The role of feared possible selves in obsessive–compulsive and related disorders: A comparative analysis of a core cognitive self‐construct in clinical samples

Increasingly, cognitive‐behavioural models have been considering the role of beliefs about the self in the development and maintenance of obsessive–compulsive disorder (OCD), including sensitive domains of self‐concept and feared self‐perceptions. This has led to the development of the Fear of Self Questionnaire (FSQ; Aardema et al., 2013 ), which has shown strong internal consistency, divergent and convergent validity, and found to be a major predictor of unwanted thoughts and impulses (i.e., repugnant obsessions). The current study aimed to investigate fear of self‐perceptions using the FSQ in an OCD sample (n = 144) and related psychological disorders (eating disorders, n = 57; body dysmorphic disorder, n = 33) in comparison to a non‐clinical (n = 141) and clinical comparison group (anxiety/depressive disorders, n = 27). Following an exploratory factor analysis of the scale in the OCD sample, the results showed that participants with OCD in general did not score significantly higher on fear of self‐perceptions than did the clinical comparison participants. However, consistent with previous findings, fear of self was highly characteristic among OCD patients with unwanted repugnant thoughts and impulses. In addition, fear of self‐perceptions were significantly more elevated in those with eating or body dysmorphic disorders relative to the other non‐clinical and clinical groups. The construct of a “feared possible self” may be particularly relevant in disorders where negative self‐perception is a dominant theme, either involving concerns about one's inner self or concerns related to perceived bodily faults.     

Psychometric evaluation of the body investment scale for use with adolescents

We conducted two studies to examine the psychometric properties of the Body Investment Scale (BIS; Orbach & Mikulincer, 1998) in U.S. adolescent samples. The BIS was designed to assess bodily experiences that are associated with suicide‐related behaviors. In Study 1, confirmatory factor analysis (CFA) with data from a combined sample of 204 high school adolescents (83 boys, 121 girls) and 197 psychiatric inpatient (101 boys, 96 girls) adolescents provided moderate support for the oblique four‐factor solution: Body Feelings (ρ=.86, 95% CI=.83–.89), Body Touch (ρ=.71, 95% CI=.65–.76), Body Care (ρ=.78, 95% CI=.71–.81), and Body Protection (ρ=.78, 95% CI=.73–.82); robust comparative fit index=.88 and the robust Tucker Lewis Index=.83. The second‐order factor model also provided moderate fit to the data. In Study 2, results of the CFA with data from adolescent psychiatric inpatients (N=205; 101 boys, 104 girls) provided additional support for the four‐factor solution. In addition, results of the receiver operating characteristic and logistic regression analyses showed that scores on the Body Feelings and Body Protection scales were most useful in differentiating the responses of suicidal and nonsuicidal adolescents, all Cohen's d values >.30. The study also examined associations between scores on the BIS scales and the validation self‐report measures of hopelessness, suicide‐related behavior, and reasons for living. © 2009 Wiley Periodicals, Inc. J Clin Psychol 66: 259–276, 2010.     

Compassionate Attention and Regulation of Eating Behaviour: A pilot study of a brief low‐intensity intervention for binge eating

A low‐intensity 4‐week intervention that included components of compassion, mindfulness, and acceptance was delivered to women diagnosed with binge eating disorder. Participants were randomly assigned to 1 of 2 conditions: intervention (n  = 11) or waiting list control (n  = 9). Participants in the intervention condition were invited to practise mindfulness, soothing rhythm breathing, and compassionate imagery practices with a focus on awareness and acceptance of emotional states and triggers to binge eating and engagement in helpful actions. Results revealed that, in the intervention group, there were significant reductions in eating psychopathology symptoms, binge eating symptoms, self‐criticism, and indicators of psychological distress; there were significant increases in compassionate actions and body image‐related psychological flexibility. Data suggest that developing compassion and acceptance competencies may improve eating behaviour and psychological well‐being in individuals with binge eating disorder.     

Psychometric properties of the Spanish version of the involvement evaluation questionnaire in caregivers of patients with borderline personality disorders

The involvement evaluation questionnaire (IEQ) was created to evaluate the caregiver's experience of burden and the consequences of providing care to people with psychotic disorders. To date, the IEQ has not been validated with caregivers of people diagnosed with borderline personality disorder (BPD). The main objective of the study was to confirm the psychometric properties and factorial structure of the Spanish version of the IEQ in 151 caregivers of people with BPD, with an average age of 54.52 (SD = 9.91). Two models were tested by means of confirmatory factor analysis, following the original factor structure. The Models 1 and 2 displayed adequate fit, with comparative fit index and Tucker‐Lewis index > 0.90 and root‐mean‐square root of approximation < 0.08; however, Model 2 was more parsimonious. The Cronbach's alphas are adequate, ranging from 0.70 to 0.85. The consequences of providing care to people with BPD had a low or moderate association with the Level of Expressed Emotion scores. IEQ scores of caregivers of people diagnosed with BPD with psychiatric comorbidity did not differ from those of caregivers of people diagnosed with BPD without psychiatric comorbidity. The IEQ has adequate psychometric properties and can be utilized to assess burden in caregivers of people with BPD.     

Relation Between Body Mass Index and Body Image in Spanish and Mexican Adolescents

This article aims to study the relation between Body Mass Index (BMI) and body image in adolescents from two different social environments in Spain and Mexico, and to compare the construction of an appropriate body scheme in youth from these two countries. The majority of participants were found to be in the normal weight category of BMI. No significant differences were found in BMI or body image comparing Mexican and Spanish adolescents. Regardless of the country of origin, youth belonging to the weight deficit category of BMI overestimated their body shape, whereas those pertaining to overweight and obesity categories underestimated it. Both over- and underestimating own body shape imply higher risk to suffer from behavioral and psychological distresses, such as eating disorders. Further research is recommended in order to analyze the social, educational, and emotional patterns related to this occurrence and to improve their quality of life.     

Body‐related cognitive distortions (thought–shape fusion body) associated with thin‐ideal exposure in female students—An ecological momentary assessment study

Etiological models of eating disorders (EDs) describe body dissatisfaction (BD)as one of the major influences fostering dysfunctional body‐related behaviour and disordered eating behaviour. BD is influenced by repeated exposure to thin ideals that evoke high self‐ideal discrepancy and result in body‐related cognitive distortions such as thought–shape fusion body (TSF‐B). The aim of this study was to investigate the covariation of daily media exposure and the experience of TSF‐B in a naturalistic setting. It was further analysed whether TSF‐B is associated with self‐ideal discrepancy, dysfunctional body‐related behaviour, and disordered eating behaviour. Moreover, person‐related predictors of TSF‐B were explored. Altogether, 51healthy female students (mean age 21.06years, SD = 1.76) participated in an ecological momentary assessment study with four daily surveys during 10consecutive days. Exposure with thin ideals in contrast to exposure to unspecific media contents went along with the experience of TSF‐B. TSF‐B was associated with higher self‐ideal discrepancy and dysfunctional body‐related behaviour as well as more pronounced disordered eating behaviour, suggesting that TSF‐B is a common phenomenon in young healthy females' everyday life. A main effect of trait measures (e.g., pre‐existing BD) on TSF‐B was observable but has no moderating effect. Thus, a specific vulnerability has not been detected.     

Four years comparative follow‐up evaluation of community‐based,step‐down,and residential specialist psychodynamic programmes for personality disorders

Although the fulcrum of service provision for personality disorder (PD) has shifted from hospital‐based to psychodynamically‐ and cognitively‐oriented outpatient programmes, very few studies have attempted to compare specialist moderate intensity outpatient programmes with specialist high‐intensity residential models, or to explore whether a period of inpatient treatment may be necessary to improve outcome and prognosis. In this article, we prospectively compare changes over a 4‐year period in 3 groups of patients with personality disorders (N  = 162) treated in a specialist community‐based (CBP, N  = 30), a step‐down (RT‐CBP, N  = 87), and a specialist residential programme (RT, N  = 45) in psychiatric distress, deliberate self‐injury, and suicide attempt using multilevel modelling and multivariate logistic regression analyses. The results showed that percentages of early‐dropout were significantly different (p  = .0001) for the 3 programmes (CBP = 13.4%, RT‐CBP = 10.2%, and RT = 41.4%). A significant interaction between treatment model and time was found for psychiatric distress (p  = .001), with CBP and RT‐CBP achieving more marked changes (g  = 1.20 and g  = 0.68, respectively) compared to RT (g  = 0.30) at 48‐month follow‐up. CBP and RT‐CBP were found to significantly reduce impulsive behaviour (deliberate self‐injury and suicide attempt) compared to RT. Severity of presentation was not found to be a significant predictor of outcome. Long‐term RT showed no advantage over long‐term CBP, either as stand‐alone or as step‐down treatment. Replication may be needed to confirm generalizability of results, and a number of limitations in the study design may moderate the inferences that can be drawn from the results.     

Body surface area equations for physically active men and women

Objectives

To improve predictive formulae for estimating body surface area (BSA) in healthy men and women using a modern three-dimensional scanner technology.

Methods

Body surface areas were obtained from a convenience sample of 1267 US Marines (464 women and 803 men) using a whole body surface scanner (Size Stream SS20). The reliability of SS20 measures of total and regional BSA within participants was compared across triplicate scans. We then derived a series of formulae to estimate SS20-measured BSA using various combinations of sex, height, and mass. We also assessed relationships between percent body fat measured by dual-energy x-ray absorptiometry and sex-specific formulae errors in Marines.

Results

Body surface areas recorded by the SS20 were highly reliable whether measured for the total body or by region (ICC ≥ .962). Formulae estimates of BSA from sex, height, and mass were precise (root-mean-square deviation, 0.031 m²). Errors from the Marine Corps formulae were positively associated with percent body fat for men (p = .001) but not women (p = .843).

Conclusions

Clinicians, military leaders, and researchers can use the newly developed BSA formulae for precise estimates in healthy physically active men and women. Users should be aware that height- and mass-based BSA estimates are less accurate for individuals with extremely low or high percent body fat.     

Psychometric properties of the Adolescent Sleep Hygiene Scale

This study evaluated the psychometric properties of the Adolescent Sleep Hygiene Scale (ASHS), a self‐report measure assessing sleep practices theoretically important for optimal sleep. Data were collected on a community sample of 514 adolescents (16–19; 17.7 ± 0.4 years; 50% female) participating in the late adolescent examination of a longitudinal study on sleep and health. Sleep hygiene and daytime sleepiness were obtained from adolescent reports, behavior from caretaker reports, and sleep‐wake estimation on weekdays from wrist actigraphy. Confirmatory factor analysis indicated the empirical and conceptually based factor structure were similar for six of the eight proposed sleep hygiene domains. Internal consistency of the revised scale (ASHSr) was α = 0.84; subscale alphas were: physiological: α = 0.60; behavioural arousal: α = 0.62; cognitive/emotional: α = 0.81; sleep environment: α = 0.61; sleep stability: α = 0.68; daytime sleep: α = 0.78. Sleep hygiene scores were associated positively with sleep duration (r = 0.16) and sleep efficiency (r = 0.12) and negatively with daytime sleepiness (r = ?0.26). Results of extreme‐groups analyses comparing ASHSr scores in the lowest and highest quintile provided further evidence for concurrent validity. Correlations between sleep hygiene scores and caretaker reports of school competence, internalizing and externalizing behaviours provided support for convergent validity. These findings indicate that the ASHSr has satisfactory psychometric properties for a research instrument and is a useful research tool for assessing sleep hygiene in adolescents.     

The influence of self‐criticism on depression symptoms among ambulatory patients with inflammatory bowel disease

Considering that self‐criticism is an important process in the development and maintenance of depression, and taking into account the stigma associated with inflammatory bowel disease (IBD), the present study aimed to analyse whether self‐criticism exacerbates the relationships of depression symptoms with IBD symptomatology and chronic illness‐related shame. The sample included 53 ambulatory IBD patients (66% females) with ages from 18 to 65. Moderation analyses were conducted using structural equation modelling. Self‐criticism exacerbated the associations of depression with IBD symptoms (b = 0.01; standard error [SE] = 0.00; Z = 3.73; P < .001) and illness shame (b = 0.02; SE = 0.01; Z = 2.40; P = .016). For the same level of IBD symptomatology or chronic illness‐related shame, those individuals who present more feelings of inadequacy towards the self, experience more symptoms of depression. This exacerbation effect is stronger when IBD symptomatology and chronic illness‐related shame are more intense. A high self‐critical IBD patient may view the illness and/or symptomatology as a flaw or error that should be self‐corrected. Physicians and other health professionals should be attentive to these pathological mechanisms and should attempt to alleviate them. It may be beneficial to refer high self‐critical patients to psychological care.     

自尊对进食障碍的影响:身体不满的中介作用

目的:考查自尊对进食障碍的影响并探讨身体不满的中介作用。方法:对1147名成都市初中女生施测进食症状检测表-21、自尊量表、身体不满量表,同时收集被试的身高、体重等人口学资料。结果:初中女生的自尊水平对进食障碍症状有显著的负向预测作用,自尊水平越低,进食障碍症状越多。初中女生的身体不满对进食障碍有显著的正向预测作用,身体不满在自尊和进食障碍症状之间起了的中介作用,身体不满是自尊与进食障碍症状关系的中介变量。结论:自尊以身体不满为中介,对进食障碍症状对进食障碍症状有负向的预测作用。     

Effects of the programmed cell death 1 (PDCD1) polymorphisms in susceptibility to systemic lupus erythematosus

The failure of immunological tolerance to self‐antigens plays a fundamental role in the pathogenesis of systemic lupus erythematosus (SLE). PD‐1 is an inhibitory receptor for regulating the immune system and preventing development of autoimmune disorders. This study aimed to determine the role of four single‐nucleotide polymorphisms (SNPs) within programmed cell death 1 (PDCD1 or PD‐1) gene and haplotypes defined by these SNPs in susceptibility to SLE in the Iranian population. Blood samples were obtained from 253 SLE and 564 healthy subjects. Red blood cells were lysed and genomic DNAs were extracted using salting‐out method. Genotype determinations of PD1.1, PD1.3, PD1.5 and PD1.9 SNPs were performed by polymerase chain reaction–restriction fragment length polymorphism (PCR‐RFLP), and 12 haplotypes were constructed by PDCD1 SNPs. Our results showed significant differences in PD1.5 genotype frequencies between patient and control groups (p < .001). The frequencies of PD1.5 C/C, C/T and T/T genotypes versus other genotypes in SLE patients significantly differed from healthy subjects (p < .001, p = .001 and p = .002, respectively). Allelic analysis indicated a significant association between the frequency of PD1.5C allele and development of SLE in our population (odds ratio [OR] = 1.91, 95% confidence interval [CI] = 1.51–2.42, p < .001). At the haplotype level, GGCC, GACT and GGCT haplotypes were significantly different between SLE and control groups (OR = 2.14, 95% CI = 1.73–2.66, p < .001; OR = 9.76, 95% CI = 4.47–21.3, p < .001; and OR = 0.32, 95% CI = 0.24–0.42, p < .001, respectively). Based on these findings, PD1.5 SNP and some haplotypes of PDCD1 contribute to SLE risk in the Iranian population.     

The assessment of cognitive‐behavioral therapy skills in patients diagnosed with health anxiety: Development and pilot study on an observer‐based rating scale

Cognitive‐behavioral therapy is a highly effective treatment of health anxiety, but it remains unclear through which mechanisms treatment effects prevail. Some evidence suggests that patients acquire skills—understood as techniques helping them reach therapy goals—through psychotherapy. In the current study, an observer‐based rating scale for the skills assessment of patients with health anxiety (SAPH) was developed and validated in a pilot study. Based on 177 videotapes, four independent raters evaluated the frequency of skills acquired during cognitive and exposure therapy among 66 patients diagnosed with health anxiety with the SAPH. Predictive validity was evaluated by the Yale–Brown Obsessive‐Compulsive Scale for Hypochondriasis. The SAPH demonstrated good interrater reliability (ICC_(1,2) = .88, p < .001, 95% CI [.81, .92]) and internal consistency (α = .94). Although patient skills did not significantly increase during three sessions, they significantly predicted a reduction in health anxiety symptoms at the end of treatment (R² = .35). Patients' skills are highly important within the treatment of health anxiety. By providing external ratings of patients' skills with good psychometric properties, our pilot data suggest that the SAPH may complement current tools for the assessment of skills, specifically in targeting health anxiety.     

Strengthening competence of therapists‐in‐training in the treatment of health anxiety (hypochondriasis): Validation of the Assessment of Core CBT Skills (ACCS)

Although the observation and assessment of psychotherapeutic competences are central to training, supervision, patient care, quality control, and life‐long practice, structured instruments are used only occasionally. In the current study, an observation‐based tool for the Assessment of Core CBT Skills (ACCS) was translated into German and adapted, and its psychometric properties were pilot evaluated. Competence of therapists‐in‐training was assessed in a random sample of n = 30 videos on cognitive behavioural therapy including patients diagnosed with hypochondriasis. Two of three raters independently assessed the competences demonstrated in the entire, active treatment sessions (n = 60). In our sample, internal consistency was excellent, and interrater reliability was good. Convergent validity (Cognitive Therapy Scale) and discriminant validity (Helping Alliance Questionnaire) were within the expected ranges. The ACCS total score did not significantly predict the reduction of symptoms of hypochondriasis, and a one‐factorial structure of the instrument was found. By providing multiple opportunities for feedback, self‐reflection, and supervision, the ACCS may complement current tools for the assessment of psychotherapeutic competences and importantly support competence‐based training and supervision.     

A time sequence analysis of the relationship between cardiovascular risk factors,vascular diseases and restless legs syndrome in the general population

Previous cross‐sectional studies regarding the association of restless legs syndrome (RLS) with cardiovascular morbidity are controversial. Our aim was to evaluate prospectively the relationship of cardiovascular risk factors and vascular diseases with incident RLS in the general population. The results are from two prospective population‐based cohort studies: the Dortmund Health Study (n = 1312, median follow‐up of 2.1 years) and the Study of Health in Pomerania (n = 4308, median follow‐up of 5.0 years). RLS status was assessed twice according to the minimal criteria. Diabetes, hypertension, myocardial infarction and stroke, as well as currently taken medications, were assessed as self‐reports. Body mass index and serum total cholesterol were also measured. The independent risks associated with each outcome were estimated by multivariable logistic regression models adjusted for comorbidities and behavioural factors. Obesity was an independent risk factor of incident RLS in the Dortmund Health Study, and higher body mass index was an independent risk factor in both studies. Diabetes, hypertension and hypercholesterolaemia were independent predictors of incident RLS in the Study of Health in Pomerania. The vascular comorbidity index, defined by the number of concurrent cardiovascular risk factors and vascular diseases, showed a positive association with incident RLS in both studies. RLS at baseline was not a significant predictor of any subsequent cardiovascular risk factors and/or vascular diseases in any of the studies. Cardiovascular risk factors and diseases predict the subsequent development of RLS in the general population. The presence of RLS is not a significant risk factor of cardiovascular morbidity.     

A dimensional examination of eating disorder symptoms in relation to cognitive processing: An event‐related potentials study

Identifying neurocognitive mechanisms involved in individuals experiencing eating disorder (ED) symptoms may be important for preventing EDs and improving rates of recovery. The present pilot study assessed how cognitive functioning may be associated with ED symptoms in college students (N = 41). Cognitive functioning was examined using electroencephalography during an auditory response inhibition task to measure the P3 component of event‐related potentials. Multiple regression analysis revealed that longer P3 latencies in the frontal region of the cortex were significantly and linearly associated with greater ED symptoms F(3, 37) = 13.62, p < .001, R² = 0.525, Adj. R² = 0.486. These pilot findings build upon prior work in clinical samples in that they indicate that functional brain differences are observable across a wide span of ED symptoms, not just in those with diagnosed ED. The present findings provide support for further exploration of changes in P3 latencies among individuals with ED symptoms to enhance our understanding of neural mechanisms that may pertain to the dimensional aspects of disordered eating attitudes and behaviors.     

Effect of maternal HIV infection,BMI and NOx air pollution exposure on birth outcomes in South African pregnant women genotyped for the p53 Pro72Arg (rs1042522)

Tumour suppressor protein, p53, plays a role in modulating innate immune responses, DNA repair, cell cycle arrest, senescence and apoptosis. Maternal nitrogen oxide (NOx) air pollution exposure, body mass index (BMI), human immunodeficiency virus (HIV) infection and p53 Pro72Arg (rs1042522) affect foetal growth. We investigated whether the aforementioned factors influence birth outcomes in a South African population. Pregnant women (n = 300; HIV ?ve = 194 and HIV +ve = 106) were genotyped for the p53 rs1042522 using polymerase chain reaction–restriction fragment length polymorphism (PCR‐RFLP), and further stratified based on HIV status, infants' birthweight (BW; NBW: normal BW [>2,500 g] and LBW: low BW [<2,500 g]) and gestational age (GA; NGA: normal GA [>37 weeks] and PTB: preterm birth [≤37 weeks]). A land use regression model was developed to characterize maternal NOx exposure. Pearson's correlation and multivariate regression analysis statistical tests were used to determine the effect of rs1042522 genotyped pregnant women's BMI and NOx exposure on maternal blood pressure and haemoglobin and iron levels, and infants' anthropometric measurements and Appearance Pulse Grimace Activity and Respiration (APGAR) scores. The prevalence of LBW and PTB was 14.7% and 18.7%, respectively. The LBW group had a higher frequency of the variant Arg‐allele versus NBW group (47.7% vs. 31.4%, p = .0046, OR = 2.0, 95% CI = 1.26–3.17). No association was observed between NGA and PTB groups. A significant association between BMI and systolic blood pressure (r = .50, p = .00; B = 0.76, p = .002) and birth length (r = ?.28, p = .01; B = ?0.107, p = .011), and NOx and birth length (r = ?.26, p = .08; B = ?0.191, p = .046) and birthweight (B = ?8.87, p = .048) was observed in HIV‐infected mothers with the variant Pro/Arg + Arg/Arg genotypes. Mothers from the LBW group with the variant genotypes displayed an association between NOx and diastolic blood pressure (r = .58, p = .04), blood iron levels (r = ?.60, p = .04; B = ?0.204, p = .004), APGAR scores at 1 min (r = ?.86, p = .00; B = ?0.101, p = .003) and 5 min (r = ?.75, p = .01) and birth length (r = ?.61, p = .04), and BMI and diastolic blood pressure (r = .72, p = .01). In the PTB group, maternal variant genotypes and NOx were associated with blood haemoglobin levels (B = ?0.132, p = .045) and APGAR scores at 1 min (B = ?0.161, p = .045) and 5 min (B = ?0.147, p = .043). Maternal rs1042522 Arg‐allele, HIV infection, BMI and NOx exposure collectively play a role in lowering blood iron levels, gestational hypertension and LBW outcomes.     

Validation of the Serbian version of the Metacognitions Questionnaire‐30 in nonclinical and clinical samples

The Metacognitions Questionnaire (MCQ‐30) is a brief multidimensional measure used for assessment of metacognitive beliefs in psychopathology. The aim of this study was to assess the psychometric properties of MCQ‐30 in Serbian nonclinical (n = 246) and clinical (n = 171; anxiety and depressive disorders) samples. The reliability of the questionnaire and its subscales was satisfactory. An exploratory factor analysis yielded a five‐factor solution in both groups, whereas a confirmatory factor analysis showed a somewhat weaker fit of the model. The MCQ‐30 showed positive associations with measures of anxiety, pathological worry, depressive, and obsessive–compulsive symptoms in both samples, demonstrating adequate convergent validity. The instrument was sensitive to differences in metacognitive beliefs between nonclinical and clinical samples. MCQ‐30 subscales showed incremental contributions in predicting pathological worry after controlling for the variance in obsessive–compulsive symptoms and vice versa. Our results suggest that the MCQ‐30 is a reliable and valid instrument for assessing metacognitive beliefs in both nonclinical and clinical samples. Moreover, the findings support the use of the MCQ‐30 in Serbian population and extend support for the metacognitive model.     

Poor sleep quality associates with self‐reported psychiatric and cardiometabolic symptoms independently of sleep timing patterns in a large sample of rural and urban workers

Poor sleep associates with mental and cardiometabolic pathological outcomes. The participation of sleep timing features in the pathways by which this relationship occurs is not clear. This study aims to evaluate the interrelationship between sleep quality and self‐reported psychiatric/cardiometabolic symptoms, considering mediation and moderation effects of sleep timing patterns, and urban versus rural work environment, respectively; and to verify the association between sleep quality and polymorphisms of AANAT, RORA and TIMELESS genes. An epidemiological survey was performed in a rural area in southern Brazil. Eight‐hundred and twenty‐nine subjects were evaluated for sleep quality using the Pittsburgh Sleep Quality Index, and sleep timing patterns using the Munich Chronotype Questionnaire. Work characteristics and psychiatric/cardiometabolic symptoms were assessed using a structured self‐report questionnaire. Three polymorphisms of AANAT, RORA and TIMELESS (rs3760138, rs782931 and rs774045, respectively) were genotyped in blood samples. We found statistically significant associations of poor sleep quality with self‐reported psychiatric symptoms (B = 0.382; 95% CI 0.289–0.476; adjusted p‐value <.001), and with self‐reported cardiometabolic symptoms (B = 0.079; 95% CI 0.013–0.151; adjusted p‐value = .048). The genetic analysis showed that RORA GA/AA genotype was associated to poor sleep quality (B = 0.146, 95% CI 0.054–0.239; adjusted p‐value = .004). No moderated mediation effects were observed in the conditional analysis. TIMELESS polymorphism was not included in the analysis due to the low frequency of risk genotypes. These results yield new insights regarding the interrelationship between sleep characteristics and psychiatric/cardiometabolic self‐reported symptoms, taking into account genes related to the biological clocks and melatonin pathways.     

SPINK5 is associated with early‐onset and CHI3L1 with late‐onset atopic dermatitis

We have recently showed that filaggrin (FLG) mutations are associated only with early‐onset of AD, but not with late‐onset of AD. Consequently, other susceptibility genes should receive attention, especially in patients with late‐onset of AD. Our aim was to assess the associations between development of AD and the polymorphisms rs2303067 in SPINK5 and rs490928 in CHI3L1. A study population of 241 AD patients and 164 healthy controls was genotyped for two polymorphisms (rs2303067 in SPINK5 and rs490928 in CHI3L1). Rs2303067 in SPINK5 was significantly associated with early‐onset AD (≤8 years: p = .003; OR = 2.57) and was characterized by the need for hospitalization (p = .006; OR = 2.76), prolonged duration (≥10 years; p = .008; OR = 2.32) and more body parts affected (p = .015; OR = 2.01). In contrast, rs490928 in CHI3L1 was associated with late‐onset AD (>8 years: p = .048; OR = 1.65) and was characterized by no need for hospitalization (p = .049; OR = 1.59), shorter duration (<10 years; p = .017; OR = 1.94) and fewer body parts affected (p = .049; OR = 1.75). Our results confirmed that different AD phenotypes, specifically early‐ and late‐onset AD, have different genetic backgrounds. Early‐onset AD was associated with rs2303067 in SPINK5, which is involved in skin barrier functioning, and late‐onset was associated with rs4950928 in CHI3L1, which is involved in the immune response. Future studies should examine the early‐ versus late‐onset subgrouping more closely.