The contribution and interplay of implicit and explicit processes on physical activity behavior: empirical testing of the physical activity adoption and maintenance (PAAM) model.

The adoption and maintenance of physical activity (PA) is an important health behavior. This paper presents the first comprehensive empirical test of the Physical Activity Adoption and Maintenance (PAAM) model, which proposes that a combination of explicit (e.g., intention) and implicit (e.g., habit,, affect) self-regulatory processes is involved in PA adoption and maintenance. Data were collected via online questionnaires in English, German, and Italian at two measurement points four weeks apart. The study included 422 participants (Mage= 25.3, SDage= 10.1; 74.2% women) from Germany, Switzerland, Italy, Canada, and the U.S. The study results largely supported the assumptions of the PAAM model, indicating that intentions and habits significantly mediate the effects of past PA on future PA. In addition, the effect of past PA on future PA was shown to be significant through a mediation chain involving affect and habit. Although the hypothesis that trait self-regulation moderates the intention-behavior relationship was not supported, a significant moderating effect of affect on the same relationship was observed. The results suggest that interventions targeting both explicit and implicit processes may be effective in promoting PA adoption and maintenance.

Eating disorder symptom dimensions and protective factors: A structural network analysis study.

Eating Disorders (EDs) and related symptoms pose a substantial public health concern due to their widespread prevalence among both genders and associated negative outcomes, underscoring the need for effective preventive interventions. In this context, deepening our understanding of the interplay between ED symptoms and related protective factors appears crucial. Therefore, this study employed a structural network analysis approach considering both ED symptom dimensions (i.e., drive for thinness, bulimic symptoms, and body dissatisfaction) and related protective factors (i.e., body and functionality appreciation, intuitive eating, and self-esteem) to shed light on how these factors are interrelated. A community sample of 1391 individuals (34.4% men; Mage = 26.4 years) completed a socio-demographic schedule and self-report questionnaires. The network showed that the nodes with the highest positive expected influence were body and functionality appreciation, while those with the highest negative expected influence were eating for physical rather than emotional reasons and unconditional permission to eat (i.e., two components of intuitive eating). Crucially, the most relevant bridges between the conceptual communities "ED symptom dimensions" and "Protective factors" were the negative relations between (a) eating for physical rather than emotional reasons and bulimic symptoms, (b) unconditional permission to eat and drive for thinness, and (c) body appreciation and body dissatisfaction. Finally, age, gender, and body mass index did not moderate any edge in the network. The practical implications of these findings are discussed, especially in terms of preventive interventions for ED symptoms.

Why we should focus more attention on uncertainty distress and intolerance of uncertainty in adolescents and emerging adults.

Sivertsen et al. (2023) showed that adolescents endorsing high levels of internalizing and externalizing symptoms are at risk of increased mental health problems during emerging adulthood and suggested the existence of both homotypic and heterotypic continuities of mental disorders over time. Since adolescence and emerging adulthood are transition periods highly intertwined with uncertainty, the present perspective contextualizes the findings by Sivertsen et al. (2023) in relation to the extant literature on intolerance of uncertainty and the recently developed Uncertainty Distress Model. Moreover, it claims for further research addressing the way adolescents and emerging adults process and deal with uncertainty. Indeed, focusing more attention on the implications of trans-situational and trans-diagnostic constructs such as uncertainty distress and intolerance of uncertainty in these life stages may hold great promise to design and implement effective mental health prevention programs.

Comorbidity among depression, anxiety and stress symptoms in naturalistic clinical samples: A cross-cultural network analysis.

Comorbidity between depression and anxiety is well-established across various settings and cultures. We approached comorbidity from the network psychopathology perspective and examined the depression, anxiety/autonomic arousal and stress/tension symptoms in naturalistic clinical samples from Serbia, Italy and Croatia. This was a multisite study in which regularized partial correlation networks of the symptoms, obtained via self-reports on the Depression Anxiety and Stress Scales-21 (DASS-21) in three cross-cultural, clinical samples (total N = 874), were compared with respect to centrality, edge weights, community structure and bridge centrality. A moderate degree of similarity in a number of network indices across the three networks was observed. While negative mood emerged to be the most central node, stress/tension nodes were the most likely bridge symptoms between depressive and anxiety/autonomic arousal symptoms. We demonstrated that the network structure and features in mixed clinical samples were similar across three different languages and cultures. The symptoms such as agitation, restlessness and inability to relax functioned as bridges across the three symptom communities explored in this study. Important theoretical and clinical implications were derived.

The relationship between body dysmorphic disorder symptoms and 'not just right' experiences in a sample of individuals seeking cosmetic surgery and aesthetic medicine procedures.

BACKGROUND: Body dysmorphic disorder (BDD) is characterized by concerns for perceived defects in physical appearance that appear to others as mild or unobservable. Individuals with BDD frequently refer concerns with their physical appearance being 'not right' (not just right experiences; NJREs), and BDD-related behaviours may be performed until their appearance is perceived as 'right'. The aim of the study was to explore the relationship between BDD and NJREs in cosmetic surgery and aesthetic medicine settings. METHODS: Individuals requesting cosmetic procedures with BDD symptoms (BDD-symptoms group; n = 24), without BDD symptoms (cosmetic intervention [CI] group; n = 45), and individuals that have never required these procedures (no cosmetic intervention [NCI] group; n = 53) entered the study. RESULTS: Results showed a greater number of past-month NJREs, higher NJREs severity, higher drive for thinness, and greater general distress in the BDD-symptoms group. Pertaining to features associated with NJREs (perfectionism and obsessive-compulsive disorder symptoms) and ED core features, the BDD-symptoms group scored higher only with respect to NCI. Regression analyses showed that BDD symptoms were predicted by age, NJREs severity, and drive for thinness above and beyond general distress, perfectionism, obsessive-compulsive disorder symptoms, bulimia, and body dissatisfaction related to weight and shape in the BDD-Symptoms group (in comparison with the CI and NCI groups). CONCLUSIONS: NJREs may represent a potential vulnerability factor for BDD symptoms in cosmetic settings.

Assessment of perceived support in the context of emergency: Development and validation of the psycho-social support scale.

In research and clinical contexts, it is important to briefly evaluate perceived Psychological and Social Support (PSS) to plan psychological interventions and allocate efforts and resources. However, an appropriate brief assessment tool for PSS was lacking. This study aimed at developing a brief and accurate scale to specifically measure PSS in clinical and emergency contexts, with specific, relevant, targeted, and irredundant items. Experienced clinicians developed the perceived Psycho-Social Support Scale (PSSS) and administered it to a clinical sample (N = 112) seeking psychological help during the COVID-19 emergency. A Confirmatory Factor Analysis examined the PSSS internal structure, and a Multiple Indicator and Multiple Causes model investigated its association with the number of sessions and emotional symptoms. The PSSS showed good psychometric properties and the Confirmatory Factor Analysis provided acceptable fit indexes for a unidimensional structure. The Multiple Indicators and Multiple Causes revealed that more sessions and emotional symptoms were associated with lower PSSS scores. The PSSS is a reliable brief tool to measure PS and could be useful to individualize treatments (i.e., number of sessions) to efficiently allocate efforts and resources in clinical contexts and emergencies (e.g., earthquake, COVID-19 pandemic). Supplementary Information: The online version contains supplementary material available at 10.1007/s12144-022-03344-z.

Dimensionality and psychometric properties of an Italian translation of the Intuitive Eating Scale-2 (IES-2): An assessment using a bifactor exploratory structural equation modelling framework.

The construct of intuitive eating is most often measured using the 23-item Intuitive Eating Scale-2 (IES-2), but previous studies have typically relied solely on confirmatory factor analysis (CFA) to understand IES-2 dimensionality. In contrast, a bifactor exploratory structural equation modelling (B-ESEM) framework offers a more realistic account of IES-2 multidimensionality. Here, we assessed the psychometric properties of a novel Italian translation using a combination of exploratory factor analysis and B-ESEM. A total of 950 adults completed the IES-2 alongside measures of positive body image, disordered eating, and psychological well-being. Results indicated that a 4-factor B-ESEM model had adequate fit to the data and that fit was improved when the correlated uniqueness of seven negatively worded IES-2 items was accounted for. This model of IES-2 scores showed adequate internal consistency and good test-retest reliability up to three weeks. Evidence of construct validity was good in terms of a global IES-2 factor, and broadly supported in terms of its specific-factors. These results highlight the utility of a B-ESEM framework for understanding the dimensionality of IES-2 scores and may help scholars better understand the extent to which the IES-2 adequately operationalises the construct of intuitive eating.

Evaluating the validity of brief prototype-based informant ratings of triarchic psychopathy traits in prisoners.

The validity of self-report psychopathy assessment has been questioned, especially in forensic settings where clinical evaluations influence critical decision-making (e.g., institutional placement, parole eligibility). Informant-based assessment offers a potentially valuable supplement to self-report but is challenging to acquire in under-resourced forensic contexts. The current study evaluated, within an incarcerated sample (n = 322), the extent to which brief prototype-based informant ratings of psychopathic traits as described by the triarchic model (boldness, meanness, disinhibition; Patrick et al., 2009) converge with self-report trait scores and show incremental validity in predicting criterion measures. Self/informant convergence was robust for traits of boldness and disinhibition, but weaker for meanness. Informant-rated traits showed incremental predictive validity over self-report traits, both within and across assessment domains. These findings indicate that simple prototype-based informant ratings of the triarchic traits can provide a useful supplement to self-report in assessing psychopathy within forensic-clinical settings.

Facing distress in Coronavirus era: The role of maladaptive personality traits and coping strategies.

The aim of the current study was to investigate the intersecting roles of dysfunctional personality traits and coping styles in relation to psychological distress during the Italian national lockdown caused by the COVID-19 pandemic. Participants included 633 adults who completed questionnaires of maladaptive personality traits, coping styles, and psychological distress. Results indicated that all the maladaptive traits were associated with psychological distress with magnitude of associations strongest for Negative Affect and weakest for Antagonism. Maladaptive traits were also generally positively associated with avoidant/maladaptive and negatively associated with acceptance and positive reframing, forms of coping. A series of path analyses further demonstrated that coping strategies partially explained associations between maladaptive personality traits and psychological distress. All told, results suggest that during an unprecedented stressful time, associations between maladaptive personality traits and psychological distress may be, at least in part, explained by maladaptive coping strategies.

Psychopathy and COVID-19: Triarchic model traits as predictors of disease-risk perceptions and emotional well-being during a global pandemic.

This study extended recent research showing that perceptions of disease risk are associated with emotional well-being during COVID-19 by examining how psychopathic traits of boldness, meanness, and disinhibition influence these perceptions and psychological outcomes. During the Italian national lockdown, a large community sample (M age = 31.3 years) completed online questionnaire measures of the triarchic psychopathic traits, perceptions of disease susceptibility and danger, and recent well-being. Path analyses revealed differing roles for the triarchic traits: boldness and meanness predicted greater well-being (lower stress, higher positive affect) and disinhibition predicted lower well-being. Further, boldness and meanness were linked to well-being through distinct indirect pathways of low perceived susceptibility to infection (boldness) and low perceived dangerousness of COVID-19 (boldness and meanness). Findings speak to the triarchic model's utility in explaining socioemotional phenomena during times of crisis and support the distinct biobehavioral conceptualizations of boldness as low threat sensitivity, meanness as low affiliative capacity, and disinhibition as deficient affective and behavioral control.

The Psychosocial Assessment of Transplant Candidates: Inter-Rater Reliability and Predictive Value of the Italian Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT).

BACKGROUND: The Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT) is a comprehensive instrument developed to accurately assess the main pretransplant psychosocial risk factors that may impact transplant outcomes. OBJECTIVE: As neither established assessment procedures nor standardized tools designed to perform pretransplant psychosocial evaluation are currently available in Italy, the present study was designed to develop and preliminarily validate the Italian version of the SIPAT. METHODS: First, our team developed the Italian version of the SIPAT, following standard forward-back translation procedures. Then, the Italian version of the SIPAT was retrospectively and blindly applied to 118 randomly selected transplant cases (40 heart, 40 lung, and 38 liver) by 2 independent examiners. Information about the patients' final transplant listing recommendation (i.e., listing vs. deferral) was independently collected from the respective transplant teams. RESULTS: The inter-rater reliability of the Italian version of the SIPAT scores was substantial (Cohen's kappa = 0.77; P < 0.001). Moreover, the predictive value of the SIPAT ratings on the final transplant listing recommendation (i.e., listing vs. deferral) for each examiner was significant (both P < 0.05). CONCLUSION: Current findings suggest that SIPAT is a promising and reliable instrument in its Italian version. Given these excellent psychometric characteristics, the use of the SIPAT as part of the pretransplant psychosocial evaluation in Italian medical settings is highly encouraged.

Testing the Italian version of the Cyberchondria Severity Scale and a metacognitive model of cyberchondria.

Cyberchondria refers to the tendency to excessively and compulsively search for online medical information despite the distress experienced, with consequent impairment of daily-life activities. The current two studies sought to explore (i) the factor structure of the Italian version of the Cyberchondria Severity Scale (CSS) and (ii) a metacognitive model of cyberchondria. Participants were Italian community adults who reported using the Internet to search for health-related information (Study 1: N = 374, Study 2: N = 717). Results from Study 1 supported the Italian version of the CSS exhibiting a five-factor structure, with the resulting scales demonstrating good internal consistency, 5-week test-retest reliability, and generally strong correlations with indices of health anxiety. In Study 2, results of a path analysis showed that the negative metacognitive belief domain ("thoughts are uncontrollable") shared the strongest direct association with each of the five dimensions of cyberchondria, followed by beliefs about rituals. Consistently, the strongest indirect associations were found between "thoughts are uncontrollable" and all the five cyberchondria dimensions via beliefs about rituals. These results provide support for an Italian version of the CSS and the metacognitive conceptualization of cyberchondria.

Body dysmorphic disorder and its associated psychological and psychopathological features in an Italian community sample.

OBJECTIVE: Body Dysmorphic Disorder (BDD) is a psychiatric condition characterized by preoccupation with perceived defects in physical appearance that are not observable or appear slight to others, along with low self-esteem, high perfectionism, and high comorbidity. Little is known about BDD prevalence and phenomenology in the Italian context, and no data are currently available on BDD prevalence using DSM-5 criteria in the Italian context. The aims of the current study were to explore the prevalence and the phenomenology of BDD and its associated psychological and psychopathological features such as self-esteem, perfectionistic traits, social anxiety, depressive, and obsessive-compulsive symptoms in a community sample. METHODS: Six hundred and fifteen community individuals completed a battery of self-report questionnaires. RESULTS: 10 (1.63%) individuals met DSM-5 diagnostic criteria for BDD; hair, nose and teeth were the most common areas of concern. Individuals with BDD reported also lower levels of self-esteem, more severe social anxiety symptomatology, general distress, depression and obsessive-compulsive features than people without BDD. CONCLUSIONS: BDD is not a rare condition in the Italian context and it emerged to be associated with significant morbidity.

Intolerance of uncertainty, not just right experiences, and compulsive checking: Test of a moderated mediation model on a non-clinical sample.

OBJECTIVE: Intolerance of uncertainty (IU) and not just right experiences (NJREs) have been claimed putative vulnerability factors for obsessive-compulsive disorder (OCD). The aim of the present study was to test whether IU could represent a trans-diagnostic construct accountable for OC checking behaviors and whether NJREs could embody an OCD-specific criterion through which IU operates. METHOD: One hundred and eighty-eight Italian community individuals completed self-report measures of IU, NJREs, OC symptoms, worry, anxiety, and depression. Mediation and moderated mediation models were tested using a bootstrapping approach, wherein IU was included as the independent variable as well as the moderator; checking behaviors were entered as the dependent variable; and NJRE severity was included as a mediator. RESULTS: The main findings highlighted that NJREs were a mediator of the relationship between IU and checking behaviors; nonetheless, in connection with medium levels of IU, NJREs no longer mediated the path. Furthermore, IU did not emerge to moderate the mediation. CONCLUSION: Despite their preliminary nature, the present results might be a hint for future research, as theoretical integration may represent a way to go for better understanding OCD etiology and phenomenology.

The Italian version of the Depression Anxiety Stress Scales-21: Factor structure and psychometric properties on community and clinical samples.

OBJECTIVE: The Depression Anxiety Stress Scales-21 (DASS-21) is the short version of a self-report measure that was originally developed to provide maximum differentiation between depressive and anxious symptoms. Despite encouraging evidence, the factor structure and other features of the DASS-21 are yet to be firmly established. METHOD: A community sample of 417 participants and two clinical groups (32 depressive patients and 25 anxious patients) completed the Italian version of the DASS-21 along with several measures of psychopathology. RESULTS: Confirmatory factor analyses suggested that the DASS-21 is a measure of general distress plus three additional orthogonal dimensions (anxiety, depression, and stress). The internal consistency and temporal stability of the measure were good; each DASS-21 scale correlated more strongly with a measure of a similar construct, demonstrating good convergent and divergent validity. Lastly, the DASS-21 demonstrated good criterion-oriented validity. CONCLUSION: The validity of the Italian DASS-21 and its utility, both for community and clinical individuals, are supported.

Compulsivity and Impulsivity in Pathological Gambling: Does a Dimensional-Transdiagnostic Approach Add Clinical Utility to DSM-5 Classification?

Although the phenomenology of Pathological Gambling (PG) is clearly characterized by impulsive features, some of the Diagnostic and Statistical Manual of Mental Disorder (DSM-5) criteria for PG are similar to those of Obsessive Compulsive Disorder (OCD). Therefore, the compulsive-impulsive spectrum model may be a better (or complementary) fit with PG phenomenology. The present exploratory research was designed to further investigate the compulsive and impulsive features characterizing PG, by comparing PG individuals, alcohol dependents (ADs), OCD patients, and healthy controls (HCs) on both self-report and cognitive measures of compulsivity and impulsivity. A better understanding of the shared psychological and cognitive mechanisms underlying differently categorized compulsive and impulsive disorders may significantly impact on both clinical assessment and treatment strategies for PG patients. With respect to self-report measures, PG individuals reported more compulsive and impulsive features than did HCs. As regards motor inhibition ability indices, PG individuals and HCs performed similarly on the Go/No-go task and better than AD individuals and OCD patients. Results from the Iowa Gambling Task highlighted that PG, AD, and OCD participants performed worse than did HCs. An in-depth analysis of each group's learning profile revealed similar patterns of impairment between PG and AD individuals in decision-making processes. Current findings support the utility of adopting a dimensional-transdiagnostic approach to complement the DSM-5 classification when working with PG individuals in clinical practice. Indeed, clinicians are encouraged to assess both compulsivity and impulsivity to provide individualized case conceptualizations and treatment plans focusing on the specific phenomenological features characterizing each PG patient.

Beyond the score: clinical evaluation through formal psychological assessment.

Questionnaires generate numerical scores, but endorsing different sets of items could produce the same score despite reflecting qualitatively different configurations of clinical features. Formal psychological assessment (FPA) attempts to overcome this by identifying the clinical features entailed by observed response patterns. This study illustrates an application of FPA to the cleaning subscale of a questionnaire assessing obsessive-compulsive symptoms and DSM-IV-TR diagnostic criteria for obsessive-compulsive disorder. A deterministic model of the items-criteria relationships was constructed by mapping each item to each diagnostic criterion. The resulting model was tested on a large community sample (N = 4,412). Results indicate that the theoretical model has adequate fit; item error rates and probabilities for each of the criteria are examined. Clinically relevant examples of the items-criteria relationships are discussed. Possible applications of FPA to personality assessment are also discussed, including long multidimensional questionnaires and questionnaires that use subtle item content.

Emotion dysregulation and psychopathological symptoms in non-clinical adolescents: The mediating role of boredom and social media use.

BACKGROUND: Emotion dysregulation, boredom, and problematic social media use are well-known vulnerability factors for psychopathology during adolescence; nevertheless, the interplay between these factors remains underinvestigated in the literature. Therefore, the present cross-sectional study aimed to explore the mediating role of boredom and problematic social media use in the relations between emotion dysregulation and both internalizing and externalizing problems in a non-clinical group of Italian adolescents. METHOD: 721 students (64.6% girls; Mage = 15.49 years ± 1.82) were involved and completed self-report tools assessing emotion dysregulation, boredom, problematic social media use, and psychopathological symptoms. Path analysis was used to test whether boredom and problematic social media use mediated the relation between emotion dysregulation and psychopathology, distinguishing between internalizing and externalizing problems. RESULTS: Path models showed that emotion dysregulation predicted both internalizing and externalizing problems, as well as boredom and problematic social media use. Importantly, boredom mediated the associations between emotion dysregulation and both psychopathological dimensions, while problematic social media use mediated only the relation with externalizing problems. CONCLUSIONS: Our results highlight that the influence of emotion dysregulation on psychopathology can manifest through different paths, leading to specific symptomatology based on interactions between various variables. In particular, boredom seems to be a transdiagnostic factor for psychopathology in adolescence, whereas problematic social media use would be a dimension-specific factor. The practical implications of these findings are discussed.

Triarchic Model of Psychopathy and Intimate Partner Violence: An Empirical Study on the Italian Community.

Intimate partner violence (IPV) is a serious and recurrent phenomenon in many societies with severe physical and psychological consequences. In the present study, we aimed to explore the role of triarchic dimensions of psychopathy (disinhibition, boldness, and meanness) across gender in this occurrence. A questionnaire on inflicted (self) and experienced (partner) IPV and the Triarchic Psychopathy Measure were administered to a sample of 1,149 individuals from the Italian community. In general, self and partner IPV were moderately correlated. Bayesian regression analysis showed that disinhibition was positively correlated to both self and partner IPV (psychological and physical). In addition, boldness was negatively associated with perpetrated psychological IPV. Interactions by gender showed that meanness was positively related to perpetrated IPV in women (psychological and physical), whereas men with disinhibition features inflicted more physical violence than women. A high externalizing tendency (i.e., disinhibition) is therefore an important correlate of both perpetrated and reported IPV; moreover, boldness was associated with less psychological violence in general, whereas the effect of meanness depended on the gender of the individuals involved. Interestingly, the association between IPV and self-reported delinquent activities was low in magnitude (Spearman's Rho around .20) suggesting limited overlap between these two constructs.

Agreement and discrepancies in patient-clinician reports of DSM-5-TR section III maladaptive personality traits: A study on a mixed outpatient sample.

The assessment of personality pathology based on dimensional models may improve self-other agreement, but previous research mainly adopted a categorical approach and overlooked the role of the person of the therapist. Our study examined patient-clinician agreement in a mixed sample of Italian outpatients using the Personality Inventory for DSM-5 (PID-5) and the PID-5-Informant Form (PID-5-IRF). Moreover, the role of clinician personality traits on agreement was preliminary explored. Sixty-eight outpatients (51.4% male, M = 30.30, SD = 12.05 years) and their treating clinicians (N = 22; 77.3% female, M = 43.77 ± 8.45 years) entered the study. Patients completed the PID-5, whereas clinicians filled-in the PID-5-Brief Form (PID-5-BF) and the PID-5-IRF for each patient they involved. A multilevel Bayesian analysis showed that rank-order agreement was large for domains (mean r = .60) and moderate for facets (mean r = .44). As regards mean-level agreement, patient ratings on cognitive/perceptual dysregulation, distractibility, eccentricity, and emotional lability were higher than clinician ratings, whereas patients' scores on depressivity were lower than clinicians' ones. Scores on the PID-5-BF detachment positively predicted agreement on anhedonia, anxiousness, depressivity, distractibility, separation insecurity, and suspiciousness, while scores on the PID-5-BF negative affectivity, antagonism, and disinhibition negatively predicted agreement on few specific facets. Current findings suggest that clinician personality traits may contribute to agreement on maladaptive personality traits, but areas of discrepancies remain in case of low observable internal ones. Since patient-clinician agreement is crucially involved in therapeutic alliance, further research on this issue is highly encouraged. (PsycInfo Database Record (c) 2024 APA, all rights reserved).