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This study aimed to examine the role of decentering and committed action as mediators of the link of external and internal shame with psychological health, in people with a chronic disease diagnosis (n = 223) and without chronic disease (n = 230). Participants with chronic disease presented higher levels of both external and internal shame. Path analysis results showed that these variables seem to be negatively linked to psychological health and that their effects on this outcome seem to be reduced by the mechanisms of decentering and committed action. The tested model explained 56% of psychological health's variance and was invariant across groups. This study emphasizes the importance of taking a decentered stance towards internal experiences and behaving accordingly to one's personal values on psychosocial functioning, independently of disease status. These results may have particular relevance to individuals with high levels of shame.

Acceptance and Commitment Therapy (ACT) has been widely tested for chronic pain, with demonstrated efficacy. Nevertheless, although there is meta-analytical evidence on the efficacy of face-to-face ACT, no reviews have been performed on online ACT in this population. The aim of this meta-analysis is to determine the efficacy of online ACT for adults with chronic pain, when compared with controls. PubMed, PsycINFO, CENTRAL, and Web of Knowledge were searched for randomized controlled trials (RCTs) of online-delivered ACT for chronic pain. Effects were analyzed at post-treatment and follow-up, by calculating standardized mean differences. Online-delivered ACT was generally favored over controls (5 RCTs, N = 746). At post-treatment, medium effects for pain interference and pain acceptance, and small effects for depression, mindfulness, and psychological flexibility were found. A medium effect for pain interference and acceptance, and small effects for pain intensity, depression, anxiety, mindfulness, and psychological flexibility were found at follow-up. ACT-related effects for pain interference, pain intensity, mindfulness, and anxiety increased from post-treatment to follow-up. Nevertheless, the current findings also highlight the need for more methodologically robust RCTs. Future trials should compare online ACT with active treatments, and use measurement methods with low bias. Perspective This is the first meta-analytical review on the efficacy of online ACT for people with chronic pain. It comprises 5 RCTs that compared online ACT with active and/or inactive controls. Online ACT was more efficacious than controls regarding pain interference, pain intensity, depression, anxiety, mindfulness, and psychological flexibility.

This study aimed to explore the association between perceived isolation and symptoms of distress in people with GI disorders at the time of the pandemic; and to examine factors which moderate this relationship. This online cross-sectional survey was advertised in May–September 2020 via patient organisations and associated social media. Overall, 831 people (82% female, mean age 49 years) from 27 countries participated. A significant relationship between social isolation and psychological distress was noted (r = .525, p

This study aimed to investigate the associations between the different abuse types, and gastrointestinal (GI) and extraintestinal symptom severity in irritable bowel syndrome (IBS), and possible mediators of these relationships.We assessed sexual and physical abuse in childhood and adulthood with the Drossman and Leserman abuse questionnaire, whereas GI and extraintestinal symptoms were assessed with the Gastrointestinal Symptom Rating Scale and the Symptom Check List-90 Revised. General linear models with bootstrapping tested the mediating role of depressive symptoms, anxiety symptoms, and GI-specific anxiety and rectal pain threshold. A path model analysis testing all relationships simultaneously was also performed.Among our 186 patients with IBS, an overall history of abuse (i.e., at least one type) was found in 37%. The effects of child and adult sexual abuse on GI symptom severity were fully mediated by GI-specific anxiety and rectal pain threshold (F = 21.540, R2 = 0.43, and F = 22.330, R2 = 0.44, respectively; p.001 for both). The effect of adult sexual abuse and child physical abuse on extraintestinal symptom severity was fully mediated by GI-specific anxiety, depressive symptoms, and rectal pain threshold, whereas the effect of child sexual abuse was partially mediated (F = 14.992, R2 = 0.28; F = 15.065, R2 = 0.30; and F = 18.037, R2 = 0.32, respectively; p.001 for all). When analyzed in a single path model, child sexual abuse and adult physical abuse only had a direct effect on extraintestinal symptom severity, whereas child physical abuse had an indirect effect through depressive symptoms.Abuse is associated with increased GI and extraintestinal symptom severity in IBS. These associations are mediated by levels of GI-specific anxiety, depressive symptoms, and rectal sensitivity.

Although several studies have reported the impact of fears relating to coronavirus-19 on several chronic illnesses, there are few studies focused on gastrointestinal conditions. Therefore, the aim of this study was to compare the fear of coronavirus-19 in patients with inflammatory bowel disease to other gastrointestinal conditions and how the fear of COVID-19 manifests across different demographical backgrounds among inflammatory bowel disease respondents.Participants with gastrointestinal conditions (age ≥ 18) were recruited from 27 countries. Demographic, clinical, and psychosocial information was collected. An adapted scale for inflammatory bowel disease patients measuring the fear of coronavirus-19 and gastrointestinal-specific fear of coronavirus-19 was used.In 831 participants (312 inflammatory bowel disease), only significant increases in gastrointestinal-fear of coronavirus-19 were found in between inflammatory bowel disease and other gastrointestinal conditions (mean [standard deviation]: 13.5 [5.5] vs 10.9 [5.0], P.01). Among inflammatory bowel disease respondents, persons on sick leave had significantly more fear of coronavirus-19 than those employed (median [IQR], 31.0 [28.5-39.5] vs 26.0 [20.0-33.0], P = .035) and significantly more gastrointestinal-fear of coronavirus-19 compared to the employed (18.0 [14.5-22.0] vs 13.0 [9.0-17.0], P = .033) or respondents outside of the labor market (12.0 [7.0-16.0], P = .022). Persons living in a rural setting had significantly more fear of coronavirus-19 compared to persons living in regional setting (29.5 [22.0-37.8] vs 25.0 [20.0-31.3], P = .007) and gastrointestinal-fear of coronavirus-19 (15.0 [11.0-19.8] vs 12.0 [9.0-16.0], P = .02).Respondents with inflammatory bowel disease are more afraid of coronavirus-19 regarding their disease; especially, persons on sick leave or persons living in a rural setting. This should be taken into consideration to personalize the support that health care providers can offer in mitigating fear related to coronavirus-19.

BACKGROUND: Irritable bowel syndrome patients report reduced disease-specific quality of life (IBSQOL). Factors of potential relevance for QOL include gastrointestinal (GI), psychological, and somatic symptoms, demographics, and GI motor and sensory abnormalities. OBJECTIVE: The aim of our study was to evaluate the relative importance of these factors on the different IBSQOL dimensions. METHODS: We included irritable bowel syndrome (IBS) patients who completed validated questionnaires to assess QOL, stool form and frequency, GI symptom severity, psychological distress, GI-specific anxiety, sense of coherence, and overall somatic symptom severity. Patients also underwent tests for oroanal transit time and rectal sensitivity. The nine dimensions of IBSQOL and their average (overall IBSQOL) were used as outcome variables, and factors associated with these were assessed using general linear models. RESULTS: We included 314 IBS patients (74% female, mean age 36.3 ± 12.2 years). Higher stool frequency, GI and overall somatic symptom severity, psychological distress, and GI-specific anxiety were independently associated with reduced overall IBSQOL, with the model explaining 60% of the variance (p

Irritable Bowel Syndrome (IBS) negatively influences mental and physical quality of life (QoL), but factors that explain this impact are still unclear. Increasing evidence has associated IBS severity, psychological distress, somatic symptoms, and gastrointestinal (GI)-specific anxiety with QoL in IBS. The aim of this study is to further explore these associations and to analyze potential mediating factors.A total of 1017 IBS patients (69.3% female, mean age 40.6 years) who completed a QoL measure (SF-36) were included in this study. A proportion of these participants (N = 183; 72.7% female, mean age 41.7), who additionally completed psychological distress, somatic symptoms, and GI-specific anxiety measures, was included in the mediation analysis. This analysis was conducted via structural equation modelling to identify factors of importance for generic QoL, using a cross-sectional design.IBS patients reported lower QoL than what is observed in the general population, in particular regarding role limitations caused by health and emotional functioning, vitality, and social functioning. Female patients scored lower than male patients on most QoL dimensions. The effects of IBS severity on mental and physical QoL were mediated by GI-specific anxiety. In addition to GI-specific anxiety, depressive symptoms were also of importance for mental QoL, and somatic symptom severity for physical QoL.QoL is reduced in patients with IBS and GI-specific anxiety, depressive symptoms, and somatic complaints are particularly important for this outcome. Future trials should test the efficacy of psychological interventions specifically targeting these factors in improving QoL in IBS.

Objectives Evidence shows that Acceptance and Commitment Therapy (ACT) is an empirically supported psychological approach for chronic pain (CP) management. Although self-compassion is not explicitly a target of ACT, it seems to be one mechanism of change in ACT for CP. However, research is lacking on the benefits of including explicit self-compassionate exercises in ACT for CP. The current study pilot tested a Compassionate ACT 8-session group program (COMP.ACT; n=9), as well as an ACT-only 8-session group program (ACT; n=7), in a sample of women with CP. Methods The current study follows a quasi-experimental design, and conducts Reliable and Significant Change analyses comparing pre- to post-intervention scores of self-report measures. Results No differences were found between conditions at baseline, nor between completers and drop-outs. Although preliminary, results showed COMP.ACT led to greater clinical improvements in depression and anxiety, while ACT led to greater improvements in stress and uncompassionate self-responding. Reliable and Significant Change analysis showed that some participants improved significantly (in psychopathological symptoms, valued living and uncompassionate self-responding) in both conditions, while the majority did not change significantly. Conclusions More research is needed to conclude whether explicit self-compassion exercises are useful in ACT for CP. Limitations and implications are further discussed.

The aim of this cross-sectional study was to use an extended common sense model (CSM) to evaluate the impact of fear of COVID-19 on quality of life (QoL) in an international inflammatory bowel disease cohort. An online study involving 319 adults (75% female, mean (SD) 14.06 (15.57) years of symptoms) completed the Gastrointestinal Symptom Rating Scale, Brief Illness Perceptions Questionnaire, Fear of Contracting COVID-19 Scale, Brief-COPE, Depression, Anxiety and Stress Scale, and the EUROHIS-QOL. The extended CSM had an excellent fit (χ

Objective The COVID-19 pandemic has had a significant impact on mental health across the globe. People living with a chronic gastrointestinal (GI) disorder might be particularly at risk of mental health complications given higher rates of comorbid anxiety and depression compared to the healthy population. As GI disorders affect up to 40% of the population worldwide, this international collaborative study seeks to evaluate the extent of the impact of the COVID-19 pandemic on GI symptoms specifically and more generally on the well-being of those living with chronic GI conditions. Methods A longitudinal survey with three time points (baseline, 6-month, and 12-month) will be conducted online. Adult participants with GI disorders from multiple countries will be recruited via patient associations, social media advertising, utilizing snowball sampling. Participants will be invited to complete a battery of questionnaires including demographic and health parameters, and measures of gastrointestinal symptoms, fear of COVID-19, perceived impact of COVID-19, illness perceptions, coping, depression, anxiety, stress, catastrophizing, and quality of life, using validated measures where available. Statistical analyses will include univariate descriptive models, multivariate models utilizing regression, mediation, and moderation, and latent growth models. Conclusions This project may present novel information to the field of psychogastroenterology and may provide crucial information regarding the areas of impact for individuals with GI disorders during and following the pandemic. Further, this information can guide healthcare providers and patient associations on how to target support related to the pandemic mental health sequelae for these patients.

Considering that self-criticism is an important process in the development and maintenance of depression, and taking into account the stigma associated with inflammatory bowel disease (IBD), the present study aimed to analyse whether self-criticism exacerbates the relationships of depression symptoms with IBD symptomatology and chronic illness-related shame. The sample included 53 ambulatory IBD patients (66% females) with ages from 18 to 65. Moderation analyses were conducted using structural equation modelling. Self-criticism exacerbated the associations of depression with IBD symptoms (b = 0.01; standard error [SE] = 0.00; Z = 3.73; P < .001) and illness shame (b = 0.02; SE = 0.01; Z = 2.40; P = .016). For the same level of IBD symptomatology or chronic illness-related shame, those individuals who present more feelings of inadequacy towards the self, experience more symptoms of depression. This exacerbation effect is stronger when IBD symptomatology and chronic illness-related shame are more intense. A high self-critical IBD patient may view the illness and/or symptomatology as a flaw or error that should be self-corrected. Physicians and other health professionals should be attentive to these pathological mechanisms and should attempt to alleviate them. It may be beneficial to refer high self-critical patients to psychological care.

This study aimed to explore, through structural equation modelling, experiential avoidance and committed action’s effects on the association between anxiety and psychological quality of life and whether this relationship presents significant differences across a sample of 115 college students with chronic illness and a sample of 232 students without illness. Students with chronic illness presented higher levels of anxiety and experiential avoidance and lower levels of quality of life. The association between anxiety and psychological quality of life was partially explained by experiential avoidance and committed action. This path model was shown to be invariant between the two groups of students.

This study aims to (a) explore individual differences in women with chronic pain (CP) in regard to pain intensity, functional impairment, cognitive fusion, and depressive symptoms and (b) longitudinally test whether cognitive fusion is a significant predictor of depression symptoms, while controlling for pain intensity and functional impairment, over a 12-month period. This study follows a longitudinal design and was conducted in a sample of 86 women with CP who responded to an online battery of questionnaires in three equally spaced assessment moments. In order to explore the growth trajectory of variables of interest, latent growth curve models were examined. Also, correlation analyses were conducted between demographic and illness-related variables and depressive symptoms, as well as between all variables in all assessment moments. Cognitive fusion and functional impairment (but not pain intensity) were significantly associated with baseline levels of depressive symptoms. Cognitive fusion significantly predicted the growth trajectory of depressive symptoms, whereas pain intensity and functional impairment did not. No demographic (age, marital status, education, socio-economic) nor illness-related variables (number of CP diagnoses, duration of CP, taking medication) were associated with depressive symptoms at any point. These results suggest that the trajectory of depressive symptoms in women with CP is not predicted by the intensity of pain nor pain-related functional impairment, but rather by the tendency to get entangled with internal experiences (e.g., thoughts, emotions, and physical sensations), which may or may not be related to pain-specific contents. Clinical implications are discussed.

Aims No empirical research on the psychological impact of the coronavirus disease 2019 (COVID-19) pandemic on people living with IBD, a population known to typically present high levels of anxiety and depression and to be potentially vulnerable to COVID-19, has yet been conducted. This study aimed to explore the links between contextual variables related to the COVID-19 pandemic and disease and psychological outcomes. Methods The sample included 124 Portuguese patients with Crohn’s disease or ulcerative colitis (85.48% women) who completed self-reported measures in an online survey during April 2020. Results Fear of contracting COVID-19 and medication adherence were both high and unrelated. About half of the sample presented moderate (37.10%) to severe (14.50%) anxiety. Normal and mild anxiety levels were at 29.80% and 18.50%, respectively. Regarding depressive symptoms, 51.60% of the sample presented normal levels, 27.40% mild severity, 16.10% moderate, and 4.8% severe. No differences were found between Crohn’s disease and ulcerative colitis patients. Regression analyses showed that anxiety explained IBD symptom perception (β = 0.29; P = 0.022); fear of contracting COVID-19 (β = 0.35; P < 0.001) and IBD symptom perception (β = −0.22; P = 0.009) explained depressive symptoms; and fear of contracting COVID-19 (β = 0.41; P < 0.001), IBD symptom perception (β = 0.26, P < 0.001), and being in isolation (β = −0.16, P = 0.041) explained anxiety. Type of medication was not linked to these outcomes. Conclusions The COVID-19 pandemic does not seem to be affecting adherence to medication but seems to present relevant effects on psychological well-being. Inflammatory bowel disease health care professionals should be attentive of patients’ psychological response to this pandemic and of its possible consequences on disease expression. This study additionally provided a psychometrically sound measure of fear of contracting COVID-19.

Literature has emphasized the significant role of social acceptance and connectedness in well-being and the benefits of cultivating a positive body image in the prevention and treatment of body and eating-related difficulties. The current study aims to examine whether strategies of self-reassurance and body-image appreciation mediate the association of feelings of social safeness and acceptance with the “core” dimensions of body and eating-related psychopathology (restraint, eating concern, weight concern, and shape concern), while controlling the effects of body mass index (BMI). Participants were 309 Portuguese women, aged between 18 and 50 years that completed self-report measures. Results from the performed path analysis revealed that self-reassurance and body-image appreciation mediated the impact of feelings of social safeness and acceptance on eating psychopathology-related dimensions. Results seem to suggest that women who perceive the self as acceptable and desirable tend to adopt self-reassurance strategies. These strategies in turn seem to predict a protective and caring relationship with one’s own body and decreased severity of eating psychopathology symptoms. This path model explained 22%, 27%, 51%, and 47% of restraint, eating concern, weight concern, and shape concern, respectively, and showed an excellent model fit. Our findings appear to offer significant insights in the field of body and eating-related psychopathology and seem to support the pertinence of creating intervention programs for women from the general community with body and eating-related difficulties that encourage the adoption of self-reassurance strategies and promote a positive and respectful relationship with one’s own body image. Level of evidence V, cross-sectional descriptive study.

The current study tested a path model examining the impact of fears of compassion in the adoption of disordered eating and whether social safeness and body shame would mediate this relationship. Participants were 645 women (aged between 18 and 55) from the general community, who completed an online survey. Results indicated that fears of compassion were negatively associated with one’s ability to feel secure and safe within close relationships, and positively linked with higher levels of body shame and disordered eating. The tested model accounted for 62% of the variance of disordered eating. Path analyses results revealed that the three dimensions of fears of compassion impacted on disordered eating. Particularly, fear of expressing compassion for others presented a direct impact on disordered eating. Moreover, fears of self-compassion and fears of receiving compassion from others partially impacted on disordered eating attitudes and behaviours, through the mechanisms of social safeness and body image-focused shame. These findings suggested that women who present higher levels of fear of self-compassion and of receiving signs of affection and compassion from others tend to feel more insecure in their social group, which seem explain body shame and the engagement in disordered eating behaviours. This study highlights the pathogenic impact of fears of compassion on body image and eating attitudes and behaviours. The current data seem to offer relevant insights for research and clinical practice, by supporting the relevance of developing compassionate abilities and attitudes to target body image and eating-related difficulties.

Body compassion is a new construct which incorporates two multidimensional concepts: body image and self-compassion. Self-compassion has been revealed as a protective mechanism against body image and eating-related-related disturbances, including eating disorders. However, the study of this compassionate competence specifically focused on the domain of the body is still largely unexplored. This study aims to test whether body compassion moderate the impact of external shame on body image shame and disordered eating, in a sample of 354 women from the Portuguese general population. Correlation analyses showed that body compassion was negatively associated with experiences of shame and disordered eating. Path analysis results demonstrated the existence of a moderator effect of body compassion on the relationship between general feelings of shame and both body image shame and related behaviours, and disordered eating symptomatology. In fact, results suggested that body compassion buffered the impact of general feelings of shame on these psychopathological indices, with the tested model accounting for 46% and 39% of the variance of body image shame and disordered eating, respectively. This study contributes to a better understanding of the role of body compassion in body image and eating difficulties. Body compassion seems to be an important protector of these difficulties in women by buffering the effects of general shame on body image shame and related body concealment behaviours, as well as disordered eating. The findings from this study thus appear to offer important research and clinical implications, supporting the relevance of promoting body compassion in prevention and treatment programs for body image difficulties and disordered eating.

This study explores the impact of illness-related shame on the quality of social relationships and psychological health in chronic patients. We aimed to examine the roles of fear of receiving compassion from others and experiential avoidance as potential mediators of this relationship. Although some studies have demonstrated the negative impact of chronic illness-related shame on psychological functioning, the mechanisms that may underlie this link remain understudied. The sample was comprised by 115 college students, which had been diagnosed with at least 1 chronic illness. Participants completed self-report measures on an online platform. This study's design was cross-sectional. A path analysis was conducted using structural equation modelling. Results showed that the impact of illness-related shame on both psychological health (R2 = .45) and the quality of social relationships (R2 = .33) was fully accounted by fear of compassion from others and experiential avoidance. This model revealed an excellent fit. Fear of receiving compassion from others was the main mediator of the illness-related shame link with the quality of social relationships (β = -.22). The main mediator of the association between shame-related chronic illness and psychological health was experiential avoidance (β = -.21).This study shed light on possible psychological mechanisms linking feelings of shame associated with having a chronic condition and impaired social relationships and mental health. On one hand, resisting feelings of compassion and care from others and, on the other hand, avoiding difficult internal experiences and situations that might trigger them seem to underlie the impact of shame on psychological and social functioning in chronic patients.

Objective To date, research with people with inflammatory bowel disease (IBD) has only examined how self-compassion is linked with stress, and have exclusively used cross-sectional designs. This study aims to examine the associations of self-compassion with depressive symptoms, anxiety, and stress in people with IBD over time. Methods Participants were 155 adults with IBD who completed the SCS and the DASS-21 at two different times, spaced 9 months apart. The study design is longitudinal: three separate hierarchical regression models were conducted to examine whether self-compassion at baseline predicted depressive symptoms, anxiety, and stress measured at follow-up, while controlling for the effects of baseline IBD symptomatology and the respective outcome. Results Participants who had IBD for a longer period of time presented higher levels of self-compassion. Self-compassion at baseline predicted lower follow-up levels of depressive symptoms (β = −0.17, p = 0.015), anxiety (β = −0.15, p = 0.032), and stress (β = −0.26, p = 0.001), even in the presence of baseline levels of IBD symptomatology and the outcome. Isolation (as opposed to common humanity) was the most relevant self-compassion component for explaining higher depression levels, while the mindfulness component was important for explaining lower anxiety and stress. Conclusions This study is the first to demonstrate the prospective effects of self-compassion on mental health indicators in IBD. Given these findings, and previous evidence on the high comorbidity of depression and anxiety and frequent self-report of illness shame and self-criticism in this population, compassion-based interventions may be particularly beneficial for improving well-being in people with IBD.

Objective This study thus aims to test differences between patients with inflammatory bowel disease (IBD) regarding IBD symptomatology, cognitive fusion, and psychological and physical health, as well as to explore whether the maladaptive emotion regulation process of cognitive fusion longitudinally impacts on the baseline and evolution of these outcomes over a period of 18 months. Design and methods Participants include 116 IBD patients with a mean age of 36.76 (SD = 11.39) of both genders (69.83% females) that completed the self-report measures of interest in three different times, equally spaced 9 months apart, over a period of 18 months. Latent growth curve models were conducted using structural equation modelling to estimate the growth trajectory of the variables in study. Results Inflammatory bowel disease symptomatology and cognitive fusion's levels were negatively associated with psychological health and physical health's baseline levels. Furthermore, IBD symptomatology did not influence the growth of psychological health, while cognitive fusion did (β = .30, p = .007). The same result was found for physical health (β = .26, p = .024). These findings indicate that individuals with higher levels of cognitive fusion present lower levels of psychological health and physical health that tend to further decrease over the time through the effects of this maladaptive emotion regulation process. Conclusions This study implies that it is of crucial importance to include psychotherapeutic interventions in the health care of patients with IBD. If successful, these interventions could represent decreases in the cost of IBD treatment and in the use of drugs with adverse side effects, in addition to improving patients’ mental health and quality of life. Further implications for clinical and research work are discussed. Statement of contribution What is already known on this subject? Research has demonstrated the impact of emotion regulation on both physical and mental health. Nevertheless, the longitudinal effects of the specific emotion regulation process of cognitive fusion on physical and psychological health have never been explored. Additionally, no study has yet examined the causal role of emotion regulation in evolution of physical health in inflammatory bowel disease (IBD). What does this study add? Cognitive fusion longitudinally impacted on IBD patients’ physical and mental health. These variables were measured over a period of 18 months. Treatment for IBD should include interventions aiming to diminish maladaptive emotion regulation.

This study presents the Inflexible Eating Questionnaire (IEQ), which measures the inflexible adherence to subjective eating rules. The scale's structure and psychometric properties were examined in distinct samples from the general population comprising both men and women. IEQ presented an 11-item one-dimensional structure, revealed high internal consistency, construct and temporal stability, and discriminated eating psychopathology cases from non-cases. The IEQ presented significant associations with dietary restraint, eating psychopathology, body image inflexibility, general psychopathology symptoms, and decreased intuitive eating. IEQ was a significant moderator on the association between dietary restraint and eating psychopathology symptoms. Findings suggested that the IEQ is a valid and useful instrument with potential implications for research on psychological inflexibility in disordered eating.

Feelings of social safeness and connectedness have been associated with adaptive emotion regulation processes and well-being indicators. Further, literature has demonstrated that interpersonal experiences play an important role in the etiology and maintenance of body and eating psychopathology. However, the study of the role of social variables and emotion regulation processes in the engagement in inflexible eating rules and eating psychopathology is still in its early stages. The current study aims to fill some gaps within the literature and explore the mediator role of body appreciation and inflexible eating rules in the link between social safeness and disordered eating. Participants were 253 women, aged between 18 and 50 years old, who completed a series of online self-report measures. Results from the tested path analysis model showed that social safeness holds a significant effect on eating psychopathology, through the mechanisms of body appreciation and inflexible eating rules. Also, results suggested that women who present higher levels of social safeness tend to present a more positive and respectful attitude towards their body and decreased adoption of inflexible eating rules, which seem to explain lower levels of disordered eating behaviours. These findings seem to present empirical support for the development of intervention programs that promote a positive, affectionate and healthy relationship with one's body image, in order to prevent the inflexible adherence to eating rules and disordered eating behaviours.

The current study tested a path model that examined the association between early emotional experiences with peers and male body attitudes and whether general feelings of shame and body-focused shame mediate this relationship, while controlling for the effect of body mass index. The sample comprised 241 men from the general community, aged from 18 to 60, who completed an online survey. Correlation analyses showed that the recall of positive early emotional experiences with peers is inversely linked to shame and negative body attitudes. Path analysis results indicated that early emotional experiences with peers had a direct effect on external shame, and an indirect effect on male negative body attitudes mediated by external shame and body-focused shame. Results confirmed the plausibility of the tested model, which accounted for 40% of the variance of male body attitudes. Findings suggested that men who recall fewer positive early peer emotional experiences tend to perceive that they are negatively viewed by others and present more body image-focused shame experiences. This in turn seems to explain a negative self-appreciation of one’s muscularity, body fat and height. This study contributes to a better understanding of male body attitudes. Findings suggest that the link between early emotional experiences and male body attitudes may depend on the experience of shame feelings and, particularly, on the extent to which one’s body image becomes a source of shame. These data support the relevance of addressing shame experiences when working with men with body image-related difficulties. Level V—cross-sectional descriptive study.

Although research recognizes the advantages of creating specific content measures, no specific measure of chronic illness-related cognitive fusion had been developed to date. The current study presents the development and validation of the Cognitive Fusion Questionnaire-Chronic Illness (CFQ-CI) in a sample of inflammatory bowel disease (IBD) patients and the analysis of the role of this construct in the psychological health of those patients. Results indicated that the 7-item CFQ-CI was a unidimensional measure of cognitive fusion in patients with chronic illnesses, and that scores had adequate/good internal consistency and construct, convergent, and discriminant validity. This study also showed that chronic illness-related cognitive fusion as assessed by the CFQ-CI acted as a mediator in the association between both IBD-related symptoms and shame with quality of life. The development of the CFQ-CI may thus contribute to a better understanding of the mechanisms influencing functional outcomes in chronic illness.

Ferreira, C., Palmeira, L., Trindade, I. A., & Catarino, F. (2015). When thought suppression backfires: Its moderator effect on eating psychopathology. Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity, 20(3), 355–362. doi: 10.1007/s40519-015-0180-5. Recently, several studies point out the importance of thought suppression as a form of experiential avoidance in different psychopathological conditions. Thought suppression may be conceptualized as an attempt to decrease or eliminate unwanted thoughts. However, it encloses a paradoxical nature, making those thoughts hyper accessible and placing an extra burden on individuals. This avoidance process has been associated with several psychopathological conditions. However, its role in eating psychopathology remains unclear. The present study aims to explore the moderation effect of thought suppression on the associations between unfavourable social comparison through physical appearance, body image dissatisfaction and eating psychopathology severity in a sample of 211 female students. Correlational analysis showed that thought suppression is associated with psychological inflexibility and eating disorders’ main risk factors and symptoms. Moreover, two independent analyses revealed that thought suppression moderates, as it amplifies the impact of unfavourable social comparisons through physical appearance (model 1) and body image dissatisfaction (model 2) on disordered eating attitudes and behaviors. Hence, for the same level of these body-related internal experiences, those women who present higher levels of thought suppression present higher eating psychopathology. Taken together, these findings highlight the key role of thought suppression in eating psychopathology and present important clinical implications.

This study tested a model examining the impact that early affiliative memories (both with family and peers) on eating psychopathology, and whether these links are carried by the mechanisms of external shame and body image-related perfectionistic self-presentation, in a sample of 480 female college students. Path analyses' results revealed that this model accounted for 48% of disordered eating's variance and suggests that the lack of early positive emotional memories is associated with higher levels of shame (feelings of inferiority and unattractiveness), and with higher tendency to adopt body image-related perfectionistic strategies, that seem to explain excessive eating concern and rigid control of one's eating behaviors. This study offers important insights for future research and for the development of intervention programs, by revealing the importance of assessing and targeting shame and perfectionistic strategies and suggesting the importance of promoting adaptive emotion regulation strategies.

Depressive symptomatology in IBD patients is known to predict disease activity, which in turn can increase depressive symptoms in a perpetuating a cycle between depression and IBD symptomatology. The mechanisms that contribute to the relationship between disease activity and depressive symptoms are not clearly investigated yet. Since emotion regulation has been considered particularly relevant to define the impact of adverse experiences on different outcomes, the current study aimed to examine the longitudinal influence of two maladaptive emotion regulation processes, cognitive fusion and brooding, on the association between disease activity and depressed mood. This study was conducted over an 18-month period, using a sample of 116 IBD patients that completed self-report validated measures in three different waves. Correlation analyses and cross-lagged panel models were performed. The main result from this study discovered that the experience of IBD symptomatology at baseline, although positively linked to the manifestation of depressed mood 18 months later (r = 0.25; p < 0.01), does not directly predict depressive symptoms. This relationship is rather indirect, as it is explained by the engagement in cognitive fusion (p = 0.028) and brooding (p = 0.017). These maladaptive emotion regulation processes, that were revealed to be consistent over time, link IBD symptoms with subsequent depressed mood. These findings indicate that clinicians should be aware of the emotion regulation processes patients tend to use to handle difficult experiences. The inclusion of psychological assessments and interventions in the healthcare of IBD patients should be seriously considered. Further implications are discussed.

The aim of this study was to examine the role of body image problems in the context of inflammatory bowel disease and to explore gender differences in these associations. A sample of inflammatory bowel disease patients (60 males and 140 females) was collected. Findings from a multi-group analysis show that inflammatory bowel disease symptomatology may impact on body image in both male and female patients through the effect of body-image-related cognitive fusion. Body image difficulties in the context of inflammatory bowel disease should not be a neglected dimension in research aiming at understanding the psychosocial effects of inflammatory bowel disease and by health professionals working with these patients.

Literature suggested that the recall of early positive experiences have a major impact on the promotion of feelings of connectedness and social safeness, and seems to protect individuals against psychopathology. Recent research has also demonstrated that the absence of these positive rearing memories play a key role on disordered eating-related behaviours. The impact of early affiliative memories on disordered eating do not seem to be direct, and the mechanisms underlying this relationship are scarcely investigated. The present study aimed to clarify how memories of warmth and safeness explain the adoption of disordered eating attitudes, and tested the mediator role of social safeness, external shame and appearance-focused social comparison on aforementioned relationship, in a sample of 277 young women. The tested model explained 36% of eating psychopathology’s variance and presented an excellent fit. Path analysis results indicated that the impact of rearing memories on eating psychopathology was fully mediated through the mechanisms of social safeness, external shame and appearance-focused social comparison. Specifically, these findings suggested that the extent to which positive rearing memories are associated with lower levels of disordered eating attitudes is influenced by the current feelings of social safeness and connectedness, which in turn are totally carried by decreased feelings of external shame and by lower endorsement on unfavourable comparison based on physical appearance with proximal targets (peers). These results seem to offer important insights for research and clinical work on body image and eating-related difficulties, suggesting the relevance of promoting warm and safe interactions with others. Level V, descriptive study.

Although patients with inflammatory bowel disease seem to be prone to high levels of shame, the mechanisms behind the impact of chronic illness–related shame on patients’ functioning have not been explored yet. This study aims to address these gaps using a sample of 161 patients with inflammatory bowel disease who completed self-report measures on an online survey. The results from path analyses showed that chronic illness–related shame presented direct and indirect effects on psychological health ( R2 = .66) and social relationships ( R2 = .46). The indirect effects were mediated by experiential avoidance and uncommitted living. Possible explanations to these findings and clinical implications are discussed.

Given the clinical usefulness of the CFQ-BI (Cognitive Fusion Questionnaire-Body Image; the only existing measure to assess the body-image-related cognitive fusion), the present study aimed to confirm its one-factor structure, to verify its measurement invariance between clinical and non-clinical samples, to analyze its internal consistency and sensitivity to detect differences between samples, as well as to explore the incremental and convergent validities of the CFQ-BI scores in Brazilian samples. This was a cross-sectional study, which was conducted in clinical (women with overweight or obesity in treatment for weight loss) and non-clinical samples (women from the general population). The one-factor structure was confirmed showing factorial measurement invariance across clinical and non-clinical samples. The CFQ-BI scores presented an excellent internal consistency, were able to discriminate clinical and non-clinical samples, and were positively associated with binge eating severity, general cognitive fusion, and psychological inflexibility. Furthermore, body-image-related cognitive fusion scores (CFQ-BI) presented incremental validity over a general measure of cognitive fusion in the prediction of binge eating symptoms. This study demonstrated that CFQ-BI is a short scale with reliable and robust scores in Brazilian samples, presenting incremental and convergent validities, measurement invariance, and sensitivity to detect differences between clinical and non-clinical groups of women, enabling comparative studies between them.

Body image dissatisfaction and unfavourable social comparisons are significant risk factors to eating psychopathology. Nevertheless, the impact of these negative experiences depends on the cognitive and emotional processes involved. Previous research has shown that cognitive fusion is a nuclear process linked to psychological inflexibility, but its role on body image and eating difficulties remains unclear. This study aims to explore a model of the mediational role of body image-related cognitive fusion (CF-BI) on the relationship between body dissatisfaction, unfavourable social comparisons, and eating psychopathology in a sample of 345 female students. Results from path analyses show that the impact of unfavourable social comparisons on eating psychopathology is fully mediated by CF-BI. Moreover, CF-BI also revealed a mediational effect on the relationship between body image dissatisfaction and the severity of eating symptoms, in spite of the fact that a direct effect of body dissatisfaction still exists. The tested model highlights the crucial role that cognitive fusion, in the specific domain of body image, plays in the relationship between risk factors and the severity of disordered eating attitudes and behaviours. Furthermore, these findings present empirical support for the relevance of addressing acceptance and cognitive defusion techniques to prevent and treat eating disorders.

The current study aimed to test whether the associations of body mass index, body image discrepancy, and social comparison based on physical appearance with women's psychological quality of life (QoL) would be explained by the mechanisms of body image-related experiential avoidance and patterns of uncommitted living. The sample was collected from October 2014 to March 2015 and included 737 female college students (aged between 18 and 25 years) who completed validated self-report measures. Results demonstrated that the final path model explained 43% of psychological QoL and revealed an excellent fit. Body image-related experiential avoidance had a meditational role in the association between body image discrepancy and psychological QoL. Further, the link between social comparison based on physical appearance and psychological QoL was partially mediated by body image-related experiential avoidance and uncommitted living. These findings indicate that the key mechanisms of the relationship between body image and young women's QoL were those related to maladaptive emotion regulation. It thus seems that interventions aiming to promote mental health in this population should promote acceptance of internal experiences related to physical appearance (e.g., sensations, thoughts, or emotions) and the engagement in behaviors committed to life values.

This study aimed to test the effects of inflammatory bowel disease symptomatology and associated medical complications on physical and psychological quality of life and to explore whether these relationships are mediated by experiential avoidance. A total of 200 inflammatory bowel disease patients reported demographic and medical data and completed self-report instruments. Results revealed that the tested model presented an excellent fit, explaining 51 per cent of physical quality of life and 53 per cent of psychological quality of life. Inflammatory bowel disease–associated complications directly impacted on physical quality of life, and experiential avoidance significantly mediated the relationships between inflammatory bowel disease symptomatology and physical and psychological quality of life. These results highlight the importance of implementing psychological interventions for inflammatory bowel disease patients.

Although we have detailed information on the alterations occurring in steady-state levels of all cellular mRNAs during differentiation, we still know little about more global changes. Therefore, we investigated the numbers of molecules of RNA polymerase II that are active—and the way those molecules are organized—as two mouse cells (aneuploid F9 teratocarcinoma, and euploid and totipotent embryonic stem cells) differentiate into parietal endoderm. Quantitative immunoblotting shows the number of active molecules roughly halves. Transcription sites (detected by light and electron microscopy after allowing engaged polymerases to extend nascent transcripts in bromouridine-triphosphate) are uniformly distributed throughout the nucleoplasm. The numbers of such sites fall during differentiation as nuclei become smaller, but site density and diameter remain roughly constant. Similar site densities and diameters are found in salamander (amphibian) cells with 11-fold larger genomes, and in aneuploid HeLa cells. We conclude that active polymerases and their nascent transcripts are concentrated in a limited number of discrete nucleoplasmic sites or factories, and we speculate that the organization of transcription is conserved during both differentiation and evolution to a high C value.

Childhood and early adolescence experiences, specifically those that provide an adulthood enriched with warm and safe memories, are consistently stated in literature as powerful emotional regulators. In contrast, individuals who scarcely recall positive experiences may begin to believe that others see the self as inferior, inadequate and unattractive. In order to cope with a perceived loss of social desirability and achieve other’s acceptance, individuals may become submissive, and women, particularly, may resort to the presentation of a perfect body image. Both mechanisms are defensive responses suggested to be associated with mental health difficulties, particularly disordered eating behaviors. The present study aimed at exploring the association between early memories of warmth and safeness with peers and eating psychopathology. Also, a path analysis was conducted to investigate the mediator role of submissiveness and perfectionistic self-presentation focused on body image on this association, in a sample of 342 female students. Results revealed that the absence of early positive memories with peers holds a significant effect over eating psychopathology’s severity, and also that this effect is mediated through submissiveness and body image-related perfectionistic self-presentation. This model accounted for 13%, 19% and 51% of submissiveness, perfectionistic self-presentation of body image and eating psychopathology’s variances, respectively, and showed excellent model fit.

Literature has demonstrated the negative impact of body image dissatisfaction on women’s quality of life. Nonetheless, it has been suggested that the relationship between body dissatisfaction and women’s well-being is not linear, and that the processes that mediate this association remain unclear. This study aims to clarify the mediator role of self-judgment in the association between negative body image and psychological quality of life, in two groups: normal-weight and overweight women. This cross-sectional study comprised 200 normal-weight and 92 overweight female college students, aged between 18 and 24 years old, that completed self-report instruments of body dissatisfaction, self-judgment, and quality of life. Results showed that women who presented harsher self-judgment about their perceived failures tended to present lower levels in all quality of life domains. Also, results from mediation analyses indicated the relationship between body dissatisfaction and psychological quality of life was significantly mediated by the mechanisms of self-judgment in the two BMI groups (95% CI [–2.41 to –0.04]; 95% CI [–6.35 to –.89]). This mediational model accounted for 28.3% and 40.7% of psychological quality of life in the normal-weight and overweight groups, respectively. These results suggest that a lower ability to deal with one’s failures or inadequacies (e.g., negative evaluation of body image) in a kind and accepting manner may significantly increase the negative impact of body dissatisfaction on one’s psychological quality of life. In this way, it seems that, the focus of interventions should go beyond body dissatisfaction and also target the development of adaptive attitudes (opposed to self-critical attitudes) to deal with negative body-related experiences.

Objectives: Inflammatory bowel diseases (IBD) and their treatment are known to negatively impact on patients’ body image, especially female patients. However, although there are broad evidences of body image impairment in female IBD patients, its negative impact on the quality of life (QoL) of non-operated women is not clearly and specifically studied. The aim of the current study was therefore to analyse, in a sample of non-operated female IBD patients, the factors that contribute to body image impairment and its impact on QoL. Methods: Ninety-six non-operated women (39.7 % with CD and 60.3 % with UC), aged between 18 and 40 years old, completed an online survey with validated self-report measures, which included the Body Image Scale and the WHO Brief Quality of Life Assessment Scale. Results: Negative body image was correlated with lower psychological and physical QoL and increased corticosteroids use, associated medical complications, body mass index (BMI), and IBD symptomatology. Regression analyses revealed that BMI and IBD symptomatology significantly predicted body image impairment. Furthermore, results from path analyses indicated that BMI and IBD symptomatology’s effect on psychological and physical QoL was mediated through the negative effects of body image impairment. This model explained 31 % of psychological QoL and 41 % of physical QoL. Conclusions: These findings suggest that non-operated female patients are subject to pervasive and harmful effects of body image impairment on psychological and physical functioning. Therefore, psychological interventions aiming to target body dissatisfaction should be implemented in the health care of IBD, independently of patients’ operative status.

The aims of the present study were to develop and validate a scale specifically focused on shame feelings derived from chronic illness-related experiences, the Chronic Illness-related Shame Scale (CISS) and to fill a gap in literature and analyse the role of this construct in the association between inflammatory bowel disease (IBD) symptomatology and depressed mood. This study comprised two samples: a sample of 161 IBD patients and a mixed sample of 65 chronic patients that reported medical data and completed self-report measures. The CISS's unidimensional seven-item structure was evaluated through confirmatory factor analyses. These analyses revealed good to excellent global and local adjustments in both samples. Results also showed that the CISS presents excellent internal consistencies and convergent, concurrent and divergent validity, being a valid, short and robust scale. Furthermore, the present study explored through path analyses, the role of CISS and self-judgement in the relationship between IBD symptomatology and depressed mood. Results showed that, although the level of IBD symptomatology directly predicted patients' depressive symptoms, the majority of this effect was mediated by CISS and self-judgement. Possible explanations for these findings are discussed in more detail in the succeeding text. The present study seems to highlight the pertinence of developing IBD patients' self-compassionate abilities to adaptively deal with symptomatology and related shame feelings. It thus may represent an avenue for the development of compassionate-based interventions for IBD patients and for the conduction of future studies exploring the shame phenomenon in other chronic illnesses. Copyright © 2016 John WileySons, Ltd.A new measure, the Chronic Illness-related Shame Scale (CISS), was developed CISS was revealed to be robust instrument in samples of inflammatory bowel disease (IBD) and cancer patients CISS and self-judgement mediate the relationship between IBD symptomatology and depressed mood This model presented an excellent adjustment and explained 55% of depressed mood's variance Results suggest that treatment programmes for IBD should include compassionate-based interventions.

This study explored self-compassion as a mediator between body dissatisfaction, social comparison based on body image and quality of life in 662 female college students. Path analysis revealed that while controlling for body mass index, self-compassion mediated the impact of body dissatisfaction and unfavourable social comparisons on psychological quality of life. The path model accounted for 33 per cent of psychological quality of life variance. Findings highlight the importance of self-compassion as a mechanism that may operate on the association between negative body image evaluations and young women’s quality of life.

BACKGROUND: Several studies have indicated that depressive symptomatology plays a pertinent role in the clinical recurrences of ulcerative colitis (UC). Due to the self-perpetuating cycle between UC symptomatology and depressive mood, it is considered that more investment should be given to the study of factors that influence depressive symptomatology in UC patients. AIMS: This study aimed therefore at analyzing the exacerbator effect of maladaptive psychological strategies, such as cognitive fusion and brooding, on the relationship between UC symptomatology and depressive symptoms. METHODS: The sample of the current study included 84 Portuguese patients with UC that completed an Internet-based survey (comprising demographic and medical questions, and self-report measures of depression, cognitive fusion, and brooding). RESULTS: Results showed that UC symptomatology explained 21% of depression severity's variance. In addition, a significant interaction between UC symptomatology and cognitive fusion was found and explained 50% of depressive symptoms' severity. A similar interaction was revealed between UC symptomatology and brooding, which accounted for 42% of depression's variance. These findings demonstrated that, for the same level of UC symptomatology, those participants who revealed more cognitive fusion or more brooding presented significant higher levels of depression. CONCLUSIONS: The present study revealed cognitive fusion and brooding as moderators that exacerbate the impact of UC symptomatology on reported levels of depression. Psychological interventions that focus on the promotion of adaptive emotion regulation strategies to deal with adverse and stressful events should therefore be developed and implemented in UC patients' health care.

Ferreira, C., & Trindade, I.A. (2015). Body image-related cognitive fusion as a main mediational process between body-related experiences and women's quality of life. Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity, 20 (1), 91-97. doi: 10.1007/s40519-014-0155-y. Purpose: Although the experience of body image has been considered an important indicator of women’s psychological quality of life (QoL), it has also been suggested that the impact of unwanted body-related experiences on QoL may be mediated by emotional regulation processes. The aim of the current study was therefore to explore for the first time the role of body image-related cognitive fusion on these associations. Methods: This study comprised 779 young females who completed self-report measures. A path analysis was conducted to explore whether BMI, body dissatisfaction, and feelings of inferiority based on physical appearance would impact on psychological QoL through body image-related cognitive fusion. Results: The model explained 39% of psychological health, and revealed an excellent fit. Results showed that BMI did not directly impact on psychological health. Furthermore, the effects of increased body dissatisfaction and feelings of inferiority based on physical appearance on psychological health were fully and partially mediated by body image-related cognitive fusion, respectively. Conclusions: These findings suggest that the presence of body image-related negative experiences does not necessarily lead to impairment in women’s quality of life, which is rather dependent upon one’s ability to observe these unwanted experiences as transient and subjective. Therefore, intervention programs aiming at increasing women’s quality of life should focus on targeting emotional regulation processes in order to develop the ability to pursue life goals and values, even in the presence of unwanted experiences concerning body image.

Adolescence has been considered a critical time for the development of body image-related difficulties and disordered eating behaviours, especially in females. Although adherence to eating rules has been linked to disordered eating, literature has not yet explored how the inflexible subscription to those rules impacts on eating psychopathology. Therefore, the aim of the current study was to explore whether inflexible eating impacts on the relationships between weight and body image-related variables, and disordered eating. Participated in this study are 497 female adolescents from the community, aged between 14 and 18 years old, who completed self-report measures. Results revealed that the majority of the participants were dissatisfied with their weight and body shape. Moreover, 6.64 % of the participants demonstrated severe eating psychopathology. A path analysis revealed that BMI, body dissatisfaction and social comparisons based on physical appearance impact on disordered eating behaviours, through the mechanism of inflexible adherence to eating rules. This model explained 52 % of eating psychopathology’s variance. Findings highlight the relevance of body image-related difficulties in adolescence and additionally they emphasise the importance of promoting more flexible attitudes towards eating in prevention and intervention programmes with female adolescents.

Perfectionistic self-presentation defines the attempt at presenting the self as perfect through the public concealment of personal defects and/or through the display of attributes perceived as capable to gather positive attention of others. Although perfectionism has long been considered a central aspect of eating psychopathology mediational studies between this construct and these conditions are scarce. This study aimed at examining the mediational role of body image-related perfectionistic self-presentation in the effects of external shame and internal shame on drive for thinness, in a sample of young women. Results revealed body image-related perfectionistic self-presentation as a significant mediator (p < .05) of the relationships between external and internal shame, and drive for thinness. Furthermore, 86% and 69% of the effects of external shame and internal shame, respectively, were explained by their indirect effects through body image-related perfectionistic self-presentation on drive for thinness (95% CI). These results highlight that the control over eating may emerge as a maladaptive strategy to deal with shame when mediated by an endorsement in the belief that presenting a perfect body image is crucial to be accepted and valued by others. Study findings suggest that this perfectionistic strategy should be targeted while treating eating psychopathology.

Ferreira, C., Trindade, I.A., & Martinho, A. (2016). Explaining rigid dieting in normal-weight women: the key role of body image inflexibility. Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity, 21(1), 49–56. doi: 10.1007/s40519-015-0188-x. Restrictive dieting is an increasing behavior presented by women in Western societies, independently of their weight. There are several known factors that motivate diet, namely a sense of dissatisfaction with one’s body and unfavorable social comparisons based on physical appearance. However, dieting seems to have a paradoxical effect and has been considered a risk factor for weight gain and obesity in women, and associated with maladaptive eating. Nevertheless, the study of the emotional regulation processes that explain the adoption of inflexible and rigid dietary patterns still remains little explored. In this line, the present study aims to explore why normal-weight women engage in highly rigid and inflexible diets. We hypothesize that body and weight dissatisfaction, and unfavorable social comparisons based on physical appearance with peers explain the adoption of inflexible eating rules, through the mechanism of body image inflexibility. The study comprised 508 female college students who presented BMIs between 18.5 and 25. Path analyses were conducted to explore the study’s hypotheses. Results revealed that the model explained 43% of inflexible eating and revealed excellent fit indices. Furthermore, the unwillingness to experience unwanted events related to body image (body image inflexibility) mediated the impact of body dissatisfaction and unfavorable social comparisons on the engagement in inflexible eating rules. This study highlights the relevance of body image inflexibility to explain rigid eating attitudes, and it seems to be an important avenue for the development of interventions focusing on the promotion of adaptive attitudes towards body image and eating in young women.

Literature has shown that young women present high rates of body dissatisfaction, independently of their weight. Therefore, dieting may emerge as a strategy to control one's body image. Nonetheless, it also seems to be a source of great suffering rather than a solution. The aim of the present study was to explore what variables explain the inflexible engagement in eating rules. Our hypothesis is that an inflexible eating pattern results not exclusively from weight and body dissatisfaction and shame but mainly from emotional regulation processes (such as body image-related cognitive fusion). The sample of the present study comprised 659 female college students, aged between 18 and 25 years old, who completed self-report measures. Results revealed that the majority of the normal-weight participants desired to lose weight and to have a thinner body shape. Findings from the path analyses demonstrated that the effects of weight dissatisfaction and shame on the inflexible adhesion to eating rules were fully mediated through the mechanism of body image-related cognitive fusion. Furthermore, the effect of body dissatisfaction was partially operated by this process. This model was controlled by BMI and explained a total of 36% of inflexible adhesion to eating rules. In conclusion, these findings suggest that it is when a woman gets fused and entangled with her body image-related thoughts that these unwanted inner events most impact on her eating rules. This study thus offers important new data for research and clinical practise in the field of body image and eating difficulties.

Objectives Several studies have highlighted the role of cognitive fusion on human suffering and a wide range of psychopathological conditions. Namely, this process has been regarded as a core aspect in eating disorders. Nevertheless, the study of cognitive fusion on eating psychopathology is scarce and a measure that specifically concerns body image was still to be created. The present study aimed therefore at developing and validating such measure, the Cognitive Fusion Questionnaire – Body Image (CFQ-BI). Design and methods The current study was conducted using different samples of both genders, collected in the general and student populations. The dimensionality of the CFQ-BI was tested through an exploratory factor analysis and a confirmatory factor analysis (CFA). The scale's internal reliability and other psychometric qualities were also analysed. Results The CFQ-BI's final structure was one-dimensional and comprised 10 items that assess body image-related cognitive fusion. This final structure explained a total of 73.41% of the variance. The adequacy of the questionnaire was corroborated through a CFA which revealed that CFQ-BI presents good global and local adjustment values and goodness-of-fit indices. Results also showed that the CFQ-BI holds a very good internal consistency (α = .96), convergent, divergent and temporal reliabilities, and is able to discriminate cases from non-cases of eating psychopathology. Conclusions The CFQ-BI was thus established as a short, robust, and reliable measure of body image-related cognitive fusion. This new measure may correspond to a significant contribution to research and clinical practice in the field of body image and eating-related difficulties. Practitioner points A new measure of body image-related cognitive fusion (CFQ-BI) was developed. The CFQ-BI was proved to be a short, robust, and reliable measure. Body image-related cognitive fusion was strongly linked to eating psychopathology. CFQ-BI may be useful in eating psychopathology's research and clinical practice.

Decentering has been defined as the ability to deal with thoughts and emotions as subjective and ephemeral inner events. Since it implies a non-judging and present focused attitude towards thoughts and emotions, decentering has been considered as an important protective process against psychopathology, as it has been empirically shown to decrease depressive relapse rates. Nevertheless, its role in eating disordered attitudes and behaviours has not been fully uncovered. Therefore, the aim of the present study is to explore the moderator effect of decentering on the relationship between eating psychopathology and one of its main risk factors, body image dissatisfaction. The sample comprised 279 female students, aged between 14 and 21 years-old. Results revealed that decentering abilities were negatively linked to body image dissatisfaction and to the global score of eating psychopathology. Through a path analysis, the buffer effect of decentering was confirmed. The findings suggest that the ability to take a non-judgmental and accepting stance towards internal experiences diminishes the impact of one's body dissatisfaction on disordered eating attitudes and behaviours. This study seems especially pertinent since it uncovers a mechanism to lessen the pervasive impact of body image dissatisfaction, which is highly prevalent in women from Western societies.

Contains fulltext : 70889.pdf (Publisher’s version ) (Closed access) Recognition of microbial components by germ-line encoded pattern recognition receptors (PRR) initiates immune responses to infectious agents. We and others have proposed that pairs or sets of PRR mediate host immunity. One such pair comprises the fungal beta-glucan receptor, Dectin-1, which collaborates through an undefined mechanism with Toll-like receptor 2 (TLR2) to induce optimal cytokine responses in macrophages. We show here that Dectin-1 signaling through the spleen tyrosine kinase (Syk) pathway is required for this collaboration, which can also occur with TLR4, 5, 7 and 9. Deficiency of either Syk or the TLR adaptor MyD88 abolished collaborative responses, which include TNF, MIP-1alpha and MIP-2 production, and which are comparable to the previously described synergy between TLR2 and TLR4. Collaboration of the Syk and TLR/MyD88 pathways results in sustained degradation of the inhibitor of kappaB (IkappaB), enhancing NFkappaB nuclear translocation. These findings establish the first example of Syk- and MyD88-coupled PRR collaboration, further supporting the concept that paired receptors collaborate to control infectious agents.

The formation of genomic loops by proteins bound at sites scattered along a chromosome has a central role in many cellular processes, such as transcription, recombination and replication. Until recently, few such loops had been analyzed in any detail, and there was little agreement about the nature of the molecular ties maintaining these loops. Recent evidence suggests that loops are found in both prokaryotes and eukaryotes, and that the transcription machinery is a molecular tie. In addition, results obtained using site-specific recombination in bacteria and chromosome conformation capture in eukaryotes support the idea that active transcription units are in close contact. These data are consistent with a model for genome organization in which active polymerases cluster into transcription ‘factories’, which, inevitably, loops the intervening DNA. They are also consistent with the ties functioning as barriers, silencers, enhancers or locus control regions, depending on their positions relative to other genes.