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Background Perinatal depression is a high prevalent mental health problem with serious consequences. Evidence about effective psychological interventions in treating perinatal depression has been increasing, but it lacks a comprehensive synthesis of findings. Methods A systematic review of systematic reviews and meta-analyses concerning the effectiveness of psychological interventions in treating perinatal depression (depression during pregnancy and the first 12 months postpartum) in adult women was conducted. The electronic databases MEDLINE (PubMed), PsycINFO, The Cochrane Library, Web of Science and Prospero were searched, on May 2020, using a combination of keywords. Data were independently extracted by two authors and a synthesis of the results was presented. Methodological quality was independently assessed by two authors, using AMSTAR-2. Results Seven systematic reviews were included and reported, overall, the effectiveness of psychological interventions in decreasing depressive symptoms in women in the perinatal period, both short and long-term. CBT was found to be the most effective intervention, regardless of the treatment format. Limitations Grey literature was not searched, and some studies may overlap among the included systematic reviews. These (the included reviews) were rated with low methodological quality, which weakens the evidence of the reported results. Conclusions CBT is currently the most evidence-based psychological intervention, provided in different delivery formats (individual, group, face-to-face or Internet-based). Further studies, including systematic reviews, with other types of psychological interventions (e.g., third-wave CBT) and with higher quality are needed.

This study aimed to examine whether attachment orientations (anxiety and avoidance) were associated with perceived stress through self-critical rumination (a specific type of rumination focused on the content of self-critical thoughts). It also aimed to examine the factor structure of the Portuguese version of the Self-Critical Rumination Scale (SCRS) and to present additional evidence on its construct validity and reliability. A sample of 317 Portuguese women from the general community was recruited online. Participants completed the SCRS and measures of self-compassion, perceived stress, difficulties in emotion regulation, and adult attachment. The results of the mediation analyses showed that self-critical rumination mediated the association between attachment anxiety and perceived stress but not the association between attachment avoidance and perceived stress. In addition, the SCRS showed good psychometric properties. Specifically, the scale showed adequate reliability (Cronbach’s alpha was .933 and composite reliability was .932) and construct validity. Significant correlations were found between the SCRS and measures assessing constructs expected to be associated with self-critical rumination (self-compassion, perceived stress, difficulties in emotion regulation, and attachment anxiety and avoidance). Confirmatory factor analyses confirmed the one-factor structure of the Portuguese SCRS. This study identifies a new mechanism underlying the association between adult attachment and perceived stress. In addition, the results of the present study provide further evidence of the internal consistency and construct validity of the SCRS and indicate that the Portuguese version is a psychometrically robust and adequate measure of self-critical rumination.

IntroductionPerfectionism is a consistent risk factor for various psychopathological conditions, including psychological distress and eating disorders. Recently, we have shown, for the first time, that there is a relationship between perfectionism and generalized problematic internet use/GPIU (Sobral et al. 2020). Specifically, we found that the role of perfectionism in psychological disorder is partially mediated by GPIU. On the other hand, it has been suggested that the widespread use of digital media can lead to negative body image perception and abnormal eating attitudes and behaviors.ObjectivesTo explore, for the first time, the relationship between perfectionism, GPIU and disordered eating behavior.Methods475 university students (78.9% girls; mean age 20.22±1.695) answered the Portuguese validated versions of: Composite Multidimensional Perfectionism Scale, GPIU Scale and Eating Attitudes Test-25. SPSS and Hayes’ Process Macro (2020) were used.ResultsBulimic Behaviours/BB significantly and moderately correlated with Perfectionist efforts (r=.263), Perfectionist concerns (r=.284) and GPIU (r=.25) (all pConclusionsThe evidence that both negative and “positive” perfectionism dimensions are associated to eating pathology is in line with our previous research. The present study adds, for the first time, that one of the perfectionism pathways of influence on BB operates through UGPI. Assessment and intervention to diminish eating psychopathology should focus on perfectionism and compulsive traits which could be involved in both ED and GPIU and in their comorbidity.DisclosureNo significant relationships.

Resumo O uso da internet tem aumentado exponencialmente a nível mundial. Ainda que ele não seja por si só negativo, já que integra benefícios vários, alguns indivíduos parecem exibir problemas relacionados com o seu uso excessivo, descontrolado e disfuncional. Consequentemente, tem sido crescente, particularmente nas últimas duas décadas, o interesse dos investigadores em explorar este uso, quando excessivo e pouco saudável. Porém, e sendo um tema/constructo tratado por diferentes autores com quadros teóricos também diferentes, são vários os termos usados na literatura para descrever este fenómeno. Neste sentido, este artigo propõe-se a apresentar o trabalho uma revisão de literatura de dois dos conceitos mais usados e espartilhados na literatura científica, ou seja, adição à internet e uso problemático da internet. Résumé L’utilisation d’ Internet a augmenté de manière exponentielle dans le monde. Bien que l’utilisation d’ Internet ne soit pas négative en soi, étant donné qu’elle intègre plusieurs avantages, certaines personnes semblent présenter des problèmes liés à son utilisation excessive, incontrôlée et dysfonctionnelle. En conséquence, l’intérêt des chercheurs pour exploiter cet usage, qu’il soit excessif ou malsain, a augmenté, particulièrement au cours des deux dernières décennies. Cependant, étant un thème/construit traité par différents auteurs avec différents cadres théoriques, plusieurs termes sont utilisés dans la littérature pour décrire ce phénomène. En ce sens, nous proposons de présenter dans cet ouvrage une analyse de deux des concepts les plus utilisés et les plus partagés dans la littérature scientifique, à savoir l’addition à internet et son utilisation problématique. Resumen El uso de Internet ha aumentado exponencialmente a nivel mundial. Aunque esto no es por sí solo negativo ya que integra diversos beneficios, algunos individuos parecen presentar problemas relacionados con su uso excesivo, descontrolado y disfuncional. En consecuencia, en las últimas dos décadas ha aumentado cada vez más el interés de los investigadores en estudiar este uso, cuando es excesivo o poco saludable. Sin embargo, y siendo un tema/constructo tratado por diferentes autores con cuadros teóricos también diferentes, son varios los términos usados en la literatura para describir este fenómeno. En este sentido, nos proponemos presentar en este trabajo una revisión de dos de los conceptos más usados y más divididos en la literatura científica, es decir, adición a Internet y uso problemático de Internet. Abstract Internet use has increased exponentially worldwide. Although the use itself is not negative, since it integrates several benefits, some individuals seem to show problems related to its excessive, uncontrolled, and dysfunctional use. Therefore, the interest of researchers in exploring this use, when it is excessive and unhealthy, has been growing, especially in the last two decades. However, being a subject/construct treated by different authors with different theoretical frameworks, several terms are used in the literature to describe this phenomenon. Regarding this, this article proposes to present a literature review of two of the most used and shared concepts in the scientific literature, that is, internet addiction and problematic internet use.

Our objective was to analyze the relationships between Repetitive negative thinking (RNT), perfectionism and psychological distress. Specifically we wanted to test if RNT mediates the relationship between perfectionism and psychological distress. 788 college students completed self-report questionnaires to evaluate perfectionism trait dimensions [Evaluative concerns (EC) and Positive strivings (PS)], RNT dimensions [Repetitive thinking (RT) and Cognitive interference and unproductivity (CIU)], perceived stress, and perceived support. Psychological distress was measured with the Profile of Mood States subscales: Depression (D), Tension–anxiety (TA), Anger–hostility (AH), Fatigue–inertia (FI) and Vigor–anxiety (VA). After controlling for perceived stress and support, perfectionism dimensions and RNT (particularly CIU) remained a significant predictors of psychological distress. CIU was a partial mediator of the relationship between EC and D, TA, AH, FI and VA and a full mediator of the relationship of PS with D and FI. Whereas the effect of negative perfectionism on emotional disturbances was potentiated by RNT, PS was only associated to it when high levels of RNT were also present. Showing that Positive striving effects on psychological distress may be a function of specific mediators, these results contribute to a better understanding of the nature of positive perfectionism.

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.

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.

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.

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.

Background The potential relationships between sleep–wake behaviors and emotional/disruptive problems in otherwise healthy school-aged children are unclear. Methods A parental questionnaire was developed for the epidemiologic survey of children’s sleep and wake behavioral patterns. The questions covered a wide range of features including sleep length (school days, weekends), time to fall asleep, night awakenings, bedtime and nighttime sleep-related behaviors, daytime sleepiness, irritability, and tiredness. To assess psychiatric symptomatology, the Rutter Scale B2 was completed by teachers. In addition to the total score, sub-scores of emotional, hyperactivity, and conduct problems were obtained. The representative population sample comprised 779 children (403 girls), with an age range of 6–11 years. Results Hyperactivity and conduct problems at school in boys were both associated with parental reports of bedtime resistance. Hyperactivity was also associated with longer sleep duration during weekends. Conduct and emotional problems in girls were associated with earlier bedtime during school days. Emotional problems in girls were also associated with longer sleep durations in school days and weekends. Conclusion Bedtime resistance was the only sleep behavior associated with either hyperactivity or conduct problems in children, and longer sleep durations appear to occur more frequently in children with both hyperactive or emotional problems. Information about good sleep hygiene at bedtime may help parents setting sleep limits.

Objectives To investigate in non-depressed perinatal women, whichBeck Depression Inventory-II (BDI-II) and Postpartum Postpartum DepressionScreening Scale (PDSS) scores and proportions of symptomatic items significantlydiffer through the perinatal period. Methods 273 women were assessed with the Diagnostic Interviewfor Genetic Studies, BDI-II and the PDSS at the third trimester of pregnancy/T0(mean age =29.42±7.159 years; mean weeks gestation=32.6±3.61),three/T1, six/T2 and twelve/T3 months postpartum. Results Significantlyhigher scores in T0 than in T1/T2/T3 and in T1 than in T2/T3 were found for: Total PDSS, Sleeping-Eating Disturbances, Emotional Liability, Total BDI-II andits dimension Somatic-Anxiety. Only T0 and T1/T2 didnot significantly differ in Anxiety/Insecurity, Mental Confusion, and Loss of Self. In Guilty/Shame only T1 was significantly higher than T3. Suicidalthoughts were significantly higher in T0 than T1 and lower in T1 than T2/T3. Theproportions of symptomatic items systematically and significantly decreased fromT0 to T3 in changes of sleep, loss of interest in sex, feeling overwhelmed. Significantlyhigher symptomatic proportions in T0 than in all post-partum moments were foundfor: loss of energy, irritability, fatigue, changes in appetite, crying, indecisiveness and worthlessness (these last three also higher in T1 than inT3). Agitation was significantly higherin T1 than in T0. All the cognitive-affective symptoms from BDI-II and PDSSdid not differ. Conclusion From pregnancy to the twelfth month postpartum the depressivesymptomatology, particularly somatic-affective symptoms, significantlydecreased. However even for the women who are not clinically depressed, theperinatal period requires considerable psychological adjustment.

IntroductionCollege students are known for their variable sleep schedules. Such schedules, along with other common student practices are associated with poor sleep hygiene. The persistence of the precipitating stressor is one of the factors involved in the persistence of insomnia.AimsTo examine the role of the perceived stress, perseverative thinking, strategies of cognitive emotion regulation and negative affect as predictors of sleep difficulties.MethodsThe sample comprises 549 college students.MeasuresPSS-10, PTQ, CERQ and POMS-58. Three questions were used to access difficulties in initiating sleep (DIS), maintaining sleep (DMS) and early morning wakening (EMA). A Sleep Difficulties Index (SDI) was calculated by summing DIS, DMS and EMA scores.ResultsIn total sample, the multiple linear regression explained 27.7% of the SDI total variance (R2 = .277, F(9, 375) = 15,942, P < .0001). The significant predictors of the total variance of SDI were perceived distress (B = .246, P = .0001), repetitive thought (B = .189, P = .005), cognitive interference and unproductiveness (B = −.188, P = .006), rumination (B = .130, P = .044) and negative affect (B = .156, P = .018).ConclusionsPreventive interventions focused on predictor factors (perceived stress, perseverative thinking, rumination and negative affect) should be considered in order to promote better mental health in college students.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Purposes To analyze which Beck Depression Inventory-II (BDI-II) and Postpartum Depression Screening Scores (PDSS) total and dimensional scores, as well as symptomatic answers proportions significantly differ between women in the perinatal period (pregnant/postpartum) without major depression, with major depression and women outside the perinatal period. Methods 572 pregnant women in the third trimester completed Beck Depression Inventory-II and Postpartum Depression Screening Scale and were assessed with the Diagnostic Interview for Genetic Studies. 417 of these were also assessed (with the same instruments) at three months postpartum. Ninety non-pregnant women or that did not have a child in the last year (mean age=29.42±7.159 years) also filled in the questionnaires. Results Non-depressed pregnant women showed lower scores than depressed pregnant women and higher scores than women outside the perinatal period in the BDI-II total score and in its Somatic-Anxiety dimension. Non-depressed postpartum women showed significantly higher scores than women outside the perinatal period only at Sleep/Eating Disturbances. Compared to women outside the perinatal period, pregnant women without depression presented higher scores only in the somatic items. Women with vs. without depression in the postpartum period did not significantly differ and both presented higher scores than women outside the perinatal period in the proportions of loss of energy and sleep changes. Limitations Women outside the perinatal period were not diagnosed for the presence of a depressive disorder, but their BDI-II mean score was similar to the figures reported worldwide regarding women in childbearing age. Conclusion In the perinatal period, most particularly at pregnancy, women experience significant somatic changes even if not clinically depressed. Cognitive-affective symptoms are more useful when assessing the presence of perinatal depression.

Introduction In comparison with postnatal depressive symptoms, few studies considered antenatal depressive symptoms risk factors/correlates. Objectives/aims In a multidimensional work our aim was to explore the associations/predictive role of lifetime and current pregnancy variables for antenatal depressive symptoms. Methods Two hundred and thirty six women (M = 30.5; SD =4.02; variation = 19-41), at the third pregnancy trimester were interviewed with the DIGS/OPCRIT (to make lifetime/current depression diagnoses) and answered a booklet about sociodemographic variables, lifetime/current insomnia, current stress perception, perception of being an anxious person, gynecological variables, past health perception and pregnancy health problems, among others. They filled in the Profile of Mood States to assess anxious symptoms, Negative and Positive affect and the Postpartum Depression Screening Scale (PDSS) to assess antenatal depressive symptoms at pregnancy. Women with a depression diagnosis (DSM-IV/ICD-10, n =5) and on sleep medication at pregnancy were excluded from the analyses. Results We found significant associations between antenatal depressive symptoms (PDSS total score), current job situation, perception of being an anxious person, lifetime history of depression (DSM-IV/ICD-10), past health perception, health problems at current pregnancy, stress perception at pregnancy, lifetime and current insomnia, anxious symptoms at pregnancy, Negative and Positive affect. In an hierarquical multiple regression past health perception, negative affect, positive affect and current insomnia were significant predictors of antenatal depressive symptoms. Conclusions Past health perception, negative affect (anxious and depressive symptoms) and insomnia at current pregnancy seem to be risk factors/correlates for the outcome. Positive affect seems to work as a protective correlate.

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).

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.

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.

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.

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.

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.

In Portugal, the medical school selection process relies exclusively on past academic results, involving the most stringent criteria of all courses, with no attention given to the personality traits of the students. In a competitive context, perfectionism dimensions may be relevant to consider. Socially Prescribed Perfectionism (SPP) has been correlated with Neuroticism, while Self-Oriented Perfectionism (SOP) is strongly associated with Conscientiousness. These domains of personality have been linked (lower levels of Neuroticism and higher levels of Conscientiousness) to academic and professional success in Medicine. The premedical syndrome describes premedical students as overachieving, excessively competitive, cynical, dehumanized, overspecialized and narrow. Our main objective was to compare SPP and SOP levels between Medical and Humanities students, as they may be possible indicators of the premedical syndrome among Portuguese medical students.The Portuguese version of the Multidimensional Perfectionism Scale was administered to 908 undergraduate students from Medicine and Humanities courses of Coimbra University. The sample covered students from the 1st to the 5th year of the courses but most of the students were from the 1st year (n=436).With respect to SPP, significant statistical differences were found, with Medicine students showing lower levels (mean 48.60+/-11.02; p=0.023) than Humanities students (mean 50.00+/-9.56). No significant differences were found in SOP.Our results are reassuring, suggesting the lack of a negative impact of the medical school selection process in the personality traits of the students and the probable absence of the premedical syndrome.

IntroductionPrevious suicide attempts are a consistent risk factor for suicide. Repetition has been associated with higher future morbidity and suicidality.AimTo examine the relationship between psychological variables at pregnancy and previous repetition of suicidal attempts, first attempts and absence of attempts.MethodsThe sample comprise 568 third trimester pregnant women, mean aged 29.82 years (SD = 4.55; variance = 17–44). Previous suicidal behaviors were assessed with diagnostic interview for genetic studies, depression with PDSS and BDI-II, and affect with POMS. Current suicidal thoughts were assessed with PDSS dimension; hopelessness and helplessness by summing the scores of the POMS items hopeless/gloomy; and lonely/helpless, respectively.ResultsRepeaters (R; n = 11, 1.9%) scored higher than non-repeaters (NR; n = 20, 3.5%) in most of the clinical variables, but only significantly in sleeping/eating disturbances (PDSS).R and NR when compared to women who never attempted suicide (NA; n = 535, 94.5%) both revealed significant higher levels of depressive/hostility affect (POMS), BDI-II total score, suicide ideation, guilt/shame (PDSS) and anxiety/insecurity or anxiety/somatic (PSDD or BDI-II).In comparison with NA, R also revealed significant higher levels of negative affect (POMS), PDSS total score, loss of self, mental confusion (PDSS), cognitive and affective symptoms, fatigue (BDI-II), hopelessness and helplessness. NR also differs from NA in their higher emotional liability (PDSS).ConclusionWomen with previous suicide attempts are at elevated risk for high depressive symptoms, negative affect and suicide ideation at pregnancy. Compared to never attempters, repeaters revealed high morbidity than first attempters. The intervention in pregnancy must carefully assess previous history of suicide attempts.Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionWe have recently found that Perfectionism and Perseverative Negative are both correlates of psychological distress/PD and that PNT mediates the relationship between perfectionism and PD (Macedo et al., 2015).ObjectivesTo investigate if perfectionism and PNT are prospectively associated to PD and if PNT is a longitudinal mediator between perfectionism and PD, controlling for perceived stress and gender.MethodsA total of 227 university students (80.1% girls) filled in the Portuguese validated versions of Perseverative Thinking Questionnaire (PTQ), Multidimensional Perfectionism Cognitions Inventory (MPCI), Profile of Mood States and Perceived Stress Scale, with an additional item to evaluate perceived social support/PSS at T0 and after approximately one year (T1) (Mean months = 12.77 ± 1.137). Only variables significantly correlated with the outcomes (Tension/Anxiety at T1 and Depression at T1) were entered in the conditional process analysis. The moderating role of perceived support on the link between Concern over Mistakes (MPCI) and psychological distress and between PTQ total score and psychological distress (anxiety and depression separately) was examined via conditional process analyses.ResultsThe estimated models were significant (F = 4.257, P = .002; F = 6.476, P < .001) explaining 15.9% of tension-anxiety and 25.5% of depression variance. A significant conditional indirect effect of PTQ total score on psychological distress at average and higher levels of perceived support was found, in both models (anxiety and depression). On the contrary, the two models showed a non-significant conditional direct effect of Concern over Mistakes on psychological distress only at any level of perceived support.ConclusionPNT prospectively mediates the relationship between negative perfectionism and PD.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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.

Introduction To study the association between sleep quality/quantity and eating behaviours in female university students. Materials and methods 520 females (mean = 19.3 years, sd = 1.31), completed a series of questionnaires that assessed eating behaviours (Eating Attitudes Test-25), sleep-wake aspects, arousability, coping, emotional expressivity, worry, neuroticism/extraversion, perceived physical/mental health, academic stress, positive/negative affect, pre-sleep arousal (cognitive/somatic arousal) and Body Mass Index (BMI; KG/M2). Results BMI mean score was of 20.7 (sd = 2.39; range = 14.5–34.7). 14,7% were classified as underweight (BMI 18.5), 81,8% normal weight (BMI of 18.5–24.9), 2,9% overweight (BMI of 25.0–29), and 0,6 obese (BMI ⩾ 30.0). EAT-25 mean score was 24.25 (sd = 14.2; range = 0–78). 55.8% usually slept 7–8 h a night, 9.1% slept more than 8 h and 8.7% usually slept 6 h or less. 66% considered their sleep as “Very good/Good”. Logistic Regression analyses models showed that neuroticism, sleep reactivity to stress and sleep quality were independent significant predictors of drive for thinness (respectively, Odds ratio/OR = 1.220; OR = 1.506; OR = 1.926). Pre-sleep somatic arousal, negative emotion expressiveness, perceived academic stress, sleep reactivity to stress and usual sleep duration were independent significant predictors of bulimic behaviours (respectively, OR = 1.285; OR = 1.290; OR = 1.183; OR = 0.823; OR = 0.356). Pre-sleep cognitive arousal, usual sleep duration and sleep quality were independent significant predictors of Social pressure to eat (respectively, OR = 1.714; OR = 3.810; OR = 1.537). Pre-sleep cognitive arousal, perceived daytime sleepiness and usual sleep duration were independent significant predictors of global eating disturbance (respectively, OR = 1.293; OR = 0.577; OR = 0.148). Conclusion In young females, usual sleep duration/quality, neuroticism, emotion expressiveness, perceived stress, sleep reactivity to stress and pre-sleep arousal were predictors of disordered eating behaviours/attitudes. Acknowledgements The co-operation of Professors and Students is gratefully acknowledged.

Introduction Postpartum depression (PPD) can occur through all the perinatal period and it is a public health problem. Positive and negative affect (at pregnancy and previous postpartum moments) are protective and risk factors for PPD. The Profile of Mood States (POMS) factor structure at pregnancy and three months postpartum has already been explored. Objective to explore the POMS factor structure at six and 12 months postpartum. Methods 336 women (mean age=30,3; SD = 4,09; range=19-42 years) and 276 women (mean age=30,5; SD=3,99; range=19-41 years), respectively, filled in the Profile of Mood States (POMS), at six and 12 months postpartum. Results A principal components analysis revealed, at six months postpartum, three components that explained 54,12% of the total variance: F1 Depression-Hostility (21 items; 39,5% explained variance/EV); F2 Anxiety-Anger/fatigue (14 items; 10,1% EV) and F3 Vigor-Activity (12 items; 4,8% EV); at 12 months postpartum, revealed also three components, that explained 46,16% of the variance: F1. Anxiety-anger/fatigue (13 items; explained 30,4% of the variance); F2. Depression-Hostility (6 items; 11,2% VE); F3. Vigor-Activity (14 items; 2,9% EV). At both postpartum moments, F1 and F2 can be summed to calculate Negative Affect (Cronbach Alpha, α=0,968 at six months and α=0,948 at 12 months). F3 corresponds to Positive Affect (α=0,863; α=0,875, respectively, at six months and 12 months). Conclusions The POMS factor structure at six and 12 months is robust, meaningful and can now be used to explore different aspects of the postpartum experience, at these postpartum moments.

In this paper we review some of the best available evidence to argue that screening for perinatal depression should be systematically conducted since pregnancy. Our view is organized in ten topics: (1) perinatal depression high prevalence; (2) its potential negative consequences, including maternal, conjugal, foetal, infantile, and child effects; (3) its under-detection and treatment; (4) its stigma; (5) the professionals and women misconceptions related to perinatal depression; (6) the availability of valid and short self-report screening instruments for perinatal depression and (7) their acceptability; (8) the increase in recognition, diagnosis, and treatment rates in comparison with routine practice; (9) the opportunity, given the large number of contacts that women have with health professionals in the perinatal period; and (10) perinatal depression screening potential cost-effectiveness.

Introduction Immigration involves significant changes in the psychosocial context, due to losses, relationship breakdowns, lack of social support, not feeling at home, novelty, discrimination, resettlement demands (occupation, language). These life stressors might lead to psychological distress, including depression. Objectives/Aims To explore if there are differences in the prevalence of depression and depressive symptoms in immigrant and Portuguese women during the perinatal period. Methods The sample comprises 397 women. 348 (87.7%) of them were Portuguese and the remaining 49 (12.4%) were born in other Countries (5.8% Other/European, 3.8% African, 2.8% South America). They were both interviewed at the last trimester of pregnancy (T0) and at 3 months postpartum (T1), using the Diagnostic Interview for Genetic Studies , which allows CID-10 and DSM-IV diagnoses of depression. Both at T0 and T1, they also completed the Postpartum Depression Screening Scale (PDSS) to evaluate depressive symptoms. Results Immigrants compared with Portuguese women did not differ in respect to a CID-10/DSM-IV depression diagnosis and in respect to PDSS total scores at T0 and T1. Being immigrant is associated with higher levels of passive suicidal ideation ( death seem the only way out of this nightmare ) (rs=.116, p Conclusions Being immigrant might contribute to higher levels of depressive symptoms during the perinatal period, including suicidal ideation. These findings have clinical implications, while working with immigrants.

Introduction The Beck Depression Inventory-II [BDI-II] (Beck et al., 1996) is the self-report instrument to depressive symptoms most widely used. A 2-factor structure is frequently obtained in clinical and nonclinical samples. Our group found an identical 2-factor solution in pregnant (3rd trimester) and postpartum women (3 months); the two factors were: Cognitive-Affective and Somatic-Anxiety (Bos et al., 2009). Objectives To investigate the BDI-II factor structure in a sample of childbearing age women who were not pregnant or that did not have children in the last year and to compare the structure of depression symptoms experienced by women in the perinatal period versus outside the perinatal period. Methods 120 non-perinatal women (students and employees at health and education institutions), aged 18-44 (M=29.42±7.159 years), currently or in the last year unpregnant, were asked to to fill in the BDI-II. A principal components analysis with Varimax rotation was performed. Results The internal consistency coefficient Cronbach alpha (α) was of .82. Following the Kaiser and the Cattel's Scree Plot criteria, a two factors structure was selected, which explained 43.56% of the variance [EV]. Based on items content, Factor [F] 1 (EV=33.55%; a=.83) and F2 (EV=10.26%; a=.82) were respectively denominated’Somatic-Anxiety’ and’Cognitive-Affective’. The dimensions composition completely overlapped with the Bos et al. (2009) structure, obtained with perinatal women. Conclusions The BDI-II factorial structure in non-perinatal childbearing age women is robust and meaningful. Our results support the view that the structure of depressive symptoms does not differ between perinatal and non-perinatal women.

Introduction This report describes associations between subjective measures of sleepiness, eating disturbances and body mass index in female university students. Materials and methods 520 females (mean = 19.3 years, sd = 1.31), completed a series of questionnaires that assessed eating behaviours (Eating Attitudes Test-25), arousability, coping, emotional expressivity, worry, neuroticism/extraversion, perceived physical/mental health, academic stress, positive/negative affect, pre-sleep arousal (cognitive/somatic), body mass index (BMI; KG/M2) and sleep-wake aspects including subjective sleep propensity/Epworth Sleepiness Scale (ESS) and perceived daytime sleepiness (PDS, four items: feel excessively sleepy during the day, being sleepy during the day is a problem, feel performance is impaired due to daytime sleepiness, feel the need to nap during the day). Results ESS and PDS correlated moderately with each other (r = .415, p 001). EAT-25 mean score was 24.25 (sd = 14.2). BMI mean score was of 20.7 (sd = 2.39; range = 14.5–34.7). 14,7% were classified as underweight (BMI 18.5), 81.8% normal weight (BMI of 18.5–24.9), 2.9% overweight (BMI of 25.0–29), and 0,6 obese (BMI ⩾ 30.0). Most students had very/good mental (75.7%) and physical health (82.7%). Logistic Regression analyses models showed that perceived daytime sleepiness/PDS (but not sleep propensity/ESS) and self-reported usual sleep duration were independent significant predictors of global eating disturbance (Odds ratio/OR = .57; p = .049). Daytime sleep propensity, perceived daytime sleepiness, and perceived physical health were independent significant predictors of high BMI (respectively, OR = 1.58; p = .004; OR = 0.62; p = .046; OR = 0.034; p = .002). Neither subjective sleep quality nor usual sleep duration were associated with BMI. Conclusion In young females, daytime sleep propensity/perceived sleepiness and perceived physical health were predictors of higher BMI. Perceived daytime sleepiness and usual sleep duration were both predictors of global disordered eating behaviours/attitudes.

Introduction Factors associated with postpartum/PPT anxiety have been insufficiently investigated. Objective To identify correlates of PPT anxiety. Methods 201 3-months postpartum women completed the Portuguese versions of Postpartum Depression Screening Scale (PDSS), Beck Depression Inventory/BDI-II, Profile of Mood States, Difficult Infant Temperament Questionnaire/DITQ, Multidimensional Perfectionism Scale and questions on sociodemographic variables, Lifetime history of insomnia/LTHD, Lifetime history of depressive symptomatology/LTHDS, Current insomnia, Health perception/HP, Stress perception/SP, Perceived social support/PSS, Quality of life/QOL, Health problem/complication postpartum, Sensibility to hormonal fluctuations, Type of delivery and Type of feeding. Postpartum anxiety was measured with the Anxiety/Insecurity (AI) subscale of the PDSS. Results AI significantly correlated with LTHDS (rS=.32), LHI (rS=.18), Current insomnia (rS=.32), BDI-II (r=.76), SP (rS=.38), PSS (rS=.25), Perceived QOL (rS=.37), Health perception (rS=.29), Health problem in the postpartum (rS=.26), Negative Affect/NA (r=.66), Positive Affect/PA (r=.58), Conditional Acceptance/CA (r=.29) and DIT (r=.38) (all p M-1DP) DIT, CA, NA and low vs. high PA had significantly higher mean scores in AI (all p Conclusion Our findings are in accordance with previous research and contribute to the progress on this topic.

Introduction Knowledge about the mechanisms underlying the relationship between perfectionism and eating behaviors in overweight/obese women is very scarce. Objectives To investigate the relationship between perfectionism, eating behaviors and affect in overweight women. Methods The Portuguese validated versions of the Eating Disorders 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; Mean BMI = 32.82 ± 5.43) attending a weight loss treatment in a public hospital. Results Correlations between Social Prescribed Perfectionism/SPP and EDEQ total (T) and its dimensional scores (Weigh and Shape Concern and Dissatisfaction/WSCD, Eating Concern/EC, Restraint) were all moderate (r > .30) and significant (p > .001). Self-Oriented Perfectionism/SOP was also significantly correlated with EDEQ-T, WSCI and Restraint (r = .20). Positive affect/PA was negatively correlated and Negative affect/NA was positively correlated with all EDEQ dimensions (r > .25; p > .001). SPP, but not SOP, was significantly correlated with PA (r = −.27) and NA (r = .34). Participants with high (>M+SD) vs. low ( Conclusions As in studies with other type of samples, SPP is related to disordered eating in overweight women.

Introduction Postpartum depressive symptomatology is highly prevalent and has negative impact in the entire family. Objective To identify correlates of postpartum depressive symptomatology. Methods 201 3-months postpartum women completed the Portuguese versions of Postpartum Depression Screening Scale/PDSS, Profile of Mood States, Difficult Infant Temperament Questionnaire/DITQ, Multidimensional Perfectionism Scale and questions on sociodemographic variables (marital status, work status, educational level, parity), Lifetime history of insomnia/LTHD, Lifetime history of depressive symptomatology /LTHDS, Current insomnia, Sleep needs, Health perception/HP, Stress perception/SP, Perceived social support/PSS, Quality of life/QOL, Health problem/complication postpartum, Sensibility to hormonal fluctuations, Type of delivery and Type of feeding. Results Total PDSS significantly correlated with LTHDS (rs=.35), LHI (rs=.22), Current insomnia (rs=.37), SP (rs=39), PSS (rs=.25), Perceived QOL (rs=.31), Health perception (rs=.28), Health problem or complication in the postpartum (rs=.16), Negative Affect/NA (r=.59), Positive Affect/PA (r=-.67), Conditional Acceptance/CA(r=.29) and DIT (r=.40) (all p M-1DP) DIT, CA, NA and low vs. high PA had significantly higher mean scores in AI (all p Conclusion These results are in line with previous findings and contribute to the progress on this topic.

Introduction Positive affect (PA) is correlated to several positive outcomes and might be a constituent of happiness (Lyubomirsky et al., 2005). Objectives To investigate the correlates of PA in pregnancy and postpartum. Methods 397 pregnant women (T0) were also followed at 3 months postpartum (T1). At both time-points, they completed a questionnaire, the Postpartum Depression Screening Scale (PDSS), the Profile of Mood States (POMS), and were also interviewed with some sections of the Diagnostic Interview for Genetic studies (DIGS). Descriptive and correlation analyses were performed. Results T0/T1 PA scores were correlated (p Conclusions PA is a protective emotional trait, a good indicator of physical/mental health, and well-being in perinatal period. Mother's PA influences her perception of the infant temperament and may contribute positively to the dyadic interaction.

Introduction It has been shown that perfectionism constitutes a risk factor both for insomnia and postpartum depression. Objective To analyse the relationship between perfectionism, depressive symptoms and insomnia in the postpartum. Methods 201 3-months postpartum women (M=12.27 ± .91 weeks postpartum) completed the Portuguese versions of Postpartum Depression Screening Scale (PDSS) and Multidimensional Perfectionism Scale (MPS). Three MPS dimensions derived by factorial analysis with data from this sample were used: Self-Oriented Perfectionism/SOP, Social Prescribed Perfectionism-Conditional Acceptance/SPP-CA and SPP-Others Highs Standards/OHS. Women also answered 5 questions about sleep, considering the previous month, based on which three insomnia groups were formed: Good Sleepers/GS (women without insomnia symptoms or daytime impairment); Insomnia Symptoms Group (women with at least one insomnia symptom but no daytime impairment); Insomnia Syndrome Group/ISG (women with at least one insomnia symptom and sleep related daytime impairment). Results Insomnia and PDSS were correlated (r = .39, pr .25, pr Conclusion SPP-C is a relevant correlate of postpartum insomnia.

Introduction Although developed for postpartum depression, the Postpartum Depression Screening Scale (PDSS; Beck & Gable, 2002) is accurate to screen for antenatal depression (Pereira et al., 2011). Nonetheless, as any screening instrument should be valid, short and easy it is important to develop a PDSS short form to use in pregnancy. Objectives To develop PDSS short version to use in pregnancy and to determine its cut-off points and associated conditional probabilities to screen for antenatal depression according to DSM-IV and ICD-10 criteria. Methods 441 pregnant women in their last trimester of pregnancy (M = 32.6 ± 3.47 weeks of gestation) completed the Portuguese PDSS adapted to pregnancy and were interviewed using the Mood Disorders Section/Diagnostic Interview for Genetic Studies. A factor analysis was performed to select the items (factor loadings > .60). ROC analysis was applied and cut-off points adjusted to the prevalence were determined. Results Four factors were extracted, making a total of 24 items selected to the short version (PDSS-24). For major depression/DSM-IV the cut-off point (CO) of 44, resulted in sensitivity 83.3%, specificity 78.9%, positive predictive value (PPV) 8.5% and negative predictive value (NPV) 99.7%; for depressive disorder/ICD-10 the CO of 42 determined sensitivity 85.7%, specificity 79.2%, PPV 11.9%, NPV 99.4%; for mild/moderate depression with somatic syndrome or severe depression without psychotic symptoms/ICD-10 the CO of 46 was associated to sensitivity 87.5%, specificity 82.2%, PPV 9.3% and NPV 99.7%. Conclusions The PDSS-24 is a good alternative to the 35-items version, equally valid, but more economic, faster and easier.

IntroductionScreening for perinatal depression is essential. The Postpartum Depression Screening Scale (PDSS; Beck & Gable, 2002) is a self-report instrument, composed of 35 items. The Portuguese version of the PDSS revealed to be a valid instrument to screen for perinatal depression (Pereira et al., 2010a,b).ObjectivesTo develop PDSS short version and to determine its cut-off points and associated conditional probabilities to screen for depression according to DSM-IV and ICD-10 criteria.MethodsParticipants were 452 women in their third month post-partum (M = 13.07 weeks post-partum; SD = 1.808). All women completed the Portuguese PDSS and were interviewed using the Mood Disorders Section/Diagnostic Interview for Genetic Studies. To select items for the short version the items that showed the highest correlations with their respective seven dimension scores were retained. ROC analysis was applied and both cut-off points and associated conditional probabilities adjusted to the real prevalence were determined.ResultsFor major depression/DSM-IV the cut-off point of 15, resulted in sensitivity of 77.8%, specificity of 88.9%, positive predictive value (PPV) of 21.7% and negative predictive value (NPV) of 98.9%; for depressive disorder/ICD-10 the cut-off point of 14 determined sensitivity 77.3%, specificity 84.0%, PPV 19.7%, NPV 98.6%; for mild/moderate depression with somatic syndrome or severe depression without psychotic symptoms/ICD-10 the cut-off point of 18 was associated to sensitivity 91.7%, specificity 94.5%, PPV 31.4% and NPV 99.8%.ConclusionsThe Portuguese short version of PDSS is a good alternative to the 35-items version, equally valid and precise, but more economic, faster and easier.

Introduction/Aim Postpartum depression interferes negatively with mother9s well-being and infant9s development. The aim of this study was to investigate whether Positive Affect in late pregnancy was a protective factor for later Postpartum depression. Methods A total of 491 pregnant women filled in the Profile of Mood States (POMS), the Beck Depression Inventory, socio-demographic characteristics, psychosocial variables and answered a Psychiatric Interview. After delivery 272 women participated for a second time. Results POMS factor analyses revealed a 30-item scale in pregnancy and a 27-item scale in post partum. Based on both factor analyses two dimensions of affect could be determined: a negative affect (NA) and a positive affect (PA) of affect could be determined. NA was associated with more intense depressive symptomatology, more self-perceived stress, low self-reported social support and low quality of life in pregnancy as well as post partum. By contrast, PA was negatively associated with these variables. In pregnancy, NA was a predictor of post partum depression (Diagnostic and statistical manual of mental disorders, DSM-IV/OR 2.1, 95% CI 1.3 to 3.4, p=0.003; International Classification of Diseases, ICD-10/OR 2.1, 95% CI 1.5 to 3.0, p Conclusion Opposed dimensions of affect could be appropriately assessed using POMS. Reinforcing PA in late pregnancy may help preventing Postpartum depression.