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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S69–S105


The role of maladaptive psychological

strategies in the association between

shame and psychological quality of


C. Ferreira

, A.L. Mendes , J. Marta-Simões

Faculty of Psychology and Education Sciences - University of

Coimbra, CINEICC, Cognitive Behavioural Centre for Research and

Intervention, Coimbra, Portugal

Corresponding author.

Shame experiences have been highly associated with the engage-

ment in maladaptive strategies (such as experiential avoidance

and cognitive fusion) to cope with unwanted thoughts and feel-

ings. Furthermore, these maladaptive processes have been linked

to different psychopathological conditions.

The current study aimed to test the mediational effect of two dif-

ferent emotional regulation processes, cognitive fusion (i.e., the

entanglementwith unwanted inner events) and experiential avoid-

ance (i.e., the unwillingness to be in contact with these inner

experiences and the tendency to avoid and control them), on the

association between external shame and psychological quality of


Participants were 421 (131 males and 290 females), aged between

18 and 34 years old.

The tested path model explained 40% of the variance of psycholog-

ical quality of life and showed excellent model fit indices. Results

demonstrated that external shame presented a significant direct

effect on psychological quality of life and, in turn, an indirect effect,

through themechanisms of cognitive fusion and experiential avoid-

ance. In fact, these findings seem to suggest that higher levels of

external shame are linked to a higher tendency to engage in cog-

nitive fusion and to lower acceptance abilities, which appear to

explain decreased levels of psychological quality of life.

The present findings seem to offer significant clinical implications,

emphasizing the importance of targeting maladaptive emotion

strategies through the development of acceptance and decentering


Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.


Interaction between previous

attempts and diagnosed psychiatric

disorder as a risk marker of repeated

suicide attempts among adolescents:

Results from a prospective

hospital-based study

G. Martinez-Ales

, E. Jimenez , E. Roman , P. Sánchez , I. Louzao ,

A. Cano , A. Orosa , I. Rubio , A. Fraga , A. De Diego , M. Coll ,

L. Nocete , V. Baena , R. Gallego , B. Rodríguez , M.F. Bravo

Hospital Universitario La Paz, Psychiatry, Madrid, Spain

Corresponding author.

Suicide is the secondmost frequent cause of death among the youth

and its rates among adolescents have recently risen. Up to 30% of

adolescents who attempt suicide will try it again within a year. Our

objective is to analyze how previous attempts and diagnosed psy-

chiatric disorder behave as markers of risk of reattempts and their

statistical interaction. We include every underage patient treated

by an emergency roompsychiatrist after a suicide attempt in a Gen-

eral Hospital between years 2010 and 2015. Patients free of relapse

after 1000 days are censored. We obtain Kaplan–Meier estimates

for the risk of a new attempt as a time-dependant variable, divid-

ing them by the presence of previous suicide attempts, diagnosed

psychiatric disorder or both at a time, checking the differences by

using log-rank tests. Then, we perform Cox proportional risk mod-

els including both variables and a factor of their interaction and

adjust them by sex and age in a non-automatically driven mul-

tivariate analysis, thus obtaining HR estimates. We present 150

cases (118 female; mean[SD] age in years: 15.8 [1.6]). Overall, 22.6%

of them relapse during follow-up time. Multivariate models show

interaction of previous attempts and diagnosed psychiatric disor-

der is associated with relapse with an HR of 1.27




(95% CI:





– 2.9




). Interaction of both factors is an outstand-

ing risk marker of relapse after an attempted suicide and should

thus be given clinical importance in tertiary prevention.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.


Personality and spirituality as

predictors of suicidality in depressed


S. Mihaljevic

1 ,

, B. Aukst-Margetic


, S. Karnicnik



B. Vuksan-Cusa



General Hospital Virovitica, Psychiatry department, Virovitica,



Clinical Hospital Centre Zagreb, Psychiatry Department, Zagreb,


Corresponding author.


Some studies show that more expressed spiritual-

ity and some dimensions of personality have protective role from



The aim of our study is to examine the influence of the spir-

itual quality of life (QoL) and dimensions of personality on course

of suicidality in patients with depression.


Ninety-nine patients were assessed with self-report

measures of suicidality (BHS), personality (TCI), spirituality

(WHOQOL-SRPB) during a yearlong follow-up.


Spirituality was inversely linked with suicidality at

baseline and during follow-up and more expressed spirituality

influenced faster recovery from suicidality. Dimensions of temper-

ament harm avoidance and self-directedeness show as significant

predictors of recovery from suicidality.


In our sample, spirituality, harm avoidance and self

directedeness are significant predictors of recovery from suicidal-

ity. This finding is stimulus for further researching of protective

factors from suicidality.

Disclosure of interest

The authors have not supplied their decla-

ration of competing interest.