Pre-operative body shape concerns moderate excess weight loss trajectory in bariatric surgery patients: a 2-year longitudinal study.

PURPOSE: The main research aim was to inspect whether pre-operative body shape concerns and discomfort as Body Shape Questionnaire (BSQ) scores moderate post-operative weight loss trajectory in bariatric patients. METHODS: Two studies were conducted. Study 1 analyzed cross-sectional data and verified the structural validity of the 34-item BSQ questionnaire on a sample of 327 candidates for bariatric surgery. Study 2 examined longitudinal data, with objective Body Mass Index (BMI) recorded every 6 months, from surgery intervention on, with 5 measurement occasions, from 111 patients who initially completed BSQ as bariatric surgery candidates and then underwent periodic medical post-operative follow-ups, over 2 years. RESULTS: In Study 1, confirmatory factor analysis of a single-dimension model yielded acceptable fit indices and high internal consistency levels. Study 2 showed that post-operative excess BMI reduction trend was not linear and pre-operative BSQ scores moderated it, with a higher risk of weight regain in patients who initially were less concerned with their body shape. CONCLUSIONS: The present findings support the structural validity of the BSQ questionnaire in bariatric candidates and call attention on the role of pre-operative body shape concerns on post-operative weight loss trajectories over 2 years, in accordance with a pathoplasty model. They suggest the need for systematic attention on perceived body image and psychological paths aimed to help bariatric patients regain positive attitudes towards their own body. Level of evidence III, well-designed cohort.

Validation of the Italian version of the Dark Tetrad at Work scale.

This study presents and validates the Italian adaptation of the Dark Tetrad at Work (DTW) scale, an instrument for assessing four socially aversive personality traits (narcissism, Machiavellianism, psychopathy and sadism) in the context of the workplace. A total of 300 Italian-speaking participants (50% female, M age = 32 years ± 9.2) and 253 English-speaking participants (38% female, M age = 39 years ± 12.1) were recruited via an online survey platform. The Italian-speaking sample was used to test the factorial structure, reliability and criterion-related validity of the Italian version of the DTW, whereas the English-speaking sample was used to test cross-language measurement invariance. Results from confirmatory factor analysis showed that the original four-factor model provided the best fit to the data. The Italian DTW scale demonstrated acceptable internal consistency, with reliability coefficients of ω = .77 for narcissism, ω = .80 for Machiavellianism, and ω = .81 for both psychopathy and sadism. Concurrent associations between the DTW scales and negative and positive workplace outcomes supported the criterion validity of the scale. Machiavellianism, psychopathy, and sadism positively correlated with counterproductive work behaviors and workplace bullying, and negatively with organizational citizenship behaviors and affective organizational commitment. In contrast, narcissism exhibited a unique pattern: It correlated positively with positive workplace behaviors and negatively with counterproductive behaviors toward the organization, but it was also found to be a significant predictor of workplace bullying. This finding may reflect multidimensional nature of narcissism, but a note of caution is warranted in interpreting this result, as all measurements relied on self-report instruments, introducing the possibility of socially desirable associations influencing the outcomes. Finally, the comparison with the English sample established configural, full metric and partial scale invariance, allowing for valid cross-language comparisons between Italian and English-speaking populations in the future. Preliminary Italian normative data were provided to offer a benchmark for the interpretation of DTW values. This study provides a reliable and valid instrument tailored to the Italian workforce, enhancing our understanding of dark personality traits within organizational contexts and providing organizations with an effective means to address and manage dark personality traits for a healthier workplace culture.

Body Uneasiness, Body Figure Perception, and Body Weight: Factor Structure and Longitudinal Measurement Invariance of a Set of Attitudinal and Perceptual Body Image Assessment Tools in Adolescents.

Body image is a multifaceted construct that includes attitudinal and perceptual components, but its attention has mainly been focused on the facet of body dissatisfaction. The present longitudinal study extended the validation of a multifacet attitudinal questionnaire, the Body Uneasiness Test (BUT), against perceptions of body shape and weight. A convenient sample of adolescents took part in a 2-year unbalanced panel study (5 waves). The participants completed the BUT questionnaire and selected their perceived actual, ideal, and reflected body figures along the Contour Drawing Rating Scale; ideal/actual and ideal/normative body mass index discrepancies were also included. After replicating the expected five-factor structure of the BUT items, results from confirmatory factor analysis revealed that the five BUT scales loaded on an attitudinal dimension, whereas the perceived body figures and the discrepancy indices were on a perceptive domain. Such a two-domain structure of body image measures showed gender and seasonal (1-year) measurement invariance, whereas longitudinal 6-month and 18-month invariance partially failed. Overall, the present findings support the validity of the Body Uneasiness Test in adolescence, further demonstrating a preliminary multidimensional structure of body image onto which attitudinal and perceptual body image-related measures were projected.

SCL-90 empirical factors predict post-surgery weight loss in bariatric patients over longer time periods.

PURPOSE: This longitudinal study examined how pre-intervention psychological health helps predict bariatric surgery (BS) success as percentage of expected body mass index loss (%EBMIL) over shorter to longer periods. METHODS: Adult candidates for BS (N = 334, 67.4% females) completed the Symptoms Checklist 90 (SCL-90) questionnaire; on average, 11 months occurred between the pre-surgery psychological evaluations and the bariatric intervention. We explored the factor structure of the SCL-90 items and inspected how SCL-90 empirical factors compared with SCL-90 scales and general indices predicted %EBMIL at 3-6-month, 1-year, and 2-year follow-up occasions, adjusting for gender, pre-intervention use of antidepressants and actual and ideal BMIs. RESULTS: Factor analysis combined the 90 items into 8 factors, which partially replicated the expected item structure. The SCL-90 empirical factors (but not the SCL-90 scales and indices) contributed to predict BS success. In fact, the Relational Distress factor directly protected from weight regain at 1-year follow-up, indirectly via 1-year %EBMIL at the 2-year follow-up, when it further strengthened the impact of the empirical factor of Generalized Anxiety on the 2-year BS outcome. The results also evidenced a cascade effect of the pre-surgery actual BMI across time as well as unique and direct effects of pre-surgery use of antidepressants and perceived ideal BMI on the 2-year outcome. CONCLUSIONS: SCL-90 empirical factor scores for obese patients are more efficient in anticipating BS success compared with original scale scores. They reveal that relational distress and anxiety are risk factors for postoperative weight loss, in addition to pre-intervention actual BMI, antidepressant therapy, and perceived ideal BMI. LEVEL OF EVIDENCE: III, well-designed cohort.

Longitudinal Impact of Social Restrictions on Sexual Health in the Italian Population.

BACKGROUND: Several trials have reported on the impact of social restrictions due to SARS-CoV-2 (COVID-19) pandemic on sexual function and psycho-physical well-being. However, data showing modifications of these outcomes over time and at the end of lock-down are scant. AIM: We investigated the longitudinal changes in sexual function during social restrictions for COVID-19 pandemic in Italy. METHODS: A web-based survey was administered to Italian citizens of legal age via social networks. The Beck Depression Inventory Primary Care, the General Health Survey, Female Sexual Function Index, International Index of Erectile Function, UCLA Loneliness Scale-version 3 questionnaires were used to test mental, physical and sexual well-being. The questionnaires were administered at the beginning of the lockdown (T0), 15 days from the first assessment (T1) and 1 month after the end of the restrictions in 2020 (T2). OUTCOMES: Descriptive statistics and multiple regression analysis were applied to investigate changes in sexual function over and at the end of social restrictions. RESULTS: Data were available for 2543 people (47.2% of men; 43.4% women; 9.4% undefined). Mean age was 48.3 ± 15.1 years for males and 43.9 ± 13.4 for females. Overall, 2.6% reported depressive symptoms according to Beck Depression Inventory Primary Care, 7.4% reported a high level of UCLA loneliness and 19.4% low levels of general mental health. Mild to severe erectile dysfunction was reported by 59.1% of men at T0, while 68.4% of women reported sexual dysfunction. Sexual function levels remain generally unchanged at further follow-up over the social restriction time period (T1), although those who were sexually active at baseline showed a decrease in sexual function scores. At T2, there was an overall improvement in sexual function scores with a rate of severe erectile dysfunction decreasing from 37.1% to 24.1% from T0 to T2 among males and a significant decrease of female sexual dysfunction from 68.4% to 51.2%. CLINICAL IMPLICATIONS: Young individuals and those with good mental and physical health were more likely to improve sexual function at the end of social restrictions. STRENGTHS & LIMITATIONS: Valid and reliable questionnaires and longitudinal approach design represent strengths; a large but convenient sample and lack of pre-pandemic baseline data represent limits. CONCLUSION: Social restrictions due to COVID-19 pandemic led to an increase in sexual dysfunctions in both genders. However, these conditions appeared temporary since an overall improvement was observed at the end of lockdown and especially in younger individuals with higher psycho-physical well-being. Vedovo F, Capogrosso P, Di Blas L, et al. Longitudinal Impact of Social Restrictions on Sexual Health in the Italian Population. J Sex Med 2022;19:923-932.

Exploring the stability of HEXACO-60 structure and the association of gender, age, and social position with personality traits across 18 countries.

OBJECTIVES: The present paper tests the cross-national stability of the HEXACO-60 structure across 18 countries from four continents. Gender and age differences across countries will be examined. Finally, this is the first study to explicitly analyze the relationships between the HEXACO and social position. METHOD: Ten thousand two hundred and ninety eight subjects (5,410 women and 4,888 men) from 18 countries and 13 languages were analyzed. Confirmatory factor analysis techniques were used to test configural, metric and scalar invariance models. Congruence coefficients with the original structure of the HEXACO-60 were computed for every culture. Effect sizes of gender, age, and social position factors across countries were also computed. RESULTS: HEXACO-60 demonstrates configural and metric invariance, but not scalar invariance. Congruence coefficients show a great equivalence in almost all countries and factors. Only Emotionality presents a large gender difference across countries. No relevant effect of age is observed. A profile of high scores on Honesty-Humility, Extraversion, Conscientiousness, and Openness to Experience, and low scores on Emotionality increases the likelihood of achieving a higher social position, although the effect sizes are small. CONCLUSIONS: HEXACO-60 is a useful instrument to conduct personality trait research and practice around the world. Implications of gender, social position, and country differences are discussed.

Physical, Mental and Sexual Health Among Transgender Women: A Comparative Study Among Operated Transgender and Cisgender Women in a National Tertiary Referral Network.

BACKGROUND: Few studies have investigated how physical, mental and sexual function are associated with each other in operated transgender women (oTW). AIM: To provide information on the physical, mental and sexual health of oTW in comparison with a group of cisgender women (cisW). METHODS: An age-matched control study was carried out, recruiting 125 oTW in 7 national referral centers and 80 volunteer women. Beck Depression Inventory Primary Care (BDI-PC), General Health Survey (SF-36), Female Sexual Function Index (FSFI) and operated Male to Female Sexual Function Index (oMtFSI) questionnaires were web-based administered. Data included: age, area of origin, educational level, sexual orientation, years since surgery and hormone therapy. OUTCOMES: T-test was applied to inspect mean score differences between oTW and cisW, in mental, sexual and physical health; simple correlations and multiple regression analysis revealed how mental, sexual and physical health were concurrently associated in the two groups RESULTS: Response rate 60% (52% oTW, 71% cisW). oTW mean age 38.5 years (SD = 9.3), cisW 37.7 years (SD = 11.5). Both cisW and oTW reported average values in the range of mental, physical and sexual health. Statistical comparisons revealed no significant group differences in mental and physical health. oTW who referred a worse sexual function also reported worse overall mental well-being and higher levels of depressive symptoms. FSFI scores were negatively associated with years since surgery, but not with age. Multiple regression analysis showed that FSFI Pain accounted for a significant unique variance proportion of risk of depression in oTW. FSFI Sexual Pain was the strongest estimator of inter-individual differences in BDI-PC among oTW (P < .01). CLINICAL IMPLICATIONS: No significant differences in the levels of depressive symptoms, physical and mental well- being were found in oTW and cis-W. The relation between depressive symptoms and sexual function in oTW is stronger than in cisW, and sexual pain substantially predicts risk of depression in oTW. STRENGTHS & LIMITATIONS: The evaluation of outcomes using validated questionnaires and the relatively large sample size. The convenience control group reported mental, physical and sexual health levels within the range of Italian normative data. Since this is a cross-sectional study, we must be careful in drawing conclusions from our results. CONCLUSIONS: Sexual pain and lubrication difficulties are the main causes of worse sexual function in oTW, highlighting the importance of perioperative counseling to make surgical expectations realistic and to educate to a proper neovagina management. Vedovo F, Di Blas L, Aretusi F, et al. Physical, Mental and Sexual Health Among Transgender Women. A comparative Study Among Operated Transgender and Cisgender Women in a National Tertiary Referral Network. J Sex Med Rev 2021;18:982-989.

Operated Male-to-Female Sexual Function Index: Validity of the First Questionnaire Developed to Assess Sexual Function after Male-to-Female Gender Affirming Surgery.

PURPOSE: No questionnaire is currently available to evaluate sexual function after male-to-female gender affirming surgery. Such a limit leads to a suboptimal evaluation in postoperative sexual function in these patients. We developed and validated a new questionnaire, the oMtFSFI (operated Male-to-Female Sexual Function Index), for assessing sexual function in male-to-female patients after surgery. MATERIALS AND METHODS: A panel of experts in gender dysphoria defined the main content areas to be assessed, including genital self-image, desire, arousal, lubrication, orgasm, satisfaction and sexual pain. After a pretest on 10 patients the oMtFSFI was applied in the main study to 65 operated male-to-female patients, recruited at 7 Italian centers, and 57 women. The participants provided self-ratings on online oMtFSFI, Female Sexual Function Index, Beck Depression Inventory for Primary Care and Short Form Health Survey questionnaires. Operated male-to-female patients completed the oMtFSFI twice, 4 weeks apart. RESULTS: Principal component analysis performed on self-ratings provided by operated male-to-female patients on oMtFSFI items yielded a 3-domain structure of sexual dissatisfaction, sexual pain and genital self-image. The 3 domains were internally consistent and test-retest reliable. Convergent associations with Female Sexual Function Index scales emerged for sexual dissatisfaction and sexual pain but not for genital self-image. Male-to-female patients reported lower sexual function levels than cisgender women. CONCLUSIONS: The present preliminary results support reliability and psychometric validity of the oMtFSFI in the assessment of key sexual function domains in transgender women, further revealing that genital self-image represents an assessment area to be considered in male-to-female patients, in addition to domains that are salient for cis women as well.

Multicultural Validation of the Zuckerman-Kuhlman-Aluja Personality Questionnaire Shortened Form (ZKA-PQ/SF) Across 18 Countries.

The aim of this study was to assess the psychometric properties of the Zuckerman-Kuhlman-Aluja Personality Questionnaire shortened form (ZKA-PQ/SF) in 18 cultures and 13 languages of different African, American, Asian, and European cultures and languages. The results showed that the five-factor structure with 20 facets replicated well across cultures with a total congruence coefficient of .97. A confirmatory factor analysis (CFA) resulted in adequate fit indices for the five factors based on the comparative fit index (CFI), Tucker-Lewis index (TLI; >.90), and RMSEA (.031-.081). A series of CFA to assess measurement invariance across cultures resulted in adequate CFIs and TLIs for configural and metric invariance. However, factors did not show scalar invariance. Alpha internal consistencies of five factors ranged between .77 (Sensation Seeking) and .86 (Neuroticism). The average alpha of the 20 facets was .64 with a range from .43 (SS4) to .75 (AG1). Nevertheless, alpha reliabilities were lower in some facets and cultures, especially for Senegal and Togo. The average percentage of the variance explained based on the adjusted R2 was 2.9%, 1.7%, and 5.1% for age, sex, and, cultures, respectively. Finally, multidimensional scaling suggested that geographically or culturally close cultures share mean profile similarities.

A prospective study on the reciprocal influence between personality and attitudes, behaviors, and psychological characteristics salient in eating disorders in a sample of non-clinical adolescents.

Eating disorders are mosy likely to occur for the first time in adolescence. Delineating vulnerable personality profiles of unhealthy conditions helps prevent their onset and development. This study investigated a non-clinical sample of 142 adolescents and how some theoretically salient individual differences in personality contribute to predict changes in behaviors, attitudes, and psychological characteristics that are clinically significant in eating disorders (EDs). The results from cross-lagged pattern analyses supported the influence of depression, obsessiveness, and self-esteem in the trajectories favoring the development of psychological characteristics, such as ineffectiveness and interoceptive awareness, which are salient in the ED risk process. Results also confirmed that body mass index, perfectionism, and body dissatisfaction predict increases in dysfunctional concerns with weight control and food consumption. Empirical support for the impact of ED-relevant variables on personality self-views emerged as well. Trajectories linking EDs and personality in relation to sex differences and permeability to transitory psychological conditions in adolescence were also confirmed.

Adolescents' Appraisal of Homophobic Epithets: The Role of Individual and Situational Factors.

Homophobic epithets have become commonly used insults among adolescents. However, evidence suggests that there are differences in how these homophobic epithets are evaluated based on beliefs held by the observer and the context in which they are used. To examine this, Italian high school students were asked to rate the offensiveness of homophobic epithets, as well as to consider how they or others would react to homophobic epithets across various situations. Homophobic beliefs and beliefs about the social acceptability of homophobic epithets were also examined. It was found that greater perceived social acceptability of homophobic epithets was related to dismissive reactions to their use, whereas homophobic beliefs were predictive of negative emotional reactions but in varying ways depending on the specific context. The results indicate that homophobic epithets may not always be perceived as homophobic by adolescents, and that attempts to alter the social acceptability of these insults may be an effective manner of reducing their use.

Assessing the interpersonal circumplex model in late childhood: the interpersonal behavior questionnaire for children.

The authors developed the Interpersonal Behavior Questionnaire for Children with the aim of assessing the constructs of the interpersonal circumplex model, that is, Dominance and Love and their possible combinations, via third- to fifth-grade children's self- and peer reports. In the three studies presented herein, the authors examined several psychometric properties of the questionnaire. Results demonstrated that children's ratings along the questionnaire yielded the hypothesized circumplex structure of the interpersonal variables; that they reached significant association levels with external criteria; and that they were reliable. Specifically, interrater correlations were shown to reach substantive levels when inspected in older children, when scores were aggregated over raters, and when dominant behaviors were evaluated. Overall, the findings demonstrated the tenability of the circumplex model in young ages via children's ratings. The authors suggest that both personality assessment and personality development research may take advantage from using children's evaluations, in addition to adults' ratings of their children's personality.

[Assessing work-related stress: an Italian adaptation of the HSE Management Standards Work-Related Stress Indicator Tool]. / La valutazione dello stress lavoro correlato: adattamento italiano dell'HSE Management Standards Work-Related Stress Indicator Tool.

The aim of this paper is to present a preliminary validation of an Italian adaptation of the HSE Management Standards Work-Related Stress Indicator Tool (IT), an instrument for assessing work-related stress at the organizational level, originally developed in Britain by the Health and Safety Executive. A scale that assesses the physical work environment has been added to the original version of the IT. 190 employees of the University of Trieste have been enrolled in the study. A confirmatory analysis showed a satisfactory fit of the eight-factors structure of the instrument. Further psychometric analysis showed adequate internal consistency of the IT scales and good criterion validity, as evidenced by the correlations with self-perception of stress, work satisfaction and motivation. In conclusion, the Indicator Tool proved to be a valid and reliable instrument for the assessment of work-related stress at the organizational level, and it is also compatible with the instructions provided by the Ministry of Labour and Social Policy (Circular letter 18/11/2010).

CircE: an R implementation of Browne's circular stochastic process model.

In confirmatory analysis of whether data have a circumplex structure, Browne's (1992) model has played a major role. However, implementation of this model requires a dedicated program, CIRCUM, because the analysis routine is not integrated in any of the most widely used statistical software packages. Hence, data entry and graphical representation of the results require the use of one or more additional programs. We propose a package for the R statistical environment, termed CircE, that can be used to enter or import data, implement Browne's confirmatory analysis, and graphically represent the results. Using this new software, we put forward a new approach to assess the sustainability of theoretical models when the analysis is carried out at the level of questionnaire items. The CircE package (for either Mac OS X or Windows) and additional files may be downloaded from http://brm.psychonomic-journals.org/content/supplemental.

Only three factors of personality description are fully replicable across languages: a comparison of 14 trait taxonomies.

We tested the hypothesis that only 3 factors of personality description are replicable across many different languages if they are independently derived by a psycholexical approach. Our test was based on 14 trait taxonomies from 12 different languages. Factors were compared at each level of factor extraction with solutions with 1 to 6 factors. The 294 factors in the comparisons were identified using sets of markers of the 6-factor model by correlating the marker scales with the factors. The factor structures were pairwise compared in each case on the basis of the common variables that define the 2 sets of factors. Congruence coefficients were calculated between the varimax rotated structures after Procrustes rotation, where each structure in turn served as a target to which all other structures were rotated. On the basis of average congruence coefficients of all 91 comparisons, we conclude that factor solutions with 3 factors on average are replicable across languages; solutions with more factors are not.

A circumplex model of interpersonal attributes in middle childhood.

This article presents evidence for the validity of the circumplex model to represent how parents and teachers organize interpersonal attributes in children. Study 1 showed that the ratings of adults using interpersonal adjectives to describe 4- to 10-year-old children conformed to a circumplex structure. Eight scales-labeled Interpersonal Adjective Scales for Children (IAS-C)-were developed to represent the circular sequence of children's interpersonal attributes, as ordered around the reference axes of Extraversion and Social Appropriateness. The continuum of interpersonal variables substantially corresponded to Schaefer's model for social and emotional behavior, as follows: Warm-Agreeable, Sociable-Cheerful, Exuberant-Dominant, Impulsive-Aggressive, Egocentric-Irritable, Fearful-Insecure, Shy-Silent, and Mild-Placid. Study 2 demonstrated cross-validity for the IAS-C and how they are related to Big Five measures. Study 3 used data from Studies 1 and 2 in a confirmatory approach to test the circumplex IAS-C structure. Findings are discussed in relation to the adult circumplex model and suggest that the child circumplex has distinctive features that must be kept in due consideration when attempting to assess interpersonal qualities in children validly.

A six-factor structure of personality-descriptive adjectives: solutions from psycholexical studies in seven languages.

Standard psycholexical studies of personality structure have produced a similar 6-factor solution in 7 languages (Dutch, French, German, Hungarian, Italian, Korean, Polish). The authors report the content of these personality dimensions and interpret them as follows: (a) a variant of Extraversion, defined by sociability and liveliness (though not by bravery and toughness); (b) a variant of Agreeableness, defined by gentleness, patience, and agreeableness (but also including anger and ill temper at its negative pole); (c) Conscientiousness (emphasizing organization and discipline rather than moral conscience); (d) Emotionality (containing anxiety, vulnerability, sentimentality, lack of bravery, and lack of toughness, but not anger or ill temper); (e) Honesty-Humility; (f) Intellect/Imagination/Unconventionality. A potential reorganization of the Big Five factor structure is discussed.