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According to the main international guidelines, patients with obesity and psychiatric/psychological disorders who cannot be addressed to surgery are recommended to follow a nutritional approach and a psychological treatment. A total of 94 patients (T0) completed a battery of self-report measures: Symptom Checklist-90-Revised (SCL-90-R), Barratt Impulsiveness Scale-11 (BIS-11), Binge-Eating Scale (BES), Obesity-Related Well-Being Questionnaire-97 (ORWELL-97), and Minnesota Multiphasic Personality Inventory-2 (MMPI-2). Then, twelve sessions of a brief psychodynamic psychotherapy were delivered, which was followed by the participants completing the follow-up evaluation (T1). Two groups of patients were identified: Group 1 (n = 65), who fully completed the assessment in both T0 and T1; and Group 2-dropout (n = 29), who fulfilled the assessment only at T0 and not at T1. Machine learning models were implemented to investigate which variables were most associated with treatment failure. The classification tree model identified patients who were dropping out of treatment with an accuracy of about 80% by considering two variables: the MMPI-2 Correction (K) scale and the SCL-90-R Phobic Anxiety (PHOB) scale. Given the limited number of studies on this topic, the present results highlight the importance of considering the patient's level of adaptation and the social context in which they are integrated in treatment planning. Cautionary notes, implications, and future directions are discussed.
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Cirurgia Bariátrica , Aprendizado de Máquina , Obesidade , Pacientes Desistentes do Tratamento , Humanos , Feminino , Masculino , Adulto , Obesidade/psicologia , Obesidade/cirurgia , Obesidade/terapia , Itália , Pessoa de Meia-Idade , Cirurgia Bariátrica/psicologia , Pacientes Desistentes do Tratamento/estatística & dados numéricos , Pacientes Desistentes do Tratamento/psicologia , Sobrepeso/psicologia , Sobrepeso/terapia , Inquéritos e Questionários , Psicoterapia PsicodinâmicaRESUMO
The present study tested the influence of stimuli emotional valence, emotional arousal, and typicality on memory recollection in three groups of participants exposed to the same environment through different modalities: in vivo exposure (i.e., real-life), 3D virtual reality (i.e., VR), and 2D pictures. Context-related free-recall, recognition accuracy, and recognition confidence were analyzed. The results showed that memory performance was best in the real-life modality, and participants in the VR and 2D pictures modalities performed comparably. Interesting effects of stimuli emotional valence and typicality emerged: in the VR and 2D pictures modalities, positive items were better recalled than negative items; typicality was relevant only in the real-life modality, with less common objects within the explored setting (i.e., an office) recalled more often. Furthermore, recognition accuracy and confidence were significantly higher in the real-life modality than in the VR and 2D pictures modalities. Further research is needed to support the creation of VR environments that are sufficiently comparable to real-life contexts in order to obtain higher ecological validity in studies of cognitive performance. In particular, the impact of stimuli typicality and emotional valence in VR contexts should be investigated to gain insight into how these features might improve memory recall in virtual scenarios.
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Emoções , Realidade Virtual , Humanos , Memória , Rememoração Mental , Reconhecimento PsicológicoRESUMO
Expressed Emotion (EE) describes the tone of a caregiver's response to a patient with a mental disorder, and it is used to predict relapse. The Five-Minute Speech Sample (FMSS) is a 5-min interview with a caregiver that evaluates only two EE dimensions. The present study aimed at evaluating HEE (High Expressed Emotion) as a predictor of relapse in patients with schizophrenia and major depressive disorder. Six studies were selected for the meta-analysis. In total, the studies included 297 subjects. The analyses included a random effects model; a meta-analysis excluding the study with the smallest sample; a cumulative meta-analysis; a meta-regression with random effects, using patient age and duration of illness as moderators; a leave-one-out meta-analysis; and a funnel plot to estimate publication bias. The FMSS emerged as a valid and reliable tool for measuring EE as a predictor of relapse in patients with schizophrenia and major depressive disorder. Patient age and duration of illness had no significant effect on the results. Future meta-analyses should include more studies to reduce publication bias. EE may be a good predictor of relapse when examined through a fast measurement technique such as the FMSS, which may also be useful to analyze the psychopathological structure of caregivers.
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OBJECTIVES: This study aims to explore the long-term efficacy of a psychoeducational family intervention (PFI) in bipolar I disorder at one and five years post-intervention in terms of improvement of: (1) patients' symptoms and global functioning and (2) relatives' objective and subjective burden and coping strategies. METHODS: This is a multicentre, real-world, controlled, outpatient trial. Recruited patients and key-relatives were consecutively allocated to the experimental intervention or treatment as usual. Patients were assessed at baseline, and after one and five years. RESULTS: One hundred and thirty-seventh number families have been recruited; 70 have been allocated to the experimental intervention, and 67 have been allocated to the control group. We observed an increasing positive effect of the PFI on patients' clinical status, global functioning and objective and subjective burden after one year. We also found a reduction in the levels of relatives' objective and subjective burden and a significant improvement in the levels of perceived professional support and of coping strategies. The efficacy of PFI on patients' clinical status was maintained at five years from the end of the intervention, in terms of relapses, hospitalizations and suicide attempts. CONCLUSIONS: The study showed that the provision of PFI in real-world settings is associated with a significant improvement of patients' and relatives' mental health and psychosocial functioning in the long term. We found that the clinical efficacy of the intervention, in terms of reduction of patients' relapses, hospitalization and suicide attempts, persists after 5 years. It is advisable that PFI is provided to patients with BD I in routine practice.
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Transtorno Bipolar , Adaptação Psicológica , Transtorno Bipolar/terapia , Família/psicologia , Hospitalização , Humanos , Saúde Mental , RecidivaRESUMO
The COVID-19 pandemic and its protective measures had a tremendous effect on the general population's mental health and deeply affected their lifestyle. The present study carried out a longitudinal analysis to evaluate the long-lasting psychological effects of the pandemic and its impact on the general population's day-to-day routine. Three points in time were considered: the initial period of the lockdown (T1; n = 2766; March 2020), the final period of the lockdown (T2; n = 439; May 2020) and two years after the lockdown (T3; n = 268; July 2022). Frequency analyses were carried out to examine which behavioral changes were maintained following the COVID-19 pandemic and lockdown; furthermore, a repeated measures ANOVA test was run to measure differences in depression, stress, and anxiety levels between the three periods considered; lastly, multivariable ordinal logistic regression analyses were carried out to examine which variables were associated with psychological distress more than two years after the lockdown. The results highlighted that depression at T3 was associated with depression at T2 and negative affect, whereas stress at T3 was associated with stress at T2 and detachment. The psychological effects and lifestyle changes are also discussed.
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COVID-19 , Humanos , COVID-19/epidemiologia , COVID-19/psicologia , Saúde Mental , SARS-CoV-2 , Estudos Longitudinais , Pandemias , Ansiedade/epidemiologia , Ansiedade/psicologia , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia , Controle de Doenças Transmissíveis , Depressão/epidemiologia , Depressão/psicologia , Estilo de VidaRESUMO
The current study aimed at increasing our understanding of the psychological impact of the COVID-19 lockdown on undergraduate students, particularly with respect to the association between personality traits; defense mechanisms (DMs); depression, anxiety, and stress symptoms (DASSs); and compliance with the government recommended health measures. A sample of 1,427 Italian undergraduate students were administered the Personality Inventory for the DSM-5-Brief Form; the Defense Style Questionnaire-40; and the Depression, Anxiety and Stress Scale-21. Compliance with the COVID-19 behavioral recommendations was measured through a 10-item survey measure. Results showed that immature DMs and internalizing personality traits (i.e., detachment, negative affect, psychoticism) were risk factors of DASSs. Furthermore, subjects with higher levels of DASSs appeared less compliant with the health measures recommended by the Italian government. Experts may use these results to identify and subsequently support (via the Internet) young subjects at greater risk of mental health problems as a result of the COVID-19 pandemic.
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Internet addiction (IA) has mostly been investigated with the fear of missing out and difficulties in emotional regulation. The present study examined the link between IA and variables related to problematic social media use (i.e., fear of missing out, social media addiction), together with emotional (dys)regulation and personality traits, providing new insights and an integrated assessment of IA. In total, 397 participants, aged 18-35 years (M = 22.00; SD = 3.83), were administered a set of questionnaires pertaining to IA, problematic social media use, emotional (dys)regulation, and personality traits. Pearson's correlations showed significant associations between IA and the investigated variables, and the tested mediation model highlighted the crucial role played by emotional (dys)regulation in the fear of missing out and problematic use of social networks. Overall, the findings provide support for a new integrated model for understanding the features, predictors, and risk factors of IA.
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Most studies on well-being during the COVID-19 pandemic have focused on the mental health of the general population; far less attention has been given to more specific populations, such as patients with mental illness. Indeed, it is important to examine the psychiatric population, given its vulnerability. The present study aimed at assessing the psychological and emotional impact of isolation on patients in Residential Rehabilitation Communities, compared to healthy controls. A questionnaire was administered cross-sectionally on an online survey platform and both psychiatric patients and healthy controls accessed via a designed link. The results showed significant differences between psychiatric patients and controls on Anxiety, Stress, Worry, and Risk Perception variables. Psychiatric patients scored lower on Stress compared to healthy controls and higher on Anxiety, Perceived Risk of getting infected with COVID-19 and Worry about the emergency situation. The results showed that, during the Italian lockdown, psychiatric patients living in residential communities received unbroken support from peers and mental health professionals, maintained their usual medication treatment, and were informed of COVID-19 consequences. This finding provides insight into the differences between residential and healthy populations and highlights the importance of continuous support for psychiatric patients, especially during stressful situations such as a pandemic.
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Interrogative suggestibility (IS) describes the extent to which an individual behavioral response is affected by messages communicated during formal questioning within a closed social interaction. The present study aimed at improving knowledge about IS in the elderly (aged 65 years and older), in particular about its association with both emotive/affective and cognitive variables. The sample (N = 172) was divided into three groups on the basis of age: late adult (aged 55-64, N = 59), young elderly (aged 65-74, N = 63), and elderly (aged 75 and older, N = 50). Cognitive (i.e., Kaufman Brief Intelligence Test-2, Rey Auditory Verbal Learning Test), emotive/affective (i.e., Rosenberg Self-Esteem Scale, Marlowe-Crowne Social Desirability Scale, Penn State Worry Questionnaire) and suggestibility measures (i.e., Gudjonsson Suggestibility Scale-2) were administered. In order to identify differences and associations between groups in IS, cognitive and emotive/affective variables, ANOVAs tests and Pearson's correlations were run. Furthermore, moderation analyses and hierarchical regression were set to determine whether age, cognitive and emotive/affective variables predicted IS components (i.e., Yield and Shift). Finally, machine learning models were developed to highlight the best strategy for classifying elderly subjects with high suggestibility. The results corroborated the significant link between IS and age, showing that elderly participants had the worst performance on all suggestibility indexes. Age was also the most important predictor of both Yield and Shift. Results also confirmed the important role of non-verbal intelligence and memory impairment in explaining IS dimensions, showing that these associations were stronger in young elderly and elderly groups. Implications about interrogative procedures with older adults were discussed.
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Sugestão , Idoso , Idoso de 80 Anos ou mais , Algoritmos , Análise de Variância , Cognição/fisiologia , Emoções/fisiologia , Feminino , Humanos , Modelos Lineares , Aprendizado de Máquina , Masculino , Pessoa de Meia-IdadeRESUMO
The spread of coronavirus disease 2019 (COVID-19) has called for unprecedented measures, including a national lockdown in Italy. The present study aimed at identifying psychological changes (e.g., changes in depression, stress, and anxiety levels) among the Italian public during the lockdown period, in addition to factors associated with these changes. An online follow-up survey was administered to 439 participants (original sample = 2766), between 28 April and 3 May 2020. A paired sample t-test tested for differences in stress, anxiety, and depression over the period. Multivariate regression models examined associations between sociodemographic variables, personality traits, coping strategies, depression, and stress. Results showed an increase in stress and depression over the lockdown, but not anxiety. Negative affect and detachment were associated with higher levels of depression and stress. Higher levels of depression at the start of the lockdown, as well as fewer coping strategies and childlessness, were associated with increased depression at follow-up, whereas higher levels of stress at the start of the lockdown and younger age were associated with higher stress at follow-up. These results may help us to identify persons at greater risk of suffering from psychological distress as a result lockdown conditions, and inform psychological interventions targeting post-traumatic symptoms.
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Infecções por Coronavirus/psicologia , Depressão/epidemiologia , Pneumonia Viral/psicologia , Angústia Psicológica , Ansiedade/epidemiologia , Betacoronavirus , COVID-19 , Seguimentos , Humanos , Itália/epidemiologia , Pandemias , SARS-CoV-2 , Isolamento SocialRESUMO
In the wake of the sudden spread of COVID-19, a large amount of the Italian population practiced incongruous behaviors with the protective health measures. The present study aimed at examining psychological and psychosocial variables that could predict behavioral compliance. An online survey was administered from 18-22 March 2020 to 2766 participants. Paired sample t-tests were run to compare efficacy perception with behavioral compliance. Mediation and moderated mediation models were constructed to explore the association between perceived efficacy and compliance, mediated by self-efficacy and moderated by risk perception and civic attitudes. Machine learning algorithms were trained to predict which individuals would be more likely to comply with protective measures. Results indicated significantly lower scores in behavioral compliance than efficacy perception. Risk perception and civic attitudes as moderators rendered the mediating effect of self-efficacy insignificant. Perceived efficacy on the adoption of recommended behaviors varied in accordance with risk perception and civic engagement. The 14 collected variables, entered as predictors in machine learning models, produced an ROC area in the range of 0.82-0.91 classifying individuals as high versus low compliance. Overall, these findings could be helpful in guiding age-tailored information/advertising campaigns in countries affected by COVID-19 and directing further research on behavioral compliance.
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Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus/prevenção & controle , Aprendizado de Máquina , Pandemias/prevenção & controle , Cooperação do Paciente/estatística & dados numéricos , Pneumonia Viral/prevenção & controle , Algoritmos , Betacoronavirus , COVID-19 , Humanos , Itália , SARS-CoV-2RESUMO
The uncontrolled spread of the coronavirus disease 2019 (COVID-19) has called for unprecedented measures, to the extent that the Italian government has imposed a quarantine on the entire country. Quarantine has a huge impact and can cause considerable psychological strain. The present study aims to establish the prevalence of psychiatric symptoms and identify risk and protective factors for psychological distress in the general population. An online survey was administered from 18-22 March 2020 to 2766 participants. Multivariate ordinal logistic regression models were constructed to examine the associations between sociodemographic variables; personality traits; depression, anxiety, and stress. Female gender, negative affect, and detachment were associated with higher levels of depression, anxiety, and stress. Having an acquaintance infected was associated with increased levels of both depression and stress, whereas a history of stressful situations and medical problems was associated with higher levels of depression and anxiety. Finally, those with a family member infected and young person who had to work outside their domicile presented higher levels of anxiety and stress, respectively. This epidemiological picture is an important benchmark for identifying persons at greater risk of suffering from psychological distress and the results are useful for tailoring psychological interventions targeting the post-traumatic nature of the distress.
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Infecções por Coronavirus/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Angústia Psicológica , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ansiedade/epidemiologia , COVID-19 , Infecções por Coronavirus/prevenção & controle , Depressão/epidemiologia , Feminino , Inquéritos Epidemiológicos , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Quarentena/psicologia , Fatores de Risco , Adulto JovemRESUMO
Background: Psychoeducational family intervention (PFI) has been proven to be effective in improving the levels of family burden and patients' personal functioning in schizophrenia and bipolar disorders (BDs). Less is known about the impact of PFI on relatives' coping strategies in BD. Methods: A multicenter, controlled, outpatient trial funded by the Italian Ministry of Health and coordinated by the Department of Psychiatry of the University of Campania "Luigi Vanvitelli" has been conducted in patients with bipolar I disorder (BD-I) and their key relatives consecutively recruited in 11 randomly selected Italian community mental health centers. We aim to test the hypothesis that PFI improves problem-oriented coping strategies in relatives of BD-I patients compared to the Treatment As Usual (TAU) group. Results: The final sample was constituted of 123 patients and 139 relatives. At baseline assessment (T0), the vast majority of relatives already adopted problem-oriented coping strategies more frequently than the emotion-focused ones. At the end of the intervention, relatives receiving PFI reported a higher endorsement of adaptive coping strategies, such as "maintenance of social interests" (odds ratio [OR]=0.309, CI=0.04-0.57; p=0.023), "positive communication with the patient" (OR=0.295, CI=0.13-0.46; p=0.001), and "searching for information" (OR=0.443, CI=0.12-0.76; p=0.007), compared to TAU relatives, after controlling for several confounders. As regards the emotion-focused coping strategies, relatives receiving the experimental intervention less frequently reported to adopt "resignation" (OR=-0.380, CI=-0.68 to -0.08; p=0.014) and "coercion" (OR=-0.268, CI=-0.46 to -0.08; p=0.006) strategies, compared to TAU relatives. Conclusion: PFI is effective in improving the adaptive coping strategies of relatives of BD-I patients, but further studies are needed for evaluating the long-term benefits of this intervention.
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Bread characteristics are dependent upon the chemical composition and fiber content of the wheat flour used. A healthy diet can help prevent chronic diseases, where whole grains and fewer calories from fat are components of a healthy diet. The aims of this study were to determine the centesimal composition of wheat flour samples (whole, refined, and flour blends) along with their farinographic parameters (water absorption, development time and stability) and also to verify the specific volume, crumb texture profile and digital imaging of bread loaves made with 60% whole wheat flour and 3% fat or fat replacer. Increasing the whole wheat flour percentage in the blends also increased levels of protein, ash and insoluble fiber. All the farinographic parameters were also increased. Enzymatically modified starch was found to be an effective fat replacer in whole wheat loaves. The loaves made using fat replacer had the same specific volume and higher cell density as those made with fat, but exhibited different texture profile parameters such as higher hardness value and lower springiness value.
A composição química da farinha de trigo e a presença de fibras afeta as características dos pães. Uma forma de contribuir com a prevenção de doenças crônicas não transmissíveis é através de alimentação saudável, incluindo grãos integrais na dieta alimentar e reduzindo as calorias de determinado alimento, substituindo a gordura. Assim, este trabalho tem como objetivo determinar a composição centesimal das amostras de farinha de trigo integral, refinada e as misturas entre elas; bem como os parâmetros farinográficos (absorção de água, tempo de desenvolvimento e estabilidade) das mesmas. Além disso, verificar volume específico, perfil de textura do miolo e análise de imagem de pães elaborados com 60% de farinha de trigo integral e com 3% de gordura ou com substituto de gordura. Os dados foram submetidos à análise de variância. À medida que aumenta o percentual de farinha integral, os teores de proteína, cinzas e fibra insolúvel alcançam valores significativamente maiores e a absorção de água fica maior na farinografia, bem como o tempo de desenvolvimento e a estabilidade. O amido modificado enzimaticamente utilizado na elaboração de pão com 60% de farinha de trigo integral funcionou como um efetivo substituto de gordura. O pão integral elaborado com substituto de gordura apresentou volume específico significativamente igual ao pão integral elaborado com gordura, porém com diferenças em relação a parâmetros do perfil de textura, maior firmeza e menor elasticidade além de maior densidade celular do que o pão elaborado com gordura.