Maria Karekla

Maria Karekla
University of Cyprus · Department of Psychology

Ph.D.

About

165
Publications
49,442
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
3,596
Citations

Publications

Publications (165)
Article
Background Digital early-intervention programs for a variety of psychological conditions, including eating disorders (EDs) are increasing. Yet, none to date have leveraged gamification and vicarious learning components grounded in empirically-supported therapeutic approaches to engage young people at risk for developing EDs in behaviour change. Pu...
Article
Full-text available
Significance Communicating in ways that motivate engagement in social distancing remains a critical global public health priority during the COVID-19 pandemic. This study tested motivational qualities of messages about social distancing (those that promoted choice and agency vs. those that were forceful and shaming) in 25,718 people in 89 countries...
Article
Full-text available
Vaccination hesitancy is an important barrier for the effective control of the COVID-19 pandemic. Identifying determinants of COVID-19 vaccination hesitancy is essential in order to reduce mortality rates. Further, given the variability of the factors and the different recommendations used in each country, it is important to conduct cross-country r...
Conference Paper
Full-text available
More than half of cancer patients are dealing with moderately severe pain on a monthly basis and most of them report a breakthrough pain experience at least once. Despite the importance of pain management for cancer patients, cancer pain remains undertreated. With computer technology and especially Virtual Reality offering open endless opportunitie...
Article
Full-text available
Eating disorders (ED) constitute a serious public health issue affecting predominantly women and appearing typically in adolescence or early adulthood. EDs are extremely difficult to treat, as these disorders are ego-syntonic, and many patients do not seek treatment. It is vital to focus on the development of successful early-intervention programs...
Article
Full-text available
Considering the high impact strain that the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has put on medical personnel worldwide, identifying means to alleviate stress on healthcare professionals and to boost their subjective and psychological wellbeing is more relevant than ever. This study investigates the extent to which...
Preprint
Eating Disorders (ED) constitute a serious public health issue affecting predominantly women and appearing typically in adolescence or early adulthood. EDs are extremely difficult to treat as these disorders are ego-syntonic and many patients do not seek treatment. It is vital to focus on the development of successful early-intervention programs fo...
Article
Full-text available
The coronavirus disease (COVID-19) pandemic fundamentally disrupted humans’ social life and behavior. Public health measures may have inadvertently impacted how people care for each other. This study investigated prosocial behavior, its association well-being, and predictors of prosocial behavior during the first COVID-19 pandemic lockdown and soug...
Preprint
We aim to understand the factors that drive citizens of different countries adhere to recommended self-protective behaviors during the COVID-19 pandemic. Survey data obtained through the COVID Impact project was used. We combined previous evidence and change-point detection analysis to establish variations in self-protective behaviors across partic...
Article
Full-text available
A population-based cross-sectional study was conducted during the first COVID-19 wave, to examine the impact of COVID-19 on mental health using an anonymous online survey, enrolling 9565 individuals in 78 countries. The current sub-study examined the impact of the pandemic and the associated lockdown measures on the mental health, and protective be...
Article
Anxiety disorders differ in the association between subjective distress and physiological reactivity towards threat. For some anxiety disorders, like Social Anxiety Disorder (SAD), the relationship among emotion responses remains unclear. The current study examines how different components of subjective distress relate to autonomic arousal (Heart R...
Article
Full-text available
The COVID-19 pandemic has had a great impact on the mental health and well-being of different populations including young adults. This study replicates and extends previous research by evaluating the impact of the COVID-19 pandemic on the well-being of college students in Cyprus, a Mediterranean island with unique sociocultural and genetic characte...
Article
Full-text available
Introduction: Following the onset of the COVID-19 pandemic, most countries imposed strict governmental lockdowns. Research investigating the psychological impact of pandemic-induced lockdowns is accumulating, though to date no study has examined the psychological health and associated parameters of well-being in countries that underwent additional...
Article
Full-text available
Background Medication nonadherence of patients with chronic conditions is a complex phenomenon contributing to increased economic burden and decreased quality of life. Intervention development relies on accurately assessing adherence but no “gold standard” method currently exists. Purpose The present scoping review aimed to: (a) review and describ...
Article
Background: Medication nonadherence of patients with chronic conditions is a complex phenomenon contributing to increased economic burden and decreased quality of life. Intervention development relies on accurately assessing adherence but no "gold standard" method currently exists. Purpose: The present scoping review aimed to: (a) review and descr...
Article
Full-text available
Background: The COVID-19 pandemic is a massive health crisis that has exerted enormous physical and psychological pressure. Mental healthcare for healthcare workers (HCWs) should receive serious consideration. This study served to determine the mental-health outcomes of 1,556 HCWs from 45 countries who participated in the COVID-19 IMPACT project, a...
Preprint
Full-text available
Background: Digital prevention programs for a variety of psychological conditions, including eating disorders (EDs) are increasing. Yet, none to date have leveraged gamification and vicarious learning components grounded in empirically-supported therapeutic approaches to engage young people at risk for developing EDs in behavior change. The current...
Poster
Background: Medication adherence (MA) is a serious problem for people diagnosed with chronic health conditions, contributing to increased economic burden and poor health outcomes. Implementing effective interventions depends on accurately assessing MA but no gold standard method currently exists. The present scoping review aimed to: a) describe the...
Poster
Background: Medication non-adherence (MNA) is prevalent across chronic health conditions, with almost one in two patients reporting low adherence to their prescribed medication. The purpose of this scoping review was to identify the barriers associated with medication adherence (MA) and the interventions and techniques developed to improve adherenc...
Poster
Full-text available
Interest in using digital methodologies and devices in research has grown immensely in the last years. The use of mobile applications during the daily life of individuals to assess behaviors, thoughts and feelings in real-time, namely ecological momentary assessment (EMA), is widely used as it appears to be a valid and reliable method overcoming th...
Presentation
Background The COVID-19 pandemic is a massive health crisis affecting our planet, with over 166,346,635 confirmed cases and 3,449,117 deaths globally till 24 May 2021. The COVID-19 pandemic is a massive health crisis which has brought enormous physical and psychological pressure. Mental health care for health care workers (HCWs), should receive ser...
Article
Psychological flexibility is increasingly studied in various contexts including clinical studies. The construct has been hypothesized to be a major determinant of mental health. Existing measures lack context-sensitivity (e.g, implicitly measuring it as a trait) and/or reference to a limited time frame. We developed a short self-report measure that...
Article
Full-text available
Introduction: The COVID-19 pandemic has impacted individuals, communities, and whole populations. Experts across many different fields contributed their time and efforts in different ways to respond to the pandemic. Psychologists working in healthcare provided support and led many initiatives, both regionally and nationally. However, it is unknown...
Article
Full-text available
The COVID-19 pandemic has increased negative emotions and decreased positive emotions globally. Left unchecked, these emotional changes might have a wide array of adverse impacts. To reduce negative emotions and increase positive emotions, we tested the effectiveness of reappraisal, an emotion-regulation strategy that modifies how one thinks about...
Article
Background Despite the demonstrated effectiveness of behavioural headache interventions, it is not yet known which intervention processes account for treatment responses. Acceptance and commitment therapy (ACT), an emerging behavioural intervention for headaches, proposes psychological flexibility (PF) processes as the mechanisms via which interven...
Article
Full-text available
The COVID-19 pandemic has increased negative emotions and decreased positive emotions globally. Left unchecked, these emotional changes might have a wide array of adverse impacts. To reduce negative emotions and increase positive emotions, we tested the effectiveness of reappraisal, an emotion-regulation strategy that modifies how one thinks about...
Article
Full-text available
The COVID-19 pandemic has increased negative emotions and decreased positive emotions globally. Left unchecked, these emotional changes might have a wide array of adverse impacts. To reduce negative emotions and increase positive emotions, we tested the effectiveness of reappraisal, an emotion-regulation strategy that modifies how one thinks about...
Article
Background: Sexual and gender minority young adults have a high prevalence of smoking and unique barriers to accessing tobacco treatment. Objective: To address these challenges as well as their preferences for sexual and gender minority-targeted interventions and digital programs, we developed and evaluated the acceptability, preliminary efficac...
Article
The COVID-19 pandemic has impacted individuals, communities, and whole populations. Experts across many different fields contributed their time and efforts in different ways to respond to the pandemic. Psychologists working in healthcare provided support and led many initiatives, both regionally and nationally. However, it is unknown how this has d...
Article
Full-text available
Science may be failing to convince a significant number of people about COVID-19 scientific facts and needed public health measures. Individual and social factors are behind believing conspiracy theories. Adults (N = 1001) were asked to rate their beliefs in various conspiracy theories circulating in social media, rate their psychological distress...
Article
Full-text available
Vaccine hesitancy is a complex health problem, with various factors involved including the influence of an individual’s network. According to the Social Contagion Theory, attitudes and behaviours of an individual can be contagious to others in their social networks. This scoping review aims to collate evidence on how attitudes and vaccination uptak...
Chapter
This chapter focuses on how acceptance and commitment therapy (ACT) can be applied for dealing with the psychological parameters and particularly depression associated with cancer. Depression is one of the most common problems cancer patients present with. This chapter discusses reasons for employing ACT for depression among cancer patients and ill...
Article
Full-text available
Introduction While the general uptake of e-mental health interventions remained low over the past years, physical distancing and lockdown measures relating to the COVID-19 pandemic created a need and demand for online consultations in only a matter of weeks. Objective This study investigates the uptake of online consultations provided by mental he...
Article
Full-text available
This study aimed to compare the mediation of psychological flexibility, prosociality and coping in the impacts of illness perceptions toward COVID-19 on mental health among seven regions. Convenience sampled online survey was conducted between April and June 2020 from 9130 citizens in 21 countries. Illness perceptions toward COVID-19, psychological...
Article
Full-text available
Background The negative impact of COVID-19 pandemic on public mental health can be persistent and substantial over a long period of time, but little is known regarding what psychological factors or processes can buffer such impact. The present study aimed to examine the mediating roles of coping, psychological flexibility and prosociality in the im...
Article
Full-text available
Executive Summary Throughout its history the strategy and tactics of contextual behavioral science (CBS) research have had distinctive features as compared to traditional behavioral science approaches. Continued progress in CBS research can be facilitated by greater clarity about how its strategy and tactics can be brought to bear on current challe...
Article
Full-text available
Objective: Illness perceptions (IP) are important predictors of emotional and behavioral responses in many diseases. The current study aims to investigate the COVID-19-related IP throughout Europe. The specific goals are to understand the temporal development, identify predictors (within demographics and contact with COVID-19) and examine the impac...
Article
Full-text available
Background Movement is a basic component of health. Little is known about the spatiotemporal movement of patients with mental disorders. The aim of this study was to determine how spatiotemporal movement of patients related to their symptoms and wellbeing. Method A total of 106 patients (inpatients ( n = 69) and outpatients ( n = 37)) treated for...
Article
The COVID-19 pandemic has brought unprecedented situations (government lockdowns, quarantines, etc.) and stressors (a seemingly “phantom” virus that can be lurking anywhere) causing uncertainty for the future, uncontrollable and unpredictable situations. It appears that especially during times of uncertainty and high stress, conspiracy theories flo...
Article
The Cognitive Fusion Questionnaire (CFQ) is a measure of cognitive fusion, a fundamental component of the psychological flexibility model, underlying Acceptance and Commitment Therapy (ACT). Numerous studies present cognitive fusion as a core pathological process contributing to psychological suffering, but none to date have examined phenomenologic...
Article
Full-text available
Adaptability is purported to be a key mental resource and refers to an individual's cognitive, behavioral, and emotional regulation (or adjustment) in situations of change, novelty, and uncertainty. Psychological flexibility refers to a person's capacity to allow experience and acceptance of negative thoughts and feelings with mindful awareness gui...
Article
Full-text available
Background The COVID-19 pandemic triggered vast governmental lockdowns. The impact of these lockdowns on mental health is inadequately understood. On the one hand such drastic changes in daily routines could be detrimental to mental health. On the other hand, it might not be experienced negatively, especially because the entire population was affec...
Article
In 2017, the European Federation of Psychologists Associations made a statement on psychotherapy. It recognizes that psychotherapy is a “special competence” practiced by psychologists, and that psychologists practicing psychotherapy receive specific education, including supervision. The statement also stresses that they have demonstrated competenci...
Article
Full-text available
Introduction: Stress and social isolation are potent predictors of negative health outcomes and are impacted in mood and anxiety disorders. Difficulties in social interactions have been particularly noted in people diagnosed with major depression disorder (MDD) and social phobia (SP). It remains poorly understood, however, how these variables inte...
Preprint
Full-text available
BACKGROUND While the general uptake of e-mental health interventions remained low over the past years, physical distancing and quarantine measures relating to the COVID-19 pandemic created a need and demand for online consultations and telepsychology in only a matter of weeks. OBJECTIVE This study investigates the uptake of online consultations pr...
Article
Full-text available
Medication non-adherence (MNA) constitutes a complex health problem contributing to increased economic burden and poor health outcomes. The Medication Adherence Model (MAM) supports that numerous processes are involved in medication adherence (MA). Based on the MAM and guidelines of the World Health Organization (WHO), this scoping review aimed to...
Article
Full-text available
Recent years have seen a growing research interest towards designing computer-assisted health interventions aiming to improve mental health services. Digital technologies are becoming common methods for diagnosis, therapy, and training. With the advent of lower-cost VR head-mounted-displays (HMDs) and high internet data transfer capacity, there is...
Article
Full-text available
The efficacy of Acceptance and Commitment Therapy (ACT) has been evaluated in many randomized controlled trials investigating a broad range of target conditions. This paper reviews the meta-analytic evidence on ACT. The 20 included meta-analyses reported 100 controlled effect sizes across n = 12,477 participants. Controlled effect sizes were groupe...
Article
Full-text available
As the novel coronavirus disease 2019 (COVID-19) pandemic continues, engaging the public in adherence to precautionary measures for preventing COVID-19 spread or infection becomes difficult. The present study aims to extend our understanding of how illness perceptions, coping, and self-efficacy affect adherence to precautionary measures among the p...
Article
Given the challenges of COVID-19, practical measures including psychological support for frontline healthcare workers are essential. The aim of this article is to provide psychological aid to frontline healthcare professionals based on evidence-based practices. Suggestions for self-care entail sleep, rest, regular breaks at work, physical activity...
Article
Full-text available
Prevention of headaches via avoidance of triggers remains the main behavioral treatment suggestion for headache management despite trigger avoidance resulting in increases in potency, lifestyle restrictions, internal locus of control decreases, pain exacerbation and maintenance. New approaches, such as Acceptance and Commitment Therapy (ACT), inste...
Preprint
Full-text available
Science may be failing to convince a significant number of people about COVID-19 scientific facts and needed public health measures. Individual and social factors are behind believing conspiracy theories. Adults (N = 1001) were asked to rate their beliefs in various conspiracy theories circulating in social media, rate their psychological distress...
Article
Full-text available
The COVID-19 pandemic has brought with it a great need for the use of telepsychotherapy and other interventions using psychological theories and techniques to support both mental and physical health. E-mental health presents a wide range of opportunities in mental healthcare to overcome barriers for receiving conventional psychological care, especi...
Article
Background: Smoking remains a global concern, especially for young adults. There is a dearth of smoking cessation programs for this population, who seldom seek help or are motivated to quit. Purpose: This pilot study assessed the effectiveness of a digital avatar-led Acceptance and Commitment Therapy (ACT) smoking cessation program (Flexiquit) f...
Article
Full-text available
Objectives Mindfulness interventions for youth are exponentially increasing in recent years, yet assessment of this construct is still in its infancy. The present study aims to examine for the first time the psychometric properties of the Greek version of Child and Adolescent Mindfulness Measure (CAMM) and additionally investigate gender and age di...
Article
This cross-sectional study aims to shed further light on the relation between self-esteem and Eating Disorders (EDs) as part of prevention efforts by testing the mediating role of psychological inflexibility in a sample of young teenagers. Four hundred and eighteen Greek-speaking students from one representative public middle school in Cyprus (43.9...
Article
Coping with food cravings is crucial for weight management. Individuals tend to use avoidance strategies to resist food cravings and prevent overeating, but such strategies may not result in the benefits sought. This study compared the effects of two cognitive techniques (Restructuring vs. Defusion) for dealing with food cravings in terms of their...
Article
Full-text available
Open Access coViD-19 is the relevant disease caused by the severe acute respiratory syndrome coronavirus 2 (sars-coV-2) transmitted via close contact between persons. on march 12th, 2020, Who announced coViD-19 outbreak a pandemic, in view of its worldwide escalation. as the pandemic disease explodes, a parallel outbreak of fear and worry is also s...
Article
Wearable devices capable of capturing psychophysiological signals are popular. However, such devices have, yet, to be established in experimental and clinical research. This study, therefore, compared psychophysiological data (skin conductance level (SCL), heart rate (HR), and heart rate variability (HRV)) captured with a wearable device (Microsoft...
Article
Full-text available
Background/Objective The manifestation of functional impairment in patients’ daily lives and interference with things they value is poorly understood. If values are compromised in patients, as theory suggests, social contexts (and the lack thereof) are especially important – though this is currently unexplored. We therefore examined whether daily v...
Research
Full-text available
This consensus statement from the different members of the EFPA project group on E-health aims to provide general rules of thumb concerning the dissemination in and use of digital psychological interventions in practice.
Article
Full-text available
The present study aimed to examine the psychometric properties and factorial structure of the Greek version of the Body Image-Acceptance and Action Questionnaire (BI-AAQ). The BI-AAQ assesses cognitive flexibility and acceptance relative to body image. Two samples: an all female middle and high school sample (N = 85; Age M = 17.97, SD = 2.74) and a...
Article
Full-text available
The present study aimed to explore the prevalence rates of eating disorders among Greek-Cypriot adolescents and young adults and examine the role of the following variables in relation to eating disorder risk: gender, age, dieting, exercise and present-ideal weight discrepancy. One thousand and eighty-one middle, high school and university students...