Personalized Virtual Reality Compared With Guided Imagery for Enhancing the Impact of Progressive Muscle Relaxation Training: Pilot Randomized Controlled Trial.

BACKGROUND: Empirical evidence has shown that virtual reality (VR) scenarios can increase the effects of relaxation techniques, reducing anxiety by enabling people to experience emotional conditions in more vivid settings. OBJECTIVE: This pilot randomized controlled study aims to investigate whether the progressive muscle relaxation technique (PMRT) associated with a personalized scenario in VR promotes psychological well-being and facilitates the recall of relaxing images more than the standard complementary intervention that involves the integration of PMRT and guided imagery (GI). METHODS: On the basis of a longitudinal, between-subject design, 72 university students were randomly exposed to one of two experimental conditions: (1) standard complementary procedure (PMRT and GI exposure) and (2) experimental procedure (PMRT and personalized VR exposure). Individuals were assessed by a therapist before and after 7 training sessions based on measures investigating anxiety, depression, quality of life, coping strategies, sense of presence, engagement, and side effects related to VR exposure. Heart rate data were also collected. RESULTS: Differences in changes between the 2 groups after the in vivo PMRT session conducted by the psychotherapist (T1) were statistically significant for state anxiety (F1,67=30.56; P<.001) and heart rate (F1,67=4.87; P=.01). Individuals in the VR group obtained lower scores both before (t67=-2.63; P=.01; Cohen d=0.91) and after (t67=-7.23; P<.001; Cohen d=2.45) the relaxation session when it was self-administered by participants (T2). A significant reduction in perceived state anxiety at T1 and T2 was observed for both groups (P<.001). After the VR experience, individuals reported feeling higher engagement in the experience than what was mentioned by participants in the GI group (F1,67=2.85; P=.03; ηp2=0.15), and they experienced the environment as more realistic (F1,67=4.38; P=.003; ηp2=0.21). No differences between groups regarding sense of presence were found (F1,67=1.99; P=.11; ηp2=0.11). Individuals exposed before to the VR scenario (T1) referred to perceiving the scenario recalled in-imagination at T2 as more realistic than what those in the GI group experienced (F1,67=3.21; P=.02; ηp2=0.12). The VR group had lower trait anxiety levels than the GI group after the relaxation session during session 7 (T2; t67=-2.43; P=.02). CONCLUSIONS: Personalized relaxing VR scenarios can contribute to improving relaxation and decreasing anxiety when integrated with PMRT as a complementary relaxation method. TRIAL REGISTRATION: ClinicalTrials.gov NCT05478941; https://classic.clinicaltrials.gov/ct2/show/NCT05478941. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/44183.

Customized virtual reality naturalistic scenarios promoting engagement and relaxation in patients with cognitive impairment: a proof-of-concept mixed-methods study.

Being immersed in a natural context has a beneficial and pervasive impact on well-being. Virtual Reality (VR) is a technology that can help expose people to naturalistic scenarios virtually, overcoming obstacles that prevent them from visiting real natural environments. VR could also increase engagement and relaxation in older adults with and without cognitive impairment. The main aim of this study is to investigate the feasibility of a customized naturalistic VR scenario by assessing motion-sickness effects, engagement, pleasantness, and emotions felt. Twenty-three individuals with a diagnosis of cognitive impairment living in a long-term care home participated in our study. At the end of the entire VR experimental procedure with older adults, five health staff operators took part in a dedicated assessment phase focused on evaluating the VR procedure's usability from their individual perspectives. The tools administered were based on self-reported and observational tools used to obtain information from users and health care staff professionals. Feasibility and acceptance proved to be satisfactory, considering that the VR experience was well-tolerated and no adverse side effects were reported. One of the major advantages emerged was the opportunity to deploy customized environments that users are not able to experience in a real context.Trial Registration: National Institute of Health (NIH) U.S. National Library of Medicine, ClinicalTrials.gov NCT05863065 (17/05/2023).

Profiling orthorexia nervosa in young adults: the role of obsessive behaviour, perfectionism, and self-esteem.

BACKGROUND: Orthorexia nervosa (ON) is a relatively new potential eating disorder characterized by an intense fixation on one's eating habits and the imposition of rigid and inflexible rules on oneself. Psychological factors such as obsessive-compulsive tendencies, perfectionism and self-esteem may interact in complex ways and contribute to the development and maintenance of ON. METHODS: This cross-sectional study included 977 participants from Italy, Lebanon, and Poland. Participants completed a questionnaire consisting of socio-demographic information, the Eating Habits Questionnaire, Obsessive-Compulsive Inventory, Obsessive Beliefs Questionnaire-44, Multidimensional Perfectionism Scale, and Rosenberg Self-Esteem Scale. Cluster analysis was used to identify subgroups of individuals with common psychological characteristics associated with ON. RESULTS: Three distinct clusters were identified based on their levels of obsession-compulsive beliefs, perfectionism, and self-esteem. The first group, labeled "High Self-Mastery," consisted of 37.0% of participants and exhibited low levels of obsession-compulsion, obsessive beliefs, and perfectionism, but high self-esteem. The second group, "Moderate Self-Mastery," comprised 39.5% of participants and had moderate levels of these traits. The third group, "Low Self-Mastery," consisted of 23.6% of participants and exhibited the highest levels of obsession-compulsion, obsessive beliefs, and perfectionism, but the lowest self-esteem. Additionally, a multivariable analysis revealed that being Lebanese (Beta = 3.39) and belonging to the last cluster (Beta = 4.53) were significantly associated with higher ON tendencies. CONCLUSION: Our findings show that individuals with low self-mastery, characterized by low self-esteem and high levels of obsessive perfectionism, are more likely to exhibit ON tendencies. This study emphasizes the need to have a comprehensive understanding of how cultural and psychological factors interact in the development of eating disorders.

Orthorexia nervosa (ON) is a relatively new eating disorder that involves an intense focus on eating habits and strict rules about food. This study aimed to identify factors that may predict the development of ON. A questionnaire was given to 977 participants from Italy, Lebanon, and Poland to assess their psychological characteristics such as obsessive­compulsive tendencies, perfectionism, and self-esteem. Cluster analysis was performed to identify subgroups of individuals with common psychological characteristics associated with ON. The study found that participants from Lebanon, and individuals with low self-mastery, characterized by low self-esteem and high levels of obsessive perfectionism, are more likely to exhibit ON tendencies and were particularly vulnerable to the disorder.

Perfectionism or Perfectionisms in Orthorexia Nervosa.

Purpose: Perfectionism is considered a transdiagnostic construct that characterises eating disorders (EDs) and obsessive-compulsive disorder (OCD) and that could also depict orthorexia nervosa (ON). The principal aim of this study was to investigate what dimensions of perfectionism mostly represent ON. Moreover, it was evaluated if dieting impacted the presence of orthorexic features and perfectionistic behaviour. Methods: The sample consisted of two groups-the "Diet" (n = 93), and the "No Diet" (n = 94) groups-composed of people with high and low orthorexic tendencies, respectively. Participants filled out self-report questionnaires to investigate orthorexic tendencies and different facets of perfectionism. Results: Analyses highlighted that people with high orthorexic tendencies showed higher perfectionistic features and that ON had a significant relationship with different facets of perfectionism. No interactions with diet were found. Therefore, no other differences were highlighted when the group type (Diet/No Diet) was considered. Conclusions: Regardless of diet, different facets of perfectionism characterise ON: perfectionism as a personality trait and perfectionism related to EDs and to obsessive-compulsive features. Our results evidenced that perfectionism could also be considered a useful construct in the conceptualization of orthorexia nervosa.

Frequency and machine learning predictors of severe depressive symptoms and suicidal ideation among university students.

AIMS: Prospective studies on the mental health of university students highlighted a major concern. Specifically, young adults in academia are affected by markedly worse mental health status than their peers or adults in other vocations. This situation predisposes to exacerbated disability-adjusted life-years. METHODS: We enroled 1,388 students at the baseline, 557 of whom completed follow-up after 6 months, incorporating their demographic information and self-report questionnaires on depressive, anxiety and obsessive-compulsive symptoms. We applied multiple regression modelling to determine associations - at baseline - between demographic factors and self-reported mental health measures and supervised machine learning algorithms to predict the risk of poorer mental health at follow-up, by leveraging the demographic and clinical information collected at baseline. RESULTS: Approximately one out of five students reported severe depressive symptoms and/or suicidal ideation. An association of economic worry with depression was evidenced both at baseline (when high-frequency worry odds ratio = 3.11 [1.88-5.15]) and during follow-up. The random forest algorithm exhibited high accuracy in predicting the students who maintained well-being (balanced accuracy = 0.85) or absence of suicidal ideation but low accuracy for those whose symptoms worsened (balanced accuracy = 0.49). The most important features used for prediction were the cognitive and somatic symptoms of depression. However, while the negative predictive value of worsened symptoms after 6 months of enrolment was 0.89, the positive predictive value is basically null. CONCLUSIONS: Students' severe mental health problems reached worrying levels, and demographic factors were poor predictors of mental health outcomes. Further research including people with lived experience will be crucial to better assess students' mental health needs and improve the predictive outcome for those most at risk of worsening symptoms.

The predictive role of intolerance of uncertainty and trait of worry in breast cancer patients: A prospective, observational, single-center clinical study.

Background: Breast cancer diagnosis and treatment compromise well-being in a pervasive way, and negative consequences may remain after recovery. The psychological side of breast cancer has been extensively investigated; however, the role of intrusive thoughts and intolerance of uncertainty have been studied less systematically. Objectives: The present study aimed to prospectively evaluate worry content, depression, anxiety, and post-traumatic stress symptoms and to define the role of the trait of worry and intolerance of uncertainty (IU) related to breast cancer. Methods: Patients with their first breast cancer diagnosis were enrolled in a single-center, prospective observational trial. The trait of worry and IU were assessed using the Penn State Worry Questionnaire (PSWQ) and the Intolerance of Uncertainty Scale-Revised (IUS-R). The psychological aspects were evaluated using the Worry Domains Questionnaire (WDQ), the Beck Anxiety (BAI), Beck Depression Inventory-II (BDI-II), and the Impact of Event Scale-Revised (IES-R). Questionnaires were administered in a randomized sequence at diagnosis (T0), 3 months post-diagnosis (T1), and 12 months post-diagnosis (T2). Results: One hundred and fifty eligible patients were enrolled in the study and provided the T0 assessment. Further compliance rates were 57% at T1 and 64% at T2. All patients showed a significant and continuous increase in the IES-R scale (p < 0.0001) from diagnosis to the end of the study, while no significant changes were observed for the WDQ, BAI, and BDI-II scales. The clinical PSWQ levels and/or high levels of the IUS-R score were the only variables that aided the distinction between patients who maintain high levels of depression, anxiety, and post-traumatic disorders and those who did not. Conclusion: An early assessment of the components of the trait of worry and intolerance of uncertainty could be critical in identifying patients with a higher psychopathological risk. Furthermore, if future studies confirm the present findings, support and monitoring throughout the prognosis may present crucial benefits, and possibly affect the course of treatment.

Personalized, Naturalistic Virtual Reality Scenarios Coupled With Web-Based Progressive Muscle Relaxation Training for the General Population: Protocol for a Proof-of-Principle Randomized Controlled Trial.

BACKGROUND: Virtual reality (VR) is an innovative tool that can facilitate exposure to either stressful or relaxing stimuli and enables individuals who have difficulties visualizing scenes to be involved in a more realistic sensorimotor experience. It also facilitates multisensory stimulation, a sense of presence, and achievement of relaxation. VR scenarios representing visual and auditory elements of natural relaxing environments can facilitate the learning of relaxation techniques such as the progressive muscle relaxation technique (PMRT). A complementary standardized technique deployed to reduce anxiety symptoms is the integration of PMRT and guided imagery (GI). Exposure to a pleasant imaginary environment helps the establishment of an association between a relaxing scenario and the relaxation technique, consequently promoting relaxation. Empirical evidence has shown that VR scenarios can increase the effects of relaxation techniques by enabling people to experience emotional conditions in more vivid settings. OBJECTIVE: The main aim of this pilot study protocol is to investigate the impact on state anxiety of PMRT, associated with a personalized relaxing scenario in VR, and the role of VR scenarios in facilitating the recall of relaxing images and a sense of presence. A secondary aim is to understand if relaxing sessions administered via Zoom are more effective for managing anxiety and stress than a procedural setting based on audio-track guidance. METHODS: Based on a longitudinal, between-subject design, 108 university students will be randomly exposed to one of three experimental conditions: (1) PMRT via Zoom and GI exposure, (2) PMRT via Zoom and personalized VR exposure, and (3) PMRT based on audio-track guidance and personalized VR exposure. Individuals are assessed before and after 7 training sessions based on self-report questionnaires investigating anxiety, depression, quality of life, coping strategies, sense of presence, engagement, and side effects related to VR exposure. Heart rate data are also detected by an Mi Band 2 sensor. RESULTS: The experimental procedure is ongoing. In this paper, preliminary data from a sample of 40 participants will be illustrated. The experimental phase is expected to conclude in May 2023, and the final results of the research will be presented in June 2023. CONCLUSIONS: The results of this study will help shape the experimental design to apply it on a subsequent randomized controlled trial, also considering clinical samples. This work is expected to measure whether VR is a more engaging and helpful technique in promoting relaxation and decreasing anxiety levels than GI, by making the visualization process easier and by helping people to face more realistic sensory experiences. Assessing the efficacy of the PMRT in alternative delivery modes may extend its applications, especially in situations where the standard procedure is more challenging to be administered. To our knowledge, no equivalent study has been published so far on this matter. TRIAL REGISTRATION: ClinicalTrials.gov NCT05478941; https://clinicaltrials.gov/ct2/show/NCT05478941. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/44183.

The experience of leaving a valuable object: An investigation of emotional processes related to Hoarding disorder features.

One of the core features of hoarding is a significant resistance to discarding objects, which is fueled by dysfunctional beliefs and unwarranted negative emotions that hoarders tend to feel when disposing of their possessions. To our knowledge, longitudinal studies investigating the psychological effects that people who hoard experience after separating from their valuable possessions have yet to be conducted. Our study's principal aim was to explore psychological processes that individuals with high hoarding features (n = 53; 49.1%) and individuals with low hoarding features (n = 55; 50.9%) experienced when they had to separate from a valuable possession. To do this, we evaluated participants' thoughts and feelings at several time points after they had to leave a valuable object at the University laboratory (evaluations were specifically conducted at baseline, during the week, and at the end of the week). To investigate hoarding and anxiety, as well as depressive, obsessive-compulsive, and emotional processes-related features, a mixed-method approach was employed involving self-report questionnaires, ad hoc surveys, and a daily self-monitoring schedule. Our findings showed that compared to participants with low hoarding features, participants with high hoarding traits: 1) scored higher for anxiety sensitivity, distress tolerance, and emotional dysregulation; 2) reported having more negative emotions when leaving their object; 3) had more intrusive object-related beliefs; and 4) experienced a higher frequency of negative emotions as well as a higher level of distress during the week. Both groups experienced more negative emotions in the first part of the week, which decreased as the time at which participants could receive their object back drew closer. Finally, dysfunctional beliefs about leaving a personal object (Saving Cognitions Inventory), sensitivity to anxiety (Anxiety Sensitivity Index-3), and distress tolerance (Distress Tolerance Scale) contributed to the level of discomfort that participants with higher hoarding scores reported when they had to leave their possession. These results highlight the relevance of emotional processes in the hoarding disorder framework as well as underscore the importance of assessing and treating them in clinical settings.

The Role of Personalization in the User Experience, Preferences and Engagement with Virtual Reality Environments for Relaxation.

Virtual Reality Environments (VREs) are widely deployed in mental health treatments, often associated with relaxation techniques. The personalization of natural VR-based scenarios is a key element that can further facilitate users' sense of presence and relaxation. This study explored the role of VREs' personalization in the user experience with an environment supporting relaxation, by deploying mixed methods. METHODS: A non-clinical sample of 20 individuals participated in exposure to a supportive body-scan-guided relaxation VRE. In the personalized conditions, the participants had the option of choosing the context (e.g., sea, mountain, or countryside) and including in the scenario different types of sounds, visual elements, and changing the time of day and weather. In the standard conditions, individuals were exposed to a relaxing VRE, but they could choose neither the context nor the auditory and visual elements. The order of presentation of the personalized vs non-personalized environments was randomized. Measures regarding relaxation, state-anxiety perceived levels, VRE-related symptoms, the usability of the Virtual Reality (VR) setting, sense of presence, pleasure, activation, engagement, and level of immersion experienced were collected before and after exposure to the VR environments. RESULTS: Findings showed that personalized VREs were preferred by users. Participants generally preferred to experience a greater immersivity, pleasure, engagement, and relaxation in the personalized virtual settings. CONCLUSION: The study further confirms the role of personalization as a component positively contributing to relaxation and engagement. Future research may further assess this effect in the context of large-scale controlled studies involving clinical and non-clinical populations.

Orthorexia Nervosa and Disordered Eating Attitudes, Self-Esteem and Physical Activity among Young Adults.

A relation between Orthorexia Nervosa (ON) and increased frequency of physical activity has been put in evidence by recent studies. It is well known that intense physical exercises are typically related to eating disorders, but its relationship with ON is still a subject of debate. Other transdiagnostic features could be necessary to conceptualize and understand ON; in this way, low self-esteem is related to eating behavior but is not still extensively investigated in ON, and, to date, data are so heterogeneous that they do not allow us to understand if this is a psychological feature somehow associated with ON. The current study aimed to assess whether disordered eating attitudes, self-esteem, and physical activity are associated with ON in young adults from Poland and Italy. Moreover, we investigated the differences by comparing lower and higher ON levels related to disordered eating attitudes, self-esteem, and physical activity. Our results indicated that a great concern about dieting significantly predicted problems associated with healthy eating, knowledge about healthy eating, and feeling positive about healthy eating. In addition, young adults with a high level of ON demonstrated higher levels of disordered eating attitudes and vigorous-intensity physical activity than young adults with a low level of ON. Future studies are needed to assess the direct effect of physical activity and self-esteem on ON.

Orthorexia nervosa and dieting in a non-clinical sample: a prospective study.

PURPOSE: Orthorexia Nervosa (ON) is characterised by excessive attention to a dietary regimen perceived as healthy. A critical factor in the distinction between ON and other eating disorders (EDs) is the dichotomy of quality-versus-quantity of food intake. We investigated whether specific types of diet or dieting frequency are associated with orthorexic features, explored the overlap between ON and EDs symptoms, and examined which constructs are predictive of ON after 6 months. METHODS: A total of 1075 students (75.1% female, mean age 20.9) completed a set of questionnaires assessing Orthorexia, Eating Disorders, Obsessions and Compulsions, Anxiety and Depression; 358 individuals (79.9 female, mean age 20.9) agreed to participate in the study and completed the same questionnaires after 6 months. Different regression models were defined to investigate our hypothesis. RESULTS: Findings suggest that ON is associated with the number and type of diets followed over a lifetime. Moreover, participants with EDs, body dissatisfaction, or a dysfunctional idea of thinness are more likely to report a greater degree of ON features. After 6 months, the best predictors of ON characteristics are the same ON characteristics assessed at the first administration, with a significant role in the ideal of thinness. CONCLUSIONS: ON is more frequent in individuals with a previous diagnosis of EDs and in individuals who followed a restrictive diet or a vegan/vegetarian one; the number of lifetime diets, beliefs, and behaviors related to the ideals of thinness or body dissatisfaction is common features of ON. Moreover, considering that having ON features in the past is the best ON predictor in the present, we can presume that ON is a construct stable over time. LEVEL OF EVIDENCE: Level IV: Evidence obtained from multiple time series analysis such as case studies. (NB: Dramatic results in uncontrolled trials might also be regarded as this type of evidence).

Orthorexia Nervosa and its association with obsessive-compulsive disorder symptoms: initial cross-cultural comparison between Polish and Italian university students.

There is limited evidence of a link between Orthorexia Nervosa (ON) and Obsessive-Compulsive Disorder (OCD), and no definitive conclusions can be drawn. The interplay between socio-cultural context and ON has been poorly investigated as well. Therefore, the objectives of the present study were: (1) to investigate the differences in ON and OCD symptoms and (2) to assess the relationship between ON and OCD symptoms among university students. Six hundred and sixty-six university students participated in the present study: 286 from Poland and 320 from Italy. No age, gender and marital status differences were identified between two samples of university students. However, on average, Polish university students had a higher Body Mass Index than Italian ones. Our findings showed that Polish students present more problems related to obsessive symptomatology, core beliefs of OCD, perfectionism traits, and a major ON symptomatology than Italian ones. Also, Polish students with a higher level of ON exhibited higher levels of OCD symptoms and parental expectations/parental criticism. While Italian students with a higher level of ON showed higher levels of perfectionism features (organization and concern over mistakes). In general, correlations were low as confirmation of partial independence ON from OCD symptoms and core beliefs of OCD in both Polish and Italian university students. The present results highlight a need for further investigation of the correlates of ON across different cultural groups. Future research may screen individuals with ON to determine the comorbidity between ON and OCD symptomology to facilitate appropriate treatment choices. LEVEL OF EVIDENCE: Level V, Opinions of respected authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.

The Short Forms of the Hewitt and Flett's Multidimensional Perfectionism Scale: Which Factor Structure Better Fits Italian Data?

One of the most used instruments to assess perfectionism is Hewitt and Flett's Multidimensional Perfectionism Scale (HFMPS). This article reports result of two studies aimed at evaluating and comparing two short HFMPS versions provided by literature in Italian samples. In Study 1, two previously proposed short forms-Cox and colleagues' and Hewitt and colleagues'-were compared in terms of factor structure and concurrent validity in a community sample of 324 participants. In Study 2, validity and reliability of the two short scales in 102 university students and 58 patients with a primary diagnosis of Obsessive-Compulsive Disorder were examined. Results revealed mixed findings concerning which of the two short form should be preferred.

Orthorexia Nervosa: over concern or obsession about healthy food?

PURPOSE: Orthorexia Nervosa is characterized by specific behaviors frequently related to other psychopathological conditions, such as Obsessive-Compulsive Disorder (OCD) and Eating Disorders (EDs). Whereas ON can mainly be described as an excessive concern regarding healthy food, the study's principal aim was to investigate if ON could be considered a condition related and differentiated from worry, other than OCD, EDs, perfectionism, anxiety, and depression. METHOD: To achieve these aims, 302 individuals from the general population were enrolled and were divided into two groups named "High EHQ" and "Low EHQ", based on their Eating Habits Questionnaire's score (EHQ-21). RESULTS: Correlations of ON with EDs and non-adaptive perfectionism constructs emerged independently from Obsessive-Compulsive (OC) symptoms, and the same pattern was observed when comparing the High and the Low EHQ groups. The two groups also differ in the worry anxiety and depression constructs and are not affected by OC symptoms removal. DISCUSSION: Our results confirm a relationship between ON with the typical ED, perfectionistic, anxious, and depressive symptomatology, mainly when the OC features are controlled; moreover, worry constructs could be considered characteristic of the ON phenomenology. This study does not entirely exclude the relationship with obsessive and compulsive characteristics, which could be associated with or serve as a mediator of the orthorexic behavior. Future research could explore the potential mediating or collateral role of OC symptoms. LEVEL OF EVIDENCE: Level III, evidence obtained from well-designed cohort or case-control analytic studies.

Students' mental health problems before, during, and after COVID-19 lockdown in Italy.

The lockdown due to the coronavirus pandemic may have exacerbated mental health problems. To what degree mental health may be affected by social isolation is still poorly known. We collected prospective data on students' mental health in two instances: (i) in October and December 2019, and (ii) 6 months later, in April 2020 amidst the COVID-19 lockdown in Italy and in mid-May/June 2020, after the lifting of lockdown. A total of 358 Italian students aged 18-30 completed socio-demographic questionnaires and the Beck Depression Inventory - 2 (BDI-2), the Beck Anxiety Inventory (BAI), the Obsessive-Compulsive Inventory - Revised (OCI-R), the Eating Habits Questionnaire (EHQ), and the Eating Disorder Inventory-3 (EDI-3). We applied multiple regression models to evince any changes in the aforementioned questionnaire scores during and after lockdown with respect to the scores before lockdown. Students reported on average worse depressive symptoms during lockdown than 6 months before isolation (median increase in the BDI-2 score +2; IQR = -3, 6; ß = 0.09 ± 0.03, p = 0.005), with students without any established diagnosis of psychopathology being affected the most. The regression models predict that 86.2% (IQR = 67.9, 91.4%) of students would not experience a clinically significant worsening of symptoms, while approximately 6% of our target population could develop more severe depressive symptoms. This study supports the view that depressive symptomatology may be aggravated during lockdown, but also highlights that after the lifting of lockdown any changes quickly vanished, as the BDI-2 scores were not different from the ones reported before lockdown.

Comparing Models of the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS) in an Italian Clinical Sample.

BACKGROUND: Obsessive-Compulsive Disorder (OCD) is a mental disorder that interferes with daily functioning and may arise during childhood. The current study is the first attempt by Italian researchers to validate the Children's Yale-Brown Obsessive-Compulsive Scale (CY-BOCS). AIMS: The study's primary aim was to investigate the best CY-BOCS model fit, adopting a Bayesian model comparison strategy, among four different factor models: a one-factor model; a two-factor model based on Obsessions and Compulsions; Storch et al.'s and Mc Kay et al.'s two-factor model based on Disturbance and Severity. The study also aimed to investigate the types of treatments found in a sample of Italian OCD children patients. METHODS: The study sample was made up of 53 children with OCD and 14 children with Tourette Syndrome and TIC. RESULTS: An analysis of our data demonstrated that the Obsessions and Compulsions model was the most plausible one, as it demonstrated the best fit indices, strong convergent validity, and good reliability. The study results additionally uncovered that 24.5% of the children in the OCD sample had not yet begun any treatment pathway a year after a diagnosis was formulated. CONCLUSIONS: These findings suggest that the Obsessions and Compulsions scales of the CY-BOCS separately represent appropriate instruments to evaluate children with OCD.

Socially anxious individuals perform better using low spatial frequency information to process facial expressions and objects.

BACKGROUND AND OBJECTIVES: It is well known that socially anxious individuals show biased processing towards threatening faces and better performance with low spatial frequencies information (LSF). It is unclear whether this bias is confined to facial processing or can be extended to other types of information. METHODS: Two experimental phases involving discrimination tasks considering neutral and angry facial expressions and everyday objects in two different spatial frequency conditions were conducted to compare the performance of "socially and non-socially anxious individuals". RESULTS: Findings showed that highly socially anxious individuals (HSAi) were faster in decision processing for LSF neutral faces than LSF angry faces and responded more slowly to LSF angry faces than unfiltered angry faces. Moreover, they responded more quickly to LSF object images than low socially anxious individuals (LSAi). LIMITATIONS: The fact that the participants were not diagnosed with social anxiety disorder limits the relevance of clinical findings. The study is further limited because it compared and contrasted only two emotional expressions and two frequency bands. CONCLUSIONS: Study results showed that HSAi better process LSF neutral information and that this advantage is not limited to neutral faces alone, but extends across other domains.

Hoarding Symptoms Are Not Exclusive to Hoarders.

Hoarding disorder (HD) was originally conceptualized as a subcategory of obsessive compulsive disorder (OCD), and numerous studies have in fact focused exclusively on investigating the comorbidity between OCD and HD. Hoarding behavior can nevertheless also be found in other clinical populations and in particular in patients with eating disorders (ED), anxiety disorders (AD), major depression (MD), and psychotic disorders (PD). The current study was carried out with the aim of investigating, using a validated instrument such as the Saving Inventory-Revised (SI-R), the presence of HD symptoms in patients diagnosed with ED, AD, MD, and PD. Hoarding symptomatology was also assessed in groups of self-identified hoarders and healthy controls. The results revealed that 22.5% of the ED patients exceeded the cut-off for the diagnosis of HD, followed by 7.7% of the patients with MD, 7.4% of the patients with AD, and 5.9% of the patients with PD. The patients with ED had significantly higher SI-R scores than the other groups in the Acquisition and Difficulty Discarding scales while the AD, MD, and PD patients were characterized exclusively by Difficulty Discarding. These data suggest to clinicians that hoarding symptoms should be assessed in other types of patients and especially in those affected by Bulimia and Binge eating.

Psychological distress and post-traumatic symptoms following occupational accidents.

Depression and post-traumatic stress disorder frequently occur as a consequence of occupational accidents. To date, research has been primarily focused on high-risk workers, such as police officers or firefighters, and has rarely considered individuals whose occupational environment involves the risk of severe, but not necessarily life-threatening, injury. Therefore, the present study was aimed at assessing the psychological consequences of accidents occurring in several occupational settings (e.g., construction and industry). Thirty-eight victims of occupational accidents (injured workers) and 38 gender-, age-, and years of education-matched workers who never experienced a work accident (control group) were recruited. All participants underwent a semi-structured interview administered by a trained psychologist, and then were requested to fill in the questionnaires. Injured workers reported more severe anxious, post-traumatic and depressive symptoms, and poorer coping skills, as compared to controls. In the injured group low levels of resilience predicted post-traumatic symptomatology, whereas the degree of physical injury and the length of time since the accident did not play a predictive role. The results suggest that occupational accidents may result in a disabling psychopathological condition, and that a brief psychological evaluation should be included in the assessment of seriously injured workers.

Posttraumatic and depressive symptoms in victims of occupational accidents.

The present descriptive study was aimed at evaluating posttraumatic and depressive symptoms and their cooccurrence, in a sample of victims of workplace accidents. Also, posttraumatic negative cognitions were assessed. Eighty-five injured workers were evaluated, using the PTSD Symptom Scale, the Beck Depression Inventory II, and the posttraumatic Cognitions Inventory. 49.4% of injured workers reported both depressive and posttraumatic symptoms of clinical relevance. 20% only reported posttraumatic, but not depressive, symptoms, and 30.6% did not report either type of symptoms. The group with both posttraumatic and depressive symptoms displayed greater symptom severity and more negative cognitions about the self and about the world than the other two groups. The obtained findings indicate that workplace accidents can have a major impact upon the mental health of victims. Early interventions should be focused not only on the prevention or reduction of posttraumatic and depressive symptoms but also on restructuring specific maladaptive trauma-related cognitions.