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Tem como objetivo analisar as propriedades psicometricas da Escala de Medo da COVID-19 no periodo perinatal, constituida por dois itens adicionais para o periodo perinatal A pesquisa foi registrada no CONEP 204 gestantes com idade media de 30 12 anos (±5 45) e idade gestacional media de 25 17 (±6 553) responderam aos questionarios atraves das redes sociais no Brasil Foi utilizado o SPSS Statistics, foram usados para medidas parametricas, o coeficiente de Pearson e o T de Student e nao-parametrica – U de Mann Whitney e para magnitude dos coeficientes de correlacao com sintomatologia ansiosa e depressiva perinatais, os criterios de Cohen Usou-se o AMOS 26 0, para a analise fatorial confirmatoria Para consistencia interna, o alfa de Cronbach Os resultados indicam que a EMC-19-9 e um construto unidimensional, possui qualidades psicometricas robustas, consistencia interna do questionario muito boa e mostra ter validade convergente, apresenta correlacao moderada e significativa com a ansiedade perinatal e correlacao significativa, apesar de ligeira, com a depressao perinatal As pontuacoes totais foram comparaveis em todas as idades, o que sugere ser um bom instrumento psicometrico para ser usado na avaliacao de medos de COVID-19 entre gravidas Brasileiras Estudos futuros tambem devem avaliar associacao com condicoes medicas subjacentes associadas a um maior medo Alternate abstract: It aims to analyze the psychometric properties of the COVID-19 Fear Scale in the perinatal period, consisting of two additional items for the perinatal period The research was registered with CONEP 204 pregnant women with an average age of 30 12 years (± 5 45) and an average gestational age of 25 17 (± 6,553) answered the questionnaires through social networks in Brazil We used SPSS Statistics, used for parametric measurements, Pearson's coefficient and Student's non-parametric T - Mann Whitney U and for the magnitude of the correlation coefficients with perinatal anxiety and depressive symptoms, Cohen's criteria AMOS 26 0 was used for confirmatory factor analysis For internal consistency, Cronbach's alpha The results indicate that EMC-19-9 is a one-dimensional construct, has robust psychometric qualities, very good internal consistency of the questionnaire and shows convergent validity, has a moderate and significant correlation with perinatal anxiety and a significant, albeit slight, correlation with perinatal depression The total scores were comparable at all ages, which suggests that it is a good psychometric instrument to be used in assessing COVID-19 fears among pregnant women in Brazil Future studies should also assess association with underlying medical conditions associated with greater fear

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

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

The objective of the present study was to develop and assess the validity of a short form of the Child–Adolescent Perfectionism Scale (CAPS). Two Portuguese samples composed of 756 adolescents were used to cross-validate the factorial structure of a nine-item Child–Adolescent Perfectionism Scale—Short Form (CAPS–SF). The CAPS–SF consists of a four-item self-oriented perfectionism subscale and a five-item socially prescribed perfectionism subscale. Both subscales demonstrated adequate internal consistency. Confirmatory factor analysis (CFA) of the CAPS–SF supported the same two-factor structure and represented a very good fit to the data for both groups. Other analyses found that the brief measure of socially prescribed perfectionism was associated with measures of distress and forms of self-criticism. The CAPS–SF appears to represent a reliable and valid alternative to the original CAPS. Overall, the CAPS-SF is considerably briefer than the original CAPS and it offers an economical and valid alternative when measuring perfectionism in children and adolescents.

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

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

Psychological reactions to pandemics and their constraints depend heavily on personality. Although perfectionism is consistently associated to depression, anxiety and stress, its role in the pandemics' psychological impact has not been yet empirically studied. Our aim was to analyze the role of perfectionism in psychological distress during the pandemic of COVID-19, testing whether it is mediated by fear of COVID-19 and repetitive negative thinking/RNT. Participants (N = 413 adults; 269.2% women) were recruited from September until December 2020, via social networks. They completed self-report validated questionnaires to evaluate perfectionism dimensions (self-critical, rigid and narcissistic perfectionism), fear of COVID-19, RNT and psychological distress (sum of anxiety, depression and stress symptoms). As women had significantly higher levels of self-critical perfectionism, RNT, fear of COVID-19 and psychological distress, gender was controlled in mediation analysis. The three perfectionism dimensions correlated with RNT, fear of COVID-19 and psychological distress. The effect of self-critical perfectionism on psychological distress was partially mediated by fear of COVID-19 and RNT whereas the effect of rigid and narcissistic perfectionism was fully mediated. Perfectionism influences emotional and cognitive responses to the COVID-19 and therefore should be considered both in the prevention and psychological consequences of the pandemic.

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

According to recent models of recovery in psychosis, the patients’ perspectives about their own difficulties, symptoms and goals (health-related and in other areas) are of major importance in intervention. Self-report measures have been increasingly studied and several authors have pointed out their validity, reliability and clinical utility in people with psychotic-disorders. The present study sought to review and critically analyse the available self-report instruments for assessing delusions. Four instruments met the inclusion criteria: Characteristics of Delusions Rating Scale; Beliefs Rating Scale; Peters Delusions Inventory; and Conviction of Delusional Beliefs Scale. All scales assess delusions in a multidimensional perspective and present adequate psychometric properties, although with high variability within studies. Refining the psychometric studies of the existing instruments (mainly confirmatory factor analysis, reliability and diagnostic accuracy analyses) and developing new instruments focused on coping are future areas of research interest., As perspetivas dos pacientes acerca das suas próprias dificuldades, sintomas e objetivos (relacionados com a sua saúde e outras áreas) são de extrema importância para as intervenções, principalmente tendo em conta modelos recentes baseados na recuperação (no original recovery) das perturbações psicóticas. Cada vez mais os instrumentos de autorresposta têm sido estudados, sendo que vários autores têm defendido a sua validade, fiabilidade e utilidade clínica para pessoas com o diagnóstico de uma perturbação psicótica. Este estudo teve como objetivo rever e analisarde forma crítica os instrumentos de autorresposta existentes para a avaliação da ideação delirante. Quatro instrumentos preencheram os critérios de inclusão: a escala de características dos delírios (Characteristics of Delusions Rating Scale), a escala de avaliação das crenças (Beliefs Rating Scale), o inventário de delírios de Peters (Peters Delusions Inventory) e a escala de convicção nas ideias delirantes (Conviction of Delusional Beliefs Scale). Todas as escalas avaliam as ideias delirantes de uma perspetiva multidimensional e todas apresentam propriedades psicométricas adequadas. Noentanto elevada variablidade foi encontrada entre os estudos. O refinar dos estudos psicométricos destes instrumentos (principalmente o investimento em análises de estrutura factorial, fiabilidade e acuidade diagnóstica) e o desenvolvimento de novos instrumentos focados no coping com os delírios são áreas de investigação de interesse para o futuro.

Abstract. Considering several etiologic, therapeutic, and comorbidity-related factors, a psychosis continuum model has been proposed for the understanding and treatment of psychotic disorders. Within the new emerging treatment approaches, Contextual Cognitive-Behavioral Therapies (CCBT) seem to hold promise for the psychosis continuum. However, considering their novelty for this specific population, the quality of efficacy evidence remains unclear. Objective: To examine, critically analyze, and summarize the results from studies based on therapeutic models within the CCBT approach (Mindfulness and Acceptance-based interventions, Compassion-Focused Therapy, Dialectical Behavior Therapy, and Metacognitive Therapy) for patients with a diagnosis within the psychosis continuum (schizophrenia, schizoaffective disorder, bipolar disorder). Methods: Three leading electronic databases (MEDLINE/PUBMED; PsycINFO; Cochrane Library), a grey literature database (OpenGrey), and registered clinical trials (ClinicalTrials.Gov) were searched using combinations of key terms regarding the CCBT models and the diagnosis considered. Reference lists of the relevant studies and reviews were searched. Only Randomized Controlled Trials (RCTs) were included. The “Cochrane Risk of Bias Assessment Tool” was used for quality assessment. Results: A total of 17 articles were included. This review was based on a majority of unclear or low risk of bias studies. Benefits regarding clinical variables such as psychotic symptoms, anxiety and depression, functioning or quality of life were found. Conclusion: Overall the studies supported some benefits of CCBT approaches for the psychosis continuum. The conceptual perspective on treatment has changed, nevertheless the outcomes assessed are still symptom-focused and there is still need for improvement. Methodological considerations and future directions are presented.

During pregnancy, obsessive-compulsive (OC) symptoms and disorder are underdiagnosed and undertreated. The Prenatal Obsessive-Compulsive Scale (PreOCS; Lord, Rieder, Hall, Soares, & Steiner, 2011) is the only self-report questionnaire that evaluates the severity and interference of specific pregnancy-related obsessions and compulsions. We aimed to analyze the validity and reliability of the PreOCS Portuguese version and to describe the prevalence, content, severity, interference, and onset of OC symptoms in pregnancy. Three hundred fifty-five pregnant women completed the PreOCS and other self-report instruments to evaluate perinatal anxiety and depression. Exploratory and confirmatory factor analyses revealed that a second-order model presented an acceptable fit. Cronbach's alphas were ≥.75 for the Severity and the Interference subscales and both were moderately correlated with depression and anxiety measures. Nearly 10% of the women presented OC symptoms with relevant severity. Co-occurrence of obsessions and compulsions (44.4%) was associated with significantly higher PreOCS scores. Obsessions about contamination, harm to the baby, others' judgment and baby's health presented the highest prevalence and increased the odds of having at least one compulsion. Searching for information, asking for reassurance, checking, and cleaning were the most reported compulsions. The Portuguese version of PreOCS has good psychometric properties, presenting itself as a valid and reliable instrument.

The Halstead Category Test (HCT) is a neuropsychological test that measures a person's ability to formulate and apply abstract principles. Performance must be adjusted based on feedback after each trial and errors are common until the underlying rules are discovered. Event-related potential (ERP) studies associated with the HCT are lacking. This paper demonstrates the use of a methodology inspired on Singular Spectrum Analysis (SSA) applied to EEG signals, to remove high amplitude ocular and movement artifacts during performance on the test. This filtering technique introduces no phase or latency distortions, with minimum loss of relevant EEG information. Importantly, the test was applied in its original clinical format, without introducing adaptations to ERP recordings. After signal treatment, the feedback-related negativity (FRN) wave, which is related to error-processing, was identified. This component peaked around 250ms, after feedback, in fronto-central electrodes. As expected, errors elicited more negative amplitudes than correct responses. Results are discussed in terms of the increased clinical potential that coupling ERP information with behavioral performance data can bring to the specificity of the HCT in diagnosing different types of impairment in frontal brain function.

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

Described as a contextual behavioural approach, Compassion-focused Therapy (CFT) aims at helping people develop compassionate relationships both with others and with the self. CFT has been used to promote recovery in psychosis with promising results. The development process of the Compassionate Approach to Schizophrenia and Schizoaffective Disorder (COMPASS) builds upon the available research on contextual behavioural approaches for psychosis. Its main framework is the affect regulation system's model and the compassion-focused therapy rationale as it was adapted for psychosis. Other theoretical and empirical influences are presented and innovations regarding CFT protocols for psychosis are highlighted. COMPASS is already being studied and details on the pilot study are provided. With further study and continuing improvement COMPASS has the potential to help foster recovery in psychosis.

Brief Introduction–Perinatal mental illness–diagnosis, etiology, treatment options, dilemas, case report presentation Perinatal mental illness is a significant complication of pregnancy and the postpartum period. These disorders include depression, anxiety disorders and postpartum psychosis. Perinatal depression and anxiety are the most common. Their occurrence has complex psychological, environmental and biological underpinnings. Perinatal psychiatric disorders impair a woman's function and are associated with suboptimal development of her offspring. Currently available treatment options have many limitations regarding safety and efficacy. There is a need to establish new treatment tools in this special group of patients. Efficacy of repetitive transcranial magnetic stimulation (rTMS) in decreasing postnatal depression symptoms: a systematic review. Non-pharmacological interventions, such as repetitive Transcranial Magnetic Stimulation (rTMS; a non-invasive brain stimulation technique), are attractive options for women concerned with infant exposure to medication during the breastfeeding period, combining efficacy with low risk. rTMS is an approved treatment for Major Depression Disorder by the Food and Drug Administration (USA), and previous systematic reviews support its efficacy as a stand-alone or add-on procedure to accelerate responsiveness to SSRI's (Wang, 2017), suggesting the scale-up of this intervention to the Postnatal depression disorder (PND). As of now, results concerning its application in postnatal depression come from two open label, one Randomized Controlled Trail (RCT) and one case report. Reliable evidence concerning whether rTMS is indeed effective in treating postnatal depression is lacking. Here, we will present a systematic review that gathers the available information concerning rTMS clinical significance in treating postnatal depression, and establish the direction for needed future studies. Transcranial direct current stimulation for treatment of depression during pregnancy Six pregnant women (mean 32 years) with major depressive disorder (mean HAMD 22.5, mean BDI 26 at baseline) were treated with a two-step tDCS regimen: Two weeks of twice daily tDCS (30 min, 2 mA, anode F3–cathode F4 electrode position) and an optional elongation phase of two weeks with one stimulation per day. Four patients completed the whole study, two patients quitted after two weeks. All patients showed a marked improvement of depression. After two weeks of treatment, patients (n = 6) showed a mean HAMD reduction of 9 points or 37%, including two patients fulfilling response criteria. For BDI ratings, patients showed a mean reduction of 15 points or 54%, 3 achieved response, and one achieved remission. Patients who completed the whole study (n = 4) had a mean HAMD reduction of 17 points or 76%, three achieved response, and one achieved remission. In BDI ratings these patients showed a mean reduction of 17 points or 60%, two achieved response, and one achieved remission. TDCS was well tolerated and there were no adverse effects or serious events related to stimulation. Prevalence and incidence of perinatal depression, anxiety and obsessive-compulsive disorder in Portuguese women Following a categorical and dimensional approach, we will present new epidemiological data on perinatal depression, anxiety and obsessive-compulsive disorders in a population-based cohort of Portuguese women (mean age = 32.75 ± 4.721). The sample sizes range from 300 to 600 subjects depending on the diagnostic/screening instruments used at different stages of this study. Specifically, we will present: – estimates of prevalence of postpartum major depression (n = 475), anxiety disorders (n = 350) and OCD (n = 350) according to the DSM-5 diagnostic criteria, using the Diagnostic Interview for Psychological Distress-Postpartum (DIPD-PP); – proportions of caseness (prevalence and incidence) of clinical significant depressive (n = 600), anxiety (n = 300) and OC symptoms (n = 300) in the second trimester of pregnancy and in the 3rd to 6th months postpartum, according to their scores on the Portuguese versions of the Postpartum/Perinatal Depression Screening Scale, Perinatal Anxiety Screening Scale and Perinatal Obsessive Compulsive Scale. New psychometric and operative parameters of these screening questionnaires will also be presented, as well as relevant correlates and risk-factors of the psychological distress variables measured by these instruments. Perinatal OCD–can rTMS be an answer? A growing body of literature suggests that obsessive-compulsive disorder (OCD) is common in pregnancy and puerperium with risks of persisting consequences for both the mother and her child if untreated. Moreover, OCD is challenging to treat especially in the perinatal period. The extreme responsibility that characterizes OCD patients leads women in the perinatal period, often experiencing obsessions involving the safety of the foetus to a preference of non-pharmacological approaches. However, cognitive-behavioural psychotherapy drop-out rate is high due to time management difficulties especially in exposure and response prevention tasks involving family members or in family environment. One potential treatment alternative to antidepressants for pregnant and postpartum women with OCD is repetitive transcranial magnetic stimulation (rTMS). rTMS has proven to be effective in OCD symptoms and the its non-pharmacologic nature eliminates concerns about foetal exposure to the potential risks of psychotropic medications. However, the absolute number of pregnancies exposed to TMS remains small and evidence regarding its efficacy in women with perinatal OCD is limited. In this presentation we will discuss treatment challenges of perinatal OCD, the potential benefits of a rTMS based approach and present a rTMS protocol designed to treat OCD in the perinatal period.

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.

Eating disorders (ED) are a significant source of physical and psychosocial impairment, mainly amongst women in adolescence and early adulthood. The development and progression of ED are influenced by a large set of environmental and social factors, but it has also been recognized that ED have important biological and psychological determinants. This article reviews the literature on ED concerning defensive emotion and psychological processes involved in the development and maintenance of ED, but also their neuroimaging/electrophysiological correlates. Furthermore, it also reviews treatment approaches that focused on the improvement of ED patients’ symptomatology. An extensive literature exists regarding neuroimaging/electrophysiological studies associated with clinical features of ED patients in terms of body image and food processing and reward/inhibition processes. However, studies addressing the neural correlates of psychological processes, such as rumination, experiential avoidance, cognitive fusion and self-criticism, and the defensive emotion of shame, which are key components for the development and maintenance of ED, are still scarce if not lacking. In the context of this cognitive set, cognitive-contextual approaches for ED patients, such as mindfulness, acceptance- and compassion-based interventions are promising to change the way individuals relate to their aversive experiences, but still requires a deeper understanding of the mechanisms by which it operates and further testing of its therapeutic efficacy. This review highlights the lack of neuroimaging/electrophysiological studies in ED patients in which concerns shame and other relevant psychological processes, but also the scarce evidence in terms of brain modifications associated with therapeutic efficacy of cognitive-contextual approaches that help to change the way individuals relate to their body, weight and food concerns, reduce maladaptive emotion regulation strategies and improve well-being in patients suffering from ED.

Objective To explore 1) if perfectionism, perceived distress/coping, and cognitive emotion regulation (CER) are associated with and predictive of negative/positive affect (NA/PA); and 2) if CER and perceived distress/coping are associated with perfectionism and if they mediate the perfectionism-NA/PA associations. There is a distinction between maladaptive and adaptive perfectionism in its association with NA/PA. CER and perceived distress/coping may mediate the maladaptive/adaptive perfectionism and NA/PA associations. Methods 344 students (68.4% girls) completed the Hewitt & Flett and the Frost Multidimensional Perfectionism Scales, the Composite Multidimensional Perfectionism Scale, the Profile of Mood States, the Perceived Stress Scale, and the Cognitive Emotion Regulation Questionnaire. Results NA predictors were maladaptive/adaptive perfectionism, maladaptive CER and perceived distress (positively), positive reappraisal and planning, and perceived coping (negatively). PA predictors were maladaptive/adaptive perfectionism and perceived distress (negatively), positive reappraisal and planning, positive refocusing and perceived coping (positively). The association between maladaptive perfectionism and NA was mediated by maladaptive CER/low adaptive CER, perceived distress/low coping. Maladaptive perfectionism and low PA association was mediated by perceived distress. High PA was determined by low maladaptive perfectionism and this association was mediated by adaptive REC and coping. Adaptive perfectionism and NA association was mediated by maladaptive CER and perceived distress. Conclusion CER and perceived distress/coping are associated and mediate the perfectionism-NA/PA associations. Resumo Objetivo Explorar 1) se o perfeccionismo, o estresse/copingpercebidos e a regulação emocional cognitiva (REC) estão associadas e predizem o afeto negativo/positivo (AN/AP); e 2) se a REC e o estresse/copingestão associados e mediam a relação perfeccionismo-AN/AP. Existe uma distinção entre o perfeccionismo mal-adaptativo/adaptativo na associação com o AN/AP. A REC e o estresse/copingpoderão mediar as associações entre o perfeccionismo mal-adaptativo/adaptativo-AN/AP. Métodos 344 estudantes (68.4% do sexo feminino) completaram as Escalas Multidimensionais do Perfeccionismo de Hewitt & Flett e de Frost, a Escala Multidimensional de Perfeccionismo Compósita, o Perfil dos Estados de Humor, a Escala de Estresse Percebido e o Questionário da Regulação Emocional Cognitiva. Resultados Os preditores do AN foram o perfeccionismo adaptativo/mal-adaptativo, a REC mal-adaptativa e o estresse percebido (positivamente), a reavaliação positiva e planeamento e o coping(negativamente). Os preditores do AP foram o perfeccionismo adaptativo/mal-adaptativo e o estresse percebido (negativamente), a reavaliação positiva e planeamento, a refocalização positiva e o copingpercebido (positivamente). A associação entre o perfeccionismo mal-adaptativo e o AN foi mediada pela REC mal-adaptativa/baixa REC adaptativa, pelo estresse/baixo copingpercebidos. A associação entre o perfeccionismo mal-adaptativo/adaptativo e baixo AP foi mediada pelo estresse percebido. O elevado AP foi determinado pelo baixo perfeccionismo mal-adaptativo e esta associação foi mediada pela REC adaptativa e pelo coping. A associação entre o perfeccionismo adaptativo e o AN foi mediada pela REC mal-adaptativa e pelo estresse percebido. Conclusão A REC e o estresse/copingpercebidos estão associados e medeiam as associações entre o perfeccionismo e AN/AP.

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

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

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.

Fears of Compassion (FOC) relate to experiencing defensive emotions and avoidance reactions when receiving and giving compassion. Three different flows have been identified: giving compassion to ot...

Evidence emerged for the HEXACO Model, summarized the domains of personality in six dimensions. The difficulties associated with the diagnosis of dysthymia have raised questions in maintaining in mood disorders. Given the literature review and defending a modification in the structural model of personality, this study proves the importance of a preliminary study of the psychometric properties of HEXACO in a Portuguese sample. It is important the exploration of personality traits in a clinical population diagnosed with Persistent Depressive Disorder. The sample, for the first study, consisted of 118 women and 48 men aged 18 to 57 years (M=26.21, SD=10.23). The study 2 includes participants belonging to the clinical group (M=48.33, SD=10.23) and nonclinical group (M=41.23, SD=9.63) all female aged between 23 and 63 years. The instruments used for the study were the HEXACO-60, NEO-FFI-20 and PHQ-9. The results demonstrate that the HEXACO-60 has satisfactory psychometric properties that make it a suitable tool to evaluate the personality, presenting high correlations with NEO-FFI and a higher internal consistency. It is also verified that there are significant correlations between depressive symptoms and personality traits. Although this analysis is preliminary with regard to psychometric study of the assessment tool HEXACO-60 personality, the statistical analysis of the instrument showed that it has adequate psychometric properties proving to be an appropriate tool to evaluate the constructs of personality. We conclude that there is evidence to suggest the need for reformulation of the diagnosis of persistent depressive disorder. info:eu-repo/semantics/publishedVersion

Although functional recovery could be advocated as an achievable treatment goal, many effective interventions for the treatment of psychotic symptoms, such as antipsychotic drugs, may not improve functioning. The last two decades of cognitive and clinical research on schizophrenia were a turning point for the firm acknowledgment of how relevant social cognitive deficits and negative symptoms could be in predicting psychosocial functioning. The relevance of so cial cognition dysfunction in schizophrenia patients’ daily living is now unabated. In fact, social cognition deficits could be the most significant predictor of functionality in patients with schizophrenia, non-redundantly with neurocogni tion. Emerging evidence suggests that negative symptoms appear to play an indirect role, mediating the relationship between neurocognition and social cognition with functional outcomes. Further explorations of this mediating role of negative symptoms have revealed that motivational deficits appear to be particularly important in explaining the relationship between both neurocognitive and social cognitive dysfunction and functional outcomes in schizophrenia. In this paper we will address the relative contribution of two key constructs—social cognitive deficits and negative symptoms, namely how intertwined they could be in daily life functioning of patients with schizophrenia.

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

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.

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.

IntroductionAnxiety, depression, and stress in pregnancy are risk factors for adverse outcomes for mothers and children (Glover, 2014). There is good evidence showing a decrease in psychological distress when pregnant women participate in interventions comprising mindfulness and self-compassion practices (Dunn et al., 2012). However, there are few studies on the relationship between mindfulness, self-compassion and psychological distress variables in pregnancy, without being within the scope of intervention trials (Cohen, 2010; Zoeterman, 2014).ObjectiveTo explore the association between mindfulness, self-compassion and psychological distress/PD in pregnant women.MethodsFour hundred and twenty-seven pregnant women (mean age: 32.56 ± 4.785 years) in their second trimester of pregnancy (17.34 ± 4.790 weeks of gestation) completed the Facets of Mindfulness Questionnaire-10 (FMQ-10; Azevedo et al., 2015; to evaluate Non-udging of experience/NJ, acting with awareness/AA and observing and describing), Self-Compassion Scale (SCS; Bento et al., 2015; to evaluate self-kindness/SK, self-judgment, common humanity, isolation, mindfulness and over-identification) and Depression Anxiety and Stress Scale-21 (DASS-21; Xavier et al., 2015). Only variables significantly correlated with the outcomes (Total DASS-21, Stress, Anxiety and Depression) were entered in the multiple regression models.ResultsFMQ-10 and SCS Total scores were both significant predictors of DASS-21 (B = –.335,–.296). Stress predictors were NJ, AA, SK and isolation (B = –.164;–.196;–.087; .353); Anxiety predictors were NJ, SK and isolation (B = –.198;–.124; .268); depression predictors were NJ, SK and Isolation (B = –.277;–.128; .232) (all P < .01).ConclusionsMindfulness and self-compassion dimensions, particularly non-udging of experience and self-Kindness are protective for PD in pregnancy. Isolation is a correlate of PD in pregnancy.Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionAlthough self-compassion has been pointed as an effective strategy for coping with depression, there are not any studies investigating its association with lifetime history of depression (LTHD).ObjectiveTo compare self-compassion levels in pregnant women with vs. without LTHD and to analyze if self-compassion dimensions are significant predictors of LTHD.MethodsFour hundred and twenty-seven pregnant women with a mean age of 33 years (±4.785) in their second trimester of pregnancy completed the Self Compassion Scale validated for pregnancy (SCS; Bento et al., 2015) and a new self-report questionnaire to evaluate the presence of LTHD according to DSM-5 criteria for depression.ResultsNinety-seven (23.0%) women had LTHD. Bisserial Spearmen correlations between LTHD and SCS total score were significant, negative and moderate (r = –0.31). SCS subscales, except Common Humanity, showed significant correlations: Self-Kindness/SK (r = –0.130), self-judgement (SJ) (0.313), isolation (0.357), mindfulness (r = –0.102), over-identification (OI) (r = 0.393). Independent sample t tests revealed that women with vs. without LTHD had significantly lower levels of total SCS, SK and Mindfulness scores and higher levels of SJ, Isolation and OI.Logistic regression (assumptions were fulfilled, Tabachnick and Fidell, 2007) showed that the SCS explained 26.7%–43.6% of the LTHD variance and correctly classified 86.9%; the odds ratio (OR) was.865 (95% CI 0.834–0.898; P < 0.001). The model composed by the correlated dimensions explained 15.9%–24.0% and correctly classified 80.6%. Odds ratios: SK = 0.017; SJ = 0.021; isolation = 16.027; mindfulness = 0.167 and OI = 20.178 (all P < 0.05).ConclusionsSelf-compassion, specifically the ability to treat oneself with care and understanding and to be aware and accepting one's present-moment experiences, decrease the probability of having LTHD.Disclosure of interestThe authors have not supplied their declaration of competing interest.

AimTo investigate the causes that postpartum women most mention for changes in sleep pattern and its associations with obstetric and sleep variables and depressive symptoms.MethodsAt three months postpartum 192 women fill in a booklet containing obstetric and sleep variables and the Postpartum Depression Screening Scale (PDSS; Pereira et al., 2010). If they experienced changes in their sleep pattern, they were asked about the perceived cause(s) (multiple choice). Chi-squared and Student t tests were applied as appropriate.ResultsA total of 64.6% women referred to some cause(s); the most mentioned were feeding/baby care and older children care (32.3%) and worries (baby and life problems related) (29.5%). Women who mentioned feeding/baby and older children care as a cause did not significantly differ in relation to type of delivery, feeding method proportions and in PDSS mean scores. Women who identified worries as a cause vs. women who did not – presented significant differences in proportions of vaginal (20.0%) vs. assisted delivery (52.2%) (OR 4.444), caesarean-section (22.2%) vs. assisted delivery (52.6%) (OR 3.827), in breast-feeding (36.0%) vs. bottle-feeding (12.9%) (OR .263) and in “having trouble sleeping even when the baby is asleep” (28.0% vs. 2.9%) (OR 12.833) (all PP < 0.05).ConclusionIt is important to distinguish the causes for changes in sleep pattern in postpartum women. Worries as a perceived cause have a higher impact and clinical significance than causes related to baby care demands.Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionThe Revised-Fibromyalgia Impact Questionnaire (FIQR), composed by 21 items, is one of the most used tools to measure the impact of fibromyalgia both in clinical and research settings. Although it has demonstrated good psychometric properties (Bennet et al., 2009; Costa et al., 2015), little is known about its factorial structure.Objective/AimsTo explore FIQR's factorial structure and examine its association with several psychological constructs.MethodsHundred and three women with fibromyalgia (mean age 47.32 ± 10.63) filled in the Portuguese validated versions of the FIQR, Perceived Stress Scale, Perseverative Thinking Questionnaire, Beck Depression Inventory-II and Profile of Mood States. A principal components analysis with varimax rotation was carried out. The number of factors to extract was based on Cattel's scree plot and eigenvalues’ magnitude. The associations between FIQR dimensions and psychological constructs were examined via Pearson correlations and multiple linear regressions.ResultsThree factors were extracted [F1/Function = Items 1–9, α = 0.92; F2/Symptoms = Items 12, 16–21, α = 0.83; F3/Impact = Items 10, 11, 13–15, α = 0.83] explaining 58.57% of the variance. FIQR symptoms were the best and, nearly in all analyses, the only significant predictor.ConclusionsThe factorial structure of the Portuguese version of FIQR partially overlaps with the proposed theoretical domains (Bennet et al., 2009). Similarly to Luciano et al.’s study (2013), factorial analysis also evidenced the multidimensionality of some items. Fibromyalgia symptoms seem to play the most deleterious effect, being associated with poor mental health indicators. Future studies are needed to confirm the factorial structure found, due to sample size, items subjectivity and study's exploratory nature.Disclosure of interestThe authors have not supplied their declaration of competing interest.

© 2015 Elsevier Ltd. All rights reserved., Introduction: Perfectionism constitutes a risk factor for the development of eating disorders. In overweight women, knowledge about the nature of this association is scarce. Objectives: To investigate the relationship between perfectionism, eating behaviors and affect in overweight women. Methods: The Portuguese versions of the Eating Disorder Examination Questionnaire/EDEQ, the Multidimensional Perfectionism Questionnaire and the Profile of Mood States were administered to an outpatient sample of 276 women (mean age = 43.85 ± 11.89 years; mean BMI = 32.82 ± 5.43 kg/m2). Results: Correlations between Socially Prescribed Perfectionism/SPP, EDEQ total (T) and its dimensional scores (Weight and Shape Concern and Dissatisfaction/WSCD, Eating Concern/EC, Dietary Restraint/DR) were significant (r N .30; p N .001). Self-Oriented Perfectionism/SOP was significantly correlated with EDEQ-T, WSCD and DR (r = .20). Participants with high (NM + SD) vs. low (bM-SD) SOP and SPP had significantly higher means in EDEQ-T, WSCD, EC and DR (p b .001). Linear regression showed that SPP was predictor of EDEQ-T and EC (p b .001). Conclusions: SPP and SOP are related to disordered eating in overweight women.

Background: New treatment approaches for psychosis indicate that effective interventions require a therapeutic focus on emotional regulation, cognitive appraisals, and functioning. Efficacy of psychotherapeutic interventions’ evaluation has changed from exclusively assessing symptom frequency/severity to a comprehensive and functional assessment of interference, functioning, and the relationship people have with symptoms. This shift led to new needs in clinical assessment. This study aimed to develop and submit to expert evaluation a new clinical interview for psychotic disorders which considers the new needs of the field. Methods: CIPD was developed by a multidisciplinary team considering the DSM-5 criteria for psychotic and affective disorders. Relevant information was retrieved from leading research in the area of assessment and evaluation of interventions in psychosis. An expert panel of recognized professionals in the main areas of mental health evaluated each question of the interview (5-point Likert scale) regarding pertinence and clarity. Results: A detailed description of CIPD is presented. Results from the experts’ evaluation showed that, overall, the CIPD questions were evaluated as pertinent and clear for the target population. Conclusion: CIPD assesses both diagnosis or presence of psychotic symptoms and symptoms’ psychosocial correlates. Psychotherapy and pharmacotherapy may benefit from CIPD since it may detect subtle changes caused by intervention and changes in areas other than symptom reduction. info:eu-repo/semantics/publishedVersion

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 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 Perfectionism has been associated with a plethora of medical conditions and psychopathological symptoms/disorders. 1 However, the potential impact of perfectionism in different chronic pain conditions is scarcely explored. Objectives Compare patients with fibromyalgia (FM), rheumatoid arthritis (RA) and pain-free controls regarding mean scores of perfectionism dimensions and cognitions; and test if perfectionism dimensions are significantly associated with the disease group. Methods Participants were recruited among consecutive attendees with FM, RA and pain-free controls at rheumatology and gynecology practices in Coimbra. Patients with FM and RA satisfied currently accepted classification criteria. 2,3 The absence of chronic pain in healthy controls (HC) was established by a score of zero in the London Fibromyalgia Epidemiological Study Screening 4 . All participants completed the Portuguese versions of the Frost and of the Hewitt and Flett Multidimensional Perfectionism Scales (MPS) and the Multidimensional Perfectionism Cognitions Inventory. To achieve our aims, descriptive analyses, one-way independent ANOVA (followed by post hoc tests) and linear multiple regression (LMR) were performed. Results The total sample comprised 302 participants [103 FM (34.11%), 98 RA (32.45%) and 101 HC (33.44%)]. Differences between samples were found regarding age (F=30.598; p p Results revealed significant differences between the samples regarding: parental criticism (PC), organization (O), Frost-MPS total score, perfectionism cognitions related with concern over mistakes (CoM) and pursuit of perfection (PP). Post hoc comparisons indicated that FM patients exhibited higher levels than RA patients and HC in all of these variables (except for PP that did not significantly differ between FM and HC). No significant differences were found between RA and HC, except for PC and O, with RA patients scoring higher. Regarding LMR, the model was significant (F(8,245)=5,203; p p t =-2.567; p=.011) significantly predicting the type of sample. Conclusions FM patients seem to be noticeably more perfectionistic than RA patients and HC, which in turn, do not differ significantly, in the majority of the perfectionism traits and cognitions. PC and O appear to be the most discriminative perfectionism dimensions. Perfectionism seems a variable of utmost importance, especially in FM, and may deserve consideration as a target for interventions. References Sirois F & Molnar DS (Eds). Perfectionism, health and well-Being. Springer International Publishing, 2016. Wolfe F et al. The American College of Rheumatology. Criteria for the classification of Fibromyalgia. Report of the multicenter criteria committee. Arthritis Rheum 1990; 33: 160–172. Arnett FC et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum, 1988; 315–324. White KP et al. Testing an instrument to screen for fibromyalgia syndrome in general population studies: The London Fibromyalgia Epidemiology Study Screening Questionnaire. J Rheumatol. 1999; 26: 880–884. Disclosure of Interest None declared

IntroductionSelf-Concealment Scale (SCS) is composed of ten items to measure self-concealment, defined as a tendency to conceal from others personal information that one perceives as distressing or negative (Larson and Chastain, 1990).ObjectiveTo investigate the psychometric properties of the SCS-10 Portuguese version and of an adapted version containing two additional items specifically focused on self-concealment related do health problems (physical and psychological)–SCS-12.MethodsThe Portuguese version of the SCS-12 and other validated questionnaires designed to evaluate self-reported health, perfectionism and optimism-pessimism were administered to a convenience sample of 555 adults from the community (60.5% females; mean age = 43.49 ± 10.565).ResultsThe SCS-10 and SCS-12 Cronbach's alphas were α < 0.80. In both versions, all the items contribute to the internal consistency. The factor analysis, following the Kaiser and the Cattel's Scree Plot criteria, revealed that SCS-10 is unidimensional and that SCS-12 reliably and validly evaluates two dimensions: F1 Keeping secrets (Explained variance = 48.60%; α = 0.816), F2 Personal concealment including health problems (9.65%; α = 0.797). The pattern of correlations of the SCS dimensional and total scores was as follow: negative low correlations with physical health (@−0.20), negative moderate correlations with psychological health (@–.30), moderate correlations with self-oriented perfectionism, social-prescribed perfectionism, pessimism (@0.25) and optimism (@−0.20).ConclusionsThe Portuguese versions of SCS have good reliability and validity (construct and convergent-divergent). The factorial structure partially overlaps with the original. SCS could be useful for research proposes, namely in an ongoing project on the role of the mentioned personality traits on illness and health behavior.Disclosure of interestThe authors have not supplied their declaration of competing interest.

IntroductionSeveral studies have demonstrated a strong link between fibromyalgia, negative affect (NA) and depression. However, it remains unclear why some fibromyalgia patients get depressed while others do not and, primarily, which mechanisms account for this difference. We hypothesize that, besides clinical features, the engagement in dysfunctional strategies like perseverative negative thinking (PNT) followed by an amplification of NA levels may increase the risk of fibromyalgia patients experiencing depressive symptoms.Objective/AimsTo explore the serial mediator effect of PNT and NA on the relationship between fibromyalgia symptoms and depressive symptoms.MethodsHundred and three women with fibromyalgia (mean age 47.32 ± 10.63) completed the Portuguese version of the Revised-Fibromyalgia Impact Questionnaire, Perseverative Thinking Questionnaire, Profile of Mood States and Beck Depression Inventory-II. The association between the variables was investigated via Pearson correlations and serial multiple mediation.ResultsThe estimated model was significant [F (3.86) = 57.318, P < .001] explaining 66.66% of depressive symptoms variance. The total effect of fibromyalgia symptoms on depressive symptoms was of .4998 (SE = 0.0795, P < 0.001; CI > 0.3417 and < 0.6578), with a significant direct effect of 0.1911 (SE = 0.0653; CI > 0.0614 and < 0.3209). The total indirect effects were of 0.3086 (SE = 0.0619; CI > 0.2033 < 0.4458). Three significant specific indirect effects were found.ConclusionThe effect of fibromyalgia symptoms on depressive symptoms is partially operated through cognitive interference/unproductiveness, which in turn influences NA levels. Such findings highlight the crucial role of these constructs in the relationship between fibromyalgia symptoms and depressive symptoms and the urge to address them when treating individuals reporting greater fibromyalgia symptoms.Disclosure of interestThe authors have not supplied their declaration of competing interest.