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It is widely known that stress reactivity and social functioning impairment are important difficulties in people with psychosis. However, the specific impact of stress reactivity on social functioning and its underlying mechanisms are still less explored. Social rank variables, such as shame and self‐criticism, have been pointed out as relevant in the development, maintenance of several types of psychosocial suffering and, specifically, in psychotic disorders. This study's aim was to explore the associations between external shame, self‐criticism, social stress reactivity, and social functioning difficulties and understand the mediator role of shame and self‐criticism in the relationship between social stress reactivity and social functioning. Seventy‐seven participants with a psychotic disorder filled in self‐reported measures of stress reactivity, shame, and self‐criticism and were clinically evaluated for social functioning. To study the associations between variables in the study, Spearman correlation coefficients were used. The PROCESS macro was used to test the sequential mediation analyses. All variables under study were associated with each other, and social stress reactivity predicted social functioning difficulties through external shame, whereas self‐criticism was not a significant mediator. The present study highlights the role of external shame in the pathway from stress reactivity to social impairment. These results inform recovery‐oriented interventions and reinforce the relevance of considering social competitive mentality when working with people with psychosis. Further research is needed to clarify the role of self‐to‐self relationship in social impairment and to identify other mechanisms aimed at dealing with shame used by people with psychosis. [ABSTRACT FROM AUTHOR]

The present literature review investigated the recent knowledge/ findings on Insomnia, the most prevalent sleep disorder in the general population. Insomnia consequences included mortality risk, physical and mental problems, particularly depression, cognitive impairment, work-related problems such as accidents, injuries, absenteeism, lower productivity and diminished job satisfaction. Female gender, aging, unemployment, lower education levels, manual occupations, lifestyle behaviors (e.g. heavy drinking) and sleep hygiene practices (e.g. improper sleep schedules) increased the likelihood of experiencing Insomnia. By contrast, physical exercise improved Insomnia symptoms. Personality factors such as Neuroticism, Perfectionism and Evening Chronotype increased the odds of experiencing Insomnia. Conversely, Extroversion and Optimism were associated with less Insomnia symptoms. Negative affect (depression and anxiety) predicted new cases of Insomnia in the long term. Cognitive processes (e.g. worry), sleep-related cognitive processes (e.g. dysfunctional sleep beliefs) and emotional dysregulation processes were also related to Insomnia. In the workplace, Insomnia was associated with night work and short-time duration for recovery between shifts or work-related psychological processes such as embeddedness, effort-reward imbalance, surface acting, low social support or interpersonal conflict, higher over commitment, low employment level and job insecurity. [ABSTRACT FROM AUTHOR]

Burnout negatively affects around 40 % of medical and dentistry students, a group with high levels of perfectionism, repetitive negative thinking (RNT) and low self-compassion. So far, literature has highlighted the beneficial effects of mindfulness and self-compassion-based interventions on reducing psychological distress; nevertheless, the relationship between perfectionism, self-compassion, RNT and burnout has not yet been studied in this population with a prospective study design. The aim of this prospective study was to analyse the role of perfectionism, self-compassion and RNT on burnout levels in medical and dentistry students after approximately one year and a half. 202 medical and dentistry students answered in T0 and T1 (after 18 months) to a self-report questionnaire that included measures to assess perfectionism, RNT, self-compassion, and burnout. Perfectionism, RNT and self-compassion correlated significantly with each other, and all correlated with Burnout. In mediation analyses, total perfectionism at T0 predicted burnout at T1, both directly and indirectly, through the mediating effect of self-compassion and RNT at T0. This study reinforces recent findings that self-compassion is a mediator of the relationship between perfectionism and burnout and adds that RNT also plays an important role in this predictive pathway. [ABSTRACT FROM AUTHOR]

Recent studies proposed that maladaptive cognitive emotion regulation (CER) is associated with negative dimensions of perfectionism and mediates the relationship between this trait and negative affect dimensions. In the present longitudinal study, our aim was to examine whether and which perfectionism cognitions and CER strategies would mediate the relationship between perfectionism traits and psychological distress, controlling for perceived stress, social support and outcome measure at one year before. At T0 and after approximately one year (T1), 258 college students (79.8% female) filled in the Portuguese validated versions of self-report questionnaires to evaluate perfectionism trait dimensions (perfectionistic concerns and perfectionistic strivings), perfectionism cognitions, CER dimensions, perceived stress, social support and psychological distress (depression, hostility-anxiety, and amiability-vigor). We found that higher perfectionistic concerns at T0 contribute significantly, after one year, to maladaptive perfectionism cognitions, which in turn are associated with higher levels of catastrophizing and rumination, and altogether will ultimately contribute to greater anxiety/hostility (total indirect effect: 0.03; 95% CI: 0.01 to 0.07) and depression (total indirect effect: 0.06; 95% CI: 0.02 to 0.13). In this cognitive setting, perfectionist individuals may benefit from psychological interventions to reduce their tendency to use maladaptive CER strategies. [ABSTRACT FROM AUTHOR]

Background: This study aimed to compare brain asymmetry in patients with schizophrenia (SCZ), bipolar disorder (BPD), and healthy controls to test whether asymmetry patterns could discriminate and set boundaries between two partially overlapping severe mental disorders. Methods: We applied a fully automated voxel-based morphometry (VBM) approach to assess structural brain hemispheric asymmetry in magnetic resonance imaging (MRI) anatomical scans in 60 participants (SCZ = 20; BP = 20; healthy controls = 20), all right-handed and matched for gender, age, and education. Results: Significant differences in gray matter asymmetry were found between patients with SCZ and BPD, between SCZ patients and healthy controls (HC), and between BPD patients and HC. We found a higher asymmetry index (AI) in BPD patients when compared to SCZ in Brodmann areas 6, 11, and 37 and anterior cingulate cortex and an AI higher in SCZ patients when compared to BPD in the cerebellum. Conclusion: Our study found significant differences in brain asymmetry between patients with SCZ and BPD. These promising results could be translated to clinical practice, given that structural brain changes detected by MRI are good candidates for exploration as biological markers for differential diagnosis, besides helping to understand disease-specific abnormalities. [ABSTRACT FROM AUTHOR]

Objective: To investigate the predictive/protective role of negative affect/positive affect in late pregnancy on the outcome of postpartum depression. Methods: A total of 491 pregnant women participated in the study. The participants were asked to ill out a series of questionnaires, which included the Profile of Mood States, the Beck Depression Inventory-II, psychosocial variables and socio-demographic characteristics and were asked to participate in a psychiatric interview. After delivery, 272 mothers participated again in the study and filled out a similar series of questionnaires. Results: Negative affect was associated with more intense depressive symptomatology, more self-perceived stress, lower self-reported social support, lower quality of life and perception of having a more difficult infant. By contrast, positive affect was negatively associated with these variables. Negative affect in late pregnancy increased the likelihood of experiencing postpartum depression (DSM-IV/OR = 2.1, 95%CI = 1.3-3.4, p = .003; ICD-10/OR = 2.1, 95%CI = 1.5-3.0, p < .001), while positive affect increased the odds of not having this condition (DSM-IV/OR = 2.0, 95%CI = 1.5-2.7, p = .042). Conclusion: In pregnancy, negative affect was a predictor of postpartum depression, whereas positive affect showed a protective role. Future studies are required to explore whether psychotherapeutic strategies focusing on decreasing negative affect and enhancing positive affect in the last trimester of pregnancy can reduce the risk of postpartum depression. [ABSTRACT FROM AUTHOR]

Objective: To investigate the predictive/protective rote of negative affect/positive affect in late pregnancy on the outcome of postpartum depression. Methods: A total of 491 pregnant women participated in the study. The participants were asked to fill out a series of questionnaires, which included the Profile of Mood States, the Beck Depression Inventory-II, psychosocial variables and socio-demographic characteristics and were asked to participate in a psychiatric interview. After delivery, 272 mothers participated again in the study and filled out a similar series of questionnaires. Results: Negative affect was associated with more intense depressive symptomatology, more self-perceived stress, lower self-reported social support, lower quality of life and perception of having a more difficult infant. By contrast, positive affect was negatively associated with these variables. Negative affect in late pregnancy increased the likelihood of experiencing postpartum depression (DSM-IV/OR = 2.1, 95%CI = 1.3-3.4, p = .003; ICD-10/OR = 2.1, 95%CI = 1.5-3.0, p < .001), while positive affect increased the odds of not having this condition (DSM-IV/OR = 2.0, 95%CI = 1.5-2.7, p = .042). Conclusion: In pregnancy, negative affect was a predictor of postpartum depression, whereas positive affect showed a protective role. Future studies are required to explore whether psychotherapeutic strategies focusing on decreasing negative affect and enhancing positive affect in the last trimester of pregnancy can reduce the risk of postpartum depression. [ABSTRACT FROM AUTHOR]

Summary This study investigates the association between sleep disturbances, body mass index (BMI) and eating behaviour in a sample of undergraduate students. The sample comprises 870 medicine and dentistry students from Coimbra University (62.5% females), aged between 17 and 25 years. The Eating Attitudes Test-40 was used to measure eating behaviour, and two questions were applied addressing difficulties of initiating sleep (DIS) and difficulties of maintaining sleep (DMS). A sleep disturbance index (SDI) was calculated from the sum of DIS and DMS scores. Body mass index (BMI) was determined from self-reported weight and height. The correlation analyses generally indicated that global eating disturbance, bulimic behaviour dimension and social pressure to eat were associated particularly with sleep difficulties. An association between diet concerns and sleep difficulties was less consistent. Regression analyses showed that bulimic behaviour (BB) and social pressure to eat (SPE) dimensions were associated significantly with sleep difficulties (DIS, DMS, SDI) in the total sample (BB: from P < 0.01 to P < 0.001; SPE: P < 0.05) and in males (BB: from P < 0.05 to P < 0.001; SPE: P < 0.05) and with insomnia symptoms ( P < 0.01). In females, bulimic behaviour was the only factor associated significantly with sleep difficulties (SDI, DIS; P < 0.01) and with insomnia symptoms ( P < 0.05). Although BMI was correlated negatively with sleep difficulties ( P < 0.05), regression analyses indicated that it was not associated significantly with them. Our findings support an association between eating behaviour and sleep disturbances in both genders, which may have treatment implications. [ABSTRACT FROM AUTHOR]

Aim To investigate the role of perfectionism in the development of disordered eating behaviours. Method 382 female university students completed the Hewitt & Flett MPS and the EAT-40 at baseline, and 1 year after (T1) and 206 2 years later (T2). Results Perfectionism at baseline was significantly associated with long-term abnormal eating attitudes/behaviours. Self-Oriented Perfectionism (SOP) and Socially Prescribed Perfectionism (SPP) were significant predictors of disordered eating behaviours. Regression analysis revealed that SOP at baseline was predictive of Diet Concerns and overall eating disturbance (EAT total score), at T1 and T2. SPP was a significant predictor of Social Pressure to Eat at T1 and T2 and of Bulimic Behaviours only at T1. Conclusion Our findings contribute to a more clear understanding of the association between perfectionism and eating disorders. SOP and SPP were prospectively associated with abnormal eating attitudes/behaviours and SOP was found to be predictive of diet concerns and overall eating disturbance. Copyright © 2009 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]

Pregnancy is essentially a physiological event, but neuroendocrinal and psychosocial changes are also important components of this experience. In this context, perceived stress may be enhanced by the activation of certain personality traits, like perfectionism, which in turn may be associated with more psychological distress (PD). The aim of this study was to investigate if perfectionism could be associated with more negative emotional outcomes (PD) in the transition to motherhood and to look at which of the perfectionism dimensions these consequences are specifically linked. The sample comprises 421 pregnant women (mean = 29.8, SD = 4.48 years) who completed measures of perfectionism and mood symptoms. A two-factor model with self-oriented perfectionism (SOP) and socially prescribed perfectionism (SPP) dimensions and a three-factor model with SOP, SPP-others’ high standards and SPP-conditional acceptance (CA) factors were explored. Correlations and linear regressions were calculated between perfectionism factors and mood variables. Results showed that higher levels of SPP factors were associated with increased anxiety, depression, anger, fatigue and confusion, with decreased vigour and with more severe depressive symptoms. Our results, in contrast with those from the study of Campbell and DiPaula (2002, In: Flett G, Hewitt P (eds) Perfectionism. Theory, research, and practice. American Psychological Association, Washington, pp 181–198), did not confirm a preferential association between SPP-CA and PD, revealing that both components of SPP were associated with PD. [ABSTRACT FROM AUTHOR]

Abstract: It has been proposed that schizophrenia results from an environmental insult in genetically predisposed individuals. Environmental factors capable of modulating transcriptional activity and their carriers could link the genetic and environmental components of schizophrenia. Among these is transthyretin (TTR), a major carrier of thyroid hormones and retinol-binding protein (RBP). Retinoids and thyroid hormones regulate the expression of several genes, both during development and in the adult brain. Decreased TTR levels have been reported in the cerebrospinal fluid of patients with depression and Alzheimer’s disease, and the absence of TTR influences behavior in mice. DNA variants capable of altering TTR ability to carry its ligands, either due to reduced transcription of the gene or to structural modifications of the protein, may influence development of the central nervous system and behavior. In the present study we searched for variants in the regulatory and coding regions of the TTR gene, and measured circulating levels of TTR and RBP. We found a novel single nucleotide polymorphism (SNP), ss46566417, 18 bp upstream of exon 4. Neither this SNP nor the previously described rs1800458 were found associated with schizophrenia. In addition, serum TTR and RBP levels did not differ between mentally healthy and schizophrenic individuals. In conclusion, our data does not support an involvement of the TTR gene in the pathophysiology of schizophrenia. [Copyright &y& Elsevier]

Objectives: The main objective was to explore which are the dimensions of perfectionism that are linked to disordered eating behaviour (EB) in a large non-clinical sample of both genders. Method: One thousand one hundred and sixty-three undergraduate students of the University of Coimbra completed the Portuguese versions of the multidimensional perfectionism scale (MPS) and the eating attitudes test (EAT-40). Results: In both genders, the MPS total score was associated with the EAT total score and all EAT dimensions (except for socially prescribed perfectionism in females). Self-oriented perfectionism (SOP) and socially prescribed perfectionism (SPP) were associated with EAT total score, diet concerns (DC) and bulimic behaviour (BB) in females while in males the social prescribed perfectionism (SPP) was the useful predictor of EAT total score, BB and social pressure to eat (SPE). Conclusion: These results confirm that in general high levels of perfectionism are associated with abnormal EB. This was the case for both genders for SPP but for SOP for females only. The association for other oriented perfectionism (OOP) was greater for males than for females. Copyright © 2006 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]

International guidelines endorse psychological treatment for Bipolar Disorder (BD); however, the absence of a recognised gold-standard intervention requires further research. A Dialectical Behaviour Therapy (DBT) skills group intervention with 12 sessions was developed. This pilot randomised controlled trial (RCT) aims to evaluate the feasibility, acceptability, and outcomes variance of Bi-REAL – Respond Effectively, Assertively, and Live mindfully, tailored for individuals with BD, in preparation for a future RCT. 52 participants (female = 62.7 %; mean age = 43.2 ± 11.1) with BD were randomised by blocks to either the experimental group (EG; n = 26; Bi-REAL + Treatment as Usual, TAU) receiving 12 weekly 90-minutes sessions, or the control group (CG; n = 26, TAU). Feasibility and acceptability were assessed with a multimethod approach (qualitative interviews, semi-structured clinical interviews and a battery of self-report questionnaires – candidate main outcomes Bipolar Recovery Questionnaire (BRQ) and brief Quality of Life for Bipolar Disorder (QoL.BD)). All participants were evaluated at baseline (T0), post-intervention (T1) and 3-month follow-up (T2). Acceptability was supported by participants' positive feedback and ratings of the sessions and programme overall, as well as the treatment attendance (86.25 % of sessions attended). The trial overall retention rate was 74.5 %, with CG having a higher dropout rate across the 3-timepoints (42.31 %). A significant Time × Group interaction effect was found for BRQ and QoL.BD favouring the intervention group (p <.05). The assessors were not blind at T1 (only at T2). Recruitment plan was impacted due to COVID-19 restrictions and replication is questionable. High attrition rates in the CG. The acceptability of Bi-REAL was sustained, and subsequent feasibility testing will be necessary to establish whether the retention rates of the overall trial improve and if feasibility is confirmed, before progressing to a definitive trial. • Bi-REAL is an acceptable DBT-ST programme for bipolar and related disorders. • All participants would recommend the intervention to people with BD • The retention rate of the experimental group was high (88 %). • Participants found DBT skills useful in regulating mood symptoms. • A second pilot is warranted to improve retention in comparison group. [ABSTRACT FROM AUTHOR]

Inhibition is implicated across virtually all human experiences. As a trade-off of being very efficient, this executive function is also prone to many errors. Rodent and computational studies show that midbrain regions play crucial roles during errors by sending dopaminergic learning signals to the basal ganglia for behavioural adjustment. However, the parallels between animal and human neural anatomy and function are not determined. We scanned human adults while they performed an fMRI inhibitory task requiring trial-and-error learning. Guided by an actor-critic model, our results implicate the dorsal striatum and the ventral tegmental area as the actor and the critic, respectively. Using a multilevel and dimensional approach, we also demonstrate a link between midbrain and striatum circuit activity, inhibitory performance, and self-reported autistic and obsessive–compulsive subclinical traits. [ABSTRACT FROM AUTHOR]

The Ruminative Response Scale for Eating Disorders (RRS-ED) measures ruminative thought content specifically related to eating disordered themes, assessing two domains of rumination, brooding and reflection. This study aims to examine the factor structure of the RRS-ED in a Portuguese community sample, using correlated two-factor models, unifactorial and bifactor models and test for invariance across sex. A sample of 535 adults (179 male; 356 female) filled out the RRS-ED. A subsample (n=347) answered additional measures of repetitive negative thinking and eating psychopathology. The bifactor model of the RRS-ED provided the best fit, demonstrating a reliable general rumination factor. Also, the bifactor model of the RRS-ED was invariant across sex. RRS-ED showed moderate to strong correlations with negative perseverative thinking and eating psychopathology. Both domain-specific factors of RRS-ED were associated with higher levels of eating psychopathology. Findings indicate that RRS-ED is a reliable and valid measure to assess the ruminative response from the general population in Portugal, showing initial evidence that supports the use of a total score of RRS-ED as an overall measure of rumination, while specific factor scores should be reported with caution. Future studies are needed to replicate the findings and further corroborate the unidimensionality of the RRS-ED. [ABSTRACT FROM AUTHOR]

Given the recent interest in acceptance-based interventions for psychosis, it has been recommended that coping with voices mechanisms, namely experiential acceptance, are routinely assessed in clinical and research settings. The Voices Acceptance and Action Scale (VAAS-12) is a self-report measure developed to specifically assess acceptance-based or action-based beliefs in relation to verbal auditory hallucinations. This study aimed to translate, adapt and study the psychometric properties of the Portuguese version of the VAAS-12 in a clinical sample within the psychosis-spectrum disorders. The VAAS-12 was translated and adapted to Portuguese. Its psychometric properties were then studied in a sample of fifty-four male participants, mostly single, unemployed, and with a last week voice hearing experience. Confirmatory analysis was performed for the one-factor and two-factor structure suggested for the VAAS in previous studies. Both had unacceptable fit indicators. Exploratory analysis then yield an alternative two-factor structure ("Non-interference and action" and "Acceptance and Life functioning" subscales) with adequate fit. Adequate internal consistency and construct validity were found, with the VAAS being negatively associated with perception of voices as hostile-dominant and resistance regarding voices. The VAAS-12 seems adequate to use in clinical and research studies, although further study is needed particularly regarding subscale "Acceptance and Life functioning". [ABSTRACT FROM AUTHOR]

• *Our systematic literature review indicated a beneficial effect of physical activity on insomnia when sleep was objectively assessed through polysomnography or actigraphy. This is a novel finding in the literature. • Sleep efficiency and total sleep time increased; sleep latency and time awake after sleep onset decreased after physical activity. • *The use of objective methods to assess sleep (polysomnography and/or actigraphy) in insomnia is relevant particularly when evaluating the efficacy of specific strategies as physical activity in ameliorating or preventing insomnia. The aim of our study was to investigate if physical activity has a beneficial impact on insomnia. A systematic literature review was conducted in PubMed database using the terms "Physical activity" and "Insomnia" and 591 records were retrieved. The preferred reporting items for systematic reviews and meta-analyses guidelines were followed and fifteen articles were considered eligible for further analysis. Participants were mainly female, between 40 and 60 years; design studies were variable and most studies involved long-term interventions; insomnia definition was mainly based on diagnostic criteria or considered a specific cut-off point of well-known insomnia questionnaires; sleep was mostly assessed with polysomnography (PSG) or actigraphy; physical activity interventions included different methodologies (predominantly treadmill exercise). A beneficial effect of physical activity on insomnia was observed in most studies when sleep was evaluated with PSG or actigraphy. Sleep efficiency was the objective sleep parameter that mainly provided statistically significant results, as expected, followed by sleep onset latency, wake after sleep onset and, less frequently, total sleep time. Using objective methods to assess sleep in insomnia might be useful to support subjective insomnia complaints and to evaluate the efficacy of physical activity interventions in ameliorating sleep of people with insomnia. [ABSTRACT FROM AUTHOR]

Affective temperaments are frequently described as a biologically determined early emerging variation in emotional reactivity, with solid temporal stability. We aimed to analyse affective temperament variation and dominance while adapting and translating the Affective Temperament Questionnaire (ATQ) to European Portuguese in both clinical (Major Depressive Disorder - MDD and Bipolar Disorder - BD) and non-clinical samples. ATQ was administered to 42 subjects with MDD, 64 with BD and 411 non-clinical. A 3-factor model CFA was performed (comprising hyperthymic, cyclothymic and dysthymic temperaments), revealing good adjustment and acceptable internal consistency levels. ATQ subscales showed a general higher internal consistency in people with mood disorders. Support for convergent validity was found. BD and MDD presented higher prevalence in Cyclothymic and Dysthymic temperaments than non-clinical, although they did not differ significantly between them regarding the last one. Findings suggest ATQ is a valid and reliable self-report measure to assess affective temperaments in the Portuguese population and proved to be acceptable for either clinical or non-clinical samples. This measure can be applied to detect early vulnerability to affective disorders, which can be very helpful in clinical settings and primary care. [ABSTRACT FROM AUTHOR]

The aim of our study was to explore the contribution of psychological factors for healthy sleep within a sample of one hundred employees (M= 43.4 ± 9.91 years; 74% female) with regular working schedules. Participants completed a set of questionnaires about sociodemographic characteristics, lifestyle behaviours, sleep times, healthy sleep, insomnia, sleep hygiene behaviours, personality traits, work-related cognitions, mood and well-being. Descriptive, correlational and multiple linear regression analyses were performed. Extraversion, perception that work effort was properly rewarded, job autonomy, satisfaction with working conditions, vigour-activity, friendship and well-being were positively associated with healthy sleep; arousal predisposition, neuroticism, can't stop thinking of work, rumination, worry, depression-dejection, tension-anxiety, confusion-bewilderment and fatigue-inertia were negatively associated. Multiple linear regression analyses identified four factors that mostly contributed to healthy sleep (41.3%): neuroticism (R2=.245, p<.001), worry during sleep (R2 change=.094 p=.001), well-being (R2 change=.044, p=.016) and job autonomy (R2 change=.030, p=.041). Employees with lower levels of neuroticism, less worry during the night, better well-being and higher autonomy at work experienced healthier sleep. To promote healthy sleep among employees with regular/daytime working hours it might be important to consider personality traits, work-related cognitions and well-being. [ABSTRACT FROM AUTHOR]

Psychotic disorders are serious mental health conditions that emerge from cumulative interactions between multiple risk factors. They are associated with several pathophysiological alterations, including dysregulations in neurotransmitter systems and immune system dysfunction. Moreover, psychosocial factors such as stress, trauma, and social adversity also play a role in psychosis. In addition to their repercussions at the cognitive level, studies have found that stress and trauma are correlated with alterations in immune function. Presently, it is unclear how these interactions contribute to psychosis or whether other predictors and protectors of psychopathology are associated with similar alterations. Thus, the first aim of this project is to investigate associations between a selection of cognitive-emotional processes relevant for psychosis and alterations in immune markers. This could have important applications in the development of therapeutics for psychotic disorders. When it comes to treatment, psychosocial interventions have been recommended for psychosis due to their potential to alleviate distress and improve functionality. Contextual Cognitive Behavioral Therapies (CCBT) are approaches that focus on broadening the repertoire of functional responses to internal experiences. Studies show they help decrease psychopathology, improve well-being, and even promote positive changes in immune function. CCBT's have been adapted to psychosis with promising results. However, these efficacy studies are scarce, and none have tested the effects of CCBT's at the immune level in this population. Thus, this project aims to test the efficacy of a CCBT intervention for psychosis - the COMPassio-nate Approach for people with Schizophrenia and Schizoaffective disorder (COMPASS). A two-arm randomized controlled trial will be implemented, comparing the experimental group with a treatment-as-usual control group. Results from baseline assessments will be compared with post-intervention and follow-up (three- and six-month post-intervention) results for both groups, to ascertain the effects of COMPASS on psychological and immune function parameters, and analyze its contribution to recovery. [ABSTRACT FROM AUTHOR]

Endoplasmic reticulum (ER) stress and mitochondrial dysfunction, which are key events in the initiation and/or progression of several diseases, are correlated with alterations at ER-mitochondria contact sites, the so-called "Mitochondria-Associated Membranes" (MAMs). These intracellular structures are also implicated in NLRP3 inflammasome activation which is an important driver of sterile inflammation, however, the underlying molecular basis remains unclear. This work aimed to investigate the role of ER-mitochondria communication during ER stress-induced NLRP3 inflammasome activation in both peripheral and central innate immune systems, by using THP-1 human monocytes and BV2 microglia cells, respectively, as in vitro models. Markers of ER stress, mitochondrial dynamics and mass, as well as NLRP3 inflammasome activation were evaluated by Western Blot, IL-1β secretion was measured by ELISA, and ER-mitochondria contacts were quantified by transmission electron microscopy. Mitochondrial Ca2+ uptake and polarization were analyzed with fluorescent probes, and measurement of aconitase and SOD2 activities monitored mitochondrial ROS accumulation. ER stress was demonstrated to activate the NLRP3 inflammasome in both peripheral and central immune cells. Studies in monocytes indicate that ER stress-induced NLRP3 inflammasome activation occurs by a Ca2+-dependent and ROS-independent mechanism, which is coupled with upregulation of MAMs-resident chaperones, closer ER-mitochondria contacts, as well as mitochondrial depolarization and impaired dynamics. Moreover, enhanced ER stress-induced NLRP3 inflammasome activation in the immune system was found associated with pathological conditions since it was observed in monocytes derived from bipolar disorder (BD) patients, supporting a pro-inflammatory status in BD. In conclusion, by demonstrating that ER-mitochondria communication plays a key role in the response of the innate immune cells to ER stress, this work contributes to elucidate the molecular mechanisms underlying NLRP3 inflammasome activation under stress conditions, and to disclose novel potential therapeutic targets for diseases associated with sterile inflammation. [ABSTRACT FROM AUTHOR]

Objective: To characterize medical interns' experience regarding communication skills education and to explore potential associations with preparedness for practice.Methods: Two hundred sixty-six medical interns answered an original questionnaire specifically developed to explore how well they feel their undergraduate training had prepared them in key aspects of medical communication. Instrument's psychometric properties were tested. Medical schools' curricula were considered and associations explored using non-parametric tests.Results: The questionnaire reliability was high, with Cronbach's alphas ranging from 0.89 to 0.94 on all the factors. Core communication skills were highly rated. Perceived preparedness was lower in aspects concerning dealing with emotion, breaking bad news and communicating with speech impaired patients. Better preparedness was associated with a longitudinal integration of communication skills throughout the curriculum, simulation with standardized patients and real patient interviewing with feedback on communication skills.Conclusions: Integrated programs, standing on a strong experimental component, particularly combining patient-simulation strategies with continuous supervision and learner centred feedback, were associated with higher preparedness. These results support the expansion of an educational model based on simulation strategies and structured longitudinally throughout the undergraduate medical curriculum.Practice Implications: This study intends to inform educational background and to support further development of communication skills curricula. [ABSTRACT FROM AUTHOR]

The current study examines the potential moderating effect of depression and anxiety on the relationship between visual acuity and health-related quality of life in patients with chronic eye diseases. Of the 71 patients, 37 (52%) were female and 34 (48%) were male, age (mean ± SD) was 69 ± 12 years. A significant multivariate regression model was found for patients' health-related quality of life (EQ-5D-5L index) (R2 = 0.43, p < 0.001), in which visual acuity (logMAR) (p < 0.001), anxiety (HADS-A) (p = 0.007), and age of diagnosis (p = 0.04) were independently associated with health-related quality of life (EQ-5D-5L). The moderation model for anxiety (R2 = 0.47, F = 5.91, p < 0.001) revealed a significant interaction of visual acuity and levels of anxiety in relation to health-related quality of life. Conditional effects analysis suggested that higher logMAR values (which indicate more vision loss) were associated with lower EQ-5D-5L index (indicating worse health-related quality of life), this relationship being stronger (even more negative), when levels of anxiety are high. Clinical and rehabilitation services providing care for chronic eye disease patients should include regular checks for patients' levels of anxiety, even in patients who still have preserved visual acuity, to help preventing a synergistic source of long-term poor quality of life and disability. [ABSTRACT FROM AUTHOR]

Premenstrual dysphoric disorder (PMDD) affects 1.2 to 5% of women of reproductive age. Besides significant suffering and social, occupational, and interpersonal impairment, it has been suggested that this syndrome is associated with other affective disorders, in different reproductive phases, such as pregnancy and the postpartum period. However, the literature on this association is scarce and presents great variability in terms of adopted methodology and mixed results. To analyze the relationship between PMDD and other affective disorders, aiming to contribute to the clarification of whether PMDD can be considered a risk factor for perinatal depression (PND). Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we conducted a comprehensive literature search in PubMed, EMBASE, CINAHL, PsycINFO databases. Seven original studies were included. Only one study linked PMDD with depression during pregnancy, with evidence of a positive association between PMDD and PND. This and five other studies show a positive relationship between PMDD and postpartum depression (PPD), assessed in periods ranging from 2 to 4 days to 1 year after birth. Only one study found no significant association between PMDD and PPD, assessed at 4 weeks postpartum. There seems to be a positive and significant association between PMDD and the development of perinatal depression, particularly postpartum depression. This review supports the relevance of health professionals systematically evaluating the presence of premenstrual dysphoric disorder, when monitoring women throughout the perinatal period. [ABSTRACT FROM AUTHOR]

Abstract: The neurogranin (NRGN) gene produces a postsynaptic brain-specific protein that regulates calmodulin-Ca2+ availability in neurons. Acting downstream of the NMDA receptor and upstream of calcineurin and other proteins implicated in schizophrenia, NRGN is a good candidate for association studies in schizophrenia. NRGN expression is regulated during development and is modulated by thyroid hormones and retinoids, molecules essential for the proper development of the central nervous system. Given the genetic complexity of schizophrenia and the potential genetic heterogeneity in different populations, we studied a possible association of NRGN with schizophrenia in 73 Azorean proband-parent triads and in two independent case-control samples from the Portuguese-mainland (244 schizophrenic and 210 controls) and Brazil (69 schizophrenic and 85 mentally healthy individuals). Genotype distribution showed association of the rs7113041 SNP with schizophrenia in males of Portuguese origin, which was confirmed by the analysis of the proband-parent triads. This evidence, implicating NRGN in schizophrenia, introduces another player into the glutamatergic hypothesis of schizophrenia. [Copyright &y& Elsevier]

Background The patient-centeredness (PC) is particularly challenging for the deaf population, mainly due to communication barriers. We compared the perception of PC, regarding the last medical appointment, satisfaction with the consult, adherence and health perception among a group of deaf adults and a group of adults from the general population; and analyzed the relation between these variables in adult's deaf group. Methods Adults from the general population (n = 1335) and deaf adults (n = 36) from different national associations completed the validated Portuguese version of a self-reported questionnaire (PPCD-16) and answered questions on satisfaction, adherence and health perception. The deaf group subsample watched a video with the translation of the questionnaire to Portuguese Sign Language. Results The two subsamples didn't differ significantly in the PPCD-16 total and dimensional scores; only in 5 items, related to the perception of the consult motive and to the doctor's concern for the patient, did the deaf group subsample show significantly lower scores. The same was verified for the satisfaction, adherence, and physical and psychological health perceptions. The PPCD-16 total and dimensional scores presented a significant, positive and moderate- high correlation with satisfaction and adherence. Total PPCD-16 and the dimensional score of Empathy were significant predictors of satisfaction and adherence. Conclusions There wereńt significant differences between the two groups in the PPCD-16 scores, but deaf participants consider that 'many times', they cańt understand and be understood by the physician. These factors may contribute to their lower satisfaction and adherence. More studies will be necessary to show the relevance of Portuguese Sign Language interpreters. [ABSTRACT FROM AUTHOR]

Objective: To investigate whether visual acuity has the same importance as a factor of depression and anxiety comparing with other psychological variables, particularly perceived social support, in patients diagnosed with age-related eye diseases, with and without low vision. Design: Observational cross-sectional study. Setting: Patients attending outpatient appointments at the department of ophthalmology of a general hospital in Portugal. Subjects: Patients with age-related macular degeneration and patients with diabetic retinopathy attending routine hospital appointments were recruited for this study. Measures: Anxiety and depression were measured using the hospital anxiety and depression scale and perceived social support using the multidimensional scale of perceived social support. Visual acuity was measured with ETDRS charts. Results: Of the 71 patients, 53 (75%) were diagnosed with diabetic retinopathy, 37 (52%) were female and age (mean ± SD) was 69 ± 12 years. Acuity in the better seeing eye was 0.41 ± 0.33 logMAR. The mean anxiety score was 4.38 ± 3.82 and depression 4.41 ± 3.39. Clinically significant levels of anxiety were found in 21% (n = 15) of the participants and depression in 18%(n = 13). The total social support score was 5.29 ± 0.61. Significant multivariate regression models were found for anxiety (R 2 = 0.21, P = 0.016) and for depression (R 2 = 0.32, P < 0.0001). Social support was independently associated with levels of anxiety and with levels of depression. Gender was independently associated with levels of anxiety. Conclusion: This study suggests that patients' perceived social support might be more important than visual acuity as a factor of clinical depression and anxiety in a sample of age-related eye disease patients. [ABSTRACT FROM AUTHOR]

Introduction: The comprehensive effects on the mental health of the population due to the rapid global spread of COVID-19 are even more harmful to specific groups of individuals, including pregnant women. Objective: To analyze the psychometric properties of the COVID-19 Fear Scale for Perinatal Period (EMC19-9). Methods: This is a cross-sectional study with 204 pregnant women. Participants were recruited online through social networks. The criteria for participation in the research were: pregnant and aged 18 years or older. An electronic form was filled out, which included the preliminary Portuguese version of the COVID-19 Fear Scale (EMC19), containing the seven items in the original version and the two additional items related to pregnancy and baby, socio-demographic, psychosocial and related to pregnancy, as well as the validated Brazilian versions of the Perinatal Depression Screening Scale and the Perinatal Anxiety Screening Scale. The SPSS version 26 statistical package was used. For parametric measures, Pearson's coefficient and Student's T and non-parametric - Mann Whitney's U. And the magnitude of the correlation coefficients with perinatal anxiety and depression symptoms, Cohen's criteria. AMOS 26.0 was used for confirmatory factor analysis. For internal consistency, Cronbach's alpha. Results: The results indicate that EMC-19-9 is a one-dimensional construct, has robust psychometric qualities, very good internal consistency of the questionnaire and shows convergent validity, has a moderate and significant correlation with perinatal anxiety and a significant, albeit slight, correlation with perinatal depression. Conclusion: the Covid-19 Fear Scale for the Perinatal Period (EMC-19-9) has robust psychometric qualities and convergent validity. EMC-19-9 is a reliable and valid tool to assess the severity of fear of COVID-19 among women in the perinatal period in Brazil. [ABSTRACT FROM AUTHOR]

Internet use patterns, generalized problematic internet use, and the latter's relation to psychological distress were explored in a sample of 503 university students (Mage = 20.25; SD = 2.75). A questionnaire about internet use patterns, the Generalized Problematic Internet Use Scale 2, and the Depression, Anxiety and Stress Scales were answered. The students spent 5 hours online on a daily basis. The total generalized problematic internet use index score corresponded to a medium-risk level, with 12.9% of men and 5.0% of women presenting a high-risk level. Higher total generalized problematic internet use risk levels corresponded to higher levels of depression, anxiety and stress. Our results seem to show that university students constitute a particularly vulnerable group in terms of problematic internet use, supporting the relation between generalized problematic internet use and psychological distress. [ABSTRACT FROM AUTHOR]

There is extensive evidence showing that bilinguals activate the lexical and the syntactic representations of both languages in a nonselective way. However, the extent to which the lexical and the syntactic levels of representations interact during second language (L2) sentence processing and how those interactions are modulated by L2 proficiency remain unclear. This paper aimed to directly address these issues by using an online technique (eye-tracking) that is highly sensitive to the lexical and syntactic processes involved in sentence reading. To that purpose, native-speakers of European Portuguese (EP) learning English as L2 at intermediate and advanced levels of proficiency were asked to silently read temporally ambiguous L2 relative clause (RC) sentences disambiguated with a High-Attachment (HA) or Low-Attachment (LA) strategy while their eye-movements were monitored. Since EP and English native speakers differ in the way they process and comprehend this syntactic structure (EP: HA, English: LA), HA preferences were used as a marker of L1 RC syntax interference. Additionally, the cognate status of the complex NP that preceded the RC was manipulated to further analyze how the lexical co-activation of both languages would also affect the syntactic representations of the non-target (L1) language. Results showed cognate facilitation in early and late reading time measures regardless of L2 proficiency, and also that the cognate status of the complex NP impacted L2 reading performance, particularly at lower levels of L2 proficiency. These findings provide compelling evidence for a bilingual reading system that seems to be highly dynamic and interactive not only within each level of processing, but, importantly, across levels of representation. They also suggested that, as the level of L2 proficiency increases, L1 RC syntax interference becomes stronger, in a syntactic parser that seems to operate in a more integrated and nonselective way, with both strategies being equally available to guide L2 reading comprehension. Results are discussed attending to the current models of bilingual syntactic processing. [ABSTRACT FROM AUTHOR]

Highlights • Antipsychotic Medication Beliefs and Attitudes Scale is a brief, 12-item scale. • It assesses several aspects of antipsychotic adherence in people with psychosis, including. psychosocial drivers frequently neglected in other adherence assessment tools. • It comprises two factors: "Barriers to adherence" and "Perceived positive effects". • The scale showed good psychometric properties. Abstract Antipsychotic medication non-adherence is a complex and multifaceted problem that may hinder recovery in psychosis-spectrum disorders. Therefore, it warrants an early and comprehensive assessment. Current self-report measures focus entirely on behavioral and attitudinal barriers to adherence, failing to provide insight about key psychosocial drivers such as shame and stigma that may also account for non-adherence. This study's main goals were to develop a brief scale for measuring antipsychotic (non)-adherence and associated intra and interpersonal barriers (Antipsychotic Medication Beliefs and Attitudes Scale – AMBAS), and explore its psychometric properties. One hundred and seventy participants with a psychosis-spectrum disorder were recruited and filled in a battery of self-report measures. Exploratory factor analysis supported a two-factor solution, with one factor tapping the influence of different barriers to medication adherence and other factor encompassing perceived positive effects of medication. The scale presented good reliability and convergent validity as evidenced by significant moderate associations with the Medication Adherence Rating Scale. Although in need for further study, AMBAS seems a valid and reliable measure to assess antipsychotic (non)-adherence and underlying behavioral and psychosocial drivers. With replication, AMBAS might be a useful measure that could be used in different clinical and research settings. [ABSTRACT FROM AUTHOR]

Highlights • CIPD is a new integrative and comprehensive assessment tool. • The CIPD's major strength is including both clinical and patient assessments. • CIPD is a reliable and valid assessment interview to assess psychotic symptoms. • CIPD was positively correlated with psychotic symptoms-related measures. • Participants highlighted CIPD's utility, degree of detail and content. Abstract Given the recent treatment paradigm shift in psychosis, focusing on the recovery process, new assessment tools are needed. The Clinical Interview for Psychotic Disorders (CIPD) is an integrative and comprehensive assessment tool for psychotic disorders. CIPD encompasses the evaluation of diagnosis, psychosocial correlates and most relevant comorbidities. The study's aims were to examine CIPD inter-rater reliability, the relationships between CIPD and other instruments assessing positive and negative symptoms and functionality, and to explore participants' qualitative feedback. The sample included 30 individuals with psychotic disorders, aged between 18 and 62 years old. Two experts in clinical psychology conducted the interviews and independently rated other assessment tools (PANSS, GAF and PSP) to determine severity of psychotic symptoms and levels of functionality. Results indicated high inter-rater reliability for the majority of CIPD items and agreement regarding diagnosis was between 73% and 93%. Moreover, positive and moderate to strong correlations were found between CIPD, PANSS, GAF and PSP. From the qualitative analysis five themes emerged, namely: CIPD applicability and utility, comparison with previous interviews, interviewer aspects, negative and positive aspects. Overall, these preliminary results suggest that CIPD is a reliable and valid assessment instrument that seems to be well suited for people with psychosis. [ABSTRACT FROM AUTHOR]

Acceptance and Commitment Therapy and related constructs (experiential avoidance, cognitive defusion and committed action) have recently been applied to psychosis. However, with a few exceptions, this application has not resulted in symptom-specific assessment instruments. The current work intends to develop a measure for assessing experiential acceptance regarding delusions (the Willingness and Acceptance for Delusions Scale) and to conduct a preliminary study of its psychometric properties in a sample of 91 patients with a psychotic disorder, mostly male (87%), single (86%), unemployed (44%), presenting with a schizophrenia diagnosis (71%), and currently with delusions (last week - 52%). Exploratory factor analysis yielded a three-factor structure (Acceptance and Action, Non-entanglement and Non-struggling), which adequately fitted the data and reflected the intended constructs within an Acceptance and Commitment Therapy framework. Scores from all factors achieved adequate reliability and were associated with mindfulness and satisfaction with life. These early findings point to the internal and construct validity and reliability of the scores of the WADS. Although further research into the scale’s psychometric properties, particularly construct validity, is needed, its use in research and clinical practice with psychosis populations seems substantiated. [ABSTRACT FROM AUTHOR]

Previous research indicates that sleep difficulties and stress are prevalent in college students. The main aim of the current study was to investigate the role of repetitive negative thinking (RNT), cognitive emotion regulation, and negative affect as mediators of the relationship between stress and sleep difficulties. We also intended to analyse the associations between all these variables and the gender differences. A sample of 549 college students completed self-report measures assessing the mentioned variables. Descriptive and correlational analyses showed significant differences between genders. In total sample, sleep difficulties were positively associated with perceived stress, negative affect, RNT and cognitive emotional strategies (rumination, self-blaming, catastrophizing, and acceptance). Mediation analyses suggested that in addition to the direct effect of stress on sleep difficulties, rumination and negative affect were important mediators in this relationship (after controlling gender). RNT did not mediate this association; however it was significantly associated to rumination and/or negative affect. These findings suggest that the effect of stress on sleep difficulties is strengthened by rumination and/or negative affect. The negative impact of RNT (content free) only occurs if associated to rumination and/or negative affect. [ABSTRACT FROM AUTHOR]

Fears of Compassion (FOC) relate to experiencing defensive emotions and avoidance reactions when receiving and giving compassion. Three different flows have been identified: giving compassion to others, receiving compassion, and self-compassion. This study sought to explore: FOC within a sample of patients with psychosis; the associations between FOC and paranoia; and the mediator role of FOC in the relationship between paranoid conviction and distress. Seventy-two patients with psychosis (74% diagnosed with schizophrenia), mostly male (85%), with a mean age of 33.46 (SD = 9.43), were recruited and assessed with measures of paranoia (conviction and distress) and FOC. Participants presented significantly higher levels of FOC than non-clinical samples and lower levels than depressed patients. Different flows of FOC were associated with each other and with paranoia-related measures. A mediation effect of FOC from others and fears of self-compassion was found. Results support the relevance of including FOC in formulation and treatment protocols for psychosis. [ABSTRACT FROM PUBLISHER]

Objective: To explore 1) if perfectionism, perceived distress/coping, and cognitive emotion regulation (CER) are associated with and predictive of negative/positive affect (NA/PA); and 2) if CER and perceived distress/coping are associated with perfectionism and if they mediate the perfectionism-NA/PA associations. There is a distinction between maladaptive and adaptive perfectionism in its association with NA/PA. CER and perceived distress/coping may mediate the maladaptive/adaptive perfectionism and NA/PA associations. Methods: 344 students (68.4% girls) completed the Hewitt & Flett and the Frost Multidimensional Perfectionism Scales, the Composite Multidimensional Perfectionism Scale, the Profile of Mood States, the Perceived Stress Scale, and the Cognitive Emotion Regulation Questionnaire. Results: NA predictors were maladaptive/adaptive perfectionism, maladaptive CER and perceived distress (positively), positive reappraisal and planning, and perceived coping (negatively). PA predictors were maladaptive/adaptive perfectionism and perceived distress (negatively), positive reappraisal and planning, positive refocusing and perceived coping (positively). The association between maladaptive perfectionism and NA was mediated by maladaptive CER/low adaptive CER, perceived distress/low coping. Maladaptive perfectionism and low PA association was mediated by perceived distress. High PA was determined by low maladaptive perfectionism and this association was mediated by adaptive REC and coping. Adaptive perfectionism and NA association was mediated by maladaptive CER and perceived distress. Conclusion: CER and perceived distress/coping are associated and mediate the perfectionism-NA/PA associations. [ABSTRACT FROM AUTHOR]

Objective: Eating disorders are an increasingly prevalent health problem among adolescent girls. It is well known that biological, psychosocial, and family-related factors interact in the development of this group of disorders. However, the mechanisms underlying the interaction between these variables are still poorly understood, especially in Portuguese adolescents. The aim of this study was to investigate the relationship between eating behaviors, body dissatisfaction, self-esteem, and perfectionism in a sample of Portuguese girls. Method: A community sample of 575 Portuguese girls attending secondary school, answered selfreport questionnaires including data on weight, height, and the Portuguese versions of the Contour Figures Rating Scale, the Child and Adolescent Perfectionism Scale, the Children Eating Attitudes Test, and the Rosenberg Self-Esteem Scale. SPSS version 20.0 for Windows was used for statistical analyses. Results: High scores in the Children Eating Attitudes Test were associated with significantly higher levels of body dissatisfaction (r = 0.339), socially prescribed perfectionism (r = 0.175), self-oriented perfectionism (r = 0.211), and low self-esteem (r = -0.292) (all p o 0.001). Self-oriented perfectionism partially mediated the relation between body dissatisfaction and disordered eating behaviors. Conclusion: In this sample, dysfunctional eating behaviors appeared to correlate strongly with body dissatisfaction, low self-esteem, and perfectionism in girls. These themes should be addressed among female adolescents in the community. [ABSTRACT FROM AUTHOR]

Introduction Perfectionism constitutes a risk factor for the development of eating disorders. In overweight women, knowledge about the nature of this association is scarce. Objectives To investigate the relationship between perfectionism, eating behaviors and affect in overweight women. Methods The Portuguese versions of the Eating Disorder Examination Questionnaire/EDEQ, the Multidimensional Perfectionism Questionnaire and the Profile of Mood States were administered to an outpatient sample of 276 women (mean age = 43.85 ± 11.89 years; mean BMI = 32.82 ± 5.43 kg/m 2 ). Results Correlations between Socially Prescribed Perfectionism/SPP, EDEQ total (T) and its dimensional scores (Weight and Shape Concern and Dissatisfaction/WSCD, Eating Concern/EC, Dietary Restraint/DR) were significant (r > .30; p > .001). Self-Oriented Perfectionism/SOP was significantly correlated with EDEQ-T, WSCD and DR (r = .20). Participants with high (> M + SD) vs. low (< M-SD) SOP and SPP had significantly higher means in EDEQ-T, WSCD, EC and DR (p < .001). Linear regression showed that SPP was predictor of EDEQ-T and EC (p < .001). Conclusions SPP and SOP are related to disordered eating in overweight women. [ABSTRACT FROM AUTHOR]

The aim of this study was to analyze the psychometric properties of the Portuguese version of the Child and Adolescent Perfectionism Scale (CAPS). Method: 971 Portuguese high school students (572 girls and 399 boys) answered the CAPS. The test-retest reliability was obtained with 206 participants from the total sample. Results: Internal consistency (a= .809) and test-retest reliability (r= .691) were satisfactory. Main components of factorial analysis yielded two factors, accounting for 41.44% of the total variance. Factor structure was similar to the original version. Factors were labelled as "Socially Prescribed Perfectionism" and "Self-Oriented Perfectionism". Discussion: The Portuguese version of the CAPS is a valid and useful instrument for the evaluation of perfectionism among Portuguese adolescents. [ABSTRACT FROM AUTHOR]

Sarco/endoplasmic reticulum Ca2+ ATPase (SERCA) is a crucial component of the cellular machinery responsible for Ca2+ homeostasis. The selective inhibition of SERCA by thapsigargin (TG) leads to perturbations in Ca2+ signaling, which can trigger endoplasmic reticulum (ER) stress. The unfolded protein response (UPR) pathway is activated in response to ER stress and induces an adaptive response to preserve cell survival or committee cells to programmed death, depending on stress duration and/or level. Early stages of ER stress stimulate mitochondrial metabolism to preserve survival but under chronic ER stress conditions, mitochondrial dysfunction is induced, which, in turn, can enhance inflammation through NLRP3 inflammasome activation. This study was aimed at investigating the role of SERCA inhibition on NLRP3 inflammasome activation in human monocytes, which was evaluated in primary monocytes isolated from healthy individuals and in the THP-1 human monocytic cell line. Findings obtained in both THP-1 and primary monocytes demonstrate that SERCA inhibition triggered by TG does not activate the NLRP3 inflammasome in these innate immune cells since IL-1β secretion was not affected. Results from THP-1 monocytes showing that SERCA inhibition increases mitochondrial Ca2+ content and fusion, in the absence of changes in ROS levels and membrane potential, support the view that human monocytes counteract ER stress that arises from inhibition of SERCA through modulation of mitochondrial morphology towards mitochondria fusion, thus preventing NLRP3 inflammasome activation. Overall, this work contributes to a better understanding of the molecular mechanisms that modulate the activity of the NLRP3 inflammasome leading to sterile inflammation, which are still poorly understood. [ABSTRACT FROM AUTHOR]

Abstract: The aim of the present study was to investigate if disordered eating behaviors predicted the development of sleep disturbances. A total of 870 students participated at baseline, 592 one year later (T1) and 305 two years later (T2). The Eating Attitudes Test-40 was used to assess global disordered eating behaviors, dietary concerns (DC), bulimic behaviors (BB) and social pressure to eat (SPE). Sleep disturbances were assessed by two items related to difficulties initiating sleep (DIS) and maintaining sleep (DMS). A sleep disturbance index (SDI) was calculated by summing DIS and DMS scores. Results revealed that global disordered eating behaviors at baseline predicted DIS, DMS and SDI at T1 and T2. Students with increased BB and SPE scores at baseline were more likely to experience sleep onset and sleep maintenance difficulties in the long term. These results suggest that assessment and correction of eating behaviors might prevent sleep disturbances. [Copyright &y& Elsevier]

The aims of the present study were to develop three shorter forms of the Portuguese version of the Postpartum Depression Screening Scale (PDSS) as adapted and translated in Portugal, to analyse their psychometrics and to determine their cut-off points and associated conditional probabilities to screen for perinatal depression according to DSM-IV and ICD-10 criteria. In this study, 441 women in the third trimester of pregnancy and 453 in the third month of postpartum were interviewed for diagnostic purposes according to the Portuguese versions of the Diagnostic Interview for Genetic Studies and the Operational Criteria Checklist for Psychotic Illness. DSM-IV and ICD-10 classifications of depression were our gold standards for caseness. Three different shorter forms of the original Portuguese version of the PDSS were developed on the basis of reliability and factorial analysis. PDSS short versions, composed of seven and 21 (postpartum)/24 (pregnancy) items, presented significant reliability and validity and showed satisfactory combinations of sensitivity and specificity (≅80 %). The short forms of the original Portuguese version of the PDSS are valid alternatives to the 35-item version, given their equally precise screening performances, more concise structures and ease of completion. [ABSTRACT FROM AUTHOR]

The role of perfectionism as a correlate and as a predictor of perinatal depressive symptomatology and disorder was examined. Three-hundred and eighty-six pregnant women (mean age = 30.08 years; SD = 4.205; range = 19-44) completed the Portuguese versions of the Multidimensional Perfectionism Scale, Beck Depression Inventory-II/BDI-II and three questions evaluating anxiety trait, life stress and social support perception. Diagnoses of depression were obtained using the Portuguese version of the Diagnostic Interview for Genetic Studies/OPCRIT system. Women who were depressed in pregnancy (ICD-10/DSM-IV) were excluded from the analyses. Self-Oriented Perfectionism and Socially Prescribed Perfectionism subcomponents (Conditional Acceptance and Others' High Standards) were significant correlates of depressive symptomatology/BDI-II in pregnancy. Others' High Standards was a significant predictor of postpartum depressive symptomatology/BDI-II, after controlling the other independent variables (depressive symptomatology and trait anxiety in pregnancy, life stress and social support perception in postpartum). None of the perfectionism subscales predicted postpartum depressive disorder (ICD-10/DSM-IV). Self-Oriented Perfectionism was an important correlate of depressive symptomatology in pregnancy and Others' High Standards and Conditional Acceptance were significant correlates of perinatal depressive symptomatology. Others' High Standards accounted for 0.8 % of the depressive symptomatology variance in postpartum after controlling the effect for other depressive symptomatology correlates. Perfectionism was not a risk factor for postpartum depressive disorder. Our findings improve the knowledge regarding the risk factors implicated in the development of postpartum depressive symptomatology/disorder, which is of utmost importance to develop adequate prevention and intervention strategies. [ABSTRACT FROM AUTHOR]

Thyroid hormones are crucial during development and in the adult brain. Of interest, fluctuations in the levels of thyroid hormones at various times during development and throughout life can impact on psychiatric disease manifestation and response to treatment. Here we review research on thyroid function assessment in schizophrenia, relating interrelations between the pituitary-thyroid axis and major neurosignaling systems involved in schizophrenia's pathophysiology. These include the serotonergic, dopaminergic, glutamatergic, and GABAergic networks, as well as myelination and inflammatory processes. The available evidence supports that thyroid hormones deregulation is a common feature in schizophrenia and that the implications of thyroid hormones homeostasis in the fine-tuning of crucial brain networks warrants further research. [ABSTRACT FROM AUTHOR]

Thyroid hormones are crucial during development and in the adult brain. Of interest, fluctuations in the levels of thyroid hormones at various times during development and throughout life can impact on psychiatric disease manifestation and response to treatment. Here we review research on thyroid function assessment in schizophrenia, relating interrelations between the pituitary-thyroid axis and major neurosignaling systems involved in schizophrenia's pathophysiology. These include the serotonergic, dopaminergic, glutamatergic, and GABAergic networks, as well as myelination and inflammatory processes. The available evidence supports that thyroid hormones deregulation is a common feature in schizophrenia and that the implications of thyroid hormones homeostasis in the fine-tuning of crucial brain networks warrants further research. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the degree of absolute change, relative stability and state dependence of trait perfectionism in sleep disturbances in a sample of university students. Method: Participants completed the Multidimensional Perfectionism Scale and two items concerning sleep difficulties. The mean age at T0 (baseline) was 19.59 years (SD = 1.61, range = 17-25) and 62.5% of the sample were female. Results: Absolute changes in self-oriented and socially-prescribed perfectionism were found. Relative stability was found for all perfectionism dimensions. Prior and concurrent sleep disturbances explained a significant amount of variance in perfectionism. Controlling for the effects of sleep measures, prior self oriented perfectionism and other-oriented perfectionism were the only significant predictors of subsequent self-oriented perfectionism and other oriented perfectionism, at T1 and T2. Difficulties falling asleep at T1 and socially-prescribed perfectionism at T0 were significant predictors of socially-prescribed perfectionism at T1. Conclusion: Despite significant changes in perfectionism mean scores over the follow-up, the correlation analyses demonstrated that participants remained quite stable in regard to their relative levels of perfectionism. As concurrent difficulties initiating sleep also predicted concurrent socially-prescribed perfectionism, this seems to be one dimension of perfectionism with trait-state characteristics. [ABSTRACT FROM AUTHOR]

The purpose of the study was to analyse for the first time the validity of a slightly modified version of the Portuguese Postpartum Depression Screening Scale (PDSS), to be used as a screening instrument for antenatal depression. Specifically, the aims were to analyse its psychometric properties, to determine PDSS cutoff points and associated conditional probabilities to screen for depression according to DSM-IV and ICD-10 criteria and to compare its screening performance with that of the Beck Depression Inventory-II (BDI-II). Five hundred and three pregnant women in the third trimester of pregnancy completed both questionnaires and were interviewed face-to-face with the Portuguese version of the Diagnostic Interview for Genetic Studies. The Portuguese version of the Operational Criteria Checklist for Psychotic Illness was used to obtain DSM-IV and ICD-10 diagnoses of depression, our gold standards for caseness. PDSS reliability and validity were very good and comparable to those obtained in the postpartum validation studies developed in Portugal and in other countries, showing satisfactory sensitivity and specificity combinations (≅80%). Compared with BDI-II, it has the advantage of being more specific for the motherhood context. Although developed for postpartum depression, PDSS is accurate to screen for antenatal depression, and it could be very useful for clinical and epidemiologic purposes. [ABSTRACT FROM AUTHOR]

Abstract: The aim of the present work was to investigate if insomnia in late pregnancy is a risk factor for postpartum depressive symptomatology/postpartum depression (PPD). 581 women in their last trimester of pregnancy answered questions/questionnaires about lifetime history of insomnia, current sleep perception, current mood and depressive symptomatology. They were interviewed with the Portuguese version of the Diagnostic Interview for Genetic Studies. After delivery 382 (65.7%) mothers participated again in the study. Insomnia in pregnancy was not a risk factor for PPD (DSM-IV or ICD-10) but was a significant predictor of postpartum depressive symptomatology. Negative Affect (NA) was a significant predictor of postpartum depressive symptomatology. Women with higher NA were 4.6 (CI95%=1.69–12.74) and 5.3 times (CI95%=2.26–12.58) more likely of experiencing PPD (DSM-IV/ICD-10, respectively) than women with lower NA. Lifetime Depression was a significant predictor of postpartum depressive symptomatology and ICD-10/PPD (OR=2.6; CI95%=1.16–4.38). Positive Affect (PA) showed to be a protective factor for postpartum depressive symptomatology and DSM-IV/PPD (OR=1.5; CI95%=1.20–2.33). Controlling NA, PA and Lifetime Depression, insomnia lost its predictive role, suggesting these variables might work as mediators. Associations between insomnia, NA, PA and Lifetime Depression should be assessed in pregnancy. This might help to preventively target NA, enhance PA and reduce the likelihood of experiencing postpartum depressive symptomatology. [Copyright &y& Elsevier]

The aim of the present study was to analyse whether the Portuguese version of the Postpartum Depression Screening Scale (PDSS) was a valid instrument for screening postpartum depression. For this purpose the following objectives were delineated: (1) to analyse PDSS psychometric properties; (2) to determine PDSS cut-off points and associated conditional probabilities for screening depression according to DSM-IV and ICD-10 criteria; and (3) to compare the performance of PDSS with the Beck Depression Inventory-II (BDI-II) in screening for postpartum depression. Four hundred eighty-six 3-months-postpartum women completed both questionnaires and were interviewed with the Portuguese version of Diagnostic Interview for Genetic Studies (DIGS). The Portuguese version of the operational criteria checklist for psychotic illness (OPCRIT) was used to obtain DSM-IV and ICD-10 diagnoses of depression, our gold standards for caseness. PDSS reliability and validity were very good and equivalent to those reported in other versions, including the original. PDSS was an accurate screening instrument for postpartum depression, showing satisfactory combination of sensitivity and specificity (>80%). Compared to BDI-II it has the advantage of being more specific for the motherhood context. PDSS could be very useful for clinical and epidemiological purposes. [ABSTRACT FROM AUTHOR]