Lower urinary tract symptoms in young-middle aged males with a diagnosis of obstructive sleep apnea syndrome.

BACKGROUND: The aim of the current study is to measure the prevalence and the potential role of International Prostate Symptom Score (IPSS) score as a predictor of obstructive sleep apnea syndrome (OSAS) in male experienced lower urinary tract symptoms (LUTS). METHODS: A cross-sectional web-based Italian survey was administered via Google Forms between July 17 and October 31, 2022. The urinary functioning was measured through the IPSS questionnaire. Specifically, we considered symptoms occurring more than "about half the time" (score ≥ 3) as bothering symptoms. Multivariable logistic regression models (LRMs) adjusting for age, body mass index (BMI), International Index of Erectile Function-5, IPSS, and hypertension were fitted to predict OSAS in the cohort of men responding to the survey and experiencing LUTS. RESULTS: Overall, 58 (24.4%) patients had a confirmed diagnosis of OSAS. The overall median IPSS was 5 (inter quartile range [IQR]: 3-8), respectively. According to IPSS items, 24 (10%), 44 (18.4%), 12 (5%), 12 (5%), 12 (5%), 11 (4.6%), 63 (26.4%) patients exhibit incomplete bladder emptying, urinary frequency, intermittency, urgency, weak stream, straining, nocturia with a score ≥ 3, respectively. After multivariable LRMs predicting the developing OSAS, age (odds ratio [OR]: 1.09, p < 0.001), BMI (OR:1.12, p < 0.001) and IPSS total score (OR:1.08, p = 0.02) were independent predicting factors. CONCLUSION: This analysis revealed that the IPSS total score, age, and BMI are independent predictors of OSAS in males. In this context, the use of IPSS in daily practice could be helpful in assessing the LUTS presence and in supporting physicians to identify a hidden sleep apnea condition.

TRAUMA AND THE DISRUPTION OF TEMPORAL EXPERIENCE: A PSYCHOANALYTICAL AND PHENOMENOLOGICAL PERSPECTIVE.

A deep understanding of the subjective experience of time in traumatized individuals may require a comprehensive framework that takes into account both psychoanalytic and phenomenological contributions. Referring to the retroactive interpretation of past experiences, the concept of Nachträglichkeit is critical to analyze how trauma can be signified in the form of the après-coup, in which the original traces of traumatic experiences are signified only at a later time. Trauma alters the temporal sequence of past, present, and future, thus leaving the psyche in a time-shifted dimension, where the shadow of the past extends over the present, and the unbearable present hinders growth and development. A clinical vignette is presented to illustrate how trauma can disrupt the temporal nature of subjective experience by reshaping the meaning of psychic events. Ultimately, trauma treatment aims at inscribing the person's experience into a unified and coherent self-narrative.

Why people were less compliant with public health regulations during the second wave of the Covid-19 outbreak: The role of trust in governmental organizations, future anxiety, fatigue, and Covid-19 risk perception.

Trust in governmental organizations is a crucial factor in terms of encouraging people to conform to public health regulations, such as those recommended to slow down the spread of SARS-CoV-2. However, trust in governmental organizations tends to decline over time, reducing the compliance with public health regulations. This study aimed at exploring, first, the role of future anxiety and fatigue as serial mediators of the relationship between trust in governmental organizations and protective behaviors, and, secondly, the role of Covid-19 risk perception as a moderator between fatigue and protective behaviors. A total of 948 Italian participants (302 males and 646 females), ranged from 18 to 80 years (M = 27.20, SD = 11.01), answered an online survey during the second wave of the Covid-19 outbreak. A moderated serial mediation model was performed using a structural equation modeling. The results indicate that: (1) a higher trust in Italian governmental organizations was associated with a greater compliance in terms of adopting protective behaviors; (2) a lower trust in Italian governmental organizations increased anxiety about the future which, in turn, raised levels of fatigue, leading, finally, to a reduction in the levels of protective behaviors; and (3) as the perceived risk related to Covid-19 increased, the effect of fatigue on protective behaviors decreased. The findings of the current study may provide indications for public health policy on how to increase compliance with the recommended behaviors to be adopted in order to decrease the spread of the SARS-CoV-2.

Obstetric violence in a group of Italian women: socio-demographic predictors and effects on mental health.

This study had two aims: (1) to explore the types and incidence of obstetric violence (OV) in a group of Italian women, as well as associated socio-demographic factors; and (2) to assess whether OV affects women's mental health (e.g. psychological distress and post-traumatic stress). A web-based cross-sectional study was conducted with 282 Italian women. Women answered questions on socio-demographic factors, childbirth characteristics, OV and mental health. Multiple linear regression analyses assessing the predictive role of socio-demographic and childbirth characteristics on OV were conducted. Additionally, hierarchical multiple linear regression analyses assessing whether OV affected women's mental health were also carried out. More than three quarters of the sample (78.4%) had experienced at least one type of OV (55.5% of non-consented care and 66.4% of abuse and violence). The factors most associated with OV were younger age, low educational level, not having attended a prenatal childbirth preparedness course, and having given birth naturally. The form of OV that most affected women's mental health was that linked to abuse and violence rather than non-consented care. Study findings shed light into addressing OV from a multidimensional perspective.

Correlation between olfactory function, age, sex, and cognitive reserve index in the Italian population.

PURPOSE: Loss of smell decreases the quality of life and contributes to the failure in recognizing hazardous substances. Given the relevance of olfaction in daily life, it is important to recognize an undiagnosed olfactory dysfunction to prevent these possible complications. Up to now, the prevalence of smell disorders in Italy is unknown due to a lack of epidemiological studies. Hence, the primary aim of this study was to evaluate the prevalence of olfactory dysfunction in a sample of Italian adults. METHODS: Six hundred and thirty-three participants (347 woman and 286 men; mean age 44.9 years, SD 17.3, age range 18-86) were recruited from 10 distinct Italian regions. Participants were recruited using a convenience sapling and were divided into six different age groups: 18-29 years (N = 157), 30-39 years (N = 129), 40-49 years (N = 99), 50-59 years (N = 106), > 60 years (N = 142). Olfactory function, cognitive abilities, cognitive reserve, and depression were assessed, respectively, with: Sniffin' Sticks 16-item Odor Identification Test, Montreal Cognitive Assessment, Cognitive Reserve Index, and the Beck Depression Inventory. Additionally, socio-demographic data, medical history, and health-related lifestyle information were collected. RESULTS: About 27% of participants showed an odor identification score < 12 indicating hyposmia. Multiple regression analysis revealed that OI was significantly correlated with age, sex, and cognitive reserve index, and young women with high cognitive reserve index showing the highest olfactory scores. CONCLUSION: This study provides data on the prevalence of olfactory dysfunction in different Italian regions.

The role of cognitive and non-cognitive factors in dental anxiety: A mediation model.

Dental anxiety is a crucial problem for dentistry because it may represent a significant risk to oral health. Different factors, whether non-cognitive (e.g., traumatic dental events) or cognitive (e.g., the patient's subjective perceptions), may cause dental anxiety. However, previous studies have assessed these factors as independent predictors of dental anxiety, without providing any exploration of potential mediational pathways. The current study assessed the role of certain cognitive dimensions (i.e., the dentist's perceived professionalism and communicational attitudes, and the patient's perceived lack of control) as mediators between traumatic dental events and dental anxiety. The sample comprised 253 patients who had accessed a public university hospital dental surgery. The mediation analysis used a structural equation modeling. Traumatic dental events were positively associated with dental anxiety but, among the cognitive factors, only lack of control was. Furthermore, lack of control mediated the relationship between traumatic dental events and dental anxiety, although this mediation was only partial. This study sheds light on the mechanisms through which non-cognitive and cognitive factors may affect dental anxiety. The clinical implications for dental practice, in terms of improving the psychological well-being of patients, are discussed.

Mentalizing stigma: Reflective functioning as a protective factor against depression and anxiety in transgender and gender-nonconforming people.

OBJECTIVE: The current study examined the role of internalized transphobia (IT) as a mediator between gender-related rejection and mental health, and reflective functioning (or mentalization) as a resilience factor moderating the relationship between both rejection and IT with mental health. METHOD: This online study included 203 Italian transgender and gender-nonconforming (TGNC) individuals ranged in age from 18 to 66 years old (M = 30.70; standard deviation = 10.79). Moderated-mediation analysis was performed using a structural equation modeling approach. RESULTS: Both rejection and IT were positively associated with mental health, and IT mediated the relationship between rejection and mental health. Mentalization moderated the relationship between rejection and IT with mental health. The indirect effect of rejection on mental health through IT was moderated by mentalization. CONCLUSIONS: Findings highlight psychological paths that may inform individual- and group-level mentalization-based interventions to reduce minority stress in TGNC individuals.

Minority stress and mental health in European transgender and gender diverse people: A systematic review of quantitative studies.

The current study aimed at systematically reviewing evidence on the relationships between gender minority stress and mental health outcomes among European transgender and gender diverse (TGD) individuals. A systematic search was conducted in PsycINFO, PubMED, Scopus, and Google Scholar. It was based on Boolean operators to combine terms related to minority stress, TGD identities, and mental health. Thirty studies were identified as eligible. The results confirmed that gender minority stress factors are significantly related with mental health problems among European TGD individuals. Distal stressors were identified as strongly associated with poorer mental health, with gender-related discrimination emerging as the most documented risk factor. The significant role of proximal stressors was also highlighted, with some mediation analyses detecting an indirect effect on mental health. However, identity concealment appeared unrelated to mental health outcomes. Resilience-promoting factors buffering the impact of stressors were also identified, including self-esteem, pride, transitioning, and social support. Conversely, data on community connectedness as a source of resilience were inconclusive. The studies reviewed have several limitations, including lack of longitudinal designs, sampling bias, variability in measurement methods, and unaccounted ethnic variables. Research and clinical recommendations in this field are reported.

The affective grounds of the mind. The Affective Pertinentization (APER) model.

The paper presents the Affective Pertinentization model (APER), a theory of the affect and its role it plays in meaning-making. APER views the affect as the basic form of making sense of reality. It consists of a global, bipolar pattern of neurophysiological activity through which the organism maps the instant-by-instant variation of its environment. Such a pattern of neuropsychological activity is constituted by a plurality of bipolar affective dimensions, each of which maps a component of the environmental variability. The affect has a pluri-componential structure defining a multidimensional affective landscape that foregrounds (i.e., makes pertinent) a certain pattern of facets of the environment (e.g., its pleasantness/unpleasantness) relevant to survival, while backgrounding the others. Doing so, the affect grounds the following cognitive processes. Accordingly, meaning-making can be modeled as a function of the dimensionality of the affective landscape. The greater the dimensionality of the affective landscape, the more differentiated the system of meaning is. Following a brief review of current theories pertaining to the affect, the paper proceeds discussing the APER's core tenets - the multidimensional view of the affect, its semiotic function, and the concepts of Affective Landscape and Phase Space of Meaning. The paper then proceeds deepening the relationship between the APER model and other theories, highlighting how the APER succeeds in framing original conceptualizations of several challenging issues - the intertwinement between affect and sensory modalities, the manner in which the mind constitutes the content of the experience, the determinants of psychopathology, the intertwinement of mind and culture, and the spreading of affective forms of thinking and behaving in society. Finally, the unsolved issues and future developments of the model are briefly envisaged.

Affective Regulation and Trait Anger Personalities: The Buffering Effect of the Companion Animal Bond.

Emotional dysregulation involving anger can have severe consequences on the individual's psychosocial and emotional functioning. This study aimed to investigate the role that the companion animal bond and the personality dimension of trait anger play in explaining affective dysregulation. A cross-sectional online survey was administered to 365 participants. Using the PROCESS macro for SPSS, a moderated model was tested to analyze the hypothesis that affective dysregulation depends on trait anger and that the companion animal bond moderates the relationship between trait anger and affective dysregulation. The results showed that the effect of trait anger on affective dysregulation increases especially when the degree of bonding to an animal companion is low, suggesting that a strong bond to a companion animal may protect individuals with trait anger from the likelihood of experiencing affective regulation problems. The psychological, health-related, and educational implications of the current anthrozoological study include the potential of the human-animal bond in acting as a facilitator of adaptive affective regulation processes, which can reduce the levels of uncontrolled anger-related emotions and the subsequent risk of out-of-control behaviors.

Olfactory-related quality of life impacts psychological distress in people with COVID-19: The affective implications of olfactory dysfunctions.

BACKGROUND: Coronavirus disease 2019 (COVID-19) often causes chemosensory impairment, and olfactory dysfunctions may have negative consequences on psychological distress. This study aimed at assessing which dimension of perceived olfactory disfunctions (i.e., subjective olfactory capability, smell-related problems, or olfactory-related quality of life [QoL]) was most associated with psychological distress in people diagnosed with COVID-19. METHODS: 364 participants (65 men and 299 women) diagnosed with COVID-19 on average 7 months prior to the beginning of the study were recruited between June 5 and 21, 2021, to take part in an online cross-sectional survey. Participants answered questions on demographics, clinical factors, perceived olfactory functioning, and psychological distress. Hierarchical multiple linear regression analysis was conducted, assessing the role of demographics, clinical factors, and perceived olfactory functioning dimensions on psychological distress. RESULTS: More than half of the participants met the cut-off for all perceived olfactory dysfunctions scales and psychological distress. Being women, smoker, with comorbidities, and greater severity of COVID-19 symptoms were associated with higher scores on psychological distress. Among perceived olfactory functioning scales, only impairment in olfaction QoL was associated with psychological distress. LIMITATIONS: Limitations concerned the cross-sectional nature of the study and the unbalanced sample in terms of gender. CONCLUSIONS: The study confirmed the core intertwining between mood, perceived QoL, and olfactory functioning, showing how impairments in olfactory processing are strongly correlated with psychological distress through the impact they have on the perceived QoL.

Unmet Needs of Pediatricians in Transgender-Specific Care: Results of a Short-Term Training.

INTRODUCTION: The aim of this study was to evaluate (i) the knowledge about different dimensions of sexual identity in a group of family pediatricians and (ii) the efficacy of a training program to improve knowledge and reduce genderism and heteronormativity. METHODS: A pre-post-follow-up study was conducted with 96 Italian pediatricians (48 men and 48 women) who participated in a 6-h training program and divided into 2 sections. The first section was theoretical and focused on the conceptual foundations of sexual identity, the depathologizing approach to gender diversity, and the role of pediatricians as the first contacts of children's or adolescents' family. The second part was experiential and included the presentation of a clinical case and the activation of a group reflection on the management of gender-diverse youth. Knowledge about sexual identity, genderism, and heteronormativity was measured. RESULTS: Pre-training questionnaires revealed that the mean score of knowledge about sexual identity was 7.13 ± 3.21. One-way within-subject ANOVA revealed significant effects from pre- to post-training and from pre- to follow-up assessment but not from post-training to follow-up assessment, suggesting that significant changes in the knowledge about sexual identity (F = 39.75, p < 0.001), in personal biases related to genderism (F = 7.46, p < 0.01), and in heteronormative attitudes (F = 44.99, p < 0.001) and behaviors (F = 79.29, p < 0.001) were achieved through the training and maintained at follow-up. CONCLUSION: These findings indicate the importance of training pediatricians to work with gender-diverse youth and provide them with the best clinical interventions.

Social Support, Identity Affirmation, and Psychological Well-Being: A Developmental and Intersectional Comparison between Italian Cisgender and Non-Binary People with Bisexual Orientation.

Incorporating the perspectives of positive psychology, intersectionality, and life course into minority stress theory, this study aimed to examine the relationships between social support, identity affirmation, and psychological well-being among 483 Italian individuals with bisexual orientation, accounting for differences in gender identity (cisgender vs. non-binary) and age groups (young, early, and middle adult). A mediation model was tested in which identity affirmation served as a presumed mediator between social support and psychological well-being. We also examined whether gender identity and age group moderated the hypothesized associations. Multivariate ANOVA and multigroup mediation analyses were conducted. Results showed that (a) cisgender individuals had higher social support and psychological well-being than non-binary individuals, but not identity affirmation, which was higher in the latter group, (b) psychological well-being, but not social support and identity affirmation, differed between groups, with the youngest cohort reporting worse health than their elders, (c) identity affirmation mediated the relationship between social support and psychological well-being, (d) mediation was significant only in binary individuals (compared to cisgender), whereas no age differences were found. Overall, this study highlights the need to consider bisexual individuals as a nonhomogeneous population living multiple life experiences, especially when minority identities intersect.

Attitudes towards Trans Men and Women in Spain: An Adaptation of the ATTMW Scale.

This article presents the results of the adaptation and validation of the Attitudes Toward Trans Men and Women (ATTMW) scale-a measure capable of detecting transphobic positions towards trans men and women-in the Spanish context. A total of 310 prospective teachers from different stages of education participated in the study on its adaptation. In order to provide quantitative evidence of validity, confirmatory factor analysis and regression analysis with different constructs and sociodemographic variables were carried out. Internal consistency reliability was adequate. The study demonstrated that the ATTMW is a psychometrically sound instrument for the assessment of attitudes towards trans people, especially with items that categorize trans women and men as second-class people.

A Cross-Sectional Study on Cognitive Vulnerability Patterns in Dental Anxiety: The Italian Validation of the Dental Fear Maintenance Questionnaire (DFMQ).

Dental anxiety is a crucial problem for dentistry because it may represent a significant risk to oral health. Within the framework of the Cognitive Vulnerability Model (CVM), which sheds light on the cognitive vulnerability patterns that may cause dental anxiety, this study aimed to assess the psychometric characteristics of the Italian version of the Dental Fear Maintenance Questionnaire (DFMQ). The DFMQ is a 32-item questionnaire that assesses four cognitive vulnerability patterns, i.e., dangerousness, disgust, unpredictability, and uncontrollability. In a sample of 200 dental patients who had accessed public-university-hospital dental surgery, this study assessed the model fit of the DFMQ and different types of validity (i.e., predictive, convergent, construct, and discriminant validity). In addition, potential differences between DFMQ dimensions were assessed based on gender (men vs. women) and age ranges. All indicators of cognitive vulnerability were significantly associated with high dental anxiety when each variable was included independently. In contrast, when the DFMQ subscales were considered together, only unpredictability and uncontrollability were found to be associated with high dental anxiety. Women had higher scores for unpredictability, uncontrollability, and general dangerousness than men. In addition, older patients had higher scores for some vulnerability cognitive patterns than younger patients. This study provides Italian dentists and researchers with a valid questionnaire to assess cognitive factors associated with dental anxiety.

Perinatal depression during the fourth wave of the COVID-19 outbreak in a single prenatal clinic in Southern Italy: The role of loneliness, anxiety, and maternal support.

Background: The current study aimed at assessing the levels of perinatal depression (i.e., both antenatal and postnatal) during the fourth wave of the COVID-19 outbreak in a group of Italian women, as well as to evaluate the role of loneliness, anxiety, and lack of maternal support in cumulatively predicting perinatal depression. Methods: A cross-sectional study was conducted with 200 Italian women recruited during a peak of the COVID-19 pandemic in Italy (i.e., from September to December 2021) from a single prenatal clinic in Southern Italy. A non-parametric binomial test was conducted to assess whether the perinatal depression frequencies of the current sample differed from those found in a pre-Covid reference group. Additionally, hierarchical multiple linear regression analyses assessing whether loneliness, anxiety, and maternal support affected women's perinatal depression were also conducted. Results: The general prevalence of perinatal depression was significantly higher in participants recruited during the fourth wave of the COVID-19 pandemic compared to the pre-Covid reference group (29% vs. 9.2%). However, results showed that, contrary to postnatal depression (18.2% vs. 19.9%), only the prevalence of antenatal depression was significantly higher compared to the pre-Covid reference group (39.6% vs. 6.4%). Furthermore, loneliness and anxiety, but not maternal support, were associated with higher levels of PD. Limitations: Limitations concerned the cross-sectional nature of the study and the relatively small sample size. Conclusions: This study sheds light on the need to address perinatal mental health of women during major stressful events, such as the COVID-19 pandemic.

Envy, Social Comparison, and Depression on Social Networking Sites: A Systematic Review.

This study aims to review the evidence for the reciprocal relationship between envy and social comparison (SC) on social networking sites (SNSs) and depression. We searched PsychINFO, PubMed, and Web of Science from January 2012 to November 2022, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A total of 9 articles met our inclusion criteria. In all articles reviewed, a simple correlation was found between SC on SNSs, envy, and depression. Three cross-sectional studies successfully tested a model with envy as a mediator between SNSs and depression. The moderating role of additional variables such as self-efficacy, neuroticism, SC orientation, marital quality, and friendship type was also evident. The only two studies that were suitable to determine direction found that depression acted as a predictor rather than an outcome of SC and envy, and therefore depression might be a relevant risk factor for the negative emotional consequences of SNSs use.

Are Excessive Daytime Sleepiness and Lower Urinary Tract Symptoms the Triggering Link for Mental Imbalance? An Exploratory Post Hoc Analysis.

BACKGROUND: Both lower urinary tract symptoms (LUTS) and excessive daytime sleepiness (EDS) could negatively impair the patients' quality of life, increasing the sensitivity to psychological distress that results in mental health disorders. The relationships of both urinary and respiratory domains with psychological distress in obstructive sleep apnea patients is still underestimated. METHODS: This study was a post hoc analysis of a web-based Italian survey, which included 1998 participants. Three hierarchical multiple linear regression analyses with psychological distress as dependent variable were performed on the study of 1988 participants enrolled in the final analysis. Cohen's f2 was used for the assessment of the effect size. RESULTS: From the hierarchical multiple linear regression analyses, it emerged that the final statistical model (including sociodemographic characteristics, comorbidities, perceived urinary function, and excessive daytime sleepiness) for all dimensions accounted for 16.7% of the variance in psychological distress, with a medium effect size (f2 = 0.15). CONCLUSIONS: People reported psychological distress was impaired by the presence of LUTS and EDS. Specifically, our study showed that higher levels of distress were scored especially in young women exhibiting urinary symptoms and with high values of daytime sleepiness.

"Nocturia and obstructive sleep apnea syndrome: A systematic review".

Lower urinary tract symptoms represent a significant public health problem worldwide, impairing patients' quality of life, especially in elderly people. Among LUTS, nocturia is assessed as the most experienced entity related to several disorders such as sleep disorders and/or obstructive sleep apnea syndrome (OSAS). Among OSAS patients, nocturia stands as a bothersome symptom that increases alongside with the OSAS severity. However, despite the nocturia and OSAS shared a long-acknowledged link, the causes, and the pathophysiology for development of nocturia in OSAS have remained largely unexamined. Generally, the patients with OSAS experienced nocturia due to easy waking or increased bladder filling. However, nor the effect of treatment on management of nocturia in OSAS patients are well-established.

The Role of Affective Sensemaking in the Constitution of Experience. The Affective Pertinentization Model (APER).

The paper outlines a model of the basic cognitive process of the constitution of experience - the Affective Pertinentization Model (APER). The constitution of experience is intended as the basic cognitive process underpinning the meaning-maker's experience of mental representations as self-contained, stable, substantive entities standing for something in the external reality. Framed within the general family of theories highlighting the embodiment of cognition, the APER model claims that affects are the basic mechanism at the basis of the constitution of human experience. The first part of the paper outlines the APER model; the second part reviews some preliminary evidence supporting it.