Meta-analysis of the Difficulties in Emotion Regulation Scale and its short forms: A two-part study.

The Difficulties in Emotion Regulation Scale (DERS) is the most used self-report questionnaire to assess deficits in emotion regulation (ER), composed of 6 dimensions and 36 items. Many studies have evaluated its factor structure, not always confirming the original results, and proposed different factor models. A possible way to try to identify the dimensionality of the DERS could be through a meta-analysis with structural equation models (MASEM) of its factor structure. The MASEM indicated that a six-factor model with 32 items (DERS-32) was the most suitable to represent the dimensionality of the DERS (χ2 = 2095.96, df = 449, p < .001; root mean square error of approximation [RMSEA] = 0.024, 95% confidence interval [CI]: 0.023-0.025; comparative fit index [CFI] = 0.97; Tucker Lewis index [TLI] = 0.96; standardized root mean squared residual [SRMR] = 0.04). This result was also confirmed by a confirmatory factor analysis (χ2 = 3229.67, df = 449, p < 0.001; RMSEA = 0.075, 95% CI: 0.073-0.078; CFI = 0.94; TLI = 0.93; SRMR = 0.05) on a new sample (1092 participants; mean age: 28.28, SD = 5.82 years) recruited from the Italian population. Analyses and results from this sample are reported in the second study of this work. The DERS-32 showed satisfactory internal consistency (i.e., ordinal α, Molenaar Sijtsma statistic, and latent class reliability coefficient) for all its dimensions and correctly categorized individuals with probable borderline symptomatology. In conclusion, the DERS-32 has demonstrated to be the best model for the DERS among all the others considered in this work, as well as a reliable tool to assess deficits in ER.

Psychometric Properties of the Italian Mentalization Questionnaire: Assessing Structural Invariance and Construct Validity.

Mentalization is an important interpersonal ability, necessary for adaptive interpersonal relationships and emotion regulation. Deficits in mentalization have been associated with poor psychological outcomes and have been observed in patients with Borderline Personality Disorder. The Mentalization Questionnaire (MZQ) has been developed as self-report measure of mentalization deficit. The aim of the study was to investigate the dimensionality of the MZQ in a nonclinical sample composed of Italian adults from the general population and to analyze its performance in categorizing individuals with higher risk of borderline symptoms. A non-clinical sample of 1,015 adults (709 women and 306 men) was administered the Italian versions of the MZQ, the Reflective Functioning Questionnaire (RFQ), and a measure of borderline psychopathology. A revised single-factor solution fitted the data well and demonstrated metric invariance across gender. The internal consistency (Ordinal α = 0.87) and stability (r = 0.84) were satisfactory. The MZQ was moderately associated with the RFQ dimensions. The ROC curve analysis showed that the MZQ was able to discriminate satisfactorily people with higher risk for borderline symptomatology from those with lower risk. The MZQ may, therefore, be considered a reliable and valid measure of mentalization for categorizing people at higher risk for borderline pathology.

Psychometric properties and diagnostic accuracy of the short form of the geriatric anxiety scale (GAS-10).

BACKGROUND: Anxious symptoms have a negative impact on different aspects of the elderly's quality of life, ranging from the adoption of unhealthy lifestyle behaviours to an increased functional impairment and a greater physical disability. Different brief assessment instruments have been developed as efficacy measures of geriatric anxiety in order to overcome psychometric weaknesses of its long form. Among these, the 10-item Geriatric Anxiety Scale (GAS-10) showed strong psychometric properties in community-dwelling samples. However, its diagnostic accuracy is still unexplored, as well as its discriminative power in clinical samples. METHODS: In the present study, we explored the psychometric performance of the GAS-10 in the elderly through Item Response Theory in a sample of 1200 Italian community-dwelling middle-aged and elderly adults (53.8% males, mean age = 65.21 ± 9.19 years). Concurrent validity, as well as diagnostic accuracy, was examined in a non-clinical sample (N = 229; 46.72% males) and clinical sample composed of 35 elderly outpatients (74.28% females) with Generalized Anxiety Disorder (GAD). RESULTS: The GAS-10 displayed good internal construct validity, with unidimensional structure and no local dependency, good accuracy, and no signs of Differential Item Functioning (DIF) or measurement bias due to gender, but negligible due to the age. Differences in concurrent validity and diagnostic accuracy among the long form version of the GAS and the GAS-10 were not found significant. The GAS-10 may be more useful than the longer versions in many clinical and research applications, when time constraints or fatigue are issues. CONCLUSION: Using the ROC curve, the GAS-10 showed good discriminant validity in categorizing outpatients with GAD disorder, and high anxiety symptoms as measured by the GAS-SF cut-off. The stable cut-off point provided could enhance the clinical usefulness of the GAS-10, which seems to be a promising valid and reliable tool for maximize diagnostic accuracy of geriatric anxiety symptoms.

Does a Fundamentalist Mindset Predict a State or Trait Anxiety? The Covariate Role of Dogmatism.

Recent neuropsychological studies reported that fundamentalism beliefs and its cognitive mindset provoke sense of coherency and protection against the ambiguity as well as a rapid doubt resolution and thus offer relief from distress and uncertainty. In this study, we examined whether the need for closure dimensions predicted religious fundamentalism. Further, we tested if pronounced religious beliefs (also controlled for dogmatism) would be associated with a state or trait anxiety, in a sample of 388 Roman Catholics (females = 53.9%). Path analysis (SEM), with observed variables, was used to determine the pathways by which religious fundamentalism, need for closure dimensions, and dogmatism interacted to influence anxiety. The results revealed that religious fundamentalism was predicted by intolerance to ambiguity, preference for order, and closed-mindedness; in turn, high fundamentalism scores predicted state anxiety exclusively. Additionally, when controlling for dogmatism, the fundamentalism-anxiety path became nonsignificant. Although it seemed that fundamentalism beliefs "per se" have played no direct anxiolytic effect, they partially perform a function of avoiding chaos and disorder in order to maintain cognitive integrity.

Novel psychoactive substances: use and knowledge among adolescents and young adults in urban and rural areas.

INTRODUCTION: Novel psychoactive substances (NPS) are new psychotropic drugs, not scheduled under the International Conventions on Psychotropic Substances, but which may pose a relevant public health threat. In this study, we investigated knowledge and use of NPS in a sample of Italian youth in urban and rural areas. METHODS: Between December 2012 and October 2013, we administered a questionnaire to a sample of 3011 healthy subjects (44.7% men; 55.3% women), aged between 16 and 24 years and recruited in urban, intermediate and rural areas of Italy. RESULTS: Of the global sample, 53.3% declared to have some knowledge on NPS, with a higher knowledge in urban areas. Mephedrone (26%), desomorphine (22.6%) and methamphetamine (21.7%) were the most commonly known drugs. NPS use was reported by 4.7% of the sample, without significant differences between urban and rural areas; mephedrone (3.3%), synthetic cannabinoids (1.2%) and Salvia divinorum (0.3%) consumption has been identified. NPS use was also predictive of binge-drinking behaviours (χ(2) (4) = 929.58, p < .001). DISCUSSION: Urban areas may represent a focal point for preventive strategies, given the presence of higher levels of NPS knowledge. Moreover, the association between binge-drinking habits and NPS use was really strong. This issue should not be underestimated because of its medical, psychopathological and social consequences.

Measuring anxiety in the elderly: psychometric properties of the state trait inventory of cognitive and somatic anxiety (STICSA) in an elderly Italian sample.

BACKGROUND: Despite its increasing personal and societal impact, assessment of late-life anxiety has received relatively little attention in psychiatric research. Differential symptom presentation and physical comorbidities among the elderly, relative to younger cohorts creates a need for anxiety measures that are psychometrically validated in the elderly. METHODS: The present study examined the factor structure and discriminant validity of the state-trait inventory for cognitive and somatic anxiety (STICSA) in a sample of Italian middle-aged and older adults. Participants were 396 community-dwelling middle-aged (50-64 years) and older (≥65 years) adults. In addition to the STICSA, participants completed two depression measures and a general well-being survey with physical and mental health subscales. RESULTS: Factor analysis supported the validity of both state-trait and cognitive-somatic distinctions underlying the STICSA, all dimensions exhibited excellent internal consistency (Cronbach's α coefficients ≥ 0.86), and correlations with depression measures provided limited evidence for differentiation of anxious and depressive symptoms. The STICSA also showed evidence of discriminating anxious symptoms from physical health symptoms, a particularly relevant feature of a valid anxiety measure in elderly samples. CONCLUSIONS: The STICSA appears to be a valid measure of cognitive and somatic anxiety in the elderly.

Measurement of external shame: an inside view.

The aims of this study were to investigate the construct validity of the Other as Shamer scale (OAS) using confirmatory factor analysis (CFA) and to examine the psychometric properties of its Italian version in a sample of 687 nonclinical individuals. The CFA results indicated that the hypothesized hierarchical model (with 1 higher order factor and 3 first-order factors) was the best fitting solution. Cronbach's alpha indexes, as well as test-retest stability, provided satisfactory results. Correlations of the OAS total score and its subscales with the Beck Depression Inventory-II (rs = .30-.48) and the Teate Depression Inventory (rs = .32-.45) were both substantial and significant (p < .01). Receiver operating characteristic curves were constructed to indicate sensitivity and specificity of the OAS and its subscales when determining those nonclinical subjects who met clinical thresholds for depression symptoms. A series of cutoff scores for the OAS scale and its subscales was developed, with sensitivity values between .70 and .62, and specificity values between .71 and .62, indicating good to fair discrimination between the 2 groups (depressed vs. nondepressed). The theoretical and practical implications of these results were discussed.

Psychological Distress in Patients Who Needed Invasive versus Non-Invasive Ventilation Following SARS-CoV-2 Viral Infection.

The COVID-19 pandemic has affected the mental health of those who survived the illness but underwent long treatment and hospitalization. Much research has highlighted signs of emotional distress in those who experienced intensive care, and the procedures implemented to fight the infection. The present study investigated the effects of the illness experience in 40 subjects admitted to a rehabilitation unit after discharge from intensive care by focusing on the possibility of differences in emotional well-being depending on the type of ventilation. The results of the administration of psychological scales for anxiety, depression, and post-traumatic stress disorder showed that many subjects experienced some form of emotional distress. There were no differences between patients who underwent invasive ventilation and those who did not.

The effects of the COVID-19 pandemic on Italian primary school children's learning: A systematic review through a psycho-social lens.

The COVID-19 pandemic drastically affected many areas and contexts of today's society, including school and family. Several studies focused on the worldwide effects of school closures on students' learning outcomes, context, and well-being. However, the data emerging from these studies are often inconsistent and fragmentary, highlighting the need of a comprehensive analysis of the phenomenon. This need is especially urgent for the countries with the most severe school closure, like Italy. This systematic review aims to collect the opinions of parents, teachers, and students on: other dimensions of Italian primary school students affected by school closures, beyond academic performance; hypothetical agreement between the opinions of parents, teachers, and students regarding the different effects of school closures on Italian primary school students; possible differences between the effects of school closures on Italian primary school students and the students in other countries. Our search was conducted using PRISMA 2020 guidelines on Web of Science, Pubmed, Scopus, and EBSCOHost. The results obtained from 34 articles revealed a strong concern on the part of all stakeholders involved in learning during the pandemic, with evident negative effects for Italian school students. The constraint on distance learning led to a drastic change in everyone's routine, and a negative emotional change on the part of young students. Parents and teachers generally considered distance learning to be ineffective for the education of their children and students; they encountered technical-practical difficulties in the use of electronic devices for participation in school activities; overall learning deficits on the part of students, especially in mathematics, as confirmed by INVALSI results were also found. The investigation reveals a condition of shared emotional and academic performance difficulty, and a further challenging circumstance for students previously at risk of marginalization. Further research in this field is paramount to identify new and adequate recovery strategies.

Factor structure of the Italian version of the religious fundamentalism scale.

The Religious Fundamentalism Scale was applied to an Italian group, composed of 250 participants, to assess if it could be considered a reliable measure of fundamentalism. All participants professed to be believers of the Catholic religion. The overall group was split randomly into two smaller groups. The data of the first group were analyzed with an exploratory factor analysis (EFA) to test the factor structure of the Italian version of the scale. The data of the second sample were analyzed with a confirmatory factor analysis, to test the factor structure that emerged from EFA. Results indicated a two-dimensional structure, composed of two correlated factors apparently representing believing and skeptical attitudes.

Measuring State and Trait Anxiety: An Application of Multidimensional Item Response Theory.

The State-Trait Inventory for Cognitive and Somatic Anxiety (STICSA) is a widely used measure of state and trait anxiety. Within the Classical Testing Theory model, consistent findings provide support for its multidimensional factor structure, discriminant, convergent, and nomological validity, as well as age and gender invariance, across healthy and clinical samples. Nevertheless, some issues regarding STICSA dimensionality and item-scale composition remain unresolved (e.g., both bifactor and two-factor models were found to fit data equally well). The goal of this study was to investigate the STICSA's dimensionality within the Item Response Theory, and to assess the tenability of the bifactor model as a plausible model over the multidimensional model. The sample consisted of 3338 Italian participants (58.21% females; 41.79% males) with an average age of 35.65 years (range: 18-99; SD = 20.25). Both bifactor and two-correlated dimensions of the STICSA scales were confirmed to fit data by applying the multidimensional Item Response Theory (mIRT). While the bifactor model showed better fit indices, the multidimensional model was more accurate and precise (0.86-0.88) in estimating state and trait latent anxiety. A further comparison between multidimensional item parameters revealed that the multidimensional and bifactor models were equivalent. Findings showed that the STICSA is an accurate and precise instrument for measuring somatic and cognitive symptomatology dimensions within state and trait anxiety. The use of the state/trait total score requires special attention from the clinicians and researchers to avoid bias in the psychodiagnostic assessment.

The Influence of Individual and Contextual Factors on the Vocational Choices of Adolescents and Their Impact on Well-Being.

Adolescents who have to make decisions regarding their future career or academic path can be greatly influenced by parental expectations and other individual and contextual factors. The aim of this study is to explore the impact of adolescent-parent career congruence on adolescents' well-being and future intention to enroll in a university course. The recruitment of participants took place through a combination of convenience sampling and snowball sampling. A sample of 142 high school students who are managing their decisions for the future completed an online questionnaire. Data were analyzed through a path analysis (SEM) with observed variables, and different indices were evaluated to check the model goodness of fit. The data show that congruence with parents' wishes has a significant effect on academic motivation, work hope and mattering, which in turn have a positive and significant effect on both future intentions to undertake university studies and on the participants' occupational well-being. In line with past studies, our results demonstrate correlations between adolescent-parent career congruence in career exploration and decision making, pointing out in particular the influence due to complementary congruence with mothers. Furthermore, our study underscores the important role played by both individual and contextual factors in adolescent well-being and intentions for their future. Finally, implications for the practice of vocational guidance practitioners are discussed.

Neuropsychological Evaluation and Quantitative EEG in Patients with Frontotemporal Dementia, Alzheimer's Disease, and Mild Cognitive Impairment.

This study analyzed the efficacy of EEG resting state and neuropsychological performances in discriminating patients with different forms of dementia, or mild cognitive impairment (MCI), compared with control subjects. Forty-four patients with dementia (nineteen patients with AD, and seven with FTD), eighteen with MCI, and nineteen healthy subjects, matched for age and gender, underwent an extensive neuropsychological test battery and an EEG resting state recording. Results showed greater theta activation in posterior areas in the Alzheimer's disease (AD) and Fronto-Temporal Dementia (FTD) groups compared with the MCI and control groups. AD patients also showed more delta band activity in the temporal-occipital areas than controls and MCI patients. By contrast, the alpha and beta bands did not discriminate among groups. A hierarchical clustering analysis based on neuropsychological and EEG data yielded a three-factor solution. The clusters differed for several neuropsychological measures, as well as for beta and theta bands. Neuropsychological tests were most sensitive in capturing an initial cognitive decline, while increased theta activity was uniquely associated with a substantial worsening of the clinical picture, representing a negative prognostic factor. In line with the Research Domains Framework (RDoC) perspective, the joint use of cognitive and neurophysiological data may provide converging evidence to document the evolution of cognitive skills in at-risk individuals.

Psychological factors in adherence to COVID-19 public health restrictions in Italy: A path model testing depressed mood, anxiety, and co-rumination via cellphone.

During the COVID-19 pandemic, the success of major non-pharmaceutical interventions, such as quarantine orders, has depended upon robust rates of citizens' adherence to protocols. Thus, it is critical to public health for research to illuminate factors that affect compliance with contagion-mitigating practices. Previous research has examined sociodemographic factors and aspects of psychological distress as correlates of adherence to public health guidelines. The current study expanded this research to investigate the psychosocial process of co-rumination, which has been identified in previous research as a maladaptive type of social interaction that is associated with elevated levels of anxiety and depression. Data were collected from 932 Italian adults during the initial stages of the highly stressful COVID-19 pandemic and lockdown. A path model was tested to examine multivariate relationships among sociodemographic characteristics, symptoms of psychological distress (i.e., depression and anxiety), co-rumination via cellphone, and self-reported adherence to COVID-19-related public health restrictions. Results revealed that higher rates of co-rumination via cellphone were associated with lower levels of adherence to public health restrictions. Symptoms of depression and anxiety were differentially related to co-rumination processes and adherence to public health restrictions. Higher levels of depression symptoms were directly associated with poorer adherence to public health restrictions, and this path was mediated through higher levels of co-rumination via cellphone. On the contrary, higher levels of state anxiety were directly associated with greater adherence to public health guidelines. This path was also mediated through co-rumination via cellphone. Higher levels of anxiety were correlated with lower levels of co-rumination, which in turn were correlated with lower levels of adherence. These results suggest fruitful directions for future research examining co-rumination as a maladaptive coping behavior that may be addressed within public health interventions.

On the efficacy of the unified protocol for transdiagnostic treatment of emotional disorders: A systematic review and meta-analysis.

In recent years a large array of treatment protocols conceptualized as transdiagnostic have been developed with clinical and practical advantages compared to traditional single-disorder protocols. Within this panorama, the Transdiagnostic Unified Protocol (UP) of Emotional Disorders was developed aimed at treating the negative affective processes underlying several diagnostic categories, and accounting for the covariance of different emotional disorders. The UP has been found to efficiently target the roots of these disorders leading to a reduction in symptoms of co-occurring disorders. However, several questions have marginally addressed in the previous studies, and some UP features still remain unexplored. The present meta-analysis aims at evaluating whether the UP results to significant changes in anxiety and depression symptoms severity in children, adolescents, and adults. 19 RCTs and 13 uncontrolled pre-post trials comprising 2183 patients/clients met inclusion criteria for meta-analysis. Large to moderate combined overall effect size for both depression plus anxiety were detected in the uncontrolled pre-post studies (g = 0.756) and in RTCs studies (g = 0.452), respectively. Large effect size at pre-treatment to 3-6-month follow-up was observed for combined depression plus anxiety (g = 1.113). Subgroup analysis suggested that UP treatment does not differ across the anxiety and depression self-report measures. Moreover, UP intervention outperformed both passive and active control conditions to treat negative affective syndromes. Meta-regression confirmed the moderate effects of therapist level of experience, the sample characteristics, and the UP-protocol adaptations. The findings indicate that the manualized UP treatment has potential to contribute to improving mental health outcomes, particularly of anxiety and depression.

Italians on the Age of COVID-19: The Self-Reported Depressive Symptoms Through Web-Based Survey.

The pandemic of coronavirus disease 2019 (COVID-19) has affected the Italian community. The widespread use of quarantine had the desired impact of controlling the epidemic, although it caused many psychological consequences. To date, compliance of the Italian public with voluntary home quarantine has been very high, but little is known about the impact of psychological health on sociodemographic categories during the quarantine. The purpose of this study was to assess the prevalence of depressive symptoms in specific sociodemographic categories during the COVID-19 quarantine lockdown and the potential factors that contribute to, or mitigate, these effects. In the very early stage of the nationwide lockdown, 3,672 quarantined Italian adult residents (65% females, ranging from 18 to 85 years) participated in a web-based cross-sectional survey, including measures of depressive symptoms, which were measured by the Teate depression inventory, and state anxiety levels. The overall prevalence was 27.8% for moderate and 9.3% for severe levels of depressive symptoms. A generalized logistic model was used to identify the factors associated with mental health problems. Among these factors, sociodemographic variables (e.g., sex, age, employment status) and adherence to quarantine guidelines were analyzed. Females, younger people, students, singles, residents in northern Italy, people who were reluctant to adhere to quarantine guidelines, and people less worried about being infected with COVID-19 were at high risk of developing depressive symptoms during the COVID-19 epidemic, also after controlling for state anxiety. These findings showed that public levels of depressive symptoms did not increase the greater likelihood of being infected. Our study suggested that the monitoring of psychological outcomes for outbreaks could identify groups at higher risk of psychological morbidities due to the current pandemic in order to target future psychological interventions for implementation.

Demographic and Attitudinal Factors of Adherence to Quarantine Guidelines During COVID-19: The Italian Model.

In Italy, a large outbreak of coronavirus disease 2019 (COVID-19) occurred from 2020 January 30, before the World Health Organization has stated that it is a pandemic. The nationwide quarantine had the desired impact of controlling the epidemic, although had presented many challenges, given its large economic and social costs. Complete adherence to recommendations can potentially decelerate and reduce infectious disease outbreaks. To date, it is not clear how compliant the Italian public has been with voluntary home quarantine, neither which factors have influenced an individual's decision to comply with a quarantine order. The purposes of this study were to investigate the degree of the adherence to quarantine restrictions and the factors associated with the self-reported adherence. During the third week of the national lockdown, 3,672 Italian quarantined adult residents (65% females; range, 18-85 years) participated in an online cross-sectional survey focused on the risk perception of contracting COVID-19 and their reported adherence to quarantine protocols. Analysis of variance showed significant differences among demographic groups in tendency to comply with quarantine orders, with women, most educated people, residents of Southern Italy, middle-aged individuals, and health workers more likely to adhere to quarantine guidelines. As well, participants exhibiting the perception, anxiety, and susceptibility of risk of contracting COVID-19 disease were found significantly more likely to adhere to quarantine guidelines. The results of this study can help public health policy makers to recognize target populations for COVID-19 prevention and health education and to understand how inform communication strategies aimed at minimizing the impact and spread of the disease.

Further Insights Into the Beck Hopelessness Scale (BHS): Unidimensionality Among Psychiatric Inpatients.

Short versions of the Beck Hopelessness Scale have all been created according the Classical Test Theory, but the use and the application of this theory has been repeatedly criticized. In the current study, the Item Response Theory approach was employed to refine and shorten the BHS in order to build a reasonably coherent unidimensional scale whose items/symptoms can be treated as ordinal indicators of the theoretical concept of hopelessness, scaled along a single continuum. In a sample of 492 psychiatrically hospitalized, adult patients (51.2% females), predominantly with a diagnosis of Bipolar Disorder type II, the BHS was submitted to Mokken Scale Analysis. A final set of the nine best-fitting items satisfied the assumptions of local independency, monotonicity, and invariance of the item ordering. Using the ROC curve method, the IRT-based 9-item BHS showed good discriminant validity in categorizing psychiatric inpatients with high/medium suicidal risk and patients with and without suicide attempts. With high sensitivity (>.90), this newly developed scale could be used as a valid screening tool for suicidal risk assessment in psychiatric inpatients.

A Bottom-Up Validation of the IAPS, GAPED, and NAPS Affective Picture Databases: Differential Effects on Behavioral Performance.

The concept of emotion is a complex neural and psychological phenomenon, central to the organization of human social behavior. As the result of subjective experience, emotions involve bottom-up cognitive styles responsible for efficient adaptation of human behavior to the environment based on salient goals. Indeed, bottom-up cognitive processes are mandatory for clarifying emotion-cognition interactions. Accordingly, a huge number of studies and standardized affective stimuli databases have been developed (i.e., International Affective Picture System (IAPS), Geneva Affective Picture Database (GAPED), and Nencki Affective Picture System (NAPS)). However, these neither accurately reflect the complex neural system underlying emotional responses nor do they offer a comprehensive framework for researchers. The present article aims to provide an additional bottom-up validation of affective stimuli that are independent from cognitive processing and control mechanisms, related to the implicit relevance and evolutionistic significance of stimuli. A subset of 360 images from the original NAPS, GAPED, and IAPS datasets was selected in order to proportionally cover the whole dimensional affective space. Among these, using a two-step analysis strategy, we identified three clusters ("good performance", "poor performance", and "false alarm") of stimuli with similar cognitive response profiles. Results showed that the three clusters differed in terms of arousal and database membership, but not in terms of valence. The new database, with accompanying ratings and image parameters, allows researchers to select visual stimuli independent from dimensional/discrete-categories, and provides information on the implicit effects triggered by such stimuli.

Tailored Screening for Late-Life Depression: A Short Version of the Teate Depression Inventory (TDI-E).

A number of assessment instruments have been developed as efficacy measures of geriatric depression in clinical trials but most showed several weaknesses, such as time-consuming administration, development and validation in younger populations, and lack of discrimination between anxiety and depression. Among the extant self-report measures of depression, the 21-item Teate Depression Inventory (TDI; Balsamo and Saggino, 2013), developed via Rasch analysis, showed a satisfactory level of diagnostic accuracy, and allowed the reduction of false positives in test scoring in adult population. The present study explored the potential improvement in the psychometric performance of the TDI in the elderly by item refinement through Rasch analysis in a sample of 836 elderly people (49.5% males; mean age = 73.28; SD = 6.56). A resulting shorter version was composed of the best-fitting and discriminative nine items from the full form. The Teate Depression Inventory (TDI-E) (E for elderly) presented good internal construct validity, with unidimensional structure, local dependency, good reliability (person separation index and Cronbach's alpha), and no signs of differential item functioning or measurement bias due to gender and age (65 vs. 75+ years). Cut-off points and normative data provided could enhance the clinical usefulness of the TDI-E, which seems to be a promising valid and reliable tool for the screening of geriatric depression, with less risk of finding false positives due to overlapping of depression in elderly with other comorbid conditions.