Dieting, obsessive-compulsive thoughts, and orthorexia nervosa: Assessing the mediating role of worries about food through a structural equation model approach.

BACKGROUND: Orthorexia Nervosa (ON) is a condition characterized by an obsessive focus on healthy eating, inflexible dietary rules, and persistent preoccupations with food. Despite it has been recently the subject of increasingly relevant studies, little is known about the mechanisms that might foster ON symptoms. OBJECTIVE: This study used a structural equation modeling approach to test the mediating effect of thoughts, worries, and preoccupations about food on the relationship that eating disorders (EDs) attitudes (e.g., dieting) and obsessive-compulsive thoughts and symptoms have with ON in a large community sample. It was hypothesized that the effect of dieting and obsessive-compulsive thoughts and symptoms on ON would be partially mediated by the presence of thoughts, worries, and preoccupations about food. METHODS: Data from a cross-sectional sample of 1328 participants (females = 976) recruited from the general population were asked to fill in an online survey comprising the Eating Attitude Test-26 (EAT-26), the Obsessive-compulsive subscale of the Symptom Checklist-90 Revised (SCL-90R-OC) and the Orthorexia Scale-15 (ORTO-15). RESULTS: Structural equation models indicated that both obsessive-compulsive thoughts and symptoms and dieting had a direct effect on ON and that food preoccupation partially mediated these relationships. CONCLUSION: These findings provide novel insight into the nature of ON that could aid its conceptualization and treatment.

Understanding the role of self-esteem and emotion dysregulation in victims of intimate partner violence.

Self-esteem and emotion dysregulation appear to be important factors in the psychological well-being of trauma survivors. On the one hand, self-esteem may act as a shield against the psychological consequences of traumatic experiences; on the other hand, emotion regulation can affect the way individuals deal with post-traumatic affects (e.g., fear, terror, shame, and guilt). Consequently, the objective of this study was to investigate the role that emotion dysregulation and self-esteem play in the well-being of a sample of women after the traumatic experience of intimate partner violence (IPV). This study involved 282 women (meanage = 41.55, SD = 10.52) who experienced IPV in the last year. Conditional process analyses and Johnson-Neyman analysis for regions of significance were performed. The results showed that emotion dysregulation mediated the relationship between post-trauma affectivity (i.e., fear, terror, shame and guilt) and survivors' well-being. Furthermore, self-esteem negatively predicted lack of well-being and acted as a moderator of the relationship between emotion dysregulation and lack of well-being. In this regard, through the Johnson-Neyman analysis for regions of significance, it was possible to identify a cut-off value above which the relationship between emotion dysregulation and lack of well-being became non-statistically significant. This study contributed to understanding the role that emotion dysregulation and self-esteem play in the well-being of IPV survivors. In this regard, clinical implications will be presented.

Cognitive restraint, uncontrolled eating, and emotional eating. The Italian version of the Three Factor Eating Questionnaire-Revised 18 (TFEQ-R-18): a three-step validation study.

BACKGROUND: The Three Factor Eating Questionnaire-Revised 18 (TFEQ-R-18) is an extensively used questionnaire to measure three transdiagnostic features of eating behavior: cognitive restraint, uncontrolled eating, and emotional eating. OBJECTIVE: This research aims to investigate the psychometric properties of the Italian version of the TFEQ-R-18 in three large community samples. METHOD: Cross-sectional research designs were employed. In Study 1 (N = 537), an exploratory graph analysis (EGA) was used to examine item clustering within the TFEQ-R-18. In Study 2 (N = 645), a confirmatory factor analysis (CFA) was conducted to test its structural validity. In Study 3 (N = 346), a MANOVA was employed assessing mean differences across eating disorders (e.g., anorexia nervosa, bulimia nervosa, binge eating disorder). RESULTS: In Study 1, the EGA accurately identified the three original dimensions of the TFEQ-R-18. Study 2 showed that the Italian TFEQ-R-18 has good fit indexes (CFI = 0.989, RMSEA = 0.064; 90% CI [0.058, 0.070], SRMR = 0.062), and possesses robust psychometric properties. Study 3 reveals distinct, statistically significant differences among eating disorders. CONCLUSION: The TFEQ-R-18 proves to be a concise and precise tool for measuring transdiagnostic eating behaviors. Its applicability in the Italian context, supported by robust psychometric properties, suggests its utility for both research and clinical purposes. The findings affirm its potential to inform interventions aimed at enhancing psychological health. LEVEL OF EVIDENCE: Level V, descriptive study.

Stigma toward internalizing and externalizing disorders: How do adolescents perceive their peers? A network analysis approach.

This study's first aim was to explore whether stigma's facets differ between internalizing and externalizing disorders in adolescence. The second aim was to compare the relationships among stigma's facets toward these disorders. Two vignettes depicting a peer with Major Depressive Disorder (MDD) or Attention-Deficit Hyperactivity Disorder (ADHD) were used with 616 adolescents in Italy. A Repeated measure MANOVA showed biogenetic causes, social distancing, and discomfort were more attributed to depression, while dangerousness to ADHD. Furthermore, a Psychometric Network Analysis showed no differences between these disorders in the relations among stigma's components. However, dangerousness seemed to be among the nodes with the highest levels of "strength," confirming previous literature that shows that dangerousness plays a major role in stigma.

Weight stigma in patients with overweight and obesity: validation of the Italian Weight Self-Stigma Questionnaire (WSSQ).

PURPOSE: This study aimed to explore the factorial structure of the Italian Weight Self-Stigma Questionnaire (WSSQ) (Study1); and to test structural validity, internal consistency, test-retest reliability, and measurement invariance of the questionnaire across gender, Body Mass Index (BMI), age and occurrence of previous hospitalization for obesity (Study2). METHODS: At admission into a hospital-based program for weight reduction and rehabilitation, 150 inpatients with overweight/obesity (68% females) completed the WSSQ (Study1). In Study2, in addition to the WSSQ, 446 inpatients (61.9% females) completed the Weight Bias Internalization Scale (WBIS), the Body Uneasiness Test (BUT), and the Center for Epidemiologic Studies Depression Scale (CES-D). A subsample of 40 patients also re-completed the WSSQ at discharge from the hospital. RESULTS: The Italian WSSQ showed good overlap with the original factorial structure (Study1) and results were confirmed in Study2. Test-retest reliability and convergent validity showed adequate values. Measurement invariance revealed that WSSQ was perfectly invariant across both BMI and the occurrence of previous hospitalizations for obesity. In both studies, the internal consistency of the questionnaire was deemed acceptable. CONCLUSIONS: The Italian WSSQ is a valid, reliable, and invariant tool for the assessment of weight-related self-stigma among patients with overweight/obesity. Future studies should assess its longitudinal invariance as well as its responsiveness to weight reduction treatments. LEVEL OF EVIDENCE: V, descriptive study.

A post hoc comparison between inpatients with obesity and healthy-weight subjects in the size estimation accuracy of shoulders, waist, and hips widths and circumferences.

PURPOSE: This post hoc study aimed to assess the hypothesis that subjects with obesity could underestimate their body size. METHODS: Data from a previous study with different aims were used to compare 22 female inpatients with obesity with 21 healthy-weight women in the size estimation accuracy of their shoulders, waist, and hips circumferences and widths. The body estimation task with an individualized metric methodology was used to collect data. Frequentist and Bayesian analyses were performed. RESULTS: Samples differed significantly in the accuracy measures of shoulders width and hips as well as waist circumferences: inpatients with obesity underestimated them, while healthy-weight subjects estimated shoulders width accurately but overestimated their hips and waist circumferences. Multiple regression showed that the between-group difference in the accuracy measure of shoulders width was explained by the individuals' education level, while the difference in the accuracy measure of waist circumference resulted to be independent of both age and education level. CONCLUSION: This post hoc study supports the hypothesis that female patients with obesity might underestimate their body size. If these results will be confirmed in future studies, interventions specifically designed to equalize estimations to match the real measures of body size may play a key role in weight-reduction programs for people with obesity. LEVEL OF EVIDENCE: Level III, evidence obtained from cohort or case-control analytic studies.

Structural validity, measurement invariance, reliability and diagnostic accuracy of the Italian version of the Yale Food Addiction Scale 2.0 in patients with severe obesity and the general population.

PURPOSE: To examine the structural validity, measurement invariance, reliability, and some other psychometrical properties of the Italian version of the Yale Food Addiction Scale 2 (I-YFAS 2.0) in patients with severe obesity and the general population. METHODS: 704 participants-400 inpatients with severe obesity and 304 participants enrolled from the general population-completed the I-YFAS 2.0 and questionnaires measuring eating disorder symptoms. A first confirmatory factor analysis (CFA) tested a hierarchical structure in which each item of the I-YFAS 2.0 loaded onto one of the twelve latent symptoms/criteria which loaded onto a general dimension of Food Addiction (FA). The second CFA tested a first-order structure in which symptoms/criteria of FA simply loaded onto a latent dimension. Measurement invariance (MI) between the group of inpatients with severe obesity and the sample from the general population was also tested. Finally, convergent validity, test-retest reliability, internal consistency, and prevalence analyses were performed. RESULTS: CFAs confirmed the structure for the I-YFAS 2.0 for both the hierarchical structure and the first-order structure. Configural MI and strong MI were reached for hierarchical and the first-order structure, respectively. Internal consistencies were shown to be acceptable. Prevalence of FA was 24% in the group of inpatients with severe obesity and 3.6% in the sample from the general population. CONCLUSIONS: The I-YFAS 2.0 represents a valid and reliable questionnaire for the assessment of FA in both Italian adult inpatients with severe obesity and the general population, and is a psychometrically sound tool for clinical as well as research purposes. LEVEL OF EVIDENCE: Level V, descriptive study.

How do education and experience with mental illness interact with causal beliefs, eligible treatments and stigmatising attitudes towards schizophrenia? A comparison between mental health professionals, psychology students, relatives and patients.

BACKGROUND: The main purpose of this study was to investigate the perception of schizophrenia in different categories of persons (directly and/or indirectly) involved with it. Hypotheses were made concerning the definition of a multi-class structure where each class should identify a profile characteristic of each respondent's specific role, (e.g.: mental health professional, relative, patient, and student) and specific indicators of schizophrenia (e.g.: causal beliefs, eligible treatments, social distance, perceived dangerousness and public avoidance). METHODS: This study involved 577 participants all in contact with schizophrenia with different roles. A Latent Class Analysis (LCA) was applied to define a latent structure of schizophrenia aspects. Such structure was expected be affected by the interaction between respondents' roles, as external variable, and schizophrenia indicators as manifest variables. RESULTS: A four-latent-class structure representing the four respondents' roles was evidenced, further each class was characterized by schizophrenia indicators representing a profile for each role. Analogies and differences of views and preferences of the respondents' roles concerning schizophrenia emerged clearly. CONCLUSIONS: The four groups of people involved with schizophrenia with different roles demonstrated to interact significantly with specific indicators of schizophrenia shedding new lights on the understanding of schizophrenia in its complexity.

Are family relations connected to the quality of the outcome in adolescent anorexia nervosa? An observational study with the Lausanne Trilogue Play.

The study aims to explore the connection between the family interactive patterns, investigated with a standardized observational tool based on a recorded play session, the Lausanne Trilogue Play, and the outcome of adolescent patients with anorexia nervosa after a 6 months treatment, based on the Morgan-Russel Outcome Assessment Schedule. Seventy-two parents and adolescent daughters with anorexia nervosa, consecutively referred to an adolescent neuropsychiatric service, participated in the study and underwent an integrated model of treatment, based on constant neuropsychiatric and dietary monitoring, weekly individual psychotherapy for the daughter, and parental counselling and support. A better adolescents' functioning in family relationships, in particular in the triadic ones, at first assessment, was associated with a better outcome. Data on family interactions may help predict the most appropriate intervention for the patient and his family.

Pediatric epilepsy and psychiatric comorbidity: preliminary observational data from a prospective study.

BACKGROUND: Several studies have confirmed psychiatric comorbidity and a worse quality of life in children with epilepsy, but the clinical assessment and monitoring of these patients often pays insufficient attention to their psychological aspects alongside their neurological issues. The present study aims to describe the distribution of psychopathologies and their clinical evolution over 18 months in a sample of children followed up since the onset of their epilepsy. METHODS: After being diagnosed with epilepsy, 49 subjects (age 4-18 y) were followed up with psychiatric and psychological assessments based on the use of dimensional and categorical psychometric tools. RESULTS: Baseline data (T0) showed a high psychiatric comorbidity in epileptic children, with a prevalence of anxious-depressive disorders and attention deficit hyperactivity disorder (ADHD). Specifically, generalized epilepsy, antiepileptic drug intake and more frequent seizures were associated with externalizing problems, while focal epilepsy was linked with anxiety disorders. The follow-up at 18 months revealed that about 90% of patients had achieved a reduction in the frequency and duration of their seizures, but their psychopathological assessment remained virtually unchanged. The patients' psychological issues had warranted psychotherapy in 43% of cases. CONCLUSIONS: When children or adolescents are diagnosed with epilepsy, their psychopathological profile should be investigated and monitored over time. Psychotherapy and/or psychopharmacological treatments should be offered to pediatric patients with epilepsy who suffer from emotional-behavioral disorders.

Psychopathology, quality of life and risk factors in children and adolescents with recent-onset epilepsy.

BACKGROUND: The aim of this study was to describe the distribution, timing, and risk factors for psychopathology and to further examine the quality of life (QoL) in an Italian sample of children with recent onset epilepsy. Sociodemographic and psychosocial variables, family factors, as well as illness-related factors themselves were examined in order to clarify the relationship among these variables, psychopathology and QoL. METHODS: For this purpose, 49 children and adolescents (4-18 years), consecutively referred to a Neurophysiology Service, were evaluated by a multidisciplinary team using dimensional as well as categorical instruments both self-administered (self-report and proxy-report) and interviewer administered. RESULTS: Forty-five percent of the patients exhibited one or more Axis I disorders (DSM-IV) when evaluated with K-SADS-PL interview. It's worth noting that preadolescent and adolescent patients tend to underestimate their problems compared to their parents'opinion, when answering self-administer questionnaires. Self-reported QoL appeared to be generally satisfactory. Social and family factor, as well as epilepsy related factors appeared to be linked both to the presence of psychopathology and to the QoL. Patients affected by psychiatric disorders exhibited the poorest QoL. CONCLUSIONS: Also after many years from the onset, childhood epilepsy frequently fosters negative consequences in terms of social life, work, psychopathology and life expectancy. The ability of health services and public health measures to prevent and treat psychiatric comorbidity may have a pivotal role in enhancing patients' QoL.

Alexithymia and psychosocial problems among Italian preadolescents. A latent class analysis approach.

The study, conducted on Italian preadolscents aged 11 to 13 belonging to the general population, aims to investigate the relationship between the emotional functioning, namely, alexithymia, and the risk of developing behavioral and emotional problems measured using the Strength and Difficulty Questionnaire. The latent class analysis approach allowed to identify two latent variables, accounting for the internalizing (emotional symptoms and difficulties in emotional awareness) and for the externalizing problems (conduct problems and hyperactivity, problematic relationships with peers, poor prosocial behaviors and externally oriented thinking). The two latent variables featured two latent classes: the difficulty in dealing with problems and the strength to face problems that was representative of most of the healthy participants with specific gender differences. Along with the analysis of psychopathological behaviors, the study of resilience and strengths can prove to be a key step in order to develop valuable preventive approaches to tackle psychiatric disorders.

Anxiety, bulimia, drug and alcohol addiction, depression, and schizophrenia: what do you think about their aetiology, dangerousness, social distance, and treatment? A latent class analysis approach.

PURPOSE: Mental illness stigma is a serious societal problem and a critical impediment to treatment seeking for mentally ill people. To improve the understanding of mental illness stigma, this study focuses on the simultaneous analysis of people's aetiological beliefs, attitudes (i.e. perceived dangerousness and social distance), and recommended treatments related to several mental disorders by devising an over-arching latent structure that could explain the relations among these variables. METHODS: Three hundred and sixty university students randomly received an unlabelled vignette depicting one of six mental disorders to be evaluated on the four variables on a Likert-type scale. A one-factor Latent Class Analysis (LCA) model was hypothesized, which comprised the four manifest variables as indicators and the mental disorder as external variable. RESULTS: The main findings were the following: (a) a one-factor LCA model was retrieved; (b) alcohol and drug addictions are the most strongly stigmatized; (c) a realistic opinion about the causes and treatment of schizophrenia, anxiety, bulimia, and depression was associated to lower prejudicial attitudes and social rejection. CONCLUSION: Beyond the general appraisal of mental illness an individual might have, the results generally point to the acknowledgement of the specific features of different diagnostic categories. The implications of the present results are discussed in the framework of a better understanding of mental illness stigma.

The relevance of security: A latent domain of attachment relationships.

In the present study an adult attachment dimension, latent to the constructs of security, anxiety, and avoidance, was hypothesized, wherein security was expected to occupy the most relevant position. Furthermore, the reciprocal functioning of attachment constructs and their interactions with self-esteem were explored. Four hundreds and thirty-four Italian university students responded to two adult attachment questionnaires (Attachment Style Questionnaire and Adult Attachment Questionnaire) and to the Rosenberg Self-esteem scale. A Many-Facet Rasch Measurement modeling approach was adopted. The main results can be summarized as follows: (a) security, anxiety, and avoidance are nested under one latent attachment dimension; (b) security occupies the most prominent position on the dimension; (c) security is positively associated with a moderate level of attachment anxiety and negatively related to avoidance; and (d) a positive interaction between self-esteem and security, and a negative relation between self-esteem and anxiety, were detected. Theoretical, clinical, and empirical implications of the results are further discussed.

Worry about the Future in the Climate Change Emergency: A Mediation Analysis of the Role of Eco-Anxiety and Emotion Regulation.

The climate change emergency is one of the most important challenges of our time, and its impact on mental health has been evident for years. It is very important for clinicians to delve deeper into these manifestations. There are a wide variety of constructs, symptoms, and scales to measure the impact of climate change on mental health. Eco-anxiety is one of the constructs that has specifically emerged, in association with worry, about the future. In mental health studies, it is important to explore the relationship between eco-anxiety and emotion regulation and how much this relationship leads to worry about the future in order to be able to offer clinical intervention recommendations. Indeed, the hypothesis of this study is that it is possible to develop worries about the future when symptoms of eco-anxiety and a poor ability to regulate emotions are present. Particularly, emotion dysregulation could increase eco-anxiety symptoms and generate worries about one's own future. For this reason, we have chosen to explore the relationships between these three constructs with the use of a mediation analysis. For this research, 351 participants were recruited in Italy. The proposed mediation model highlighted the findings that emotion dysregulation was positively related with eco-anxiety and that eco-anxiety predicts worry about the future. An association between emotion dysregulation and worry about the future was present. Eco-anxiety appeared to be an important mediator between emotional dysregulation and worry about the future. Emotion regulation could play a pivotal role in addressing concerns about the future. These findings could pave the way for exploring new research avenues and potential clinical interventions.

Measuring Motivations to Eat Palatable Foods: Adaptation and Psychometric Properties of the Italian Version of the Palatable Eating Motives Scale (PEMS-IT).

BACKGROUND: Gaining knowledge of the various reasons behind people's consumption of highly processed foods has the potential to enhance obesity prevention initiatives and open avenues to tailor treatment approaches for obesity and binge eating at a more personalized level. This contribution aimed to test the psychometric properties and factor structure of the Palatable Eating Motives Scale (PEMS-IT) in a community sample of Italian adults. METHODS: A confirmatory factor analysis was performed to test the factor structure of the Italian version of the PEMS (PEMS-IT) on a total of 616 respondents. Furthermore, the reliability and convergent validity analysis of the tool were evaluated. RESULTS: The analysis confirmed the four-factor structure of PEMS-IT [(YBχ2 (164) = 537.901; p < 0.001, the CFI = 0.918, RMSEA = 0.072; 90%CI [0.065-0.078]; p(RMSEA < 0.05) < 0.001, and SRMR = 0.080] and satisfactory reliability on its subscales (Cronbach's α: 0.745-0.917). Positive correlations were also found with food addiction and binge-eating symptoms, compulsive eating behavior, and uncontrolled and emotional eating. CONCLUSIONS: The PEMS-IT appears to be an instrument with promising psychometric properties and potential applications in clinical settings. However, it also has some limitations, and future studies could focus on improving the semantic content of the elements to increase the overall utility and precision of the instrument.

The Association between Grazing and Food Addiction: The Italian Version of the Repetitive Eating Questionnaire (Rep(Eat)-Q) and Its Relationships with Food Addiction Criteria.

BACKGROUND: Among the dysfunctional eating behaviors associated with excessive food intake, a construct that is gaining increasing attention is grazing-the constant, continuous, compulsive, and repetitive consumption of small/moderate amounts of food. Furthermore, in some cases, grazing seems to indicate a dependence on food and/or eating. Currently, the Repetitive Eating Questionnaire (Rep(Eat)-Q) appears to be the only questionnaire that comprehensively measures grazing, including its repetitive and compulsive eating component. Therefore, in a sample of individuals with severe obesity, the objective of this study was twofold: (A) to evaluate the psychometric properties of the Italian version of the Rep(Eat)-Q, and (B) to analyze the association between grazing and food addiction (FA). METHOD: A cross-sectional research design was used. A total of 402 inpatients with severe obesity (BMI > 35) were recruited. Participants underwent a series of questionnaires to investigate structural validity and convergent validity and association with FA criteria. RESULTS: The factorial structure of the Rep(Eat)-Q is robust and showed fit indexes: CFI = 0.973; RMSEA = 0.074; 90%CI [0.056-0.091]; and SRMR = 0.029. Also, it exhibited good internal consistency and convergent validity. Furthermore, logistic regression analysis highlights a specific association between certain FA criteria and grazing. CONCLUSIONS: The Rep(Eat)-Q can be considered to be a concise, robust, reliable, and statistically sound tool to assess repetitive eating, specifically grazing. Its strong psychometric properties offer significant advantages for both research and clinical applications. Furthermore, in a sample of individuals with severe obesity, the results suggest that individuals with problematic grazing exhibit a typical behavioral profile of subjects with FA, indicating that FA can manifest through problematic grazing as well.

The Italian version of the 16-item Prodromal Questionnaire (PQ-16) and its psychometric features in help-seeking ultra-high-risk subjects and in the general population.

BACKGROUND: Increasing attention to the early stages of psychosis and the identification of symptomatic prodromal states have led to the development of a growing number of screening tools. The 16-item version of the Prodromal Questionnaire (PQ-16) is a worldwide used self-administered tool for this purpose. However, to date, fundamental psychometric properties of PQ-16 were not thoroughly investigated. This study aimed to examine the structural validity, measurement invariance, reliability and other psychometrical properties of the Italian version of the PQ-16 (iPQ-16) in help-seeking individuals and in the general population. METHODS: The iPQ-16 was administered to 449 young outpatients attending six community mental health services and to 318 control participants enrolled in educational environment. Confirmatory factor analyses (CFAs), measurement invariance (MI) between the help-seeking group and the general population sample, convergent validity, test-retest reliability, internal consistency, and prevalence analyses were performed. Lastly, the validity of the adopted PQ-16 cut-offs through Receiver Operating Characteristic (ROC) curves plotted against CAARMS diagnoses was also tested. RESULTS: CFAs confirmed the single-factor structure for the iPQ-16 and scalar MI was reached. The iPQ-16 showed high internal consistency, test-retest reliability, convergent validity, and acceptable diagnostic accuracy. ROC analysis suggested a score of ≥4 as best cut-off. CONCLUSIONS: The iPQ-16 represents a valid and reliable questionnaire for the assessment of high mental risk in both Italian outpatients and general student population. It has good psychometric properties and is easy to implement as UHR screening for clinical as well as research purposes.

Validation of the Italian Version of the Web Screening Questionnaire for Common Mental Disorders.

BACKGROUND: The ever-increasing spread of Internet-based systems for common mental disorders has generated the need for brief online screening methods. This study aims to test the psychometric properties of the Web Screening Questionnaire (WSQ) to examine its suitability for screening for common mental health problems among a community sample of Italian adults. METHODS: A total of 1282 subjects (F = 819; mean age = 42.05) answered the WSQ. Its discriminant characteristics were examined with other validated selected scales for measuring mental health widely used in the Italian population using sensitivity, specificity, and area under the curve (AUC), as well as positive (PPV) and negative predictive values (NPV). RESULTS: Most of the WSQ subscales exhibited moderate to high specificity values. Specifically, the scales of 'agoraphobia' (0.947; 95%CI [0.934, 0.960]), 'anxiety' (0.959; 95%CI [0.946, 0.970]), and 'panic disorder' (0.973; 95%CI [0.964, 0.981]) showed the highest values whilst the 'obsessive-compulsive' dimension had the lowest value at 0.838, 95%CI [0.815, 0.861]. With exceptions observed for 'depression' (0.716; 95%CI [642, 798]) and 'alcohol abuse' (0.760; 95%CI [560, 920]), instead, the WSQ demonstrated critical sensitivity values (<0.6) in all dimensions. CONCLUSIONS: The WSQ was appropriate for discriminating between people with and without a psychiatric condition, as it helps to confirm the absence of disorders. However, further diagnostic procedures are required, in case of a positive WSQ screening result.

A Rasch-based dimension of delivery experience: spontaneous vs. medically assisted conception.

AIMS AND OBJECTIVES: To devise a set of indices representative of a latent dimension of delivery perception, aimed at the assessment of birth experience after both spontaneous and medically assisted conception. BACKGROUND: Birth experience is of great importance for its prognostic value for the woman and newborn's psychophysical well-being, especially after the experience of assisted reproduction technology. Up to date, a delivery perception assessment measure targeted to both spontaneously and medically assisted conceiving women does not exist yet. DESIGN: Measure development and psychometric analysis; quantitative and qualitative analysis of women's delivery experience measures. METHODS: Thirty-one indices characterising seven relevant aspects of birth perception were devised from the literature and evaluated on a 4-point Likert-type scale by 98 childbearing women (54 spontaneously and 44 medically assisted conceiving) in the 24-48 hours postpartum time frame. Women's obstetric history information was also collected. The dimension psychometric definition was pursued within a latent trait perspective, by applying the many-facet Rasch measurement model. RESULTS: A latent delivery perception dimension composed of 18 valid and reliable indices, qualifying six labour and delivery perception clinical aspects, was identified. Medically assisted conceiving women evidenced a more positive birth perception, but when analysing each index, they showed peculiar intense worries about themselves and their baby's health, even if they felt more satisfied, safer and stronger in almost every labour and birth aspect. CONCLUSIONS: The delivery perception dimension integrates all relevant birth experience aspects in 18 easy-to-administer indices and provides a valid, reliable and feasible assessment tool for both the clinical practice and research purposes. RELEVANCE TO CLINICAL PRACTICE: The delivery perception dimension clearly discriminates between women's types of conception and identifies relevant differences in their birth experience, which are interesting for their clinical implications within a prognostic and intervention perspective of support provision in the early postpartum period.