Psychopathological Assessment of Risk of Restraint in Acute Psychiatric Patients.

The study aims to identify independent predictors of physical restraint in acute psychiatric patients and to determine the predictive power of a risk assessment model centered on psychopathological dimensions. We included 1552 patients admitted to a psychiatric intensive care unit over a 5-year period. Patients were rated on the Brief Psychiatric Rating Scale (BPRS-E) at admission. Principal axis factoring (PAF) with varimax rotation was performed on BPRS-E items to identify psychopathological factors. Multiple logistic regression analysis was performed. PAF pointed six factors: positive symptoms, negative symptoms, resistance, activation, negative affect, and disorganization. Male sex, younger age, proposal for compulsory admission, severity of symptoms, resistance, activation, and disorganization were identified as independent predictors. Negative symptoms and negative affect were instead protective factors. The BPRS-E factors, when added to other sociodemographic and clinical variables, significantly increased the predictive power of the model. Our findings suggest that a systematic evaluation of the psychopathological dimensions can be usefully included in the early risk assessment of restraint.

A Content Validity Study of AIMIT (Assessing Interpersonal Motivation in Transcripts).

UNLABELLED: Multi-motivational theories of human relatedness state that different motivational systems with an evolutionary basis modulate interpersonal relationships. The reliable assessment of their dynamics may usefully inform the understanding of the therapeutic relationship. The coding system of the Assessing Interpersonal Motivation in Transcripts (AIMIT) allows to identify in the clinical the activity of five main interpersonal motivational systems (IMSs): attachment (care-seeking), caregiving, ranking, sexuality and peer cooperation. To assess whether the criteria currently used to score the AIMIT are consistently correlated with the conceptual formulation of the interpersonal multi-motivational theory, two different studies were designed. Study 1: Content validity as assessed by highly qualified independent raters. Study 2: Content validity as assessed by unqualified raters. Results of study 1 show that out of the total 60 AIMIT verbal criteria, 52 (86.7%) met the required minimum degree of correspondence. The average semantic correspondence scores between these items and the related IMSs were quite good (overall mean: 3.74, standard deviation: 0.61). In study 2, a group of 20 naïve raters had to identify each prevalent motivation (IMS) in a random sequence of 1000 utterances drawn from therapy sessions. Cohen's Kappa coefficient was calculated for each rater with reference to each IMS and then calculated the average Kappa for all raters for each IMS. All average Kappa values were satisfactory (>0.60) and ranged between 0.63 (ranking system) and 0.83 (sexuality system). Data confirmed the overall soundness of AIMIT's theoretical-applicative approach. Results are discussed, corroborating the hypothesis that the AIMIT possesses the required criteria for content validity. Copyright © 2015 John Wiley & Sons, Ltd. KEY PRACTITIONER MESSAGE: Assessing Interpersonal Motivations in psychotherapy transcripts as a useful tool to better understand links between motivational systems and intersubjectivity. A step forward in the knowledge of evolutionary cognitivism and a contribution to the bio-psycho-social model of human relatedness and interpersonal neurobiology.

Interplay of Dyadic Consensus, Reflective Functioning, and Perinatal Affective Difficulties in Modulating Fear of COVID-19 among First-Time Mothers: A Mediation Analysis.

BACKGROUND: The COVID-19 pandemic has exacerbated fears and anxieties, potentially influencing maternal perinatal mental health. This study addresses a gap in the literature on fear of COVID-19 in pregnant women, aiming to identify contributing factors. METHOD: Participants were 401 primiparous women with an average age of 34 years (SD = 4.56) who were recruited through the National Health System during birth support courses. They completed a series of self-reported instruments via an online survey, providing information on their levels of reflective functioning, dyadic consensus, perinatal maternal affectivity, and fear of COVID-19. Pearson's correlation and mediation analysis via a generalized linear model were implemented to analyze the collected data. RESULTS: The relationship between dyadic consensus and fear of COVID-19 was significant and negative. Furthermore, a significant parallel mediation involving perinatal maternal affectivity and reflective functioning was found to the extent that, when these factors were inserted into the model, the direct association between dyadic consensus and fear of COVID-19 became non-significant (total mediation). CONCLUSIONS: The results highlight the importance of dyadic adjustment in alleviating maternal COVID-19 fear, emphasizing interventions promoting couple functioning, mentalization, and addressing affective difficulties. Such approaches are vital for supporting expecting mothers during challenging times like the COVID-19 pandemic.

Maternal Perinatal Depression, Alexithymia, and Couple Functioning: Which Relationship Exists with Prenatal Attachment.

BACKGROUND: Prenatal attachment refers to the affective investment that parents develop towards their unborn baby during pregnancy. Studies have identified depressive symptoms, affect dysregulation, and poor marital adjustment as potential risk factors for poor prenatal attachment. However, no research has concurrently examined these factors. This study aims to explore the simultaneous impact of depressive symptomatology, alexithymia, and couple functioning on prenatal attachment to develop a more comprehensive understanding of the factors shaping the emotional bond between expectant mothers and their fetuses. METHODS: This cross-sectional study involved 344 women (mean age = 34.1, SD = 4.6) in their last trimester of pregnancy recruited from the National Health System. The participants completed the Edinburgh Postnatal Depression Scale, the Twenty-Item Toronto Alexithymia Scale, the Dyadic Adjustment Scale, and the Maternal Antenatal Attachment Scale. RESULTS: Regression analyses indicated that perinatal depression and alexithymia negatively affected the Quality of Prenatal Attachment, while Dyadic Cohesion served as a protective factor. CONCLUSIONS: The results emphasize the need for early identification of perinatal depression and alexithymia, along with targeted interventions aimed at supporting Dyadic Cohesion during pregnancy. These efforts are crucial for fostering positive prenatal attachment and enhancing maternal mental health.