The Associations between Lifestyle Habits and Anxiety: A Prospective Study on Adolescents One Year after the Outbreak of the COVID-19 Pandemic.

Changes in lifestyle during the pandemic may have predisposed adolescents to vulnerability to poor mental health. This study aims to evaluate these changes and their association with the course of anxiety. A prospective study was conducted with 153 participants (16 years old, 72% female) who were assessed before the pandemic (T0, November 2019-January 2020) and one year later (T1, April-May 2021). Lifestyle habits (free-time activities, maladaptive behaviors, sleep, screen use) and anxiety were measured. Data concerning experiences related to COVID-19 and family relations during lockdown were collected. A worsening in lifestyle habits and anxiety was found. Of note, the pattern of associations between lifestyle habits and anxiety was quite different in the two time-points, suggesting that the purpose and the impact of some habits may be changed after the pandemic. Regression analyses showed that increases in anxiety were associated with increases in sleep problems, heightened efforts to reduce screen time, and loneliness. Pathway analysis revealed the absence of cross-lagged effects among anxiety, screen use, and sleep, while concurrent associations between variables were found in both the assessments. These results suggest possible long-term effects of the pandemic. Risk-factors associated with the course of anxiety were identified among lifestyle habits, thus contributing to identifying targets for interventions.

Ozone and Laser Effects on Dentin Hypersensitivity Treatment: A Randomized Clinical Study.

INTRODUCTION: The aim of this study was to evaluate and compare the clinical efficacy of diode laser and ozone gas in the treatment of dentin hypersensitivity (DHS). METHODS: One hundred thirty-two teeth from 44 patients with moderate DHS were randomized into 3 groups according to a split-mouth design. In the diode laser group, the operator irradiated the superficial dentin exposed with an 808-nm wavelength and incremental power from 0.2 to 0.6 W with a 20-second interval. In the ozone gas group, the operator applied a high dose of ozone (32 g/m3) for 30 seconds using a silicon cup. In the placebo group, no therapy was applied. The dentin sensitivity level was evaluated upon enrollment (T0), immediately after treatment (T1), 3 months post-treatment (T2), and 6 months post-treatment (T3) with a cold air blast challenge and tactile stimuli. The pain severity was quantified according to the visual analogue scale. The Wilcoxon signed rank test was used to scrutinize potential statistical disparities among the treatments. Statistical significance was predetermined at P < .05. RESULTS: A significant decrease of DHS was observed in the ozone gas group and the `diode laser group immediately after treatment and after 3 and 6 months of the therapy. After 6 months from the therapy, the sensitivity values in the teeth treated with ozone gas remained statistically lower than those treated with diode lasers (P < .05). CONCLUSIONS: A laser diode and ozone gas are both efficient as dentin sensitivity treatment. Ozone maintains an invariable effectiveness after 6 months.

The Role of Cognition in Divergent Thinking: Implications for Successful Aging.

Promoting active and successful aging has become crucial to improve quality of life in later adulthood and reduce the impact of cognitive decline. Increasing evidence suggested that the ability to think creatively (e.g., via divergent thinking), similar to cognitive reserve, could represent a beneficial factor against the negative effects of aging. However, there is still little evidence investigating the relationships between divergent thinking, cognitive functions, and cognitive reserve in late adulthood. The present study explored these relationships in a sample of 98 individuals ranging from 61 to 88 years old (mean age: 72.44 ± 6.35). Results showed that visual, but not verbal, divergent thinking was affected by aging. Interestingly, visual divergent thinking performance was predicted by both the cognitive component of crystallized intelligence and cognitive reserve. Only the crystallized component of intelligence was found to mediate the aging effect on visual divergent thinking performance. These results suggest that in later adulthood a potential shift strategy to prior knowledge and semantic components over executive and control components of cognition could underlie a preserved ability to think divergently and, plausibly, creatively. Limitations of the study and implications for successful aging are discussed.

Smartphone Distraction: Italian Validation of the Smartphone Distraction Scale (SDS).

This work aimed to validate the use of the Smartphone Distraction Scale (SDS) in Italy. The SDS was devised to assess distraction related to smartphone use in adult populations. A cross-sectional study was conducted among n = 609 adults (females = 76.4%; mean age = 30.26; SD age = 9.90). An assessment of the factorial structure of the Italian version was carried out using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The four factors identified by Throuvala and colleagues were confirmed (i.e., attention impulsiveness, online vigilance, multitasking and emotion regulation). Reliability was assessed using Cronbach's alpha coefficient (0.703-0.889). The scale's scores showed significant linear correlations with validated instruments, including the Mobile Phone Problematic Use Scale (MPPUS)and the Cognitive Failures Questionnaire (CFQ). A multivariate analysis of variance showed significant differences in the means among participants belonging to different age groups (born before 1995 vs. born after 1996). In summary, the good psychometric properties observed led us to assume that this instrument can be applied and used in Italian studies to assess the cognitive dimension of distraction related to the use of smartphones.

Italian University Students' Resilience during the COVID-19 Lockdown-A Structural Equation Model about the Relationship between Resilience, Emotion Regulation and Well-Being.

Over the past two years, the consequences of the severe restrictions imposed by the rapid spread of COVID-19 among the global population have been a central focus of scientific research. The pandemic has been a singular and unexpected event that found people unprepared and vulnerable in responding to its emergence, resulting in substantial psychological distress. Scientific evidence has highlighted that adolescents and emerging adults have been among those populations at greatest risk of adverse psychological outcomes, even in the long term. In particular, more than one-third of young adults reported high levels of loneliness, and nearly half of 18- to 24-year-olds felt lonely during the pandemic, experiencing both psychological and emotional distress. The lockdown, the consequent suspension of face-to-face academic activities and the severe restriction of social life have disrupted the daily routines of students already involved in coping with developmental tasks related to identity formation and the relational experience. Under such conditions, emotions and emotional regulation skills are crucial in adapting behavior to reach academic goals and face mounting levels of distress. Therefore, several studies have investigated resilience mechanisms and coping strategies of emerging adults during the pandemic. The present study focuses on university students and explores the impact of resilience and emotional regulation on adverse psychological outcomes related to persistent distress conditions associated with the COVID-19 pandemic. Students were administered a self-report assessment battery through an online platform at the beginning (T0) and the end of the lockdown (T1). A structural equation model (SEM) was used to explore the relationship between resilience, emotional regulation difficulties and psychological distress (depression, anxiety and stress). The findings indicate that psychological resilience and emotion regulation are protective factors that buffer the extent of possible distress resulting from an adverse condition such as the COVID-19 pandemic.

The Italian version of the mobile phone problematic use scale for adults (MPPUS): A validation study.

The Mobile Phone Problematic Use Scale (MPPUS) is a self-report measure developed to identify the problematic use of mobile phones (PSU) among adults. The purpose of this study was to create an Italian version of this scale. A sample of 568 Italian adults completed the MPPUS, presented in association with another validated scale for the assessment of smartphone addiction. We carried out exploratory factor analyses on the MPPUS. Findings emphasised that the Italian version of the MPPUS fits a bi-factor model, in which the general factor 'PSU' was found, including two additional specific factors (i.e., 'Withdrawal and social aspects' and 'Craving and escape from other problems'). The MPPUS was correlated with the Smartphone Addiction Scale short version. With respect to criterion-oriented validity, the MMPUS was also evaluated in relation to socio-demographic variables (i.e., age and gender). The internal consistency and temporal stability of the scales (test-retest assessment after three months) were confirmed.

Polysubstance Use Patterns among Outpatients Undergoing Substance Use Disorder Treatment: A Latent Class Analysis.

Substance Use Disorders (SUDs) pose significant challenges to both individuals and society at large. The primary focus of existing research with clinical SUD populations has been on individual substances, but research is required to better understand the profiles of individuals who use different substances simultaneously. The purpose of the current study was, therefore, to identify patterns of use among subjects (n = 1025) who reported using multiple substances by adopting a Latent Class Analysis (LCA) methodology. The Addiction Severity Index (ASI-lite) was included as a measure of substance misuse, we performed LCA to identify patterns of substance use through the administration of the ASI-Lite. Responses were collected from the following substances: alcohol, cannabis/cannabinoids, opioids and heroin, and cocaine. Results identified two latent classes: (1) alcohol use dominant, and (2) poly-abuser use dominants. Class 1 represented 60.0% of the sample and refers to individuals with the dominant use of alcohol, of those a higher proportion (47%) reported low-frequency use (1 to 7 days per month) and 26% reported a frequency of use of 24 to 30 days per month. Furthermore, 18% used alcohol in combination with cocaine. Class 2 represents 40.0% of the sample. This class is characterized by low-frequency and high-frequency users of several substances. The results obtained highlight the importance of deepening the study of the concomitant use of substances in individuals with SUDs to better understand the health risk of the combined use of two or more substances.

Dealing with Loved Ones' Addiction: Development of an App to Cope with Caregivers' Stress.

Caregivers remain the primary source of attachment, nurturing, and socialization for human beings in our current society. Family caregivers provide 11 to 100 h of care per week to their loved ones, including emotional and social support, assistance with transportation, home care, and so on. However, caregivers find the workload challenging due to fatigue, burnout, depression, anxiety, and sleep disturbances, and sometimes also from an excessive burden. Caregiver burden and stress ultimately negatively affect family members and caregivers. The caregiver is then at risk of developing deleterious physical, psychological, social, and emotional problems such as mood and anxiety disorders. Mobile health applications (mHealth applications) can be a solution to help family caregivers care for their loved ones and also for themselves. In this study, we present the development of an mHealth application for caregivers of persons with substance use and tested its usability. We used a user-centered design and intervention (UCDI) approach to develop the app by conducting a focus group with parents of individuals with addiction problems. Four key themes were identified during the focus group: (i) information section, (ii) self-care section, (iii) how-to: stress-reduction section, and (iv) chat section. The final app was developed with the software vendor and divided into several sections that were useful for managing psychological problems (such as stress or anxiety), informing about addiction and behavioral dependency problems, and helping users find a professional or services nearby. An analysis of the results of a usability test related to the app administered to a subsample of the focus group showed that the app provided ease of use, usefulness, and satisfaction.

Digital Help for Substance Users (SU): A Systematic Review.

The estimated number of Substance Users (SU) globally has currently reached a very high number and is still increasing. This aspect necessitates appropriate interventions for prevention and specific treatments. The literature shows that digital treatments can be useful in the context of health services and substance abuse. This systematic review focuses mainly on research on the effectiveness of digital treatments for SU. Data sources included studies found on PsycINFO, PubMed, SCOPUS, and WebOfScience (WOS) database searches. The following keywords were used: TITLE (digital OR computer OR software OR tablet OR app OR videogame OR seriousgame OR virtualreality) AND ABSTRACT((mental AND health) AND (addiction OR dependence OR substance OR drug)). We focused on peer-reviewed articles published from 2010 through 2021 using PRISMA guidelines. A total of 18 studies met the inclusion criteria (i.e., type of intervention, efficacy in terms of misuse of substances and scored outcomes from questionnaire or toxicology tests, study methodology). The studies included investigations of specific digital treatments for SU of various kinds of drugs. The interventions were administered using personal computers, smartphones, or, in a few cases, tablets. Most of the interventions focused on the cognitive behavior therapy (CBT) model and/or on the use strategies, tips, or feedback. A minority provided information or training programs. The current review shows that digital treatments and interventions are effective in reducing the frequency of use, augmenting abstinence, or reducing the gravity of dependence for most of the studies at post-treatment. However, due to the heterogeneity of the variables (i.e., substance type, digital tool used, and treatment administered), there was a reduced generalizability of the results. This review highlights the need to continue the research in this field, and above all, to create effective digital protocols.

Decoding Emotion in Drug Abusers: Evidence for Face and Body Emotion Recognition and for Disgust Emotion.

Background: Different drugs damage the frontal cortices, particularly the prefrontal areas involved in both emotional and cognitive functions, with a consequence of decoding emotion deficits for people with substance abuse. The present study aimed to explore the cognitive impairments in drug abusers through facial, body and disgust emotion recognition, expanding the investigation of emotions processing, measuring accuracy and response velocity. Methods: We enrolled 13 addicted to cocaine and 12 alcohol patients attending treatment services in Italy, comparing them with 33 matched controls. Facial emotion and body posture recognition tasks, a disgust rating task and the Barrat Impulsivity Scale were included in the experimental assessment. Results: We found that emotional processes are differently influenced by cocaine and alcohol, suggesting that these substances impact diverse cerebral systems. Conclusions: Drug abusers seem to be less accurate on elaboration of facial, body and disgust emotions. Considering that the participants were not cognitively impaired, our data support the hypothesis that emotional impairments emerge independently from the damage of cognitive functions.

Digital Treatment Paths for Substance Use Disorders (SUDs).

Today, there is a considerable expansion in the number of new digital tools and systems for mental health assessment, intervention, support, prevention, and treatment [...].

Development of the motivation to use substance questionnaire.

BACKGROUND: The use of a substance is always accompanied by a motivation that pushes the subject to use and abuse the substance. This work reports the validation data of the MUS (Motivation to Use Substance), which measures and evaluates the motivation to use substances based on the dimension of resistance, confidence, pleasure, and relaxation. METHODS: The validation process involved 605 subjects belonging to a clinical sample of patients who used substances. The sample was divided into two groups: on the first, consisting of 342 subjects, an exploratory analysis was carried out, and on the second, consisting of 263 subjects, a confirmatory analysis was carried out. For concurrent and convergent validation, the SCL-90 test (Symptom Check List-90) was administered for the measurement of addiction-related psychiatric symptoms, and the ASI (Addiction Severity Index) test was administered for the measurement of the severity of the addiction. RESULTS AND CONCLUSIONS: The MUS was found to be a robust test of construct validity, convergent, and concurrent. The results highlight gender and age differences for some of the MUS scales. Ultimately, MUS can be considered an excellent tool for structuring treatment programs for addiction services.

Gifted Children through the Eyes of Their Parents:Talents, Social-Emotional Challenges, and Educational Strategies from Preschool through Middle School.

Few studies have been conducted analyzing the experience of raising a gifted child. The present exploratory study focused on examining the profiles of a sample of 44 gifted children, exploring aspects related to health status, precociousness of development, and peculiarities of their potentiality and peculiar emotional profile. Through the administration of a semi-structured questionnaire and an in-depth interview, the experience of parents of gifted children was also analyzed, deepening the challenges they have to face and the educational strategies they implement. The evidence that emerged helps shed light on specific aspects that characterize gifted children and have implications for family educational practices.

Validation of a substance craving questionnaire (SCQ) in Italian population.

BACKGROUND: This study evaluated the psychometric properties of the Italian version of the Substance Craving Questionnaire (SCQ-NOW), extended version of the Cocaine Craving Questionnaire (CCQ-NOW), defined as a multidimensional measure assessing the craving about cocaine, as conceptualized by Tiffany, Singleton, Haertzen, and Henningfield (1993). METHOD: 344 substance addicts (age 38.56 ±â€¯10.63 years old; 20.6% females) took part in the research. The Confirmatory Factor Analysis showed that the Italian SCQ-NOW retains good psychometric properties, supporting the conception of substances craving as a multifold concept. RESULTS: The internal consistencies were good; correlations between the SCQ-NOW, the Symptom Check List 90 - R (SCL-90-R), and the Addiction Severity Index (ASI) were consistent with literature. CONCLUSION: Our findings confirm the application of SCQ-NOW as a psychometric useful measure of the craving in the Italian context, highlighting its validity and reliability. Implications for clinical practice are discussed.

Clinical and Patient-reported Outcome Measures in Men Referred for Consideration of Surgery to Treat Lower Urinary Tract Symptoms: Baseline Results and Diagnostic Findings of the Urodynamics for Prostate Surgery Trial; Randomised Evaluation of Assessment Methods (UPSTREAM).

BACKGROUND: Clinical evaluation of male lower urinary tract symptoms (MLUTS) in secondary care uses a range of assessments. It is unknown how MLUTS evaluation influences outcome of therapy recommendations and choice, notably urodynamics (UDS; filling cystometry and pressure flow studies). OBJECTIVE: To report participants' sociodemographic and clinical characteristics, and initial diagnostic findings of the Urodynamics for Prostate Surgery Trial; Randomised Evaluation of Assessment Methods (UPSTREAM). UPSTREAM is a randomised controlled trial evaluating whether symptoms are noninferior and surgery rates are lower if UDS is included. DESIGN, SETTING, AND PARTICIPANTS: A total of 820 men (≥18 yr of age) seeking treatment for bothersome LUTS were recruited from 26 National Health Service hospital urology departments. INTERVENTION: Care pathway based on routine, noninvasive tests (control) or routine care plus UDS (intervention arm). OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The primary outcome is International Prostate Symptom Score (IPSS) and the key secondary outcome is surgery rates 18 mo after randomisation. International Consultation on Incontinence Questionnaires were captured for MLUTS, sexual function, and UDS satisfaction. Baseline clinical and patient-reported outcome measures (PROMs), and UDS findings were informally compared between arms. Trends across age groups for urinary and sexual PROMs were evaluated with a Cuzick's test, and questionnaire items were compared using Pearson's correlation coefficient. RESULTS AND LIMITATIONS: Storage LUTS, notably nocturia, and impaired sexual function are prominent in men being assessed for surgery. Sociodemographic and clinical evaluations were similar between arms. Overall mean IPSS and quality of life scores were 18.94 and 4.13, respectively. Trends were found across age groups, with older men suffering from higher rates of incontinence, nocturia, and erectile dysfunction, and younger men suffering from increased daytime frequency and voiding symptoms. Men undergoing UDS testing expressed high satisfaction with the procedure. CONCLUSIONS: Men being considered for surgery have additional clinical features that may affect treatment decision making and outcomes, notably storage LUTS and impaired sexual function. PATIENT SUMMARY: We describe initial assessment findings from a large clinical study of the treatment pathway for men suffering with bothersome urinary symptoms who were referred to hospital for further treatment, potentially including surgery. We report the patient characteristics and diagnostic test results, including symptom questionnaires, bladder diaries, flow rate tests, and urodynamics.

The resilience scale for adults in italy: A validation study comparing clinical substance abusers with a nonclinical sample.

This article reports a validation study of the Italian version of the Resilience Scale for Adults (RSA), a measure designed to assess individual, family, and social resilience protective resources. The RSA was administered to a clinical (i.e., substance use disorders, or SUD; N = 437) and a nonclinical sample (N = 337). A confirmatory factor analyses supported the original 6-factor structure of the RSA in both samples. The RSA correlated positively with functional coping strategies and negatively with perceived stress and dysfunctional coping strategies. Moreover, the RSA subscales discriminated between SUD and non-SUD individuals. Factorial invariance testing also confirmed comparable psychometric properties across gender. The results confirm good psychometric properties of the Italian RSA and provide support for the construct validity of the scale. The RSA may be suited for use in studies examining natural course and intervention trials. (PsycINFO Database Record

Patient-specific risk of undetected malignant disease after investigation for haematuria, based on a 4-year follow-up.

OBJECTIVES: • To estimate the diagnostic accuracy of a guidelines-based haematuria clinic protocol by measuring the incidence of undetected malignancy during a follow-up period. • To estimate an individual's post-test risk of having undetected malignancy using the protocol likelihood ratio and the population prevalence of disease. METHODS: • Data were collected prospectively on a cohort of 4020 consecutive patients who were referred to a 'one-stop' haematuria clinic between 1998 and 2003. • All patients had a plain radiograph taken and underwent ultrasonography and flexible cystoscopy as a part of 'first-line' investigation. • Intravenous urography was performed where indicated after abnormal first-line tests or in patients with persistent haematuria where no abnormality had been detected. • Records of the initial 687 participants from the first year of the study were reviewed 4 years after the original consultation. Missed diagnoses of urinary tract malignancy were recorded and sensitivities, likelihood ratios and the post-test probability of missing all disease and upper tract malignancy were calculated. RESULTS: • As previously reported, the overall prevalence of malignant disease was 12.1% (18.9% for macroscopic haematuria compared with 4.8% for microscopic haematuria). • The records of the first year's cohort of patients (N = 687) were analysed 4 years after their original consultation and 10 potentially 'missed' tumours were identified. • The sensitivity of the protocol was 90.9% for the detection of all urinary tract malignancy (95% CI, 82.4 to 95.5) and 71% for upper tract tumours alone (95% CI, 45.4-88.3). The latter improves to 78.6% (95% CI, 52.4-92.4) with the addition of further upper tract testing. • The probability of missing malignant disease overall was 1.7% (95% CI, 0.95-3.04) but this rose sharply to >4% for males over 60 with macroscopic haematuria. • For those with non-visible haematuria, the percentage probability of missed malignant disease was less than 1%. CONCLUSIONS: • The haematuria clinic protocol described is robust but it is not infallible. • The risk of missing malignant disease in the higher risk groups identified in the study is much greater than previous studies would suggest. • If additional upper tract testing or interval follow-up were to be recommended, it could be rationally targeted at these groups, given the measurable risk shown here.

A prospective analysis of the diagnostic yield resulting from the attendance of 4020 patients at a protocol-driven haematuria clinic.

OBJECTIVE: To clarify the prevalence of disease as determined by age, sex and the degree of haematuria at presentation, and to ascertain the merits of using ultrasonography (US), i.v. urography (IVU) or both when imaging the upper urinary tract, in a prospective cohort of patients attending a protocol-based haematuria clinic. PATIENTS AND METHODS: In a two-tier protocol, as a part of first-line investigation, all 4020 patients attending the clinic between October 1998 and August 2003 had US and flexible cystoscopy. Subsequently, IVU was used where indicated following abnormal first-line tests and in patients with persistent haematuria where no abnormality had been detected. RESULTS: In all, 2627 men and 1393 women presented with microscopic (53.2%) or macroscopic haematuria (46.8%). The overall prevalence of malignant disease was 12.1%, but for macroscopic haematuria it was 18.9% and for microscopic haematuria 4.8%. Age and sex also influenced the observed rates of disease. Of the upper tract tumours, 70 were identified after abnormal US, with three cases of transitional cell carcinoma identified on IVU after a normal US. CONCLUSIONS: The study provides a rationale for the appropriate investigation of all patients, moderated by the age, sex and degree of haematuria, and the ubiquitous use of US with selective IVU based on age, sex and degree of (and persistence of) haematuria.