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Over the past few decades, research has suggested that cognitive variables play a key role in sleep disorders, particularly, in insomnia. The SLOC (Sleep Locus of Control Scale) evaluates the sleep locus of control, which is associated with the degree to which an individual attributes her/his experiences of sleep to chance or internal causes. The aim of this study was to develop the first translation and adaptation of the SLOC into the European Portuguese, as well as to analyze its psychometric properties. In this study, it was recruited a sample of 2029 Portuguese Higher Education students, aged ≥ 18 years, where approximately 75% of the sample were women and 25% men. The results showed that the SLOC had acceptable internal consistency value (

The current study developed the first translation and adaptation of the ICS (Insomnia Catastrophizing Scale) into European Portuguese, and studied its psychometric properties. The ICS evaluates the catastrophic thoughts related with insomnia symptoms during sleeping time (ICS-N) and during daytime functioning (ICS-D). We recruited a community-based sample of 802 Portuguese participants, aged ≥ 18 years, where approximately 80% of the sample were women. The results showed that the scale has good internal consistency values for both the ICS-N (α = 0.93) and ICS-D (α = 0.95) subscales. Factor analyses suggested the presence of a single factor in both measured scales. Posteriorly, the sample was divided into two groups labeled “Insomnia” (n = 170) and “no Insomnia” (n = 632). For all the items of each one of the subscales, it was observed that “insomnia” individuals presented higher scores than “no insomnia” group. Finally, the Receiver Operating Characteristics curves were computed for both subscales, extracting the cut-off points based on optimal sensitivity (ICS-N = 75.9%; ICS-D = 65.9%) and specificity ICS-N = 75.6%; ICS-D = 77.8%) values. Overall, these findings show similarities with the other published studies with ICS. The ICS seems to be a good psychological assessment measure used in clinical and research settings.

Individuals with insomnia complaints often report intrusive thoughts. In this sense, strategies to cope with cognitive arousal are a key topic to be addressed. The TCQI-R is a self-reporting instrument aimed at evaluating the strategies used by individuals to control their thoughts during insomnia episodes. The aim of this study was to translate and adapt the thought control questionnaire insomnia-revised (TCQI-R) for the Portuguese population. In the current study, a community-dwelling sample of 802 participants was recruited, aged between 18 and 66 years, of whom 163 were men and 639 women (80%). The principal component analysis found five components: reappraisal, cognitive distraction, aggressive suppression, worry and behavioral distraction. Both the general questionnaire (α = 0.91) and the components showed good internal consistency (Cronbach’s α between 0.74 and 0.84). Through the analyses carried out, it was possible to conclude that the instrument has a good discriminatory capacity between individuals with and without "insomnia". It was also found that the use of worry and aggressive suppression strategies was associated with greater insomnia severity, anxiety, depression, and thought catastrophizing, whereas the use of cognitive distraction strategy was associated with lower severity of insomnia, anxiety, depression, and thought catastrophizing. The results of the current study are in line with the published literature on the TCQI-R. The TCQI-R seems to be a useful tool for the assessment of intrusive thoughts’ control strategies.

Research and clinical practice have demonstrated that patients with insomnia are a heterogeneous population. As such, it is important to understand and differentiate the potential sub-groups among insomnia patients as well as individuals at risk for insomnia. Questionnaires completed by 291 students of both sexes and at risk for insomnia (FIRST scale score ≥ 22) were analyzed (age range 17–24 years). Two-step cluster analyses comprising all the valid cases (N = 291) were performed to analyze the phenotypes of individuals vulnerable to insomnia separately for men and women. The results showed that men and women present different psychological profiles. Among men, it was possible to distinguish two clusters: one with relatively low scores in negative psychological variables and high positive affect and another with high scores in negative psychological variables and low scores in positive affect. Among women, three clusters were observed: two resembling the ones found for the male sample and one additional cluster encompassing individuals with moderate scores on all of the measures. However, it is possible that this additional group in women may be due to the larger sample size. The current study supports the idea that among individuals at risk for insomnia, one can discriminate different profiles. Sex-related differences should be further investigated in the future.

Insomnia disorder has known striking developments over the last few years. Partly due to advances in neuroimaging techniques and brain sciences, our understanding of insomnia disorder has become more fine-tuned. Besides, developments within psychological and psychiatric fields have contributed to improve conceptualization, assessment, and treatment of insomnia. In this paper, we present a list of promising 10 key “hot-topics” that we think in the next 10 years will continue to stimulate researchers in insomnia’s domain: increasing of systematic reviews and meta-analyses; improvement of existing self-report measures; increasing of genetic and epigenetic investigation; research on new pharmacological agents; advances in neuroimaging studies and methods; new psychological clinical approaches; effectiveness studies of e-treatments and greater dissemination of evidence-based therapies for insomnia; call for integrative models; network approach using in insomnia; and assessment of insomnia phenotypes. The breadth of all these topics demands the collaboration of researchers from different scientific fields within sleep medicine. In summarizing, in the next decade, it is predictable that insomnia’s research still benefit from different scientific disciplines.

Sleepiness propensity and sleepiness perception are two relevant dimensions of the general multidimensional sleepiness construct. In the current study, the aim was to identify eventual homogeneous subgroups when sleepiness propensity and sleepiness perception measures are combined. Data from 678 undergraduate students (aged 17 to 24 years) from a medical school were analyzed. A Two-Step Cluster Analysis was performed taken into consideration sleepiness propensity and sleepiness perception measures as clustering variables. Four different clusters were identified. Additionally, the two groups comprising higher levels of sleepiness perception (i.e., "high perception, low propensity" and "high subjective daytime sleepiness" clusters) had the most compromised results in some of the sleep-related variables examined - sleep needs, sleep latency, sleep quality, sleep sufficiency, self-reported insomnia, sleep reactivity to stress, and cognitive arousal - and in some of non-sleep related variables, such as neuroticism and affect. As to non-sleep variables, those groups reported higher scores in neuroticism, arousability, self-reported mental health and affective states. The identification of distinct groups concerning self-reported sleepiness may bring new avenues for research and understanding of the specific and differential role of sleepiness and its dimensions in sleep health and sleep disturbances, in particular, insomnia disorder.

Schizophrenia is a common, chronic and debilitating neuropsychiatric syndrome affecting tens of millions of individuals worldwide. While rare genetic variants play a role in the etiology of schizophrenia, most of the currently explained liability is within common variation, suggesting that variation predating the human diaspora out of Africa harbors a large fraction of the common variant attributable heritability. However, common variant association studies in schizophrenia have concentrated mainly on cohorts of European descent. We describe genome-wide association studies of 6152 cases and 3918 controls of admixed African ancestry, and of 1234 cases and 3090 controls of Latino ancestry, representing the largest such study in these populations to date. Combining results from the samples with African ancestry with summary statistics from the Psychiatric Genomics Consortium (PGC) study of schizophrenia yielded seven newly genome-wide significant loci, and we identified an additional eight loci by incorporating the results from samples with Latino ancestry. Leveraging population differences in patterns of linkage disequilibrium, we achieve improved fine-mapping resolution at 22 previously reported and 4 newly significant loci. Polygenic risk score profiling revealed improved prediction based on trans-ancestry meta-analysis results for admixed African (Nagelkerke’s R2 = 0.032; liability R2 = 0.017; P −52), Latino (Nagelkerke’s R2 = 0.089; liability R2 = 0.021; P −58), and European individuals (Nagelkerke’s R2 = 0.089; liability R2 = 0.037; P −113), further highlighting the advantages of incorporating data from diverse human populations.

The present study aims to characterize the prevalence, the pattern of medically prescribed and over-the-counter medication/supplements in Higher Education students, as well as to relate the consumption of sleeping medication with insomnia severity, sleep effort, sleep locus of control, anxiety, and depression. Data was collected from a sample of 2029 Portuguese Higher Education students, aged ≥18 years old, being approximately 75% women and 25% men. Thirty-one percent of the sample considered suffering from insomnia, 6% consumed sleeping medication prescribed by a physician, 4% consumed OTC (over-the-counter) medication/supplements, and 2% undergone psychotherapy. Among the Higher Education students with insomnia, 19% reported consuming sleep medication prescribed by a physician, benzodiazepines were the most prescribed drug class, and the General Practitioner the physician who prescribed most frequently. Twelve percent of students with insomnia consumed OTC medication/supplements, with Valerian being the most consumed substance. Among students with insomnia, only 8% undergone psychotherapy.

It is known that there is significant variability in arousal levels of the individuals. The Arousal Predisposition Scale (APS) is a questionnaire intended to measure individual differences in arousability. In the current work, our aim was to present the initial psychometric properties of the Portuguese version of the APS. Three hundred forty-five undergraduate medical students from both genders were enrolled. All participants filled out a set of questionnaires—which contained the APS—at the end of their lectures and out of the evaluation period. The APS showed good internal consistency (α = .85) and discriminated individuals with extreme scores. Further, in general, the scale discriminated as well both genders pertaining to the individual items and total score. In terms of scale structure, two related factors were extracted (F1 = emotional reactivity and F2 = trait anxiety). Significant associations among APS and other sleep and psychological self-report variables were also observed. The APS seems to be a reliable and valid instrument to assess self-reported physiological arousability, at least in a sample of young adults. The two-factor composition will require more studies to be replicated in similar groups and, particularly, in clinical samples.

The Arousal Predisposition Scale (APS) is an instrument aimed to assess individual differences in self-reported arousability, specifically physiologically arousal. Besides, it is a scale frequently used in stress and sleep-related researches. The principal purpose of this study is to determine the factor structure of the APS through confirmatory factor analysis (CFA) and to test the goodness-of-fit of one- and two-factor models. A sample of 341 undergraduate medical students of both genders aged 17 to 25 years was enrolled. Beyond the APS, the participants also filled out the Portuguese versions of the Pre-Sleep Arousal Scale (PSAS), Ford Insomnia Response to Stress Test (FIRST) and the Neuroticism scale of Eysenck Personality Inventory (EPI) for concurrent validity purposes. From the studied solutions, a modified two-factor model (F1 = emotional reactivity and F2 = trait anxiety) achieved the better fit to the data. The Portuguese version of the APS was also significantly correlated with measures of neuroticism, insomnia, sleep reactivity to stress, and cognitive and somatic arousal. The two-factor modified model appears to display a superior fit to the data, supporting a scoring model of the APS according to two different factors as suggested by a previous research on the Portuguese version. This study supports reliability and validity indicators of the APS and its use in research and applied settings.

This research focused on the Basic Scale on Insomnia Symptoms and Quality of Sleep (BaSIQS), formerly validated in undergraduates using the Pittsburgh Sleep Quality Index (PSQI), and aimed to expand internal consistency analysis, examine thoroughly its validity, and determine its clinical accuracy. Considering objective and subjective measures, recruiting non-clinical and clinical samples, this research implemented a comprehensive approach to examine convergent and discriminant validity, confirmatory factor analyses, and the BaSIQS sensitivity and specificity. The BaSIQS was filled out along with the Insomnia Severity Index (ISI), questions on sleep-wake schedules, Composite Scale of Morningness (CSM) and Brief Symptom Inventory-18 (BSI-18) by 1198 adults, 18-64 years old, plus another 30 who wore actimeters, recruited in community settings. A clinical group of 30 chronic insomnia disorder patients also participated. Cronbach alpha coefficient was 0.80. A two-factor structure was confirmed. The association between BaSIQS and ISI was large, whereas actigraphy correlations were medium or small. Medium to non-significant correlations were found concerning conceptually different self-report measures. Comparing the clinic and control groups, the former showed poorer sleep, with a large effect size. Receiver operating characteristic analysis revealed an area under curve = 0.9, and an optimal cut-off score >15. In conclusion, results on reliability, validity, and accuracy provide support to the utility of the BaSIQS both in community and clinical settings, for research and practical purposes.

Morningness is a trait-like variable which has been extensively studied within chronobiology. Despite the number of existing measures to assess morningness, there is a need for brief instruments that are psychometrically sound to be used in applied settings. Accordingly, the modified version of the Preferences Scale (PS-6) comprises six items and was reported to have adequate reliability and satisfactory validity indicators. In this article, the psychometric properties of the Portuguese version of the PS-6 are reported. A total of 700 students attending medical school were recruited, and this sample was randomly divided into two groups. In the first group (n = 352), we assessed the internal consistency calculations and conducted a principal component analysis of the posited structure. In the second group (n = 348), we conducted a confirmatory factor analysis (CFA) using structural equation modeling. Overall, the results indicated that the PS-6 has adequate reliability (α = .75) and is constituted by two components: (I) preferred cognitive activities timings and (II) preferred sleeping-eating timings, respectively. In conclusion, the Portuguese version of the PS seems suitable for use in research and applied settings such as shift work schedules management. However, the applicability of the PS-6 in other samples and further validity indicators should be both investigated. The use of actigraphy and biological measures should also be collected to enhance the robustness of the PS-6.

This study aimed primarily to compare the parent-reported sleep of children with ICD-10 hyperkinetic disorder (HKD) versus community children. Thirty children aged 5-13 years (83.3% boys) diagnosed with HKD by their child and adolescent psychiatrists took part in this study, plus 30 community children, matched for sex, age, and school year. Compared to the controls, the HKD children showed significantly later bedtimes, stronger bedtime resistance, longer sleep latency, shorter sleep; more frequent behaviors and symptoms concerning falling asleep into parents bed, needing something special to initiate sleep, nightmares, sleep talking, sleep bruxism, fear from darkness, bedwetting, and, most notably, loud snoring (26.7%); they also tended to show higher daytime somnolence. Attention deficit/hyperactivity disorder (ADHD)/HKD children may thus have more sleep-related problems than typically developing children. Alternatively, our results may reflect misdiagnoses; thus, special attention should be directed to comorbidity and differential diagnosis issues between sleep disturbances and ADHD/HKD.

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 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.

Over the past few years, the comprehensive models of insomnia have exhibited impressive developments. However, there is scarce knowledge on predisposing or vulnerability factors for insomnia. One of the most promising constructs to aid in filling this gap is stress-induced sleep reactivity assessed through self-report. Our aim was to study the psychometric properties of the European Portuguese version of the Ford Insomnia Response to Stress Test (FIRST).We recruited a large sample of students attending medical school (N = 699).Several analyses were carried out such as internal consistency, construct validity, and discriminant groups' analysis.It was observed that FIRST-PT shows good internal consistency (Cronbach´s alpha = .81) and validity indicators. Interestingly, and contrary to what was observed in the previously published studies on psychometric properties of the FIRST, it was observed that a two-factor solution (Factor I = rumination, Factor II = worry) was the most adequate one to explain the correlation matrix, accounting for approximately 44% of the total variance.The FIRST-PT proved to be a useful and reliable tool to measure stress-induced sleep reactivity. However, these results should be replicated in other groups, particularly clinical samples, in order to verify the stability of its factorial dimension.

In this study, our aim was to explore the relationship between sleep quality/quantity, chronotype, pre-sleep arousal, arousability, stress, coping, neuroticism, extraversion, mood/affect, perceived health and sleep loss due to worry in college students. A total of 713 students (mean age 19.29 ± 1.256 years) completed a set of questionnaires that assessed sleep loss over worry (item from the General Health Questionnaire), other sleep–wake aspects (e.g., habitual sleep duration, sleep needs, sleep depth, subjective sleep quality, sleep latency, night awakenings, daytime sleepiness, sleep flexibility, sleep reactivity to stress), pre-sleep arousal (cognitive/somatic arousal), arousability, coping, neuroticism, extraversion, perceived physical/mental health, academic stress and positive/negative affect. Sleep disturbance due to worry was reported by 40.6 % of female and 19.2 % of male students. It was significantly correlated with perceived health and the majority of sleep–wake variables. Almost all correlations between the psychological traits under study and sleep loss over worry were significant. Results from the stepwise regression analyses, however, showed that only cognitive arousal (β = .353; p

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.

BACKGROUND: The Eating Attitudes Test (EAT) is the most widely used instrument for evaluating eating disorders in adults and adolescents in a variety of cultures and samples. OBJECTIVE: The aim of this study was to analyse the psychometric properties of the Portuguese version of the Children's Eating Attitudes Test (ChEAT). METHOD: Nine hundred and fifty-six Portuguese secondary students (565 girls and 391 boys) answered the ChEAT. The test-retest reliability was obtained with data from 206 participants from the total sample who re-answered the questionnaire after 4-6 weeks. Psychometric analyses were carried out for the total sample and separately for girls and boys. RESULTS: Internal consistency and test-retest reliability were satisfactory. Principal components factorial analysis yielded four factors in the total sample, accounting for 42.35% of the total variance. Factor structure was similar in the total sample and in both genders. Factors were labelled: F1 "Fear of Getting Fat", F2 "Restrictive and Purgative Behaviours", F3 "Food Preoccupation" and F4 "Social Pressure to Eat". The concurrent validity, explored using the Contour Drawing Figure Rating Scale (CDRS) was high. DISCUSSION: The Portuguese version of the ChEAT is a valid and useful instrument for the evaluation of abnormal eating attitudes and behaviours among Portuguese adolescents.CONTEXTO: O Teste de Atitudes Alimentares é o instrumento mais utilizado para avaliar distúrbios alimentares em adultos e adolescentes em uma variedade de culturas e amostras. OBJETIVO: O objetivo deste estudo foi avaliar as propriedades psicométricas da versão portuguesa da Escala de Atitudes Alimentares para Crianças (ChEAT). MÉ;TODO: Novecentos e cinquenta e seis alunos do ensino secundário (565 moças e 391 moços) responderam ao ChEAT. O cálculo da fidelidade teste-reteste foi feito por meio das respostas de 206 participantes da amostra total que voltaram a responder ao questionário após quatro a seis semanas. As análises psicométricas foram realizadas para o total da amostra e para ambos os sexos separadamente. RESULTADOS: A consistência interna e a fidelidade teste-reteste foram satisfatórias. A análise fatorial em componentes na amostra total resultou em quatro fatores que explicam 42,35% da variância total. A composição dos fatores foi semelhante na amostra total e em ambos os sexos. Os fatores denominaram-se: F1 "Medo de Engordar"; F2 "Comportamentos Restritivos e Purgativos"; F3 "Preocupação com a Comida" e F4 "Pressão Social para Comer". A validade concorrente foi explorada com a Escala de Silhuetas Corporais (CDFRS) e foi elevada. CONCLUSÃO: A versão portuguesa do ChEAT é um instrumento útil e válido para a avaliação de atitudes e comportamentos alimentares em adolescentes portugueses.

BACKGROUND: The Eating Attitudes Test (EAT) is the most widely used instrument for evaluating eating disorders in adults and adolescents in a variety of cultures and samples. OBJECTIVE: The aim of this study was to analyse the psychometric properties of the Portuguese version of the Children's Eating Attitudes Test (ChEAT). METHOD: Nine hundred and fifty-six Portuguese secondary students (565 girls and 391 boys) answered the ChEAT. The test-retest reliability was obtained with data from 206 participants from the total sample who re-answered the questionnaire after 4-6 weeks. Psychometric analyses were carried out for the total sample and separately for girls and boys. RESULTS: Internal consistency and test-retest reliability were satisfactory. Principal components factorial analysis yielded four factors in the total sample, accounting for 42.35% of the total variance. Factor structure was similar in the total sample and in both genders. Factors were labelled: F1 "Fear of Getting Fat", F2 "Restrictive and Purgative Behaviours", F3 "Food Preoccupation" and F4 "Social Pressure to Eat". The concurrent validity, explored using the Contour Drawing Figure Rating Scale (CDRS) was high. DISCUSSION: The Portuguese version of the ChEAT is a valid and useful instrument for the evaluation of abnormal eating attitudes and behaviours among Portuguese adolescents. CONTEXTO: O Teste de Atitudes Alimentares é o instrumento mais utilizado para avaliar distúrbios alimentares em adultos e adolescentes em uma variedade de culturas e amostras. OBJETIVO: O objetivo deste estudo foi avaliar as propriedades psicométricas da versão portuguesa da Escala de Atitudes Alimentares para Crianças (ChEAT). MÉ;TODO: Novecentos e cinquenta e seis alunos do ensino secundário (565 moças e 391 moços) responderam ao ChEAT. O cálculo da fidelidade teste-reteste foi feito por meio das respostas de 206 participantes da amostra total que voltaram a responder ao questionário após quatro a seis semanas. As análises psicométricas foram realizadas para o total da amostra e para ambos os sexos separadamente. RESULTADOS: A consistência interna e a fidelidade teste-reteste foram satisfatórias. A análise fatorial em componentes na amostra total resultou em quatro fatores que explicam 42,35% da variância total. A composição dos fatores foi semelhante na amostra total e em ambos os sexos. Os fatores denominaram-se: F1 "Medo de Engordar"; F2 "Comportamentos Restritivos e Purgativos"; F3 "Preocupação com a Comida" e F4 "Pressão Social para Comer". A validade concorrente foi explorada com a Escala de Silhuetas Corporais (CDFRS) e foi elevada. CONCLUSÃO: A versão portuguesa do ChEAT é um instrumento útil e válido para a avaliação de atitudes e comportamentos alimentares em adolescentes portugueses.

We examined if perfectionism and the perception of being an anxious person were associated with more negative infant temperament ratings by the mothers. 386 women (mean age=30.08; standard deviation=4.21) in their last trimester of pregnancy completed the Multidimensional Perfectionism Scale (MPS), the Beck Depression Inventory-II (BDI-II) and an item about their perception of being or not an anxious person. The Portuguese version of the Diagnostic Interview for Genetic Studies and the Operational Criteria Checklist for Psychotic Illness were used to generate diagnoses according to DSM-IV and ICD-10 criteria. After delivery, women completed eight items of the Difficult Infant Temperament Questionnaire (developed by our team) and filled in, again, the BDI-II and were interviewed with the DIGS. Women with depression (DSM-IV/ICD-10) and probable cases of depression using different cut-offs adjusted to Portuguese prevalence (BDI-II), in pregnancy and postpartum, were excluded. The Difficult Infant Temperament Questionnaire showed to have factorial validity and internal consistency. There was a statistically significant negative correlation between perfectionism total scale score and item 6 from the temperament scale ("is your baby irritable or fussy?"). Considering MPS 3-factor solution found for pregnancy there was also a statistically significant negative correlation between SOP and the same item. Women with low SOP differed from those with medium and high SOP in the total temperament score. Moreover, the low SOP group differed from the medium group on items three and four scores. There were no significant associations with SPP, which is the dimension more closely associated with negative outcomes. There was an association between anxiety trait status (having it or not) and scoring low, medium or high in the infant temperament scale. The proportion of anxious vs. non-anxious women presenting a high score on the infant temperament scale was higher (24.2% vs. 12.9%). Linear regressions showed that SOP (low vs. medium/high) offered a significant contribution to the prediction of total temperament scale score and items 3 and 4 scores, but a logistic regression did not confirm trait anxiety as a significant predictor of mother's infant temperament perception. Concluding, a major result concerns the fact that higher levels of adaptive perfectionism (i.e. SOP) are associated (and predict) a less negative view of their infant's temperament. These results on the effect of mother's anxiety and perfectionism on the child temperament perception might have treatment implications. As perfectionism is not always maladaptive, some of its positive features could be used to enhance women's self-efficacy/sense of parental competence in their role as mothers and positive affect towards their infants. Also, antenatal interventions aimed at minimising anxiety could help to optimise infant temperament outcomes, which could, eventually, also, lead to subsequent maternal and infant mental health better outcomes.

The present study examined the associations of sleep patterns with multiple measures of academic achievement of undergraduate university students and tested whether sleep variables emerged as significant predictors of subsequent academic performance when other potential predictors, such as class attendance, time devoted to study, and substance use are considered. A sample of 1654 (55% female) full-time undergraduates 17 to 25 yrs of age responded to a self-response questionnaire on sleep, academics, lifestyle, and well-being that was administered at the middle of the semester. In addition to self-reported measures of academic performance, a final grade for each student was collected at the end of the semester. Univariate analyses found that sleep phase, morningness/ eveningness preference, sleep deprivation, sleep quality, and sleep irregularity were significantly associated with at least two academic performance measures. Among 15 potential predictors, stepwise multiple regression analysis identified 5 significant predictors of end-of-semester marks: previous academic achievement, class attendance, sufficient sleep, night outings, and sleep quality (R 2 = 0.14 and adjusted R 2 = 0.14, F(5, 1234) = 40.99, p< .0001). Associations between academic achievement and the remaining sleep variables as well as the academic, well-being, and lifestyle variables lost significance in stepwise regression. Together with class attendance, night outings, and previous academic achievement, self-reported sleep quality and self-reported frequency of sufficient sleep were among the main predictors of academic performance, adding an independent and significant contribution, regardless of academic variables and lifestyles of the students. (Author correspondence: ana.allen@ua.pt)

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 selforiented perfectionism and other-oriented perfectionism were the only significant predictors of subsequent self-oriented perfectionism and otheroriented 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. OBJETIVOS: Avaliar o grau de mudança absoluta, de estabilidade relativa e dependência do estado do perfeccionismo nas perturbações de sono numa amostra de estudantes universitários. MÉTODO: Os sujeitos completaram a Escala Multidimensional do Perfeccionismo e dois itens sobre dificuldades em dormir. Os dados foram recolhidos em três momentos de avaliação, separados por um intervalo de um ano acadêmico. A idade média dos sujeitos noT0 era de 19,59 anos (DP = 1,61, variação = 17-25); 62,5% eram mulheres. RESULTADOS: Foram encontradas ao longo do follow-up mudanças absolutas para o Perfeccionismo Autoorientado e para o Perfeccionismo Socialmente Prescrito. Foi encontrada estabilidade relativa para todas as dimensões do perfeccionismo. As dificuldades de sono prévias e concorrentes explicaram significativamente a variância do perfeccionismo. Controlando o efeito das dificuldades em dormir, o Perfeccionismo Autoorientado e o POO prévios foram os únicos preditores significativos de Perfeccionismo Autoorientado e POO subsequente (T1 e T2). As dificuldades em iniciar o sono no T1 e o Perfeccionismo Socialmente Prescrito prévio (T0) revelaram-se preditores significativos dePerfeccionismoSocialmente PrescritonoT1. CONCLUSÃO: Apesar das mudanças significativas nas pontuações médias de perfeccionismo ao longo do follow-up, as análises de correlação demonstraram que os participantes permaneceramrelativamenteestáveisnosseusníveisdeperfeccionismo.Umavezque asdificuldades em iniciar o sono concorrentes serevelaram um preditor significativo de Perfeccionismo Socialmente Prescrito, o Perfeccionismo Socialmente Prescrito é a dimensão do perfeccionismo que possui características traço-estado.

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

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.

The purpose of the present study was to investigate the factor structure of the Beck Depression Inventory-II (BDI-II) in pregnancy and postpartum. Women were asked to fill in the BDI-II in their last trimester of pregnancy and at 3 months after delivery. A total of 331 pregnant women, with a mean age of 29.7 years (SD = 4.6), and 354 mothers, aged 30.6 years (SD = 4.6 years), answered the BDI-II. The first group was mainly nulliparas (65.6%) and the second group was mostly primiparas (57.4%). Factor analyses with principal components solution and varimax rotation were performed. Based on the scree test of Cattell a 2-factor solution and a 3-factor solution were explored. The 2-factor solution was identical in pregnancy and postpartum. Items loading in the Cognitive–Affective factor and in the Somatic–Anxiety factor were almost the same, though the Cognitive–Affective factor explained more of the BDI-II total variance in pregnancy, whereas in postpartum both factors explained similar total variances. The 3-factor solution of the BDI-II in pregnancy and postpartum slightly diverged. Besides the Cognitive–Affective and the Somatic–Anxiety factors, a third factor, Fatigue, was obtained in pregnancy while Guilt was the third factor identified in postpartum. This study reveals that the BDI-II 3-factor solution might be more appropriate to assess depressive symptoms in pregnancy and postpartum.

OBJECTIVE: To examine the factor structure of the Rutter Teacher Questionnaire in Portuguese primary school children. METHOD: The Rutter Teacher Questionnaire, a 26-item scale covering a variety of behavioral problems, was completed by teachers of 877 children, aged 6 to 11 years. Data were subjected to factor analysis using the principal components solution with varimax rotation. RESULTS: The factorial analysis in total sample revealed three factors explaining 38.88% of the total variance. The factors contained items representing hyperactivity/conduct (Factor 1), anxious/depressive (Factor 2) and truancy/stealing (Factor 3). The highest correlations between factors scores were for Factor 1 and Factor 3. These Factors scores were higher in boys than girls and correlated with lower social class. All three Factors scores correlated with school performance. The comparison between separate factorial structures for the samples of boys and girls revealed a considerable overlap. CONCLUSIONS: The pattern of the items contained on Factor 1 appears to be related with the category of hyperkinetic conduct disorder used by the International Classification of Diseases-10. Results suggest that the Portuguese language version of the Rutter Teacher Questionnaire possesses good psychometric properties and may be considered a useful instrument for measuring children's behavior problems.OBJETIVO: Analisar a estrutura fatorial do Questionário de Rutter para Professores numa amostra de crianças portuguesas do 1º Ciclo do Ensino Básico. MÉTODO: O questionário, constituído por 26 itens que avaliam problemas do comportamento, foi preenchido pelos professores de 877 crianças (6-11 anos). As respostas foram sujeitas a uma análise fatorial, por meio do método de componentes principais com rotação ortogonal varimax. RESULTADOS: Na amostra total, a estrutura fatorial resultou em três fatores que explicam 38,88% da variância total e que foram denominados: problemas de hiperatividade/conduta (Fator 1), ansiedade/depressão (Fator 2) e vadiagem/furto (Fator 3). A correlação entre os fatores 1 e 3 foi a mais elevada. As pontuações fatoriais foram significativamente mais elevadas nos rapazes do que nas raparigas e apresentaram uma relação inversa com a classe social e com o rendimento escolar. As estruturas fatoriais realizadas separadamente para rapazes e raparigas revelaram grandes similitudes. CONCLUSÕES: Os itens do Factor 1 parecem relacionar-se com o distúrbio hipercinético da conduta proposto pela Classificação Internacional de Doenças-10. Os resultados sugerem que a versão portuguesa do Questionário de Rutter para Professores apresenta parâmetros psicométricos adequados, podendo ser útil na avaliação dos problemas de comportamento das crianças.

The gap junction subunit connexin permits direct intercellular exchange of ions and molecules including glutamate, and plays an important role in the central nervous system. The connexin 40 (Cx40) and connexin 50 (Cx50) genes are located on chromosome 1q21.1, a region strongly linked with schizophrenia. These lines of evidence suggest that Cx40 and Cx50 may play a role in schizophrenia.Using an allele-specific PCR assay, four polymorphisms each were genotyped for Cx40 and Cx50 in 190 Caucasian patients with schizophrenia and 190 controls matched for sex, age and ethnicity. Following up, Cx50 rs989192 and rs4950495 were investigated in 99 Canadian and 163 Portuguese trios and nuclear families with schizophrenia probands. Hardy-Weinberg equilibrium and linkage disequilibrium (LD) block identification was carried out with HaploView, and association analysis for alleles and haplotypes with a permutation test of 10 000 simulations was carried out using the UNPHASED software program.Distributions of genotype frequencies of all markers were in Hardy-Weinberg equilibrium in Caucasian patients, controls and families. One rs989192-rs4950495 LD block was found in patients but not in controls. We found a significant association between the Cx50 rs989192-rs4950495 haplotype and schizophreniay (chi(2) = 29.55, p0.01). The A-C haplotype had a higher frequency in patients (chi(2) = 7.153, p0.01). Family studies also showed that the A-C haplotype was transmitted more often to patients with schizophrenia (chi(2) = 8.43, p0.01). No association of Cx40 with schizophrenia was found for allele, genotype or haplotype analyses.Our matched case-control and family study indicate that Cx50, but not Cx40, may play a role in the genetic susceptibility to schizophrenia.

Background: A long-standing epidemiological puzzle is the reduced rate of rheumatoid arthritis (RA) in those with schizophrenia (SZ) and vice versa. Traditional epidemiological approaches to determine if this negative association is underpinned by genetic factors would test for reduced rates of one disorder in relatives of the other, but sufficiently powered data sets are difficult to achieve. The genomics era presents an alternative paradigm for investigating the genetic relationship between two uncommon disorders. Methods: We use genome-wide common single nucleotide polymorphism (SNP) data from independently collected SZ and RA case-control cohorts to estimate the SNP correlation between the disorders. We test a genotype X environment (GxE) hypothesis for SZ with environment defined as winter- vs summer-born. Results: We estimate a small but significant negative SNP-genetic correlation between SZ and RA (−0.046, s.e. 0.026, P = 0.036). The negative correlation was stronger for the SNP set attributed to coding or regulatory regions (−0.174, s.e. 0.071, P = 0.0075). Our analyses led us to hypothesize a gene-environment interaction for SZ in the form of immune challenge. We used month of birth as a proxy for environmental immune challenge and estimated the genetic correlation between winter-born and non-winter born SZ to be significantly less than 1 for coding/regulatory region SNPs (0.56, s.e. 0.14, P = 0.00090). Conclusions: Our results are consistent with epidemiological observations of a negative relationship between SZ and RA reflecting, at least in part, genetic factors. Results of the month of birth analysis are consistent with pleiotropic effects of genetic variants dependent on environmental context. Refereed/Peer-reviewed

G.B. and S.N. acknowledge funding support for this work from the National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London. P.H.L. is supported by US National Institute of Mental Health (NIMH) grant K99MH101367. Genome-wide association studies (GWAS) of psychiatric disorders have identified multiple genetic associations with such disorders, but better methods are needed to derive the underlying biological mechanisms that these signals indicate. We sought to identify biological pathways in GWAS data from over 60,000 participants from the Psychiatric Genomics Consortium. We developed an analysis framework to rank pathways that requires only summary statistics. We combined this score across disorders to find common pathways across three adult psychiatric disorders: schizophrenia, major depression and bipolar disorder. Histone methylation processes showed the strongest association, and we also found statistically significant evidence for associations with multiple immune and neuronal signaling pathways and with the postsynaptic density. Our study indicates that risk variants for psychiatric disorders aggregate in particular biological pathways and that these pathways are frequently shared between disorders. Our results confirm known mechanisms and suggest several novel insights into the etiology of psychiatric disorders. Postprint

Based on successive samples totaling more than 5000 higher education students, we scrutinized the reliability, structure, initial validity and normative scores of a brief self-report seven-item scale to screen for the continuum of nighttime insomnia complaints/perceived sleep quality, used by our team for more than a decade, henceforth labeled the Basic Scale on Insomnia complaints and Quality of Sleep (BaSIQS). In study/sample 1 (n = 1654), the items were developed based on part of a larger survey on higher education sleep-wake patterns. The test-retest study was conducted in an independent small group (n = 33) with a 2-8 week gap. In study/sample 2 (n = 360), focused mainly on validity, the BaSIQS was completed together with the Pittsburgh Sleep Quality Index (PSQI). In study 3, a large recent sample of students from universities all over the country (n = 2995) answered the BaSIQS items, based on which normative scores were determined, and an additional question on perceived sleep problems in order to further analyze the scale's validity. Regarding reliability, Cronbach alpha coefficients were systematically higher than 0.7, and the test-retest correlation coefficient was greater than 0.8. Structure analyses revealed consistently satisfactory two-factor and single-factor solutions. Concerning validity analyses, BaSIQS scores were significantly correlated with PSQI component scores and overall score (r = 0.652 corresponding to a large association); mean scores were significantly higher in those students classifying themselves as having sleep problems (p

We previously performed a genome-wide linkage scan in Portuguese schizophrenia families that identified a risk locus on chromosome 5q31-q35. This finding was supported by meta-analysis of 20 other schizophrenia genome-wide scans that identified 5q23.2-q34 as the second most compelling susceptibility locus in the genome. In the present report, we took a two-stage candidate gene association approach to investigate a group of gamma-aminobutyric acid (GABA) A receptor subunit genes (GABRA1, GABRA6, GABRB2, GABRG2, and GABRP) within our linkage peak. These genes are plausible candidates based on prior evidence for GABA system involvement in schizophrenia. In the first stage, associations were detected in a Portuguese patient sample with single nucleotide polymorphisms (SNPs) and haplotypes in GABRA1 (P=0.00062-0.048), GABRP (P=0.0024-0.042), and GABRA6 (P=0.0065-0.0088). The GABRA1 and GABRP findings were replicated in the second stage in an independent German family-based sample (P=0.0015-0.043). Supportive evidence for association was also obtained for a previously reported GABRB2 risk haplotype. Exploratory analyses of the effects of associated GABRA1 haplotypes on transcript levels found altered expression of GABRA6 and coexpressed genes of GABRA1 and GABRB2. Comparison of transcript levels in schizophrenia patients and unaffected siblings found lower patient expression of GABRA6 and coexpressed genes of GABRA1. Interestingly, the GABRA1 coexpressed genes include synaptic and vesicle-associated genes previously found altered in schizophrenia prefrontal cortex. Taken together, these results support the involvement of the chromosome 5q GABAA receptor gene cluster in schizophrenia, and suggest that schizophrenia-associated haplotypes may alter expression of GABA-related genes.

Background:Alterations of the γ-aminobutyric acid (GABA) system have been implicated in the pathophysiology of major psychoses.Objective:Restriction fragment length polymorphisms associated with the human γ-aminobutyric acid type A (GABAA) β2 and GABAA γ2 subunit genes on chromosome 5q32-q35 were tested to determine whether they confer susceptibility to major psychoses.Methods:Thirty-two schizophrenic families and 25 bipolar families were tested for linkage.Results:Nonparametric linkage (NPL) analysis performed by GENEHUNTER showed no significant NPL scores for both genes in schizophrenia (GABAAβ2: NPL narrow=−0.450; NPL broad=−0.808; GABAA γ2: NPL narrow=0.177; NPL broad=−0.051) or bipolar disorder (GABAA β2: NPL narrow=0.834; NPL broad=0.783; GABAA γ2: NPL narrow=−0.159; NPL broad=0.070).Conclusion:Linkage analysis does not support the hypothesis that variants within the GABAA β2 and GABAA γ2 genes are significantly linked to major psychoses in a Portuguese population.

AM Vicente - Cross-Disorder Group of the Psychiatric Genomics Consortium Most psychiatric disorders are moderately to highly heritable. The degree to which genetic variation is unique to individual disorders or shared across disorders is unclear. To examine shared genetic etiology, we use genome-wide genotype data from the Psychiatric Genomics Consortium (PGC) for cases and controls in schizophrenia, bipolar disorder, major depressive disorder, autism spectrum disorders (ASD) and attention-deficit/hyperactivity disorder (ADHD). We apply univariate and bivariate methods for the estimation of genetic variation within and covariation between disorders. SNPs explained 17-29% of the variance in liability. The genetic correlation calculated using common SNPs was high between schizophrenia and bipolar disorder (0.68 ± 0.04 s.e.), moderate between schizophrenia and major depressive disorder (0.43 ± 0.06 s.e.), bipolar disorder and major depressive disorder (0.47 ± 0.06 s.e.), and ADHD and major depressive disorder (0.32 ± 0.07 s.e.), low between schizophrenia and ASD (0.16 ± 0.06 s.e.) and non-significant for other pairs of disorders as well as between psychiatric disorders and the negative control of Crohn's disease. This empirical evidence of shared genetic etiology for psychiatric disorders can inform nosology and encourages the investigation of common pathophysiologies for related disorders.

BACKGROUND: The Frost Multidimensional Perfectionism Scale is one of the most world widely used measures of perfectionism. OBJECTIVE: To analyze the psychometric properties of the Portuguese version of the Frost Multidimensional Perfectionism Scale. METHODS: Two hundred and seventeen (178 females) students from two Portuguese Universities filled in the scale, and a subgroup (n = 166) completed a retest with a four weeks interval. RESULTS: The scale reliability was good (Cronbach alpha = .857). Corrected item-total correlations ranged from .019 to .548. The scale test-retest reliability suggested a good temporal stability with a test-retest correlation of .765. A principal component analysis with Varimax rotation was performed and based on the Scree plot, two robust factorial structures were found (four and six factors). The principal component analyses, using Monte Carlo PCA for parallel analyses confirmed the six factor solution. The concurrent validity with Hewitt and Flett MPS was high, as well as the discriminant validity of positive and negative affect (Profile of Mood Stats-POMS). DISCUSSION: The two factorial structures (of four and six dimensions) of the Portuguese version of Frost Multidimensional Perfectionism Scale replicate the results from different authors, with different samples and cultures. This suggests this scale is a robust instrument to assess perfectionism, in several clinical and research settings as well as in transcultural studies. CONTEXTO: A Escala Multidimensional de Perfeccionismo de Frost (FMPS) é uma das escalas mais usadas em todo o mundo para avaliar o perfeccionismo. OBJETIVO: Analisar as características psicométricas da versão portuguesa da FMPS. MÉTODOS: A amostra foi constituída por 217 estudantes do ensino superior (178 mulheres). Um subgrupo (n = 166) completou o reteste após quatro semanas. RESULTADOS: A consistência interna da escala mostrou ser elevada (alfa de Cronbach = ,857). As correlações item-total corrigido variaram entre ,019 e ,548. Os resultados também sugeriram uma boa estabilidade temporal da escala, sendo a correlação teste-reteste de ,765. Foi realizada a análise das componentes principais com rotação Varimax e com base no Scree plot foram extraídas duas soluções fatoriais robustas (quatro e seis fatores). A análise paralela (Monte Carlo PCA) confirmou a solução de seis fatores. A validade concorrente com a escala MPS de Hewitt e Flett foi elevada, assim como a sua capacidade discriminante dos afetos positivos e negativos (Perfil de Estados de Humor - POMS). CONCLUSÃO: As duas estruturas fatoriais (quatro e seis fatores) encontradas na versão portuguesa da Escala Multidimensional de Perfeccionismo de Frost replicam os resultados obtidos por diferentes autores, em diferentes amostras e culturas. Esse fato sugere que essa escala é um instrumento robusto para a avaliação do perfeccionismo em vários contextos, clínicos e de investigação, bem como em estudos transculturais.

Introduction Socially prescribed perfectionism has been associated with long-term sleep disturbances (Azevedo et al., 2010). Objective To investigate the association between perfectionism dimensions and insomnia in pregnancy. Methods 581 pregnant women, mean age 29.8 years (SD=4.5), average weeks of gestation 32.6 (SD=3.5), mostly married (75%) and nulliparae (64%) participated in the study. The multidimensional perfectionism scale (Hewitt and Flett, 1991; Soares et al., 2003) was used to assess total levels of perfectionism, self-oriented perfectionism (SOP) and dimensions of socially prescribed perfectionism (SPP): others high expectations (OHE) and conditional acceptance (CA) (Macedo et al., 2009). Insomnia symptoms and related daytime impairment were assessed with an insomnia questionnaire (Marques et al., 2011). Objective estimations of sleep were obtained through actigraphy in a small group (n=60). Results In comparison to good sleepers, insomniacs showed higher levels of SPP (M=53.4, SD=13.0 versus M=49.6, SD=12.3, p Conclusion Conditional acceptance is the SPP perfectionism sub-dimension particularly associated with self-reported insomnia and sleep alterations measured objectively with actigraphy in pregnancy. Financial support Portuguese foundation for science and technology (POCI/SAU-ESP/57068/2004).

Background Prior genome-scans of bipolar disorder have revealed chromosome 6q22 as a promising candidate region. However, linkage disequilibrium (LD) mapping studies have yet to identify replicated susceptibility loci. Methods We analyzed 1,422 LD-tagging single nucleotide polymorphisms (SNPs) in 83 genes to test single-marker and locus-wide evidence of association with bipolar disorder in the NIMH Genetics Initiative bipolar pedigrees and the Portuguese Island Collection (PIC) (N = 1,093 in 528 informative pairs). Both studies previously demonstrated significant evidence of linkage to 6q. SNPs were genotyped using an Illumina iSelect genotyping array which employs the Infinium assay. Evidence of single-marker association was assessed using the generalized disequilibrium test (GDT). Empirical estimates of gene-wide significance were obtained by permutation (via 100,000 gene-dropping simulations) of Fisher's combined test of P-values for each locus. Results No single variant yielded significant experiment-wide evidence of association, for either the combined sample or in each subsample. Our gene-dropping simulations identified nominally significant gene-wide associations with multiple loci, of which NT5DC1 in the NIMH subsample and CCNC in the PIC were the strongest candidates. However, no one gene consistently exceeded empirical significance criteria in both independent samples or survived Bonferroni correction for the number of genes tested. Conclusions Using a gene-based approach to family-based association, we identified gene-wide associations with several genes, though no single locus was significantly associated with bipolar disorder in both cohorts. This suggests that chromosome 6q may harbor multiple susceptibility loci or that complex patterns of LD in this region may confound approaches based on common SNPs. Published 2013. This article is a U.S. Government work and is in the public domain in the USA

We wanted to explore the validity of measuring the tendency to worry and to overthink, in the Portuguese context. 714 medical students completed the following measures: Worry and Overthinking (two items each) “I worry a lot”, “The people around me consider that I worry a lot”, “I think a lot over things”, “The people around me consider that I think a lot over things”; Eysenck Personality Inventory (EPI) Neuroticism and Extroversion (NE-EPI/E-EPI); Arousal Predisposition Scale (Arousability); Revised NEO Personality Inventory (NEO-PI-R); Neuroticism facets Anxiety, Angry, Depression, Impulsiveness and Vulnerability; Profile of Mood States Positive and Negative Affect (POMS-PA/POMS-NA). Worry and Overthinking were correlated (p .50) on the NE-EPI. Worry and Overthinking were positively correlated with negative traits: NE-EPI, Arousability, POMS-NA, Neuroticism-NEO-PI-R (all p Based on Worry and Overthinking means and SD and considering frequencies five groups were formed: High worry/overthinking; High worry/low-medium overthinking; Medium worry/overthinking; Low worry/medium-high overthinking; High worry/overthinking. Groups mean comparisons significantly differ in positive and negative traits (means increased/decreased, respectively, from group 1 to 5). We provide preliminary evidence for the usefulness of this measure in this population.

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., The present work was supported by Grant POCI/SAUESP/58757/2004 from the Portuguese Science Foundation (FCT/FEDER). NCS was supported by the fellowship SFRH/ BPD/51057/2010 by FCT.

Recent family and genome-wide association studies strongly suggest shared genetic risk factors for schizophrenia (SZ) and bipolar disorder (BP). However, linkage studies have not been used to test for statistically significant genome-wide overlap between them. Forty-seven Portuguese families with sibpairs concordant for SZ, BP, or psychosis (PSY, which includes either SZ or psychotic BP) were genotyped for over 57,000 markers using the Affymetrix 50K Xba SNP array. NPL and Kong and Cox LOD scores were calculated in Merlin for all three phenotypes. Empirical significance was determined using 1,000 gene-dropping simulations. Significance of genome-wide genetic overlap between SZ and BP was determined by the number of simulated BP scans having the same number of loci jointly linked with the real SZ scan, and vice versa. For all three phenotypes, a number of regions previously linked in this sample remained so. For BP, chromosome 1p36 achieved significance (11.54-15.71 MB, LOD = 3.51), whereas it was not even suggestively linked at lower marker densities, as did chromosome 11q14.1 (89.32-90.15 MB, NPL = 4.15). Four chromosomes had loci at which both SZ and BP had NPL ≥ 1.98, which was more than would be expected by chance (empirical P = 0.01 using simulated SZ scans; 0.07 using simulated BP scans), although they did not necessarily meet criteria for suggestive linkage individually. These results suggest that high-density marker maps may provide greater power and precision in linkage studies than lower density maps. They also further support the hypothesis that SZ and BP share at least some risk alleles. info:eu-repo/semantics/publishedVersion

Objectives The main objective was to investigate the association between perfectionism and eating behaviour in a non-clinical sample of adolescents of both genders. Method 997 middle and high school students completed the Portuguese versions of the child-adolescent perfectionism scale (CAPS) and of the eating attitudes test -25 (EAT- 25). Results In both genders, the perfectionism total score and the sociallyprescribed perfectionism (SPP) score were positive and significantly correlated with the EAT total score and with all EAT dimensions: Drive for Thinness (DT), Bulimic Related Behaviour (BRB), Social Pressure to Eat (SPE). In girls, self-oriented perfectionism (SOP) was also associated with the EAT total score and its dimensions, whereas in boys it was only associated with EAT total score and DT. In both genders SPP was a useful predictor of the EAT-25 total score and of all its dimensions. In which respects SOP, there were some gender differences showing that in boys this dimension should not be considered a predictor of eating behaviours. Conclusion These results confirm that high levels of perfectionism (SOP and SPP) are associated with abnormal eating behaviour in both genders. Copyright © 2010 John Wiley & Sons, Ltd and Eating Disorders Association.

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.

To examine if perfectionism predicts self-reported sleep disturbances over time.The Hewitt-Flett Perfectionism Scale was used to assess self-oriented, socially-prescribed (SPP) and other-oriented perfectionism. Sleep disturbance was evaluated with two items: difficulty in falling asleep and waking up many times during the night. Out of 870 students who participated at baseline, 592 and 305 completed the same measures 1 year (T1) and 2 years later (T2), respectively.Subjects who reported insomnia at baseline, T1 and T2 (persistent insomnia) had significantly higher scores of baseline SPP (T1 M = 51.5, SD = 15.8; T2 M = 55.0, SD = 19.0) than subjects reporting, in all stages of the study, never/rarely having had sleep problems (T1 M = 41.9, SD = 11.4; T2 M = 42.2, SD = 12.3, P0.001 in both cases). Regression analyses showed that baseline SPP was the only significant positive predictor of difficulties in falling asleep at T1 and T2 (T1 partial R=0.187; T2 partial R=0.196, P0.001) and of difficulties maintaining sleep (T1 partial R=0.116; T2 partial R=0.244, P0.001).SPP was found to be the most reliable predictor of sleep disturbances over time, which constitutes a new important finding.

Objective: The main aims of this article are twofold. First, to assess perfectionism dimensions in obsessive-compulsive disorder and eating disorders in comparison with psychiatric control (depression/anxiety) and non-clinical control groups. Second, to examine if perfectionism is specifically related to these different clinical conditions. Method: Thirty-nine outpatients with obsessive-compulsive disorder, 24 outpatients with eating disorders, 65 outpatients with a diagnosis of depression and/or anxiety, and 70 non-clinical participants completed the Portuguese version of the Multidimensional Perfectionism Scale. Results: Compared to non-clinical subjects, individuals of all clinical samples had significantly higher scores on Multidimensional Perfectionism Scale total score, Self-Oriented and Socially-Prescribed Perfectionism. There were no significantly differences in Self-Oriented Perfectionism and Multidimensional Perfectionism Scale total score in all the three clinical samples. Subjects from the eating disorders sample had significantly higher scores of Socially-Prescribed Perfectionism in comparison to obsessive-compulsive disorder and psychiatric control samples. Conclusion: Perfectionism showed to be related with this broad range of psychopathologies. However, the differences between eating disorders versus obsessive-compulsive disorder and psychiatric control on Socially-Prescribed Perfectionism warrant further investigation in order to clarify the specificity of this perfectionism dimension in eating disorders. Descriptors: Personality; Obsessive-compulsive disorder; Eating disorders; Depression; Anxiety

The main purpose of the present research was to explore gender-related associations between sleep disturbance and perfectionism dimensions in a large sample of undergraduate students. Perfectionism dimensions have been assessed using the Portuguese version of the Multidimensional Perfectionism Scale (Hewitt and Flett, 1991 , J Pers Soc Psychol 60:456; Soares et al., 2003 , Rev Port Psicossom 5:46) and sleep disturbance with two items concerning difficulties initiating sleep and difficulties maintaining sleep. A total of 1163 undergraduate students of both genders between 17 and 25 years of age completed the scale. Results from correlational and categorial analyses indicated that socially prescribed perfectionism was the only dimension associated with sleep disturbance in undergraduate students of both genders. Males with the highest levels of socially prescribed perfectionism were approximately twice more likely to report sleep disturbances than those with less socially prescribed perfectionism. Similar results were found within the female sample. Implications for future research and clinical practice are discussed.

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.

The neurogranin (NRGN) gene produces a postsynaptic brain-specific protein that regulates calmodulin-Ca(2+) 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., Fundação para a Ciência e Tecnologia/FEDER (Portugal) grant POCTI/35837/MGI/2000 and POCI/SAU-ESP/58757/2004. D. Ruano is a recipient of a fellowship (SFRH/BD/8659/2002) from Fundação para a Ciência e a Tecnologia (FCT), Portugal

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.