Parent-Child Relationship Scale (P-CRS): A valid and clinically sensitive tool for assessing the parent-child relationship.

The present study measured the efficacy of the Parent-Child Relationship Scale (P-CRS) in assessing the relationship between parents and children. The aims of the study were to explore how the scale scores change in relation to age and sex of the children, evaluate its ability to capture relational difficulties, and investigating its usefulness to assess the parent-child relationship in the context of certain psychopathological conditions. A total of 322 clinicians rated 542 mother-child dyads (92% Italian, 8% other nationality). The clinical group was comprised of 267 children with confirmed clinical conditions. The control group was comprised of 275 children with typical development, rated by clinicians in their private offices after four to five evaluative sessions. Descriptive statistics were captured and ANOVAs and linear regression analyses were performed to investigate in both groups the efficacy of the scale in assessing the parent-child relationship. Finally, to test P-CRS accuracy, optimal cutoff scores for each subscale were computed using the ROC method. The findings provide evidence for the P-CRS ability to capture relational difficulties in both groups, showing its utility as screening tool. Thus, the results support that P-CRS can be used for exploring how different relationship patterns can occur in different clinical conditions.

El presente estudió midió la efectividad de la Escala de la Relación Progenitor-Niño (P-CRS) para evaluar la relación entre progenitores y niños. El propósito del estudio fue explorar cómo los puntajes de la escala cambian en relación con la edad y el sexo de los niños, evalúa su habilidad de captar las dificultades en la relación, e investiga su utilidad para evaluar la relación entre progenitor y niño dentro del contexto de ciertas condiciones sicopatológicas. Trescientos veintidós clínicos evaluaron 542 díadas madre-niño (92% italianas, 8 % otras nacionalidades). El grupo clínico estuvo compuesto de 267 niños con condiciones clínicas confirmadas. El grupo de control estuvo compuesto de 275 niños con un desarrollo típico, evaluados por los clínicos en sus oficinas privadas después de cuatro a cinco sesiones evaluativas. Se captaron estadísticas descriptivas y se llevaron a cabo análisis de variación (ANOVA) y análisis de regresión lineal, para investigar en ambos grupos la efectividad de la escala para evaluar la relación progenitor-niño. Finalmente, para demostrar la precisión de P-CRS, se calcularon los puntajes límites óptimos para cada subescala, usando el método ROC. Los resultados proveen evidencia de la habilidad de P-CRS de captar las dificultades de la relación en ambos grupos, demostrando su utilidad como herramienta de detección. De manera que los resultados apoyan el hecho de que P-CRS puede usarse para explorar cuán diferente los patrones de relación pueden ocurrir bajo diferentes condiciones clínicas.

Cette étude a mesuré l'efficacité de l'Echelle de Relation Parent-Enfant (Parent-Child Relationship Scale en anglais, soit P-CRS) en évaluant la relation entre les parents et les enfants. Les buts de l'étude étaient d'explorer comme les scores de l'échelle changement en relation à l'âge et au sexe des enfants, d'évaluer sa capacité à capturer les difficultés relationnelles, et de comprendre son utilité pour l'évaluation de la relation parent-enfant dans le contexte de certaines conditions psychopathologiques. 322 cliniciens ont évalué 542 dyades mère-enfant (92% Italiennes, 8% autre nationalité). Le groupe clinique comprenait 267 enfants avec des conditions cliniques confirmées. Le groupe de contrôle comprenait 275 enfants avec un développement typique, évalués par des cliniciens dans leurs cabinets médicaux après de trois à cinq sessions d'évaluation. Des statistiques descriptives ont été capturées et des ANOVA ainsi que des analyses de régression linéaire ont été faites afin d'établir chez les deux groupes l'efficacité de l'échelle à évaluer la relation parent-enfant. Enfin, pour tester la précision de l'a P-CRS, des scores limite optimaux pour chaque sous-échelle ont été calculés en utilisant la méthode ROC. Les résultats montrent la capacité de la P-CRS à capturer les difficultés relationnelles chez les deux groupes, montrant son utilité en tant qu'outil de dépistage. Par conséquent les résultats soutiennent que la P-CRS peut être utilisé pour explorer la manière dont des patterns de relation différents peuvent apparaître dans des conditions cliniques différentes.

Procedural Anxiety, Pain Catastrophizing, and Procedure-Related Pain during EGD and Colonoscopy.

OBJECTIVES: Although sedatives and analgesic drugs defuse anxiety and relieve pain, digestive endoscopy still is uncomfortable and painful for some patients. Identifying patients who tolerate digestive endoscopy less well remains difficult. The present study evaluated the relations between procedural anxiety, catastrophizing thoughts, and pain, using a prospective design and multimodal assessments of pain. METHODS: A total of 118 consecutive patients were assessed for procedural anxiety before endoscopy. During endoscopy, a doctor rated the patients' pain behavior. Before discharge, the patients retrospectively rated endoscopy pain and related catastrophizing thoughts. RESULTS: Notwithstanding sedation, our study revealed large between-subject variability in pain. Catastrophizing thoughts mediated the relation between procedure-related pain observed by the doctor and pain intensity reported by the patient. Catastrophizing thoughts also mediated the effect of procedural anxiety. Our study showed that anxiety exacerbates endoscopy pain when the patient engages in ruminative thinking and feels unable to cope with unpleasant bodily sensations. CONCLUSIONS: This study shows that catastrophizing thoughts account for between-subject differences in endoscopy pain. Rumination and helplessness but not magnification explain how procedural anxiety may evolve in a painful endoscopy experience. To the extent that one can address catastrophizing thoughts, endoscopy pain can be mitigated, especially for patients who are difficult to sedate.

The assessment of mindfulness skills: the "what" and the "how".

Background: The five facets mindfulness questionnaire-short form (FFMQ-SF) is a new, brief measure for the assessment of mindfulness skills in clinical and nonclinical samples. The construct validity of the FFMQ-SF has not been previously assessed in community samples.Aims: The present study investigated the factor structure of the Italian version of the FFMQ-SF.Method: Structured equation modeling was used to test the fit of three alternative models in a sample of highly educated adults (n = 211).Results: A hierarchical model with a single second-order factor loaded by observing, describing, and acting with awareness (i.e. the mindfulness "what" skills) performed slightly better than both a five-factor model with correlated factors and a hierarchical model with a general second-order factor. The FFMQ-SF scores were significantly higher than those reported in both Dutch depressed patients and Australian undergraduate students for all facets (but nonreactivity for the Australian sample).Conclusions: Data support the multifaceted nature of mindfulness skills. Because of its brevity and simplicity of use, the FFMQ-SF is a promising questionnaire in longitudinal and clinical research. This questionnaire can serve as a guideline to help clinicians assess and monitor mindfulness skills acquisition, strengthening, and generalization, and prioritize mindfulness skills that need immediate attention.

Efficacy of Sedation by Midazolam in Association With Meperidine or Fentanyl and Role of Patient Distress During Elective Colonoscopy.

Meperidine and fentanyl are opioids currently used in addition to midazolam for sedation and analgesia during colonoscopy in Italy. The aim of the study was to assess the impact of patients' psychological state before elective colonoscopy on the efficacy of the sedation regimens. Eighty outpatients who underwent an elective colonoscopy were included in our study. The Hospital Anxiety and Depression Scale questionnaire was self-administered to evaluate basal anxiety and depression state. The rate of baseline discomfort was evaluated by a standard 100-mm visual analog scale. Sedation was obtained alternatively with a midazolam-meperidine or midazolam-fentanyl combination. There were no statistically significant differences between the fentanyl and meperidine groups on body mass index, age, and gender composition. Patients in the meperidine group reported less pain during colonoscopy than patients in the fentanyl group. There were statistically significant positive correlations in the meperidine group with the distress, anxiety, and depression. Our study has pointed out greater effectiveness of the midazolam plus meperidine regimen, equal recovery times, and no significant differences in the duration of the endoscopic examinations. The evaluation of patients' psychological status seems to predict the efficacy of sedation when the nociceptive component of pain is well controlled.

Biopsychosocial Correlates of Adjustment to Cancer during Chemotherapy: The Key Role of Health-Related Quality of Life.

BACKGROUND: Patients adjust to cancer in a continuous process that follows the course of the disease. Previous research has considered several illness-related variables and demographics, quality of life, personality, and social factors as predictors of adjustment to cancer, which can be maladaptive (e.g., helplessness-hopelessness and anxious preoccupation) or adaptive (e.g., fighting spirit). AIMS: Assuming a biopsychosocial view, we test an empirical model in which disease stage, patient's age, and gender are viewed as the distal antecedents of positive and negative adjustment to cancer for chemotherapy patients. Health-related quality of life (HRQoL) has a key role, interposing between the distal antecedents and adaptational outcomes. Social support and positive thinking are also included in the model as related to adjustment. METHODS: One-hundred-sixty-two consecutive cancer patients receiving adjuvant or standard chemotherapy participated in the study. Patients completed the Mini-Mental Adjustment to Cancer, the Brief-COPE, the Social Provision Scale, and the SF-12 Health Survey. Partial least squares structural equation modeling (PLS-SEM) was applied for model building and hypotheses testing. RESULTS: We found a negative association between advanced stage and physical functioning, a strong positive link between physical functioning and mental health, and significant relations between mental health and helpless-hopelessness, anxious preoccupation, and cognitive avoidance. Social support and positive thinking were related to fighting spirit and fatalism. Cancer stage and female gender were indirectly associated with adaptational outcomes through HRQoL. The patient's age had no significant relationships in the model. DISCUSSION: HRQoL (both physical and mental) is a key factor for preventing maladjustment in chemotherapy patients. Social support and positive thinking coping style fosters fighting spirit and fatalism on health outcomes. Two potential lines of action seem promising: preventing maladaptive and promoting adaptive adjustments working on patient's mental health individually and involving significant others in supportive care, respectively.

Moral foundations, worldviews, moral absolutism and belief in conspiracy theories.

In the present research, we examined whether individual differences in basic moral concerns might be related to a greater endorsement of conspiracy theories. Building on the notion that conspiracy theories often deal with super-individual relevant events in which a group perspective is central, we proposed that individual differences in moral concerns pertaining to group- and community-concerns (i.e., binding moral foundations) rather than to individual well-being (i.e., individualising moral foundations) would be positively associated with conspiracy beliefs. We further hypothesised that such relations would be totally mediated by beliefs in a dangerous world and by embracing moral absolutism. We found support for these predictions in two community samples (Ns: 319; 514). Theoretical implications were discussed.

Alexithymia and risk preferences: Predicting risk behaviour across decision domains.

Risk-taking is a critical health factor as it plays a key role in several diseases and is related to a number of health risk factors. The aim of the present study is to investigate the role of alexithymia in predicting risk preferences across decision domains. One hundred and thirteen participants filled out an alexithymia scale (Toronto Alexithymia Scale-TAS-20), impulsivity and venturesomeness measures (I7 scale), and-1 month later-the Cognitive Appraisal of Risky Events (CARE questionnaire). The hierarchical regression analyses showed that alexithymia positively predicted risk preferences in two domains: aggressive/illegal behaviour and irresponsible academic/work behaviour. The results also highlighted a significant association of the alexithymia facet, externally oriented thinking (EOT), with risky sexual activities. EOT also significantly predicted aggressive/illegal behaviour and irresponsible academic/work behaviour. The alexithymia facet, Difficulty Identifying Feelings, significantly predicted irresponsible academic/work behaviour. The results of the present study provide interesting insights into the connection between alexithymia and risk preferences across different decision domains. Implications for future studies and applied interventions are discussed.

A confirmatory bifactor analysis of the Hospital Anxiety and Depression Scale in an Italian community sample.

BACKGROUND: The Hospital Anxiety and Depression Scale (HADS) is a widely used self-report measure to assess emotional distress in clinical populations. As highlighted in recent review studies, the latent structure of the HADS is still an issue. The aim of this study was to analyze the factorial structure of the HADS in a large community sample in Italy, and to test the invariance of the best fitting model across age and gender groups. METHODS: Data analyses were carried out on a sample of 1.599 participants proportionally stratified according to the Italian census population pyramid. Participants aged 18 to 85 years (females = 51.8%), living in eight different regions of Italy, voluntarily participated in the study. The survey questionnaire contained the HADS, Health Status questions, and sociodemographic variables. RESULTS: Confirmatory factor analysis indicated that a bifactor model, with a general psychological distress factor and two orthogonal group factors with anxiety and depression, was the best fitting one compared to six alternative factor structures reported in the literature, with overall good fit indices [Non-normed Fit Index (NNFI) = .97; Comparative Fit Index (CFI) = .98; Root Mean-Square Error of Approximation (RMSEA) = .04]. Multi-group analyses supported total invariance of the HADS measurement model for males and females, and for younger (i.e., 18-44 years old) and older (i.e., 45-85 years old) participants. Our descriptive analyses showed that females reported significant higher anxiety and general distress mean scores than males. Moreover, older participants reported significant higher HADS, anxiety and depression scores than younger participants. CONCLUSIONS: The results of the present study confirmed that the HADS has good psychometric properties in an Italian community sample, and that the HADS scores, especially the general psychological distress one, can be reliably used for assessing age and gender differences. In keeping with the most recent factorial studies, our analysis supported the superior fit of a bifactor model. However, the high factor loadings on the general factor also recommend caution in the use of the two subscales as independent measures.

MMPI-2: cluster analysis of personality profiles in perinatal depression­preliminary evidence.

BACKGROUND: To assess personality characteristics of women who develop perinatal depression. METHODS: The study started with a screening of a sample of 453 women in their third trimester of pregnancy, to which was administered a survey data form, the Edinburgh Postnatal Depression Scale (EPDS) and the Minnesota Multiphasic Personality Inventory 2 (MMPI-2). A clinical group of subjects with perinatal depression (PND, 55 subjects) was selected; clinical and validity scales of MMPI-2 were used as predictors in hierarchical cluster analysis carried out. RESULTS: The analysis identified three clusters of personality profile: two "clinical" clusters (1 and 3) and an "apparently common" one (cluster 2). The first cluster (39.5%) collects structures of personality with prevalent obsessive or dependent functioning tending to develop a "psychasthenic" depression; the third cluster (13.95%) includes women with prevalent borderline functioning tending to develop "dysphoric" depression; the second cluster (46.5%) shows a normal profile with a "defensive" attitude, probably due to the presence of defense mechanisms or to the fear of stigma. CONCLUSION: Characteristics of personality have a key role in clinical manifestations of perinatal depression; it is important to detect them to identify mothers at risk and to plan targeted therapeutic interventions.

Self-regulation predicts risk-taking through people's time horizon.

In the context of decision-making research, people's regulatory orientation mode (i.e., assessment and locomotion modes) has been included among the most prominent individual difference variables, which may potentially account for choice behaviour. Thus, the main objective of our experiment was to investigate the relations between habitual use of regulatory mode and risk-taking through people's time horizon. Risk-taking was appraised using a behavioural measure (i.e., BART) 1 month following evaluation of habitual use of regulatory mode. The findings revealed a significant negative association between the assessment mode and risk-taking through individual differences in time horizon.

Family religiosity and climate: the protective role of personal interiorized religiosity in deviance propensity among justice-involved juveniles.

According to the literature, religious commitment could be a protective factor against dangerous behaviors, such as criminal offending, unsafe sex, and substance use. Our study aims to investigate the influence of Family Religiosity and climate on anger dysregulation and deviance propensity in a sample of 214 justice-involved boys from Italian Youth Detention Centers (range 14-25). The sample was divided into religious (n = 102) and non-religious (n = 112) justice-involved juveniles. Participants filled in the following questionnaires: Deviant Behavior Questionnaire, Aggression Questionnaire, Family Communication Scale, Moral Disengagement Scale, and the Multidimensional Scale of Perceived Social Support. We used a partial least square structural equation modeling (PLS_SEM) method to build our model and we found that Family Religiosity was positively associated with Family Climate which was negatively associated with Anger Dysregulation and Deviance Propensity, and Anger Dysregulation was positively related to Deviance Propensity. The multigroup analysis confirmed that for justice-involved juveniles who interiorized religious discipline and beliefs, Family Religiosity showed a positive association with Family Climate, which had a negative relationship with Anger Dysregulation, which strongly predicted Deviance Propensity. This result could be useful to promote new development goals and preventive activities and interventions based on positive religiosity values in juveniles' behavior.

Emotion regulation and risk taking: predicting risky choice in deliberative decision making.

Only very recently has research demonstrated that experimentally induced emotion regulation strategies (cognitive reappraisal and expressive suppression) affect risky choice (e.g., Heilman et al., 2010). However, it is unknown whether this effect also operates via habitual use of emotion regulation strategies in risky choice involving deliberative decision making. We investigated the role of habitual use of emotion regulation strategies in risky choice using the "cold" deliberative version of the Columbia Card Task (CCT; Figner et al., 2009). Fifty-three participants completed the Emotion Regulation Questionnaire (ERQ; Gross & John, 2003) and--one month later--the CCT and the PANAS. Greater habitual cognitive reappraisal use was related to increased risk taking, accompanied by decreased sensitivity to changes in probability and loss amount. Greater habitual expressive suppression use was related to decreased risk taking. The results show that habitual use of reappraisal and suppression strategies predict risk taking when decisions involve predominantly cognitive-deliberative processes.

Intolerance of Uncertainty and Emotional Processing in Adolescence: Separating Between-Person Stability and Within-Person Change.

Previous research on the relation between Intolerance of Uncertainty (IU) and Emotional Processing (EP) during adolescence is limited. The present study aimed to clarify how IU and EP evolve over time, to what extent they are related, and whether changes in one precede or follow changes in the other. A total of 457 Italian adolescents (53.1% girls) aged 11 to 18 years (M = 14.1 ± 2.27) completed the IU and EP scales on three separate occasions three months apart (T1, T2, and T3). Data were modeled using a Random-Intercept Cross-Lagged Panel Model (RI-CLPM) that separates individual differences between individuals from intraindividual changes. Descriptive analyses showed that IU was relatively stable between T1 and T2 and decreased slightly between T2 and T3. Consistent with the view that emotion regulation improves as adolescents develop, EP difficulties were found to decrease between T1 and T2 and between T2 and T3. The RI-CLPM revealed a strong between-person effect, showing that individual differences in IU and EP remained consistent throughout the study. In addition, significant within-person change was found, with adolescents who increased their IU at T1 and T2 also increasing their EP difficulties at T2 and T3, respectively. The opposite effect had a smaller effect size. In sum, our study showed that IU and EP are intertwined in adolescents and that changes in IU precede corresponding changes in EP. These results suggest a priority of change between IU and EP and confirm the relationship between IU and emotion regulation problems in adolescence.

The assessment of Intolerance of uncertainty in youth: An examination of the Intolerance of Uncertainty Scale-Revised in Italian nonclinical boys and girls.

Intolerance of Uncertainty (IU) is a transdiagnostic factor involved in several psychological disorders. Adolescence is characterized by elevated uncertainty and psychopathological vulnerability, but insufficient attention has been paid to IU at this age. This study aimed to investigate the factor structure and psychometric properties of the Intolerance of Uncertainty Scale-Revised (IUS-R) in Italian preadolescents and adolescents. 862 Italian students (57.3% girls) aged 11-17 (M = 14.8 ± 1.91) completed the IUS-R and measures of internalizing and externalizing symptoms, and psychological well-being. To test the factor structure of the IUS-R, one-factor, two-factor, and bifactor models were compared; measurement invariance, reliability, and validity were also addressed. Results showed that the bifactor model outperformed alternative factor models, and a general factor was needed to model the IUS-R. Bifactor model indices supported using the total score to assess IU reliably. Configural and metric invariance by age and sex were fully supported, while the IUS-R achieved partial scalar invariance. Significant correlations emerged for the IUS-R total score with psychopathological constructs, while no relationships with psychological well-being were found. Compared to adult normative data, higher total IUS-R scores were detected, suggesting that IU may be a phase-specific characteristic of adolescence. Our findings support using the IUS-R to measure IU across the lifespan. The recommended use of the total score and its associations with psychopathological dimensions highlight the transdiagnostic nature of IU in adolescence. Therefore, including IU when implementing interventions to prevent maladaptive outcomes in teenagers would be beneficial.

Daring and Distress: Insights on Adolescent Risk Taking and Difficulties in Emotion Regulation from a Network Analysis Perspective.

We explored the interrelationships between risk-taking and self-harm in typically developing adolescents by examining various contributing factors, such as personality traits, difficulties in emotion regulation, attachment styles, and maladaptive psychological functioning. A sample of 234 Italian adolescents completed the Risk-Taking and Self-Harm Inventory for Adolescents (RTSHIA), the Risk-Taking Questionnaire (RT-18), the Difficulties in Emotion Regulation Strategies (DERS), the State Adult Attachment Measure (SAAM), and the Youth Self-Report (YSR). Network analysis was used to visualize and describe the interdependencies among the variables. Risk-taking behaviors were strongly linked to rule-breaking, aggression, and risk propensity, while self-harm behaviors were connected to limited access to emotion regulation strategies and thought problems. Centrality indices indicated that variables such as anxiety/depression, limited access to emotion regulation strategies, and rule-breaking had a high influence within the network. This study provided a comprehensive understanding of the nomological network of risk-taking and self-harm behaviors among adolescents. It highlighted the relative importance of factors such as emotion regulation difficulties and maladaptive psychological functioning in influencing these behaviors. The findings could inform psychological interventions and prevention strategies targeting adolescents at risk for engaging in risk-taking or self-harm behaviors.

Analyzing Qualitative Changes in Metalinguistic Processing in Typically Developing 5- to 7-Year-Old Children.

This study was based on an analysis of some of the qualitative aspects underlying the findings of previous research into the metalinguistic abilities in 160 Italian-speaking, typically developing children aged from 5 to 7 years. This previous research had used six metalinguistic tasks, a nonverbal intelligence test, and two lexical- and grammar-comprehension tests. The outcomes showed a significant improvement in all the dependent variables in the age range considered, measured by a series of ANOVAs, with high correlation between all the variables and a strong homogeneity between the metalinguistic tasks, as revealed by a factor analysis. Using generalized estimating equation (GEE) analysis, the current study analyzed the cognitive levels of response that constituted the total score of each task, at each age (5-6, 6-7, and 7-8 years). Although based on the different distribution of the cognitive levels at each age and in each task, the results of this analysis further confirmed the significance of the developmental changes, and showed different developmental trajectories as a function of the specific task. These results are discussed in light of the different involvement of cognitive processes and literacy skills in the transitional phase between kindergarten and the first two years of primary school.

Navigating Intercultural Medical Encounters: An Examination of Patient-Centered Communication Practices with Italian and Foreign Cancer Patients Living in Italy.

Effective communication is crucial in cancer care due to the sensitive nature of the information and the psychosocial impact on patients and their families. Patient-centered communication (PCC) is the gold standard for providing quality cancer care, as it improves patient satisfaction, treatment adherence, clinical outcomes, and overall quality of life. However, doctor-patient communication can be complicated by ethnic, linguistic, and cultural differences. This study employed the ONCode coding system to investigate PCC practices in oncological visits (doctor's communicative behavior, patient's initiatives, misalignments, interruptions, accountability, and expressions of trust in participants' talk, Markers of uncertainty in doctor's talk, markers of emotions in doctor's talk). Forty-two video-recorded patient-oncologist encounters (with 22 Italian and 20 foreign patients), including both first and follow-up visits, were analyzed. Three discriminant analyses were conducted to assess differences in PCC between patient groups (Italian or foreign patients) according to the type of encounter (first visit or follow-up) and the presence or absence of companions during the encounters. Multiple regression analyses were performed to evaluate the PCC differences by oncologist age, patient age, and patient sex, controlling for the type of encounter, the presence of a companion during the visit, and patient group on ONCode dimensions. No differences were found in PCC by patient group in discriminant analyses and regressions. Doctor communication behavior, interruptions, accountability, and expressions of trust were higher in first visits than in follow-ups. The disparities in PCC were primarily linked to the type of visit and the age of the oncologist. However, a qualitative analysis showed notable differences in the types of interruptions during visits with foreign patients compared to Italian patients. It is essential to minimize interruptions during intercultural encounters to foster a more respectful and conducive environment for patients. Furthermore, even when foreign patients demonstrate sufficient linguistic competence, healthcare providers should not solely rely on this factor to ensure effective communication and quality care.

Separate but Related: Dimensions of Healthcare Provider Social Support in Day-Treatment Oncology Units.

Social support by healthcare providers has been increasingly investigated during the past decade, but studies have made different choices concerning its measurement. To evaluate how social support from a healthcare provider impacts the perceived quality of care and patient outcomes, reliable and valid instruments capable of measuring specific aspects of the construct are needed. In study 1, we tested the factor structure and the psychometric properties of a new Healthcare Provider Social Support measure (HPSS) for oncology settings. One-hundred-sixty-two patients (89 females; M age = 58.97, SD age = 13.28) from religious and government-operated hospitals completed the HPSS during day treatment. We modeled the HPSS factor structure to represent four related aspects: Emotional, Informational, Appraisal, and Instrumental social support. Study 2 preliminarily assessed the concurrent validity of the HPSS with patient perceptions of the patient-doctor relationship. Sixty-nine patients (40 females; M age = 53.67, SD age = 13.74) completed the HPPS with scales assessing perceived doctor-patient communication and patient trust in the healthcare provider. Study 1, using Exploratory Structural Equation Modeling, showed that a bifactor model had an excellent fit. The analysis supported the use of subscale scores, which were more tenable than a single total score in terms of bifactor model indices. This conclusion was also supported by greater scalability of the subscales in a Mokken Scale Analysis. Oncology patients treated in the religious hospital perceived greater Emotional, Informational, and Instrumental social support from their healthcare provider than those treated in government-operated. Study 2 showed that patient ratings of healthcare provider social support, except Instrumental, were positively correlated with better doctor communication skills and greater trust in the physician. Multiple regression analyses showed that Informational and Emotional support provided a unique contribution to building trust in the physician, controlling for the doctor's communication skills. The study results showed that the four social support ratings were reliable and valid, sharpening the distinction between functional components in the formal healthcare system.

Risk perceptions and COVID-19 protective behaviors: A two-wave longitudinal study of epidemic and post-epidemic periods.

We investigated how perceived risk and protective behaviors changed as the coronavirus epidemic progressed. A longitudinal sample of 538 people responded to a COVID-19 risk perception questionnaire during the outbreak and post-epidemic periods. Using Structural Equation Modeling (SEM), we examined the mean level change of selected constructs and differences in their relationships. We tested a risk perception pathway in which affective attitude, informed by experience, shaped risk perceptions and protective behaviors. The model also postulated a social pathway in which cultural worldviews, like individualism and hierarchy, predicted risk perceptions and protective behaviors through social norms. Latent mean difference analyses revealed a decrease in social distancing behaviors and an increase in hygiene-cleanliness, corresponding to a reduction in risk perceptions and social norms and a rise in direct and indirect experience, while affective attitude remained substantially stable. Cross-sectional and longitudinal path analyses showed that affective risk perception, primarily informed by affective attitude, and social norms promoted behavior consistency regardless of epidemic contingencies. Instead, analytic risk perceptions were linked to protective behaviors only during the outbreak. Although risk perceptions dropped over time, analytic risk perceptions dropped more steeply than affective risk perceptions. Our findings supported the distinction between affective and deliberative processes in risk perception, reinforcing the view that affective reactions are needed to deploy analytic processes. Our study also supports the claim that perceived social norms are essential to understanding cultural worldview-related protective behaviors variability.

Deliberative and Affective Risky Decisions in Teenagers: Different Associations with Maladaptive Psychological Functioning and Difficulties in Emotion Regulation?

Using network analysis, we investigated the relationships between maladaptive psychological functioning, difficulties in emotion regulation, and risk-taking in deliberative and affective behavioral decisions. Participants (103 adolescents aged between 13 and 19 years, 62% boys) took the Cold (deliberative) and Hot (affective) versions of the Columbia Card Task and completed the Youth Self-Report (YSR) and the Difficulties in Emotion Regulation Scale (DERS). In contrast to the view that risk propensity increases from preadolescence to middle adolescence and decreases at later ages, our study revealed no age-specific trend. YSR syndrome scales were significantly correlated with risk propensity, but only in the Cold version. The YSR Thought Problems scale was the most central node in the network, linking internalizing and externalizing problems with risk propensity in the Cold CCT. Lack of emotional Clarity was the only DERS consistently linked with risk-taking both in correlation and network analyses. Maladaptive psychological functioning and difficulties in emotion regulation were linked with risk propensity in affective risky decisions through deliberative processes. The statistical significance of direct and indirect effects was further examined using nonparametric mediation analyses. Our study highlights the role of cognitive factors that in each variable set might account for risk-taking in teenagers.