Nuno Bravo Ferreira

Nuno Bravo Ferreira
University of Nicosia · Department of Social Sciences

PhD in Clinical Psychology

About

75
Publications
19,225
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751
Citations
Citations since 2017
55 Research Items
667 Citations
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Introduction
Dr Ferreira is interested in the use and development of Third Wave Cognitive Behavioural approaches and in particular, the applications of Acceptance and Commitment Therapy (ACT) for long-term or chronic health conditions (e.g. Chronic Pain, Diabetes, Asthma). More specifically, he is interested in developing intervention models based on ACT across all populations and age groups (but especially in pediatric setting). He is also interested in Contextual Psychology basic research, such as the study of the impact of concepts like values, acceptance/ avoidance, cognitive fusion and mindfulness on psychosocial and physical outcomes. Furthermore, he is also interested in research in the areas of emotion, emotion regulation, alexithymia, PTSD, eating disorders, burnout and e-learning.
Additional affiliations
February 2012 - December 2017
The University of Edinburgh
Position
  • Lecturer
Education
December 2007 - November 2011
The University of Edinburgh
Field of study
  • Clinical Psychology
September 1999 - October 2004
ISPA Instituto Universitário
Field of study
  • Clinical Psychology

Publications

Publications (75)
Article
Full-text available
The aim of this longitudinal study was to examine changes in COVID-19 and illness-related perceptions, gastrointestinal symptoms, coping, catastrophising, psychological distress, and QoL during the COVID-19 pandemic. A total of 831 adults with a gastrointestinal condition completed an online questionnaire at baseline (May—October 2020). Of those, 2...
Article
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During large-scale disasters, social support, caring behaviours, and compassion are shown to protect against poor mental health outcomes. This multi-national study aimed to assess the fluctuations in compassion over time during the COVID-19 pandemic. Respondents (Time 1 n = 4156, Time 2 n = 980, Time 3 n = 825) from 23 countries completed online se...
Article
Full-text available
Zoledronic Acid (ZA) has been shown to inhibit Osteosarcoma (OSA) progression in preclinical studies. However, the use of ZA as an intervention for OSA treatment and management remains controversial. A systematic review and meta-analysis of randomized-controlled trials comparing the use of ZA with standard treatment vs. standard treatment alone for...
Article
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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...
Article
Full-text available
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 Sc...
Article
Purpose Studies have demonstrated that adverse childhood experiences, attachment and emotion dysregulation are significant predictors of self-harm. Developmental theories of self-harm propose that adverse childhood experiences can influence attachment, which in turn has an impact on emotion dysregulation, leading to self-harm. However, to date no s...
Article
Full-text available
Objective The aim of this study to examine the amount of the total variance of the subjective well-being (SWB) of psychotherapists from 12 European countries explained by between-country vs. between-person differences regarding its cognitive (life satisfaction) and affective components (positive affect [PA] and negative affect [NA]). Second, we exp...
Article
Full-text available
The aim of this study was to examine cross-cultural differences, as operationalized by Schwartz's refined theory of basic values, in burnout levels among psychotherapists from 12 European countries during the coronavirus disease (COVID-19) pandemic. We focused on the multilevel approach to investigate if individual- and country-aggregated level val...
Article
Background: 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...
Article
This study focused on the specific challenges of university students in the face of the COVID‐19 pandemic and examined similarities and differences in COVID‐related concerns and difficulties in functioning in samples of undergraduate students in five countries. A sample of 4306 undergraduate university students (43.8% males, 56.2% females) from Isr...
Article
Full-text available
Objectives The COVID-19 pandemic is having an unprecedented detrimental impact on mental health in people around the world. It is important therefore to explore factors that may buffer or accentuate the risk of mental health problems in this context. Given that compassion has numerous benefits for mental health, emotion regulation, and social rel...
Preprint
Full-text available
Objective The aim of this study was to examine cross-cultural differences, as operationalized by Schwartz's refined theory of basic values, in burnout levels among psychotherapists from 12 European countries during the coronavirus disease (COVID-19) pandemic. We focused on the multilevel approach to investigate if individual- and country-aggregated...
Article
Full-text available
Background Historically social connection has been an important way through which humans have coped with large-scale threatening events. In the context of the COVID-19 pandemic, lockdowns have deprived people of major sources of social support and coping, with others representing threats. Hence, a major stressor during the pandemic has been a sense...
Article
Full-text available
Various health settings have advocated for involving patients and members of the public (PPI) in research as a means to increase quality and relevance of the produced knowledge. However, youth PPI has been an understudied area. This protocol paper describes a new project that aims to summarize what is known about PPI with young people in mental hea...
Article
Objectives: Previous qualitative research has demonstrated that palliative care professionals (PCPs) deal with a wide array of emotionally challenging issues associated with the care they provide. Although previous research has identified self-care strategies PCPs engage in, there is a lack of focus on what responses are helpful and/or unhelpful....
Article
Background and aims The present study examines the levels of psychological distress (anxiety, depression, stress) and burnout and their relationship to challenging behaviour, amongst staff working in a special education setting. It further examines the relationships between psychological distress and burnout and psychological flexibility, role clar...
Article
Full-text available
Background: There is ample evidence of the high mental health burden caused by Inflammatory Bowel Disease (IBD). Several constructs such as experiential avoidance, cognitive fusion, shame, and self-criticism have recently emerged as potential intervention targets to improve mental health in IBD. Psychotherapeutic models such as Acceptance and Commi...
Article
Full-text available
A robust scale capable of assessing illness-related experiential avoidance (EA) in any given medical condition is currency lacking. Further, there is no available measure that assesses EA related to illness behaviours, i.e., actions and/or reactions in relation to feeling unwell that have the purpose of defining one’s state of health and obtaining...
Article
Objective: Psychological flexibility and fear of cancer recurrence are important variables that influence psychosocial outcomes in individuals diagnosed with a range of different types of cancer. Their role and how they impact on psychological distress and quality of life in men with prostate cancer specifically have not been established. Methods...
Article
Background The mental health response to the coronavirus (COVID-19) pandemic–related product shortages in those living with chronic gastrointestinal (GI) disorders has received little attention. We aimed to explore the association between the pandemic-related product shortages and psychological distress in people with GI disorders. Methods This on...
Article
Full-text available
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 p...
Article
Background Although several studies have reported the impact of fears relating to COVID-19 on several chronic illness populations, there are few studies focused on gastrointestinal (GI) conditions. The aim was to compare how fear of COVID-19 is manifested in people living with Inflammatory Bowel Disease (IBD) compared to other GI conditions; and, h...
Article
The need for a transnational validation is imperative at the stage of development of the CompACT, a self-report measure of psychological flexibility. This study aimed to translate, validate and test the factor structure of the Portuguese version of the CompACT and to conduct a measurement invariance analysis comparing the scale’s performance in Por...
Article
Full-text available
Background: The COVID-19 pandemic is a massive global health crisis with damaging consequences to mental health and social relationships. Exploring factors that may heighten or buffer the risk of mental health problems in this context is thus critical. Whilst compassion may be a protective factor, in contrast fears of compassion increase vulnerabi...
Article
Full-text available
Objective: Symptom improvement is often examined as an indicator of a good outcome of accessing mental health services. However, there is little evidence of whether symptom improvement is associated with other indicators of a good outcome, such as a mutual agreement to end treatment. The aim of this study was to examine whether young people accessi...
Article
Full-text available
Background: The current study aimed to investigate the psychometric properties of the Adverse Childhood Experiences – International Questionnaire (ACE-IQ) with individuals engaging in non-suicidal self-injury. Numerous studies have supported the association of adverse childhood experiences with non-suicidal self-injury. However, the majority of the...
Article
Purpose Although quality of life and attitudes to ageing have been explored in the context of mental and physical health problems in older adults, the interplay between these variables has received little attention. The purpose of this study is to explore how attitudes to ageing relate to and predict quality of life in an international sample of ol...
Article
Purpose This study aims to investigate the feasibility and acceptability of a new group intervention, using an acceptance and commitment therapy (ACT) approach, developed for dementia caregivers. Preliminary data regarding the effectiveness of the intervention was also collected. Design/methodology/approach A quasi-experimental design is used invo...
Article
Full-text available
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 r...
Article
Background and aim Acceptance, catastrophising and kinesiophobia have been identified within the adult literature as important processes in the relationship between pain intensity and functioning. While these constructs have received some attention within paediatric chronic pain, research is still in its infancy in understanding how these processes...
Article
Purpose The purpose of this paper was to systematically review the association between behavioural and psychological symptoms of dementia (BPSD) and the development of carer burden. Although this association has been well established in the literature, it is not clear whether there are individual symptoms or clusters of symptoms that are particular...
Article
Full-text available
Background: There is a high prevalence of children and young people (CYP) experiencing mental health (MH) problems. Owing to accessibility, affordability, and scalability, an increasing number of digital health interventions (DHIs) have been developed and incorporated into MH treatment. Studies have shown the potential of DHIs to improve MH outcom...
Article
Purpose Behavioural and psychological symptoms of dementia (BPSD) have been well established as factors involved in the development of carer burden. However, it is not clear which symptoms are most burdensome for carers and which caregiver factors may be involved. This study aims to explore symptoms associated with executive functioning deficits an...
Article
Background/Objective In this study a theoretically driven model is presented of how gastrointestinal anxiety, behavioural response, symptom severity, quality of life and IBS acceptance interact to determine how people cope and respond in IBS. Method Cross-sectional data from 166 outpatients attending a motility disorders clinic was used to test a...
Article
Objective In accordance to ACT theory, psychological inflexibility may influence the well-known link between learned helplessness and depression symptomatology. This exploratory preliminary study aims to analyse whether psychological flexibility moderates the relationship between these variables. Methods A community sample of 84 Portuguese partici...
Article
Full-text available
Objective Attention deficit hyperactivity disorder (ADHD) is one of the most prevalent disorders in childhood, which may pose risks in later life such as academic underachievement and anti-social behaviour. It has been suggested that mindfulness-based interventions (MBI) may contribute to positive outcomes with child and adult populations. In this...
Article
Full-text available
Objectives Self-concept distortion has been extensively linked with decreasing mental health in gay and lesbian youth. Social context has been proposed to have a moderating effect on the development of a healthy self-concept. However, no good quality review has approached these concepts with regards to LGBT youth. Methods A systematic review was c...
Article
Factors emerging from the “Zarit Burden Interview” and predictive variables in a UK sample of caregivers for people with dementia - CORRIGENDUM - Kerry Johanna Smith, Catriona George, Nuno Ferreira
Article
Background: The Chronic Pain Acceptance Questionnaire for Adolescents (CPAQ-A) is a measure of acceptance, which is associated with quality of life and functional disability in adolescents with chronic pain. The CPAQ-A could identify adolescents who may benefit from an acceptance based intervention to manage their chronic pain. However, the measure...
Article
https://onlinelibrary.wiley.com/doi/abs/10.1002/cpp.2182 Aim: Although most veterans have a successful transition to civilian life when they leave the military, some struggle to cope and adjust to the demands and challenges of civilian life. This study explores how a variety of psychosocial factors influence veteran adjustment to civilian life in S...
Research
Aim: Although most veterans have a successful transition to civilian life when they leave the military, some struggle to cope and adjust to the demands and challenges of civilian life. This study explores how a variety of psychosocial factors influence veteran adjustment to civilian life in Scotland, UK, and which of these factors predict a poor ad...
Article
Background: Irritable Bowel Syndrome is a gastrointestinal disorder that is associated with pain, discomfort, constipation and diarrhoea. It affects around 20% of adults in Western countries. Reports of distress and self-consciousness, as well as experiential and situational avoidance are common. Previous studies have shown that ACT may be effectiv...
Article
The aim of this study was to investigate the efficacy and proposed processes of change of acceptance and commitment therapy (ACT) in improving the outcomes of irritable bowel syndrome (IBS). A total of 56 consecutive patients recruited from a specialist clinic were included in the study and completed an ACT treatment protocol (one-day group worksho...
Article
Full-text available
Purpose: To investigate possible associations between recreational cannabis use and bone health in humans. Methods: Cross-sectional study of individuals recruited from primary care in the UK between 2011 and 2014. Cases were regular smokers of cannabis divided into moderate (n=56) and heavy user (n=144) subgroups depending on whether they reported...
Article
Full-text available
The current goal of treatments in irritable bowel syndrome focus primarily on symptom management and attempts to improve quality of life. Several treatments are at the disposal of physicians, with lifestyle and dietary management, pharmacological treatments, and psychological interventions as the most used and recommended. Psychological treatments...
Conference Paper
Full-text available
IBS is a functional GI disorder characterised by bowel discomfort, pain, diarrhoea and constipation. People with IBS also often fear having bowel accidents, and experience shame and embarrassment. People with IBS often use strategies to control or avoid these experiences, which have the unintended consequence of putting life on hold, at great cost...
Conference Paper
Abstract Objectives Executive functioning deficits have been proposed as a core feature of all types of dementia, and can result in behavioural and personality changes that are difficult for carers to manage. This study explored symptoms associated with executive functioning deficits and their impact on three dimensions of carer burden and positi...
Article
Full-text available
Objective: Emotional intelligence (EI) and acceptance have previously been identified as potential factors in the adjustment to Chronic Pain. This study examined the associations between Chronic Pain (CP) experiences, depression, and physical disability. It further investigated the mediating effect of emotional intelligence (EI) and acceptance in t...
Article
Background: Long term conditions are increasing and are associated with increased risk of psychological problems. Commonalities across long term conditions suggests that a transdiagnostic psychological intervention may be beneficial. An Acceptance and Commitment Therapy (ACT) group intervention was evaluated for people with long term health conditi...
Article
Purpose/objective: Acceptance and commitment therapy (ACT), a newer type of behavior therapy that targets psychological flexibility, may have particular utility in the context of muscle disorders. However, there has been no formal investigation of psychological flexibility in this population. This longitudinal observational study investigated whet...
Article
Purpose/Objective: Acceptance and commitment therapy (ACT), a newer type of behavior therapy that targets psychological flexibility, may have particular utility in the context of muscle disorders. However, there has been no formal investigation of psychological flexibility in this population. This longitudinal observational study investigated wheth...
Conference Paper
Full-text available
Objectives: Emerging adulthood is an important transition point for youths with Type 1 diabetes. Personal characteristics such as self-efficacy, fear of hypoglycaemia, depressive symptoms, emotional distress, and impulse control have been hypothesized to be key predictors of health and behavioural outcomes (Hanna, 2012). This study aims to test the...
Article
Research into mental imagery has increased our understanding of a range of psychological problems. However, there has been little study into the spontaneous mental images experienced in response to chronic pain. This study aimed to explore the prevalence and characteristics of these pain-related mental images. Four hundred ninety-one people with ch...
Article
Objective: The present study sought to investigate emotion regulation strategies in people with anorexia nervosa (AN) and whether the theoretical concept of 'emotion coupling' between anger and disgust could help to explain some of the specific eating disorder symptomatology in people with AN. Method: This 'emotion coupling' hypothesis was teste...
Article
Background: Cognitive- and acceptance-based approaches are used to help people live with chronic pain. Little is known about how these constructs relate to each other. In this study, we examined how cognitive representations of chronic pain relate to interpersonal styles such as catastrophizing and the behavioural process of acceptance of chronic...
Article
Full-text available
Purpose: It has been well established that how irritable bowel syndrome (IBS) patients respond to their illness experiences (physical, psychological) has a great impact on their symptoms, psychosocial functioning and quality of life. Recently it has been shown that using acceptance coping strategies (rather than control coping strategies) is linke...
Book
Full-text available
Better Living With IBS A step-by-step program to managing your symptoms so you can enjoy life to the full! Nuno Ferreira, PhD & Dr David T. Gillanders (CPsychol) Irritable Bowel Syndrome, or IBS, is one of the most common illnesses in the world, affecting approximately 20 per cent of the population. Medical treatments are only moderately effective...
Article
To compare self-reports of five basic emotions across four samples: healthy, chronic pain, depressed and post-traumatic stress disorder (PTSD), and to investigate the extent to which basic emotion reports discriminate between individuals in healthy or clinical groups. In total, 439 participants took part in this study: healthy (n = 131), chronic pa...
Thesis
Irritable Bowel Syndrome (IBS) is a common chronic illness thought to be originated and maintained by a combination of physiological, psychological and social factors. IBS is known to be associated with a high psychosocial impact on patients’ lives. Acceptance and Commitment Therapy (ACT) is an emerging model of conceptualization and treatment that...
Article
Full-text available
Biopsychosocial conceptualizations of irritable bowel syndrome (IBS) see the physical and psychological experiences (e.g. bowel discomfort, pain, stress, IBS-related anxiety) of this condition as the key influence in the poorer outcomes of this population. Most of the current therapeutic targets proposed by practitioners and patients are somehow li...
Article
Full-text available
Introduction: Psychological factors (PF) may be important in explaining impact on quality of life (IoQoL) and may also explain illness related behaviours (IRB) in IBS patients.1 A new PF –the Acceptance– may predict features such as IoQoL and IRB in chronic conditiions like Diabetes and Chronic Pain.2 No study yet has looked at its role in IBS. M...
Article
Objectives: This study investigated relationships between Illness Perceptions and Acceptance amongst IBS patients and outcomes of Symptom Severity and Impact on Quality of Life. We also examined the potential mediating role of acceptance between Illness Perceptions and IBS outcomes. Methods: 112 consecutive IBS patients recruited from a Motility Cl...

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