmeira, Lara; Vagos, Paula
    There are well-established benefits of social and emotional learning (SEL) programs for children within educational contexts. Combining social–emotional skills and compassion abilities has been seldomly done, and it may be valuable at individual and societal levels, for resilient, empathetic, and inclusive societies. This study explored the feasibility and efficacy of a program designed to promote socioemotional and compassion skills in children attending the 3rd and 4th grades, by using in-class dynamics complemented with serious games. This program, named “The Me and the Us of Emotions,” is part of the Gulbenkian Knowledge Academies 2020 and consists of 10 group sessions embedded in the school curriculum. Using a cluster-randomized controlled trial design, school classes were allocated to intervention (classes, n = 8; children, n = 163) and control groups (classes, n = 6; children, n = 132). During the program, facilitators assessed adherence to the sessions’ plan, attendance, dosage (i.e., how many sessions were delivered), and participant responsiveness. Children completed self-report measures of social–emotional skills and emotional climate at pre-, post-intervention, 3-month, and 6-month follow-ups. Results indicate that the program is feasible, with high adherence, high attendance rate, and participant responsiveness. Results also indicate empathy, soothing, and drive feelings to change from pre-intervention to all other assessment moments, for the intervention group only. Moreover, cooperation and threat changed over time for participants in both the control and the intervention groups. The current study offers empirical support for the feasibility and utility of a compassion- based social–emotional learning program on promoting children’s empathy, and emotions of soothing and vitality in the school context. Thus, these findings contribute to recent research on the potential added value of compassion practices within an SEL program.
  • PublicaçãoAcesso Restrito
    Finding the link between internalized weight-stigma and binge eating behaviors in Portuguese adult women with overweight and obesity: The mediator role of self-criticism and self-reassurance
    2017-08-01 - Pinto-Gouveia, José; Cunha, Marina; Carvalho, Sérgio; Palmeira, Lara
    Literature has emphasized the negative role of internalized self-stigma in unhealthy eating behaviors in individuals with overweight and obesity. Still, less is known about the psychological processes that mediate this relationship. Self-criticism and the inability to reassure the self are considered to play crucial roles on eating behaviors. This study aims to: 1) explore the associations between BMI, weight self-stigma, self-criticism, self-reassurance and binge-eating; 2) explore differences in weight self-stigma and self-criticism tendencies between women with and without Binge Eating Disorder (BED); 3) test the mediator effect of self-criticism and self-reassurance on the relationship between weight self-stigma and binge-eating severity. Participants were 125 Portuguese adult women with overweight and obesity (MBMI= 34.44; SD =5.51). Participants were weighted and completed a set of self-report measures. BED was assessed through a clinical structured interview. Results showed that women with BED display higher levels of weight self-stigma and self-criticism and lower tendencies to be self reassuring, than women without BED. Additionally, the mediation model tested indicated that the effect of weight self-stigma on binge eating severity was in part partially mediated by a self-to-self relationship that is critical, harsh and punitive and by a decreased ability to be reassuring when facing setbacks. Overall, the model accounted for 45% of binge eating symptoms severity. These findings may inform clinical practice with clients who present high levels of weight self-stigma. Results suggest the relevance of targeting self-criticism and promoting a self-to-self relationship that is caring and reassuring, as a way of diminishing binge eating behaviors.
  • PublicaçãoAcesso Aberto
    The role of self-disgust in eating psychopathology in overweight and obesity: Can self-compassion be useful?
    2019-11-13 - Pinto-Gouveia, José; Cunha, Marina; Palmeira, Lara
    This study explores the relationship between self-disgust and eating psychopathology and whether self-compassion plays a mediator role on this relationship. Participants were 203 adults, from both genders, with overweight and obesity (MBMI = 31.17, SD = 5.43). Women reported higher levels of self-disgust and eating psychopathology and lower levels of self-compassion than men. Path analysis’ results suggested that the effect of self-disgust on eating psychopathology occurred partially through one’s inability to be self-compassionate. Results highlight the damaging role of self-disgust on eating psychopathology and the importance of developing a more compassionate attitude towards the self to promote healthy eating behaviors.
  • PublicaçãoAcesso Aberto
    The Clinical Interview for Psychotic Disorders (CIPD): Preliminary results on interrater agreement, reliability and qualitative feedback
    2019 - Martins, Maria João; Castilho, Paula; Macedo, António; Pereira, Ana Telma; Pinto, Ana; Carreiras⁠, Diogo; Barreto-Carvalho, Célia; Palmeira, Lara; Xavier, Ana
    Given the recent treatment paradigm shift in psychosis, focusing on the recovery process, new assessment tools are needed. The Clinical Interview for Psychotic Disorders (CIPD) is an integrative and comprehensive assessment tool for psychotic disorders. CIPD encompasses the evaluation of diagnosis, psychosocial correlates and most relevant comorbidities. The study's aims were to examine CIPD inter-rater reliability, the relationships between CIPD and other instruments assessing positive and negative symptoms and functionality, and to explore participants’ qualitative feedback. The sample included 30 individuals with psychotic disorders, aged between 18 and 62 years old. Two experts in clinical psychology conducted the interviews and independently rated other assessment tools (PANSS, GAF and PSP) to determine severity of psychotic symptoms and levels of functionality. Results indicated high inter-rater reliability for the majority of CIPD items and agreement regarding diagnosis was between 73% and 93%. Moreover, positive and moderate to strong correlations were found between CIPD, PANSS, GAF and PSP. From the qualitative analysis five themes emerged, namely: CIPD applicability and utility, comparison with previous interviews, interviewer aspects, negative and positive aspects. Overall, these preliminary results suggest that CIPD is a reliable and valid assessment instrument that seems to be well suited for people with psychosis.
  • PublicaçãoAcesso Aberto
    Next-generation sequencing of 12 obesity genes in a Portuguese cohort of patients with overweight and obesity
    2023-04 - Manco, Licínio; Pereira, Janet; Fidalgo, Teresa; Cunha, Marina; Pinto-Gouveia, José; Padez, Cristina; Palmeira, Lara
    We examined 12 monogenic obesity genes in 72 Portuguese individuals with overweight and obesity (class 1 and class 2), some of which with suspected genetic obesity, to identify known or unknown potential obesity variants. Genomic DNA was analyzed for variants in genes LEP, LEPR, MC4R, POMC, PCSK1, BDNF, NTRK2, SIM1, SH2B1, UCP3, GCG and ADCY3 through next generation sequencing (NGS). The impact of the rare variants was investigated in the ClinVar database and using in silico tools for prediction of pathogenicity. Four potential pathogenic missense variants were detected at the heterozygous state in five individuals: two in the ADCY3 gene, NM_004036.5:c.1153G > A (p.Val385Ile) (rs756783003) and NM_004036.5:c.1222G > A (p.Gly408Arg) (rs201606553), one in gene SH2B1, NM_001145795.1:c.127C > A (p.Arg43Ser) (rs547678855), and the fourth in gene POMC NM_000939.4:c.706C > G (p.Arg236Gly) (rs28932472), which was found in two individuals. Moreover, six rare variants near splicing sites were also identified, as well as eight rare synonymous variants. In summary, some potential pathogenic rare missense variants were identified, two of them in ADCY3 gene, the most recently identified gene as having a role in monogenic obesity. Further analysis should be performed to confirm the clinical relevance of these variants.