Palmeira, Lara
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Palmeira
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Lara
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Lara Palmeira
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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.
BB12-1036-0E27
55974094000
ABB-5495-2020Research Projects
Organizational Units
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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Publication Restricted Access Online compassion focused therapy for overeating (CFT-OE): Feasibility and acceptability pilot study2023-12-21 - Marques, Cristiana; Castilho, Paula; Rodrigues, Dírcea; Mayr, Andreas; Soares Pina, Tiago; Pereira, Ana Telma; Castelo-Branco, Miguel; Goss, Kenneth; Palmeira, LaraObjective: 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.Publication Open Access 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, PaulaBecoming 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.Publication Restricted Access Mother–infant bonding in the first nine months postpartum: the role of mother’s attachment style and psychological flexibility2023-07-31 - Mateus, Vera; Araújo, Vânia; Xavier, Ana; Vagos, Paula; Palmeira, Lara; Silva, Joana Ribeiro daIntroduction Mother’s bond to the infant in the postpartum period plays an important role in the subsequent mother–infant relationship and the infant’s socio-emotional functioning. Several maternal characteristics, such as attachment style and psychological flexibility, may contribute to the quality of mother–infant bonding, though literature examining these variables is still scarce. The present study aimed to examine the impact of mother’s attachment on mother–infant bonding in the first month postpartum and the mediating role of psychological flexibility on that association. Methods Participants were 226 mothers of an infant up to 9 months old, who reported on their own attachment style (in terms of anxiety, comfort with proximity, trust in others), psychological flexibility (in terms of openness to experience, behavioural awareness, valued action) and mother–infant bonding. Results Results showed that mother’s attachment anxiety predicted a bond with the infant directly and indirectly via mother’s psychological flexibility, specifically through behavioural awareness and valued action. Trust in others had an impact on mother–infant bonding through behavioural awareness, whereas comfort with proximity influenced mother–infant bond indirectly, via valued action. Finally, mothers’ civil status, schooling and number of children were relevant to better understand the variance of our mediating and dependent variables. Discussion Our findings highlight the importance of mother’s attachment and psychological flexibility in promoting the quality of mother–infant bonding, which can inform future intervention programmes targeting modifiable factors, such as psychological flexibility, to promote early positive parent–infant relationships, particularly for single, first-time mothers, with higher levels of education.Publication Open Access Nurturing compassion in schools: A randomized controlled trial of the effectiveness of a compassionate mind training program for teachers2022-03-01 - Matos, Marcela; Albuquerque, Isabel; Galhardo, Ana; Cunha, Marina; Lima, Margarida Pedroso; Petrocchi, Nicola; McEwan, Kirsten; Maratos, Frances A.; Gilbert, Paul; Palmeira, LaraSchools are experiencing an unprecedented mental health crisis, with teachers reporting high levels of stress and burnout, which has adverse consequences to their mental and physical health. Addressing mental and physical health problems and promoting wellbeing in educational settings is thus a global priority. This study investigated the feasibility and effectiveness of an 8-week Compassionate Mind Training program for Teachers (CMT-T) on indicators of psychological and physiological wellbeing.Publication Open Access Next-generation sequencing of 12 obesity genes in a Portuguese cohort of patients with overweight and obesity2023-04 - Manco, Licínio; Pereira, Janet; Fidalgo, Teresa; Cunha, Marina; Pinto-Gouveia, José; Padez, Cristina; Palmeira, LaraWe 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.Publication Open Access O eu e o nós das emoções: Um programa de promoção de competências socioemocionais em crianças no contexto escolar2021-04 - Mendes, Sofia; Rocha, Vanessa; Pereira, Sónia; Tavares, Marta; Menezes, Paulo; Patrão, Bruno; Silva, Rui; Xavier, Ana; Palmeira, Lara; Vagos, PaulaA literatura reconhece a importância de desenvolver esforços para promover as competências socioemocionais em contexto escolar, enquanto variável preditora da saúde mental, bem-estar e sucesso académico. O objetivo deste trabalho é apresentar o desenvolvimento de um programa de promoção de competências socioemocionais para crianças do 3º e 4º ano de escolaridade, integrado nas Academias Gulbenkian Conhecimento 2020. Este programa é constituído por 10 sessões em grupo incluídas no currículo escolar. Os objetivos gerais são: (i) promover o autoconhecimento, através da capacidade de identificação e expressão das emoções; (ii) treinar estratégias de autorregulação emocional focadas na tranquilização e compaixão; encorajar comportamentos de cooperação e conexão social. A promoção destas competências é auxiliada com recurso a tecnologias digitais (e.g., jogos interativos). Pretende-se ainda apresentar o design experimental deste estudo e as medidas de avaliação de eficácia, com base na perspetiva multi-informadores (crianças, pais e professores). Com a implementação do programa espera-se, nas crianças, um aumento nas competências de controlo emocional, empatia e cooperação, bem como uma perceção do clima emocional em sala de aula mais tranquilo e seguro. Espera-se ainda melhorias na perceção, por parte dos pais e professores, acerca das competências socioemocionais das crianças. Pretende-se promover o bem-estar psicológico das crianças e, de forma mais ampla, um ambiente mais positivo e compassivo nas escolas.Publication Open Access 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, LaraBackground: 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.Publication Open Access 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 children2023-11-01 - Menezes, Paulo; Patrão, Bruno; Mendes, Sofia; Tavares, Marta; Xavier, Ana; Palmeira, Lara; Vagos, PaulaThere 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.Publication Open Access The Clinical Interview for Psychotic Disorders (CIPD): Preliminary results on interrater agreement, reliability and qualitative feedback2019 - Martins, Maria João; Castilho, Paula; Macedo, António; Pereira, Ana Telma; Pinto, Ana; Carreiras, Diogo; Barreto-Carvalho, Célia; Palmeira, Lara; Xavier, AnaGiven 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.Publication Restricted Access 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-reassurance2017-08-01 - Pinto-Gouveia, José; Cunha, Marina; Carvalho, Sérgio; Palmeira, LaraLiterature 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.