Marinela Congess Centre Lobby + Sofia 1 Exhibition Area

General Mental Health - A

332: Compassion satisfaction in rehabilitation professionals: the impact of self-compassion, positive affect and social safeness

Margarida Tomé, Paula Castilho, Center for Research in Neuropsychology and Cognitive Behavioral Intervention. Faculty of Psychology and Educational Sciences, University of Coimbra, Portugal

Helping professionals, in the rehabilitation context, provide care and compassion to the individuals they assist. As such, they may experience compassion satisfaction, the state of happiness and connectedness derived from their role as a caregiver. Research has shown that self-care, self-compassion, positive affect and social support can contribute to compassion satisfaction. Nevertheless, there is an absence of studies exploring the role and the activation of the soothing system (self-compassion, emotional and social outputs, such as positive affect and social safeness) in compassion satisfaction felt by rehabilitation professionals. The present study aimed to understand the impact of self-compassion, types of positive affect (i.e., active, relaxed, safe) and social safeness in rehabilitation professionals’ compassion satisfaction. A series of self-report instruments measuring these variables were completed by 152 rehabilitation professionals. Correlational analysis demonstrated significant positive correlations, as expected. A multiple linear regression showed that active affect significantly predicts compassion satisfaction. A mediational model of the relationship between self-compassion and compassion satisfaction mediated by active affect and social safeness significantly explained 24% of the dependent variable’s variance. Thus, the results suggest that the activation of the soothing system (to which self-compassion is related) is fundamental to the quality of life experienced by the professional as a caregiver (compassion satisfaction).

331: Emergency C-section, maternal satisfaction and emotion regulation strategies:  Effects on PTSD and postpartum depression symptoms

Deninotti, J., Universite Grenoble Alpes, Université Savoie Mont Blanc, LIPPC2S, 38000 Grenoble, France; Denis, A., Universite Savoie Mont Blanc, LIPPC2S, 38000 Grenoble, France; Berdoulat, E., Universite Grenoble Alpes, Université Savoie Mont Blanc, LIPPC2S, 38000 Grenoble, France.

The present study investigates the relationship between a mother’s emotion regulation strategy (antecedent-focused vs. response-focused), her satisfaction with childbirth, and posttraumatic and/or depressive symptoms towards unplanned C-section. Fifty French participants aged 18-35 (M= 27.10; S.D. =3.99) were recruited on exchange groups about C-section and completed four self-report measures online, up to two years after childbirth. These measures assessed emotion regulation strategies used, birth satisfaction, postpartum depression symptoms and PTSD symptoms. Main results indicate: (1) Mothers who use expressive suppression, a response-focused strategy, are less satisfied with childbirth. (2) Emotion regulation, when combined with maternal satisfaction, can predict posttraumatic stress score and depression score. These results imply that the expression of emotions should be encouraged during labour and delivery, especially by providing as much social support as possible, and promoting more personal control in maternal care.

329: Uncovering the impact of social ranking mentality and entrapment in the maintenance of the affective temperament in a non-clinical Portuguese Sample

Joana Rodrigues, Julieta Azevedo, Paula Castilho, Faculty of Psychology and Educational Sciences, University of Coimbra, Portugal;  Center for Research in Neuropsychology and Cognitive Behavioral Intervention. Faculty of Psychology and Educational Sciences, University of Coimbra, Portugal

Mood disorders, also designated mood affective disorders, are a category of mental illnesses that affects patients undergoing drastic mood changes with consequences in their everyday emotional state. People may experience being extremely sad, irritable or having periods of depression alternating with periods of excessive happiness, productivity and euphoria. Mood disorders have one of the highest risks of suicide among mental illnesses. The current study aims to investigate the relationship between social rank variables (e.g., memories of threat and subordination shame, self-criticism, submission, defeat), different affective temperaments and its and maintenance.
It is desired to obtain a homogeneous distribution of ages that is representative of the general population, with ages between 18 and 65 years old. Participants recruited have the opportunity to take the evaluation questionnaire in paper version or online.
This is an ongoing study and we expect to have results by September 2018. We hypothesise that participants report higher external shame, self-criticism, depression and anxiety have higher scores in the ATQ scale in the dimensions of the affective temperament measured. Subjects with higher levels of self-compassion, self-reassurance, mindfulness and social safeness and pleasure should report lower values of hyperthymia, irritability, cyclothymia and dysthymia.
Discussion and Conclusions: If our hypotheses are confirmed, our results will confirm the importance of competitive mentality for the maintenance of mood disorders and pointed the need to include in the treatment the compassionate mind training.      

328: Protective processes against compassion fatigue in rehabilitation professionals and disabled persons’ caregivers: How they relate to psychological flexibility, mindfulness and self-compassion

Margarida Tomé; Paula Castilho, Faculty of Psychology and Educational Sciences, University of Coimbra, Portugal; Center for Research in Neuropsychology and Cognitive Behavioral Intervention. Faculty of Psychology and Educational Sciences, University of Coimbra, Portugal

Several scientific studies have concluded that caregiving professionals, due to their continued exposure to suffering and stress, are likely to develop compassion fatigue. This phenomenon is often described as “the cost of caring” and consists of physiological, emotional and cognitive symptoms, leading to decreased productivity and psychological well-being. Conversely, self-compassion and mindfulness have been shown to endorse resilience, happiness, social proximity and general well-being. Despite its infrequent use in workplaces, it is thought that self-compassion would allow professionals to respond to work’s demands in a more positive and balanced manner. Therefore, our study intends to explore whether self-compassion and mindfulness in caregivers of disabled persons’ contribute to a better quality of life and psychological well-being, decreasing the compassion fatigue and emotional exhaustion.
Most of the assistance available to disabled persons’ in Portugal is provided by Non-profit Organizations. Hence, several institutions and professional caregivers were contacted and invited to fill in a series of self-report instruments, measuring self-compassion, fears of compassion, mindfulness, burnout, professional quality of life, self-criticism, social safeness and pleasure, and positive and negative affect. Participants were also requested to report the number of times they took leaves of absence and inquired on physical, emotional and cognitive indicators of compassion fatigue.
This is an ongoing study and we expect to have results by June 2018. We hypothesise that participants who report higher self-compassion and mindfulness levels will present lower scores on compassion fatigue measures, as well as a better professional quality of life and increased social connectivity and psychological well-being. 
Discussion and Conclusions:
If our hypotheses are confirmed, our results will confirm the importance of self-compassion and mindfulness in professions that provide assistance to disabled persons, suggesting its protective effect against compassion fatigue and psychopathological symptoms in caregivers.

317: Acceptability and usability of web and mobile versions of a cognitive behavioral intervention based on problem solving for depressive complaints in Turkey
Burçin Ünlü İnce 1, 2*, Didem Gökçay 1*, Ece Dinçer 1*, Heleen Riper 3, 4, 5*, Pim Cuijpers 3, 6*
1. Department of Medical Informatics, Informatics Institute, Middle East Technical University, Ankara, Turkey
2. Ruhuna İyi Bak, Online Counseling Centre, Istanbul, Turkey
3. Department of Clinical, Neuro and Developmental Psychology, Section of Clinical Psychology, VU University, Amsterdam, the Netherlands
4. EMGO+ Institute for Health and Care Research, VU Medical Centre, Amsterdam, the Netherlands
5. Department of Psychiatry, VU Medical Centre/GGZ in Geest, Amsterdam, the Netherlands
6. Department of Clinical, Neuro and Developmental Psychology, VU University, Amsterdam, the Netherlands

In Turkey, the prevalence of depression is approximately 4.4%, while mental health care has serious deficiencies. Innovativesolutions which provide cognitive behavioural interventions usingonline services are needed to fill the gap between health burden and the treatment of depression. For instance, Her Şey Kontrol Altında (HŞKA) which is based on problem-solving therapy is a goodalternative which increases self-awareness and reduces the stigma and inconvenience of office visits. In this study, a web version and a mobile application of HŞKA were developed to evaluate the usability and acceptability of online guided self-help among students and therapists. A total of 6 focus groups were organised whereparticipants were asked to perform small tasks in the intervention. Assessment of usability is made through several sub-scales such as trust to the intervention, perceived usability, value topersonalization and intention to use the intervention. Finally, the evaluation of acceptability is done through qualitative remarks. The first pilot study was conducted on the web version with four focus groups (22 students and 5 therapists). Perceived ubiquity and application mobility was significantly rated as higher among students than therapists (p=.049 and p=.03). The second pilot was performed on the mobile version with two focus groups (28 students). Trust to the intervention was moderate while value to personalization and intention to use the intervention were rated as high. In conclusion, acceptance and usability of both web and mobile applications have been evaluated as moderate to high but trust and privacy were factors of concern.

314: Being alone or with someone: Social interactions vs no social interactions in depression, social phobia, and controls

Jeanette Villanueva, University of Basel, Department of Psychology, Division of Clinical Psychology and Intervention Science, Basel, Switzerland; Andrea H. Meyer, Marcel Miché, Hanna Wersebe, University of Basel, Department of Psychology, Division of Clinical Psychology and  Epidemiology, Basel, Switzerland;  Thorsten Mikoteit, University of Basel, Psychiatric Hospital, Centre for Affective, Stress and Sleep  Disorders, Basel, Switzerland;  Jürgen Hoyer, Technische Universität Dresden, Institute of Clinical Psychology and Psychotherapy,  Dresden, Germany;  Christian Imboden,  Psychiatric Services Solothurn and University of Basel, Switzerland; Private Clinic Wyss, Muenchenbuchsee, Switzerland; Klaus Bader, University of Basel, Psychiatric Hospital, Centre for Specialized Psychotherapy, Basel, Switzerland; Martin Hatzinger, Psychiatric Services Solothurn and University of Basel, Switzerland; Roselind Lieb, University of Basel, Department of Psychology, Division of Clinical Psychology and  Epidemiology, Basel, Switzerland;  Andrew T. Gloster,University of Basel, Department of Psychology, Division of Clinical Psychology and Intervention Science, Basel, Switzerland

Even though the importance of social interactions (SIs) for people is beyond question, less research addresses what happens when people do not have any SIs. To investigate how SIs and the lack thereof are experienced, we compared the social behavior of participants diagnosed with Major Depressive Disorder (MDD) or Social Phobia (SP) with a control group (CG). During a one-week intensive longitudinal investigation in the natural environment of the participants, participants’ social behavior was investigated six times a day using Event Sampling Methodology (ESM). We investigated the frequency and quality of SIs (when SIs were experienced) and the level of wishing for a SI and avoidance of SIs (when no SIs were experienced). Results showed no difference between groups regarding frequency of SIs and the level of wishing for a SI. However, the perceived quality and level of avoidance differed: MDD and SP reported significantly lower SI quality than CG, with SP reporting even lower quality than MDD. Further, MDD and SP reported avoiding SIs significantly more often than CG. These results suggest that both diagnostic groups might not have wanted more SIs than they already had. This study makes an important contribution to the understanding of SIs in MDD and SP, which also includes implications for therapy and practice, such as patients possibly being encouraged to effectively engage in less SIs, but to focus on experiencing more high-quality SIs.

305: Validation of Turkish Inferential Confusion Scale- Expanded Version: Examination of Psychometric Properties in an Analogue Sample

Ezgi Gocek-Yorulmaz; Oya Sorias, Department of Psychology, Faculty of Letters, Ege University, Izmir, Turkey

Inferential Confusion (IC) is defined as a major cognitive factor in Obsessive Compulsive Disorder (OCD) which includes ignoring true information from senses and giving overemphasis on the possibilities. That is, IC is a subjective and irrational appraisal process about the intrusive thoughts regardless of objective reality, and it results in serious doubting contributing to intrusive experiences. The recent Inferential Confusion Questionnaire Expanded Version (ICQ-EV) provides a more comprehensive assessment in different aspects, namely overthinking about possibilities, abandon oneself to imaginary results and irrelevant connections.
After translation-back translation process and face validity, the final version of the Turkish ICQ-EV as well as Obsessive Beliefs Questionnaire, Padua Inventory, Inferential Confusion Questionnaire, Beck Anxiety and Beck Depression Inventory was administered to 261 university students. Results: Reliability analysis showed that the internal consistency and two weeks test-retest reliability of The Turkish ICQ-EV is satisfactory. Correlation analyses also confirmed convergent validity with strong relationships between the ICQ-EV and other relevant variables. Moreover, the results of partial correlation and regression analyses indicated that independent of other correlates, ICQ was still significant factor for OCD symptoms, while extreme OCD symptom group comparisons (i.e., 25 % upper and lower symptom scorers) confirmed its salient role.
As a relatively recent concept, IC seems to play a role for OCD in Turkish sample after partialling out other cognitive factors, and these results indicate that overall, the ICQ-EV Turkish version is reliable and valid instrument. However, future studies are needed in clinical samples.

304: Increasing access to therapy of anxiety disorders and/or depression for women during pregnancy and puerperium: a screening-referral-treatment model incorporating an on-line CBT module.

Pavla Stopkova, National Institute of Mental Health, Klecany, Czech Republic; Third Faculty of Medicine, Charles University, Czech Republic; Antonin Sebela,  National Institute of Mental Health, Klecany, Czech Republic; First Faculty of Medicine, Charles University, Czech Republic; Eliska Noskova, National Institute of Mental Health, Klecany, Czech Republic; Daniela Kalivodova, Institute for Care of Mother and Child, Czech Republic

To improve psychiatric care in perinatal period, we propose new screening-referral-treatment module for depressive and anxiety symptoms in pregnant and puerperal women, including online CBT module for subthreshold to mild perinatal anxiety disorders and/or depression (PADD).
Project will be carried out by National Institute of Mental Health (NIMH) in cooperation with Institute for Care of Mother and Child (ICMC). All women registering for delivery at ICMC will be invited to participate. During first two years, participants will complete on-line screening using Edinburgh Postnatal Depression Scale (EPDS) and Perinatal Anxiety Screening Scale (PASS) during each trimester and puerperium. Women scoring above published cut-off will be assessed by psychiatrist via Structured Clinical Interview for DSM-IV adapted for perinatal period (SCID). Using screening and interview data, we will authenticate threshold for PADD requiring psychiatric intervention. During next three years, women scoring under this threshold on the online screening will be randomized to internet based CBT module vs. internet based psychoeducation (1:1). All women scoring above this threshold will be referred to psychiatrist. Effectiveness of CBT and psychoeducational modules will be tested using scores on EPDS and PASS at next screening points and 3 months after puerperal control. We reasonably estimate to randomize 420 women, a sufficient size for testing.
Proposed project will enable easy access to CBT, which is recommended in guidelines as early intervention for improving maternal-child outcomes. The tested screening-referral-treatment module will serve as a starting point for establishing systematic perinatal mental healthcare in Czech Republic. This study is a result of the research funded by the project Nr. LO1611 with a financial support from the MEYS under the NPU I program.  

301: Cognitive biases in individuals with Social Anxiety: A Qualitative Study

Chantel Joanne Leung, Laboratory of Neuropsychology,The University of Hong Kong, Hong Kong;  Institute of Clinical Neuropsychology, The University of Hong Kong, Hong Kong;  Institute of Psychiatry, Psychology and Neuroscience, King’s College London, United Kingdom; Jenny Yiend, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, United Kingdom; Tatia M. C. Lee, Laboratory of Neuropsychology, The University of Hong Kong, Hong Kong; Institute of Clinical Neuropsychology, The University of Hong Kong, Hong Kong; The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong

Attention and interpretation biases, two major domains of cognitive biases, have been remediated by cognitive bias modification (CBM) that aims to promote adaptive cognitive processing in people with social anxiety disorder. Nonetheless, inconclusive results of the published meta-analysis studies suggest that there might be other specific types of cognitive biases that underpin social anxiety and they should not be studied in isolation. This qualitative study explored the types of cognitive biases involved in social interaction and performance situations that maintains social anxiety.
Eighteen individuals with social anxiety were recruited in The University of Hong Kong. They went through a semi-structured interview asking them to describe two recent distressing social situations. They were prompted to discuss: nature of the social event, the associated thoughts and feelings, attention allocation, interpretation, memory, coping method and reflections on the experience. The data were transcribed and analysed through thematic analysis. Results Initial data analysis showed that more than 50% of the participants expressed higher anxiety in performance situations compared to social interaction. They paid most attention to strangers’ facial expressions and interpreted blank faces and smiles as ambiguous expressions. They admitted to have often overestimated the cost and probability of negative events and attributed positive outcomes to luck. The results highlighted the importance of vivid visual memory in influencing evaluative concerns in current and future social situations.
A combination of attention, interpretation, expectancy, reasoning and visual memory bias was identified in maintaining social anxiety. Delineating the role of different biases is essential towards the future development of cost-effective CBM programmes.  

298: Does helping others help oneself? Preliminary results on the relationship between prosocial behavior and well-being in a clinical and nonclinical population

Marcia T. B. Rinner, University of Basel, Department of Psychology, Division of Clinical Psychology and Intervention Science, Basel, Switzerland; Andrea H. Meyer, University of Basel, Department of Psychology, Division of Clinical Psychology and Epidemiology, Basel, Switzerland; Thorsten Mikoteit, University of Basel, Psychiatric Hospital, Centre for Affective, Stress and Sleep Disorders, Basel, Switzerland; Jürgen Hoyer, Technische Universität Dresden, Institute of Clinical Psychology and Psychotherapy, Dresden, Germany; Martin Hatzinger, Psychiatric Services Solothurn and University of Basel, Switzerland; Roselind Lieb, University of Basel, Department of Psychology, Division of Clinical Psychology and Epidemiology, Basel, Switzerland; Andrew T. Gloster,  University of Basel, Department of Psychology, Division of Clinical Psychology and Intervention Science, Basel, Switzerland; University of Basel, Department of Psychology, Division of Clinical Psychology and Epidemiology, Basel, Switzerland

The social nature of humans has been described as evolutionary adaptive behavior. Helping other has been proven to increase well-being. However, the relationship between well-being and prosocial behavior has mainly been tested within nonclinical populations. Hypothetically, due to the symptoms inherent of mental disorder (e.g. experience of ahedonia, social anxiety) patients may not help others as often as nonclinical individual and may not experience well-being from help-giving to the same extend as a non-clinical population. More studies are needed that assess well-being of clinical populations in a natural environment. We used Event Sampling Methodology (ESM) – an approach that allows people to report on their experiences in the real world close to the time they occur – using smartphones, to assess the well-being of individual with MDD and SP and Controls. Data in this study was collected on 118 participants with MDD, 47 with SP and 119 participants acting as a control group.  Participants filled out questions for a week (6 times a day) about their helping behavior and well-being. In total >10,000 ESM assessments were collected. Multilevel analysis will be conducted to analysis group differences in help-giving behavior. First results indicate that MDD, SP and Controls do not significantly differ in the frequency with which they engage in help-giving behavior. In a further step we will analyze with further multilevel analysis the relationship of well-being and help-giving behavior. This will contribute to a better understanding of prosocial behavior in the natural environment in both participants with a mental disorder and controls. 

296: Mindfulness based cognitive therapy for affective disorders. Could it be useful in a Spanish public mental health center?

Beatriz Raventós, Sara González , Deparment of Psychiatry, Hospital Santa Creu i Sant Pau, Barcelona, Spain; David Closas, Anna Plaza, Luís De Ángel 2* CSMA Dreta de L’Eixample CPB-SSM, Barcelona, Spain.

Affective Disorders are nowadays one the main causes of health problems and disability around the world. Among them, Major Depressive Disorder (MDD) constitutes an invalidating illness with a high risk of relapse and recurrence. Mindfulness-Based Cognitive Therapy (MBCT) is a psychotherapeutic intervention based on evidence for recurrent depression that integrates elements from Cognitive-Behavioural Therapy for depression with a clinical application of mindfulness meditation (Segal, Williams, Teasdale, 2015). Objectives: Assess the improvement of anxious-depressive symptomatology (Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI)) within patients who present an Affective Disorder (AD) and conducted the MBCT program in a Spanish Mental Health Centre. Assess, within patients diagnosed of a recurrent MDD (MDDr), the number of relapse two years after the end of treatment between a group who conducted standard treatment and follow up (control group) and the MBCT group. Results Both BDI and BAI scores did significantly decrease during treatment (BDI: z= -4.255; p=.000 // BAI: z=-5.005; p=.000) The number of total relapses after 2 years of treatment in the MBCT group was statistically lower than the ones in the control group (z=-2.378; p=0.017). Conclusions: Patients with an Affective Disorder diagnosis who had conducted the MBCT program showed a significant reduction in depressive and anxious symptomatology at the end of the program. Patients with a Recurrent Major Depressive Disorder who had conducted the MBCT program showed significantly more reduction in the number of relapses two years after the program than those who followed the standard treatment.

292: The relationship between child maltreatment and social anxiety in adulthood

Antonia Brühl, Technische Universität Braunschweig; Hanna Kley, Universität Bielefeld ; Anja Grocholewski; Nina Heinrichs, Technische Universität Braunschweig

Child maltreatment constitutes a critical risk factor in the development of social anxiety disorder (SAD). Previous studies suggest that emotional abuse and emotional neglect show the strongest relationships with SAD compared to other types of maltreatment. Most studies compared maltreatment experiences between SAD patients and healthy controls. 
Research questions:
Are links between types of child maltreatment and (monomorbid) SAD specific to this disorder or do we find similar effects in other monomorbid anxiety disorders? Does comorbidity have an effect on the association between child maltreatment and SAD? 
Data of N = 1294 patients (among them n = 625 without comorbidities) were collected in two outpatient clinics before the start of psychotherapy. Child maltreatment (emotional abuse, physical abuse, sexual abuse, emotional neglect and physical neglect) was retrospectively assessed with the Childhood Trauma Questionnaire (CTQ). In preliminary analyses, we compared patients with monomorbid SAD, specific phobia, and agoraphobia. 
Experience of child maltreatment did not significantly differ among patients with monomorbid SAD and other monomorbid anxiety disorders.  Discussion:Preliminary analyses indicate that links between types of child maltreatment and SAD are not specific to this disorder. Further results on the role of comorbidities and etiological implications for SAD will be discussed.
Key words: Social Anxiety, Trauma, Child maltreatment, CTQ

290: The relationship between perfectionism and rumination in mood disorders

Marina Galarregui, Mariana Miracco, Fernán Arana, Lorena De Rosa, Adriana Lago, Andrés Partarrieu, Cecilia Tarruella, Emiliano Sanchez, Laura Kasangian, María Sarno, María Modeva, Eduardo Keegan, Universidad de Buenos Aires. Facultad de Psicología. Instituto de Investigaciones. Buenos Aires, Argentina

Key words: Perfectionism, rumination, transdiagnostic approaches, mood disorders The goal of the study was to evaluate the relationship between perfectionism and rumination in mood disorders. The study involved two samples and a total of 193 participants: a clinical sample of patients diagnosed with a mood disorder (n=42), and a non-clinical sample of university students (n=151). Our hypothesis was that perfectionism would be associated to rumination in both samples. Participation was voluntary and confidential, including participants of both sexes, with a gender distribution of 79.8% (n=154) women and 20.2% (n=39) men. Mean age of participants was 28.54 years (SD=8.17). In the clinical sample, 12 clients (28.6%) scored as perfectionists, with 4.8% (n=2) scoring as adaptive perfectionists, and 23.8% (n=10) as maladaptive perfectionists. Thirty patients (71.4%) scored as non-perfectionists. A positive, statistically significant relationship was found between perfectionism and rumination, specifically for the dimension of Rumination of the Rumination Rating Scale (RRS) and the Discrepancy subscale of the Almost Perfect Scale-Revised (APS-R): r=.536; p=.000. In the non-clinical sample, a positive, significant relationship between perfectionism and ruminative processes was also found. Specifically, we found positive associations between the Discrepancy subscale of the APS-R and the Brooding dimension of the RRS: r=.356, p=.000, the Reflection dimension of the RRS (RRS Reflection): r=.211, p=.009 and Positive Beliefs about Rumination: r=.245, p=.002. Discrepancy –the maladaptive dimension of perfectionism- was associated to rumination, though more strongly in the clinical sample. Treating perfectionism in clients with mood disorders might decrease their inclination to ruminating.

289: Measuring heart rate variability with smart wearable sensors on bereaved people ongoing an unguided online interventio

Liliane Efinger, Anik Debrot, Valentino Pomini, Psychology Institut, University of Lausanne 

Losing a close relative, either by death or by separation, is recognized as one of the most stressful life events, whose negative impact on physical health through multiple physiological pathways is well documented. For example, the loss of a significant person is associated with an increased risk of cardiovascular problems, which may be manifested through the reduction of heart rate variability (HRV) as a physiological consequence observed in psychological stress. The use of methods such as relaxation training enhanced by biofeedback increases the client’s awareness and control of HRV. This can be very helpful to regulate negative emotions, psychological stress, and their physical counterparts. CBT therapists indeed recommend such interventions for grieving people. However, to the best of our knowledge, both face-to-face or online therapies for grief generally neglect this aspect, and no study has evaluated their efficacy on physiological indicators such as HRV.  LIVIA is an empirically validated German online CBT-based program for bereaved/separated people to prevent the development of complicated grief symptoms (Brodbeck, Berger & Znoj, 2017). LIVIA does not propose specific exercises for controlling HRV. In our process of translating LIVIA into French we came to the idea of developing an alternative version that proposes such exercises, and to compare both versions of LIVIA. We notably want to conduct cases studies where patients wear smart wearable sensors (SWS) assessing the evolution of theirHRV during the entire program. The poster will present the challenges, design, and methods of this project.  
Keywords: HRV, biofeedback, SWS, online intervention, loss

285: CBT training in Lithuania: providing clinicians with evidence-based tools  

Julius Neverauskas, MD, PhD and Giedre Zalyte, MSc, Lithuanian University of Health Sciences

Since 1990, when Lithuania regained independence, clinicians in Lithuania have been able to train in psychotherapy. For about two decades, the dominant form of psychotherapy was psychodynamic psychotherapy. Until 2007, no training course in cognitive behavioral therapy (CBT) for clinicians was available in Lithuania.
The beginning of CBT training in Lithuania:
As late as 2007 there was only a couple of certified CBT therapists in Lithuania. That same year the first cohort of CBT therapists started their training. The training program was managed and delivered by the Lithuanian CBT Association, which is a member of EABCT. The initial training program took 3 years to complete. The teaching was mostly delivered by experienced CBT practitioners from Poland, Czech Republic, Great Britain, Germany, Argentina and the US. Further developments Since 2014, a 3-year postgraduate training program in CBT has been taught at the Lithuanian University of Health Sciences. At the moment, 151 professionals (medical doctors and psychologists) are enrolled in the program, while another 87 have already graduated from it. The teaching is still to a large degree delivered by foreign CBT experts, including experienced practitioners from various universities and other institutions in the UK, Germany, Czech Republic. However, local teachers are nowadays playing an increasingly important role, delivering a significant proportion of the teaching. Introduction of mindfulness-based interventions In 2016, Lithuanian University of Health Sciences also introduced a one-year postgraduate training program in mindfulness-based cognitive therapy (MBCT). Mindfulness-based interventions have been introduced in Lithuania by practitioners of CBT as an evidence-based supplement to the classical CBT. The first two cohorts consisting of 105 professionals had graduated by January 2018 and started introducing mindfulness-based interventions into their clinical practice. The new cohort of another 29 professionals has already started their training. These are high numbers for a country with the population of only 3 million people, indicating that the interest for evidence-based psychological treatments such as CBT and mindfulness-based interventions is growing and catching up with the rest of the Western world. Merging CBT and mindfulness-based interventions in clinical practice and beyond In Lithuania, mindfulness-based interventions are delivered both in the structured, original format as a single intervention (mostly MBSR and MBCT), and in combination with other therapeutic interventions, especially CBT. CBT therapists often employ mindfulness exercises to teach their clients to better regulate difficult emotions. For example, mindful breathing (during which the attention is focused on physical sensations of breath and is repeatedly brought back to these sensations when it wonders) is often used as a way to refocus attention and refrain from immediate and unhelpful reactions to negative experiences. The Three-Minute Breathing Space, one of the hallmarks of MBCT, can often be used to pause and re-open our eyes to the present moment reality. For clinicians coming from the CBT background, mindfulness exercises are a welcomed alternative to working on cognitive distortions in more direct ways, such as thought records or behavioral experiments. Through non-reactive observation of internal and external events, clients learn to see reality with fewer distortions, which is a goal of any psychotherapy. This can be especially helpful in complex cases such as personality disorders, where methods aiming to change thoughts or beliefs directly might not work. There is also a rapidly growing interest in mindfulness-based interventions for children, both in clinical and educational settings. In parallel, businesses in Lithuania have also started introducing mindfulness practice to their employees, with Ikea being one of the pioneers in the field. In other words, there is a widespread and growing interest in this promising practice.  
What about the future?
With the number of CBT-trained healthcare professionals constantly growing, this evidence-based treatment approach is becoming more accessible in our country. However, in the vast majority of cases, it is accessible through private funding, as CBT interventions are mostly delivered by professionals working in private institutions and having a private practice. In recent years, however, a growing number of state-owned hospitals and health centers are encouraging their employees to attend the training and are willing and able to cover its costs, so hopefully, CBT will soon be increasingly more available through the national health care system.  Suggestions Even in a small country like Lithuania, there is a big and growing interest in evidence-based approaches in psychotherapy. Our experience has also shown that even in countries where other psychotherapeutic approaches have dominated in the past, there is a place for CBT based interventions.  

283: The characteristics of traumatic events in a French population sample

Ornella Ouagazzal, LPPL EA4638, Faculté de Psychologie, University of Nantes, Nantes, France ; Abdel Hakim Boudoukha, LPPL EA4638, Faculté de Psychologie, University of Nantes, Nantes, France

A traumatic event refers to a situation of a sudden, brutal and unusual exposure to a life-threatening or serious threat to one’s physical integrity.  Epidemiological studies concerning exposure to traumatic events vary according to the population. The aim of this study is to evaluate the characteristics of traumatic exposure (type of exposure, categorical form, number of exposures and the age of the exposure) in a general French population sample, because, we hypothesize that certain characteristics of a traumatic event are predictors of specific and non-specific post-traumatic symptoms.  Five hundred and forty participants from the general French population participated in the study (249 men and 291 women, 33.51 average years). Participants completed questionnaire assessing trauma exposure characteristic with the Inventory of Traumatic Events (Ouagazzal & Boudoukha, 2017).  Our first results indicated that the number of exposure varies according to the categorical form of the traumatic events. Thus, descriptive analyze showed a strong dispersal within our sample. This can be explained by the low average age of our sample.  Our next descriptive analyzes designed to assess the prevalence of traumatic events according to their type of exposure and their age of exposure, and we will also increase the size of our sample. These preliminary epidemiological results will allow us to investigate the impact of these characteristics on the specific post-traumatic symptoms (intrusion, avoidance and negative cognitive impairment) and non-specific post-traumatic symptoms (psychological distress).