The time course of health-related Quality of Life in rectal cancer patients undergoing combined modality treatment.

Background and purpose: This exploratory prospective observational study investigated the changes in Health-related Quality of Life (HRQoL) in rectal cancer patients (RCPs), from diagnosis to one-year-post-surgery follow-up and explored the role of physical symptoms and psychological determinants on HRQoL at the different time points. Materials and methods: We assessed HRQoL, psychological distress, coping, affectivity, alexithymia and social support in 43 RCPs treated with preoperative (chemo)radiation and surgery, at three different assessment time points: diagnosis (T0), one month after the end of preoperative treatment (T1), one month after resection surgery (T2), and at follow-up (T3). Results: The data showed that HRQoL decreased during active treatments, especially between T1 and T2 (p = 0.005), before increasing again at follow-up (p = 0.002).Baseline intestinal symptoms (p < 0.001) and negative affectivity trait (p = 0.03) significantly predicted HRQoL at T0. Baseline pain (p < 0.001), intestinal (p = 0.003) and urinary (p = 0.009) symptoms at T1 significantly predicted HRQoL at T1. A fatalistic coping style at T1 (p = 0.013), psychological distress (p = 0.003), mouth symptoms (p = 0.001) at T2 significantly predicted HRQoL at T2. Similarly, a fatalistic coping style at T1 (p = 0.006), psychological distress (p = 0.004), mouth (p = 0.002) and pain symptoms (p = 0.002) at T3 significantly predicted HRQoL at T3. Conclusion: Several physical and psychological factors are involved in the changes occurring after diagnosis in RCPs' HRQoL. While cancer-related symptoms and treatment-related physical side effects are the main predictors of HRQoL at diagnosis and during active treatments, early psychological reactions have a higher predictive weight in post-treatment HRQoL.These data emphasise the importance of active screening, early diagnosis, and preventive psychological interventions immediately after diagnosis to improve HRQoL and psychological health outcomes.

Inflammatory Bowel Disease and Irritable Bowel Syndrome: What Differences in Mentalization Abilities? A Scoping Review.

Mentalization is a psychological process that enables individuals to understand the self and others in terms of intentional mental states. The aim of this scoping review was to provide an overview of the findings on mentalization in patients with inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS). A literature search, in line with the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols extension for Scoping Review guidelines, was conducted in the following bibliographic databases: PubMed, PsycINFO, and Scopus. Databases were queried using the following strings (with Boolean operators): ("mentaliz*" OR "metacogniti*" OR "theory of mind" OR "ToM" OR "reflective function*") AND ("irritable bowel syndrome" OR "IBS" OR "inflammatory bowel disease" OR "IBD"). In line with the eligibility criteria, seven articles were included. Results showed that no significant differences in metacognitive ability were found between patients in the IBD and IBS groups. This review revealed the mentalizing difficulties for patients with IBD and IBS. These results should be interpreted with caution since they are based on a few studies that used different instruments to assess mentalizing processes. Future studies are needed to clarify the role of mentalization in patients with these gastrointestinal conditions.

Expanded version of the Posttraumatic Growth and Depreciation Inventory: Scale validation and refinement among Italian adults.

OBJECTIVE: The main aim of this study was to investigate the psychometric properties of the Italian version of the newly-developed Posttraumatic Growth and Depreciation Inventory (PTGDI-X) in a heterogeneous sample of Italian adults who had experienced a traumatic event. METHOD: The instrument was translated following the forward-backward method and completed by 601 participants who met the inclusion criteria. The factorial structure of the PTGDI-X was assessed by means of multiple confirmatory factor analyses (CFA). Convergent and discriminant validity and reliability were also evaluated. RESULTS: The results of the CFA revealed that the original 5-factor model was the best fit for the growth (PTG) dimension of the PTGDI-X, whereas it poorly fit the data with respect to the depreciation (PTD) component. With regard to convergent and divergent validity, positive correlations were found between the PTG scores and the core belief disruption and rumination scores, whereas the PTG factors correlated negatively with depressive and posttraumatic symptom measures. Conversely, positive correlations were identified between the PTD total score and all the other investigated constructs. Finally, the total scales and subscales of the PTG/PTD dimensions revealed good to excellent internal consistency. CONCLUSIONS: The current findings indicate that the Italian version of the PTGDI-X appears to be a valid assessment tool for the multidimensional structure of the PTG component. Future research is needed, on the other hand, to confirm the validity of the PTD dimension in the Italian population. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Alexithymia Among People Living with HIV: A Scoping Review.

The present scoping review aimed to identify studies that investigated alexithymia, defined as a difficulty in identifying and describing one's own emotions, in people living with HIV (PLWH).A literature search, in line with the guidelines of PRISMA-ScR, was conducted in the following bibliographic databases: PubMed, PsycINFO, and Web of Science. The databases were queried using the following strings (using Boolean operators): ("alexithymia" OR "alexithymic") AND ("HIV" OR "Human Immunodeficiency Virus"). In line with the eligibility criteria, fourteen articles were found.Ten studies showed the involvement of alexithymia in disease severity (e.g., viral load levels), and adherence to antiretroviral therapy. Three studies revealed an association between alexithymia and cardiovascular disease, and three studies highlighted the implication of alexithymia in cognitive impairment.This review revealed the complex role of alexithymia in HIV disease. A careful clinical assessment of the emotional regulation process of PLWH can provide useful prognostic information.

RESUMEN: La presente revisión panorámica está orientada a identificar estudios que han investigado la alexitimia, definida como la dificultad de identificar y describir las propias emociones, en personas que conviven con el VIH.Siguiendo las directrices de PRISMA-ScR, se realizó una búsqueda bibliográfica en las siguientes bases de datos: PubMed, PsycINFO y Web of Science. Las bases de datos se consultaron utilizando las siguientes cadenas (utilizando el operador Boolean): ("alexithymia" OR "alexithymic") AND ("HIV" OR "Human Immunodeficiency Virus").De acuerdo con los criterios de elegibilidad, se encontraron catorce artículos. Específicamente, diez estudios mostraron la implicación de la alexitimia en la gravedad de la enfermedad (por ejemplo, niveles de carga viral) y la adherencia a la terapia antirretroviral, tres estudios revelaron la asociación entre la alexitimia y la enfermedad cardiovascular, y tres estudios resaltaron la implicación de la alexitimia en el deterioro cognitivo.Esta revisión reveló el complejo rol de la alexitimia en la enfermedad del VIH. Una evaluación clínica detallada del proceso de regulación emocional de las personas que viven con el VIH puede proporcionar información útil para el pronóstico.

Posttraumatic Growth and Posttraumatic Depreciation: Associations with Core Beliefs and Rumination.

BACKGROUND: The positive transformation (i.e., posttraumatic growth, PTG) that can emerge after the struggles associated with a stressful life event has been widely investigated. However, less attention has been paid to the negative posttraumatic changes (i.e., posttraumatic depreciation, PTD) that might occur after a traumatic experience. This study aimed to investigate the role of a series of psychological factors (e.g., disruption of core beliefs, rumination, and depressive symptoms) in predicting PTG and PTD, separately considered. METHODS: To reach this goal, 601 participants who experienced different types of traumatic events were recruited. They were asked to indicate sociodemographic and trauma-related information and to complete self-report measures assessing PTG/PTD, core beliefs, rumination, and depressive symptoms. RESULTS: The results of regression analyses showed that gender, age, time since the trauma, core beliefs, deliberate/intrusive rumination, and depressive symptoms were significant predictors of PTG. Conversely, core beliefs, intrusive rumination, and depressive symptoms were found to be positively related to PTD. CONCLUSIONS: Taken together, these findings highlight the role that different psychological factors may play in the manifestation of the PTG and/or PTD dimensions. From a clinical perspective, professionals should pay attention to these factors when a person struggles in coping with a highly stressful experience.

The Post-Traumatic Stress Disorder Checklist for DSM-5: Psychometric Properties of the Italian Version.

BACKGROUND: The present study aimed to investigate the psychometric properties of the Italian version of the PTSD Checklist for the DSM-V (PCL-5) in a group of adults who had experienced heterogenous traumatic events. METHODS: Six hundred and one participants met the inclusion criteria and completed a set of questionnaires through an online survey. Before administering the survey, the PCL-5 was translated into Italian according to the back-translation method. The factorial structure of the PCL-5 was assessed through multiple confirmatory factor analyses. Gender measurement invariance and concurrent and criterion validity were also evaluated. RESULTS: The instrument had a seven-factor structure and it worked in a similar manner for males and females. With regard to the concurrent validity, results showed that higher PCL-5 scores were associated with higher levels of depression and rumination and lower levels of life satisfaction. Regarding criterion validity, results revealed that PCL-5 scores were, on average, higher for females than for males, and the temporal distance from the traumatic event was negatively correlated with the total PCL-5 score. CONCLUSIONS: The findings indicated that the Italian version of the PCL-5 was able to provide valid and reliable scores for the assessment of PTSD symptoms in the Italian population.

From the First to the Second Wave of COVID-19: Anxiety, De-Pressive, and Post-Traumatic Stress Symptoms in the Italian Population.

In the early stages of the COVID-19 outbreak, high rates of clinically relevant anxiety, depression, and post-traumatic stress symptoms (PTSS) have been reported in the Italian population. The persistence of the pandemic and related restrictive measures highlight the need for a reassessment of psychopathological symptoms. The present longitudinal study consisted of two evaluations conducted during the two waves of infection. Participants were asked to complete the State-Trait Anxiety Inventory-Form Y1 (STAI Y1), the Beck Depression Inventory (BDI-II), and the PTSD Checklist for DSM-5 (PCL-5). There were no significant differences in depressive symptoms and PTSS scores reported by participants between T0 and T1, with single-case analysis revealing that in 71% and 69% of the participants, depressive symptoms and PTSS symptoms, respectively, remained stable during this period. On the contrary, mean scores comparison showed a significant decrease in anxiety levels, with 19% of participants in whom anxiety symptoms improved at single-case analysis. Taken together, these results suggest that depressive symptoms and PTSS not only occurred in a high percentage of participants but also tended to remain stable over time, thus warranting the importance of large-scale psychological screening and interventions to prevent the chronicization of these symptoms and their evolution to psychopathological disorders.

Personality, Defense Mechanisms and Psychological Distress in Women with Fibromyalgia.

BACKGROUND: Previous studies have shown that many personality traits are associated with fibromyalgia (FM), worsening both the quality of life and psychological distress of patients. Despite the high comorbidity of psychopathological disorders in this syndrome and their association with immature defense styles, few studies have examined the defense mechanisms used by FM patients. The main aim of our study was to investigate personality traits and defense mechanisms in FM patients compared to in a healthy control group (HC). Moreover, we investigated the effect of personality traits and defense mechanisms on psychological distress in both FM and HC groups. METHODS: A total of 54 women with FM and 54 healthy women completed the (1) Temperament and Character Inventory-Revised; (2) the Toronto Alexithymia Scale; (3) the Defense Style Questionnaire; and (4) the Hospital Anxiety and Depression Scale. RESULTS: The results indicated that FM patients display higher alexithymia, higher harm avoidance, lower self-directedness, lower persistence, and the higher use of a maladaptive defense style compared to HC. We found that alexithymia, harm avoidance, and maladaptive defense style are significant predictors of patients' psychological distress. Moreover, harm avoidance and adaptive defense style significantly predicted psychological distress in the HC group. CONCLUSION: The present study is the first to explore the contribution of both defense mechanisms and personality characteristics on the psychological distress of FM patients. Our findings have important clinical implications and may help diagnose and treat FM patients more in depth.

Traumatic experiences and somatoform dissociation in women with fibromyalgia.

Objective: Psychological factors like traumatic life events seem to affect the etiopathogenesis and the exacerbation of fibromyalgia (FM), a chronic widespread musculoskeletal pain syndrome. This Study investigated the prevalence of traumatic events, with a particular attention to the whole life span, and both psychoform and somatoform dissociation in patients with FM, compared with healthy controls (HC). In addition, the possible effects of traumatic events and dissociative experiences on FM symptoms have been analyzed. Method: Traumatic experiences, dissociative symptoms, and psychological distress were assessed in 99 consecutive patients with FM and 107 healthy women. Student t-tests for two independent samples were used to determine differences between the FM and HC groups. A hierarchical multiple regression analysis was used to explore the possible contribution of trauma and dissociation to FM symptoms. Results: Results revealed that the levels of both somatoform and psychoform dissociation were higher among patients with FM than HC (p < .001). Moreover, patients with FM experienced significantly more negative life events than HC (p < .001). Finally, the data suggested that the severity of FM disabilities was significantly predicted by the presence of depressive symptoms, somatoform dissociation, cumulative trauma, and educational level. The final Model explained 40% of the variance. Conclusions: Results suggest that the construct of somatoform dissociation could serve as a useful framework to improve our understanding of FM symptoms, and stressed the importance of evaluating the effects of multiple traumas in cumulative form because this has substantial implications for the evaluation and treatment of patients. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Psychological Distress among Italian University Students Compared to General Workers during the COVID-19 Pandemic.

The COVID-19 pandemic induced numerous changes in the daily life of every individual, with important social, economic, and psychological consequences. Particularly, the psychological impact encountered among students might be affected by social isolation, concern for personal health and for the health of family members and friends, and uncertainty about academic progress. The present study aimed to investigate the psychological impact of the COVID-19 outbreak on Italian university students compared to general workers. The responses of 956 participants (478 university students and 478 workers) were included in the final dataset. Participants were asked to provide sociodemographic and occupation-related information, and to complete: (1) COVID-19-related questions; (2) health-related visual analogue scales; (3) State-Trait Anxiety Inventory-Form Y1 (STAI Y1); and (4) the Beck Depression Inventory (BDI-II). Results of comparisons between university students and general workers revealed that the former reported higher levels of anxiety and depressive symptoms. Furthermore, regression analyses showed that in university students, gender, health evaluation, and health concern and gender, educational level, and health evaluation significantly predicted anxiety and depressive symptoms, respectively. Taken together these findings suggest that specific factors could predispose University students to a high risk of developing mental health symptoms as a consequence of the COVID-19 pandemic.

Traumatic Stress in Healthcare Workers During COVID-19 Pandemic: A Review of the Immediate Impact.

The disease caused by respiratory syndrome coronavirus 2 (SARS-CoV-2) called COVID-19 resulted in a pandemic that has demanded extraordinary physical and mental effort from healthcare workers. This review provides an overview of studies that have explored traumatic stress in healthcare workers and associated factors between January and May 2020. The focus is on the most relevant literature investigating the prevalence of trauma- and stressor-related symptoms. Articles were selected from PubMed and PsycINFO databases using the search terms, "healthcare workers," "COVID-19," and "posttraumatic stress" in different combinations and with various synonyms. Among the seven studies that fulfilled our criteria, five assessed traumatic stress response, one assessed acute stress symptoms, and one focused on vicarious traumatization. Overall, the available findings highlight the presence of trauma-related stress, with a prevalence ranging from 7.4 to 35%, particularly among women, nurses, frontline workers, and in workers who experienced physical symptoms. Future studies should clarify the long-term effects of the COVID-19 pandemic on the mental health of healthcare workers, with particular focus on posttraumatic stress disorder.

Mental health of healthcare workers during the COVID-19 pandemic in Italy.

BACKGROUND: The COVID-19 pandemic represents one of the most stressful events of recent times. Among the population, healthcare professionals who treat COVID-19 patients are most likely to develop psychological distress and posttraumatic stress symptoms (PTSS). The present study thus aimed to investigate the psychological impact of the COVID-19 outbreak on Italian healthcare workers. METHODS: The responses of 145 healthcare workers (72 medical doctors and 73 nurses) were included in the final dataset. Participants were asked to provide sociodemographic and clinical information, and to complete: (a) quality of life and health-related Visual Analogue Scales, (b) State-Trait Anxiety Inventory-Form Y1, (c) Beck Depression Inventory, and (d) PTSD Checklist for DSM-5. RESULTS: A comparison between healthcare professionals working in COVID-19 wards and other units revealed that the former reported higher levels of both depressive symptoms and PTSS. Moreover, the results of regression analyses showed that in healthcare professionals working with COVID-19 patients, gender and marital status, and gender and age significantly predicted depressive symptoms and PTSS, respectively. Particularly, being female and not in a relationship were found to be associated with higher levels of depressive symptoms, whereas being female and older were found to be related to higher levels of PTSS. CONCLUSIONS: The current findings suggest that specific predisposing factors could identify healthcare workers who are at high risk of developing mental health symptoms when faced with COVID-19 patients.

Attachment style and parental bonding: Relationships with fibromyalgia and alexithymia.

OBJECTIVES: Fibromyalgia (FM) is a chronic pain syndrome, and alexithymia, which is a condition that is characterised by deficits in emotional self-awareness, is highly prevalent among individuals with FM. Insecure attachment styles and inadequate parental care appear to play an important role in the onset and maintenance of both alexithymia and chronic pain. Therefore, the present study aimed to examine the associations between attachment styles, parental bonding, and alexithymia among patients with FM and healthy controls (HC). METHODS: All participants completed a battery of tests that assessed alexithymia, attachment styles, and parental bonding. Two logistic regression models were tested to examine whether these variables predict (a) group membership (i.e. patients with FM vs. HC) and (b) the likelihood of having alexithymia (i.e. among patients with FM and HC). RESULTS: Alexithymia (i.e. difficulty identifying and describing feelings subscales of the 20-item Toronto Alexithymia Scale) significantly predicted group membership (i.e. the likelihood of having FM). On the other hand, educational level and dismissive attachment (i.e. the discomfort with closeness and relationships as secondary subscales of the Attachment Style Questionnaire) were the only significant predictors of the likelihood of having alexithymia. CONCLUSIONS: These findings highlight both the relevance of alexithymic traits to the definition of FM and centrality of an insecure attachment style to the manifestation of alexithymia.