[Formal representation of the cognitive-behavioral assessment in obsessive-compulsive disorder]. / Rappresentazione formale dell'assessment cognitivo-comportamentale per il disturbo ossessivo-compulsivo.

Psychological assessment is a crucial and important part of psychologist's work. Despite this, tools utilized by clinicians are often inadequate and methods used to investigate and make decisions on the basis of collected data are even logically incorrect. In this paper two mathematical psychology theories (Knowledge Space Theory and Formal Concept Analysis) are employed to propose a method for collecting diagnostic information. The conjoint application of these two theories allows to build a hierarchical structure composed by diagnostic elements. This structure is very similar to the one determined by the clinical diagnostic process. Correct logical inferences on the patient's situation, and an exact depiction of those diagnostic elements presented or not by the patient, represent the potential advantages of such a methodology. An applicative example on Obsessive-Compulsive Disorder (using the background determined by two shared diagnostic tools i.e. DSM IV-TR and CBA 2.0) is presented. Finally, the opportunity to build an adaptive assessment procedure from the derived structure is investigated.

Maugeri Respiratory Failure questionnaire reduced form: a method for improving the questionnaire using the Rasch model.

PURPOSE: The Maugeri Respiratory Failure questionnaire (MRF-28) is the first instrument specifically developed for use with chronic respiratory failure (CRF) patients. The 28 items were selected using classical test theory. The purpose of the current analysis was to further refine the questionnaire using item response theory, specifically, the Rasch model analysis. METHODS: Three hundred and seventeen CRF patients (mean aged 66.7 yrs; Male 219, Female 98) completed the MRF-28 health status measure. Data were collected through the self-report questionnaire and analyzed using 1-parameter logistic models by means of RUMM software. RESULTS: The 28-item questionnaire has good psychometric properties in terms of discriminant power because the Person Separation Index is 0.896. However, the item-trait interaction was not good as shown by the total-item Chi-square (chi(2)(112), p<0.001). Removing two items that did not fit the Rasch model well, produced a minor improvement in Person Separation Index to 0.899 and the item-trait interaction improved (chi(2)(104), p = NS). In the preliminary analysis we identified 21 patients who were outliers; when they were excluded the distribution of the residuals, according to the Kolmogorov-Smirnov statistics, was normal and factor analysis of the item residuals showed that the components had similar eigenvalues and no strong correlation with items. These results suggest that the MRF-26 is a unidimensional measure of health-related quality of life impairment for chronic respiratory failure patients. CONCLUSIONS: A combination of classical psychometric tests and Rasch analysis produced an instrument of moderate size that covers a wide range of effects of CRF and has interval scaling properties.

The EORTC quality of life questionnaire-head and neck 35 in Italian laryngectomized patients. European organization for research and treatment of cancer.

The aim of this study was to test the validity and reliability of the European organization for research and treatment of cancer (EORTC) quality of life questionnaire (QLQ)-head and neck (H&N) 35 in Italian laryngeal cancer patients. The original questionnaire was developed by the EORTC quality of life (QoL) study group and tested in H&N cancer patients from Norway, Sweden, and the Netherlands. The Italian translation of the questionnaire used in this study was made by a team of the CRO, National Cancer Institute, using a double-back translation method between independent translators. The translated EORTC QLQ-H&N35 was given to 99 patients with H&N cancer who had undergone total laryngectomy 1-26 years before and had been then treated with radiotherapy and, in some cases, chemotherapy. The questionnaire was re-administrated to 33 patients after 1 month to test its stability over time. It was structurally made up of seven scales (pain, swallowing, sense, speech, social eating, social contact, and sexuality) and 11 single items that considered the most important clinical aspects characterizing the QoL in H&N cancer patients. The statistical analysis of the indexes of validity and reliability confirmed the results obtained with other linguistic versions of the questionnaire. Our Italian version of the EORTC QLQ-H&N35 proved to be a statistically valid instrument to assess QoL in laryngectomized patients.

Neuroticism and type A behaviour pattern in healthy Italian blue-collar workers.

BACKGROUND: Even if type A behavior pattern is not a typical pattern of specific social class, in Italy no research study has been conducted on blue-collar workers. In the present study we sought to identify differences in the psychological profiles of type A and non-type A Italian blue-collar subjects. METHODS: Seventy-three healthy male blue-collar workers, aged 35-59 years, completed the CBA-2.0 Primary Scales (a battery of standardized questionnaires) and the Jenkins Activity Survey (JAS). Following the Structured Interview each subject was classified as type A1, A2, X, or B. In the present study, type X and B subjects were considered within the group referred to as type 'non-A'. RESULTS: The analysis of variance showed that the A1 subjects had higher neuroticism scores than the A2 and non-A subjects but revealed no differences in extraversion, anxiety, depression, obsession-compulsion scores. In the JAS only the 'speed and impatience' scale differentiated the three groups: the highest scores being obtained by the A1 subjects. Among the JAS scales, only correlations (Pearson) between speed and impatience, trait anxiety and neuroticism were found. CONCLUSION: In our Italian blue-collar sample, type A1 seems to define a subject with high neuroticism score. Finally, our results do not recommend the use of the JAS in Italy for measuring the type A behavior pattern.

A computerized approach to cognitive behavioural assessment: an introduction to CBA-2.0 primary scales.

The Cognitive Behavioural Assessment-2.0 (CBA-2.0) Primary Scales is an automated assessment package investigating the cognitive-verbal response system. It consists of: (1) self-reports and questionnaires aimed at identifying and specifying patients' problems; (2) a group of programs and logical rules, implemented on personal computers, providing an editor with items, questionnaire scoring and an analysis of responses; (3) an intelligent program which analyzes the responses emerging from the questionnaires and forms hypotheses for the selection of Secondary Scales and for further assessment. The package is part of a research project aimed at reducing part of the decision-making process to an operational language and simulating behavioral therapists decisions in cases of clinical assessment.