The Use of Distance Learning and E-learning in Students with Learning Disabilities: A Review on the Effects and some Hint of Analysis on the Use during COVID-19 Outbreak.

Even if the use of distance learning and E-learning has a long tradition all over the world and both have been used to keep in contact with students and to provide lessons, support and learning materials, there is an open debate on the balance between advantages and disadvantages in the use of distance learning. This debate is even more central in their use to support students with Learning Disabilities (LDs), an overarching group of neurodevelopmental disorders that affect more than 5% of students. The current COVID-19 outbreak caused school closures and the massive use of E-learning all over the world and it put higher attention on the debate of the effects of E-learning. This paper aims to review papers that investigated the positive and negative effects of the use of Distance Learning and E-learning in students with LDs. We conducted a literature review on the relationship between Distance Learning, E-learning and Learning Disabilities, via Scopus, Eric and Google Scholar electronic database, according to Prisma Guidelines. The findings are summarized using a narrative, but systematic, approach. According to the data resulting from the papers, we also discuss issues to be analyzed in future research and in the use of E-learning during the current pandemic of COVID-19.

Teaching in Times of the COVID-19 Pandemic: A Pilot Study on Teachers' Self-Esteem and Self-Efficacy in an Italian Sample.

The aim of this research was to investigate the impact of the COVID-19 pandemic on teachers, particularly on their self-esteem and self-efficacy, their difficulty in the transition to distance learning, the difficulty of students, and specially of students with learning disabilities (LDs students), as perceived by teachers. 226 teachers were invited to complete an online questionnaire. Our results showed lower self-esteem and lower self-efficacy by the teachers compared with the normative sample. Self-esteem and self-efficacy also decrease in teachers with greater service seniority at work. Teachers perceived a greater difficulty in students than in their own difficulty. The concentration of the school system's efforts on the massive and, for long periods, exclusive organisation of distance learning risks favouring only cognitive aspects to the detriment of affective dynamics. This aspect could make teaching more complex for teachers and learning poorer for students, impoverishing the complex relational process that forms the basis of the learning process.

School Closure and Children in the Outbreak of COVID-19.

School closure and home confinement are two of the measures of lockdown chosen by governments and policymakers all over the world to prevent and limit the spread of the infection of COVID-19. There is still an open debate about the real effect of school closure on the reduction of risk of infection on children and the risk of infection on with other age groups (parents, grandparents and others). There is an agreement on the effect of school closure in reducing and delaying the peak of the outbreak. In this Editorial, starting from the ongoing Italian experience, we discuss direct and indirect effects of school closure on children's psychological health and learning. We also highlight the need for an "on peace time" planning of measures and strategies necessary to face the direct and indirect effect of this outbreak and other outbreaks, on children's psychological health.

Psychological Aspects of Students With Learning Disabilities in E-Environments: A Mini Review and Future Research Directions.

What are the main learning difficulties or advantages encountered by students with learning disabilities (LDs) within e-environments? As a result of the Covid-19 emergency, e-learning is being increasingly used to support students' learning processes. A number of countries closed their schools altogether, so face-to-face lessons were and have been replaced by distance lessons. A search of current literature via Scopus, Eric and Google Scholar electronic databases was conducted according to Prisma Guidelines. Other sources of literature were also considered, starting from the references in the full text of the articles consulted. We used the following search keywords: "LDs" combined with the "AND/OR" Boolean operator and "e-learning platforms," "well-being," "psychological factors," "emotional distress," and "self-regulation." One body of literature highlights the lack of inclusive accessibility standards and a lack of attention to specific tools for addressing LDs, which causes students to develop high levels of stress/anxiety and emotional distress, in addition to low levels of well-being, self-esteem and self-efficacy. Another area of literature looks at how students can develop high levels of self-regulation and emotional awareness, as well as high levels of inclusion. Results are discussed in terms of the promotion of e-learning that focuses on the psychological well-being of students and teachers use of technological tools.

Quick Identification of the Risk of Psychosis: The Italian Version of the Prodromal Questionnaire-Brief.

BACKGROUND: Diagnosing people during the prodromal phase of an incipient psychosis can improve the chance of better outcome. In busy clinical settings, the ideal tool is a brief, easy-to-complete self-report questionnaire. OBJECTIVE: To test the psychometric properties of the Italian version of one of the most used screening tools for the identification of the risk of psychosis, the Prodromal Questionnaire-Brief (PQ-B). METHODS: Cross-sectional design. A convenience sample of college students was enrolled via snowball procedure (n=243; men: 45%). After understanding and signing the consent form, the participants received a booklet containing the following questionnaires: the 21-item Prodromal Questionnaire-Brief (PQ-B); the 12-item General Health Questionnaire (GHQ-12), and the 74-item Schizotypal Personality Questionnaire (SPQ). Receiver operating characteristic (ROC) analysis was used to assess the capacity of the PQ-B to identify individuals at risk of psychosis as independently defined based on the combination of GHQ-12 and SPQ thresholds. RESULTS: The Italian version of the PQ-B revealed good internal consistency, test-retest reliability, and adequate convergent and divergent validity. The Youden method retrieved a cut-off = 7 for the PQ-B frequency score and a cut-off = 22 for the PQ-B distress score. Both PQ-B scores had a perfect (99%) negative predictive value. CONCLUSION: The PQ-B is a promising screening tool in two-stage protocols. The major advantage of the PQ-B is to exclude cases that are unlikely to be at risk of psychosis.

Bifactor structure of the schizotypal personality questionnaire (SPQ).

The schizotypal personality questionnaire (SPQ) is used to characterize schizotypy, a complex construct helpful for the investigation of schizophrenia-related psychopathology and putative endophenotypes. The SPQ factor structure at item level has been rarely replicated and no study had tested a bifactor model of the SPQ so far. The unidimensional, the correlated, the second-order and the bifactor models of the SPQ were tested to evaluate whether the items converge into a major single factor defining the schizotypy-proneness of the participants, to be used for grouping purpose. Parallel principal component analysis (PCA) and confirmatory factor analysis (CFA) were used to determine the optimal number of factors and components in a cross-sectional, survey design involving 649 college students (males: 47%). The first-order, nine-subscale model was confirmed by CFA in the whole sample. The best evidence from parallel PCA in the training set was in favor of a two-factor model; the bifactor implementation of this model showed good fit in the subsequent CFA. Two main dimensions of positive and negative symptoms underlie schizotypy in non-clinical samples, entailing specific risk of psychosis. On a measurement level, the study provided support for the use of the total scores of the SPQ to characterize schizotypy.

Mental disorders in Italian prisoners: results of the REDiMe study.

The goal of the study was to estimate the prevalence of current and lifetime mental disorders in a consecutive sample (n=300) of detainees and prison inmates held in an Italian prison and compare it with the prevalence observed in a sample randomized from the community (n=300) within the same age interval (18-55 years) and sex proportion of prisoners, and with a similar socio-economic status. Psychiatric disorders were identified with the Mini International Neuropsychiatric Interview (MINI). Current psychiatric disorders were present in 58.7% of prisoners and 8.7% of the comparison group. Lifetime psychiatric disorders were present in 88.7% of prisoners and 15.7% of the comparison group. Current anxiety disorders and current stress-related disorders were related to prisoners serving their first-ever prison sentence. A variable fraction of prisoners with an ongoing psychopathology is not diagnosed or does not receive proper treatment. The provision of effective treatment to prisoners with psychiatric disorders might have potentially substantial public health benefits.

Patterns of hand preference in Italian adolescent high-school students.

The Annett Hand Preference Questionnaire (AHPQ) is amongst the most widely used self-report measures of handedness. The psychometric properties of the AHPQ have been rarely evaluated outside the Anglo-Saxon culture where the majority of the studies on the AHPQ were done. In this study, 1,023 students (males=49.5%) from four large high schools operating in the district of Cagliari (Italy) were invited to fill in the Italian version of the AHPQ. The AHPQ was proved to measure a unidimensional latent trait, and the questionnaire was good at assessing deviation from right-handedness with high discrimination between subjects. Some items were more informative than others, and in particular the non-equivalence between the primary and the non-primary actions was confirmed by both the confirmatory factor and the item response theory analysis. The use of the rule of thumb that classifies subjects on the basis of the primary actions was supported for the distinction between consistent right- and left-handed. However, the mixed-handed group identified on the basis of the rule of thumb was not entirely consistent with the mixed-handed class predicted by the latent class analysis. Males were about twice as likely as females to be in the mixed-handed class.

Prevalence and dimensionality of hallucination-like experiences in young adults.

BACKGROUND: The study of hallucination-like experiences (HLEs) in non-clinical populations is increasingly used to corroborate etiological models of psychosis. This method capitalizes on the absence of confounding factors that typically affect the study of hallucinations in clinical subjects. AIM: To estimate the prevalence of HLEs in young adults; validate the mutidimensionality and explore the correlates of latent HLEs clusters. METHODS: Cross-sectional survey design. The extended 16-item Launay-Slade Hallucination Scale (LSHS-E) and the 12-item General Health Questionnaire (GHQ-12) were administered to 649 Italian college students (males: 47%). Confirmatory factorial analysis was used to test multidimensionality of the LSHS-E. Hierarchical nested, progressively constrained models were used to assess configural, metric and scalar invariance of the LSHS-E. Latent class analysis was used to test the existence of different profiles of responding across the identified hallucination-proneness dimensions. RESULTS: Factor analysis showed that the four-factor model had the best fit. Factors were invariant across demographic variables and levels of psychological distress. Three latent classes were found: a large class with no HLEs (70% of participants), a multisensory HLEs class (18.8%), and a high hallucination-proneness class (11%). Among those reporting high levels of HLEs, approximately half reported scores indicative of considerable psychological distress. CONCLUSIONS: Although HLEs have a relatively high prevalence in the general population, the majority of those experiences happen in isolation and are not associated to psychological distress. Approximately half of those individuals experiencing high levels of HLEs report significant psychological distress. This may be indicative of general risk for mental health conditions rather than specific risk for psychosis.

Study on psychoeducation enhancing results of adherence in patients with schizophrenia (SPERA-S): study protocol for a randomized controlled trial.

BACKGROUND: Poor adherence to pharmacotherapy negatively affects the course and the outcome of schizophreniaspectrum psychoses, enhancing the risk of relapse. Falloon and coworkers developed a Psychoeducation Program aimed at improving communication and problem-solving abilities in patients and their families. This study set out to evaluate changes in adherence to pharmacotherapy in patients diagnosed with schizophrenia-spectrum psychoses, by comparing one group exposed to the Falloon Psychoeducation Program (FPP) with another group exposed to family supportive therapy with generic information on the disorders. METHODS: 340 patients diagnosed with schizophrenia and related disorders according to standardized criteria from 10 participating units distributed throughout the Italian National Health System (NHS), will be enrolled with 1:1 allocation by the method of blocks of randomized permutations. Patients will be reassessed at 6, 12 and 18 months after start of treatment (duration: 6 months).The primary objective is to evaluate changes in adherence to pharmacotherapy after psychoeducation. Adherence will be assessed at three-month intervals by measuring blood levels of the primary prescribed drug using high pressure liquid chromatography, and via the Medication Adherence Questionnaire and a modified version of the Adherence Interview. Secondary objectives are changes in the frequency of relapse and readmission, as the main indicator of the course of the disorder.Enrolled patients will be allocated to the FPP (yes/no) randomly, 1:1, in a procedure controlled by the coordinating unit; codes will be masked until the conclusion of the protocol (or the occurrence of a severe negative event). The raters will be blind to treatment allocation and will be tested for blinding after treatment completion. Intention-to-treat will be applied in considering the primary and secondary outcomes. Multiple imputations will be applied to integrate the missing data. The study started recruitment in February 2013; the total duration of the study is 27 months. DISCUSSION: If the psychoeducation program proves effective in improving adherence to pharmacotherapy and in reducing relapse and readmissions, its application could be proposed as a standard adjunctive psychosocial treatment within the Italian NHS. TRIAL REGISTRATION: Protocol Registration System of ClinicalTrials.gov NCT01433094; registered on 20 August 2011; first patient was randomized on 12 February 2013.

Sheehan Suicidality Tracking Scale (S-STS): reliability, convergent and discriminative validity in young Italian adults.

BACKGROUND AND PURPOSE: The Sheehan Suicidality Tracking Scale (S-STS) is a patient self-report or clinician-administered rating scale that tracks spontaneous and treatment-emergent suicidal ideation and behaviors. This study set out to evaluate the reliability, convergent and divergent validity of the S-STS in a sample of college students, a population with a high risk of completed and attempted suicide. METHODS: Cross-sectional, survey design. Participants (303 undergraduate students; males: 42%) completed several measures assessing psychological distress (General Health Questionnaire; GHQ); self-esteem (Rosenberg Self Esteem Scale; RSES); social support (Modified Social Support Survey; MOSSS); and suicidal behavior, including ideation and attempts (S-STS). RESULTS: Both internal consistency and test-retest stability were excellent for the S-STS-global score. The S-STS subscale on suicide ideation also showed good reliability, while the subscale on suicidal behavior showed some inconsistency at retest. Convergent and divergent validity of S-STS was confirmed. All S-STS items loaded on a single factor, which had an excellent fit for the unidimensional model, thus justifying the use of the S-STS as a screening tool. In a mediation model, self-esteem and social support explained 45% of the effects of psychological distress on suicide ideation and behavior as measured by the S-STS-global score. CONCLUSIONS: This study provided promising evidence on the convergent, divergent, internal consistency and test-retest stability of the Sheehan Suicidality Tracking Scale. The cross-sectional design and lack of measures of hopelessness and helplessness prevent any conclusion about the links of suicidal behavior with self-esteem and social support.

Beliefs and attitudes among Italian high school students toward people with severe mental disorders.

The negative attitudes surrounding mental disorders and their treatment are a major obstacle to the correct identification and treatment of emerging psychopathologies. The purpose of this study was to investigate mental health literacy in a large and representative sample of high school students in Italy, via a booklet containing several questionnaires delivered to 1032 teenagers. The items in the questionnaires probed knowledge about mental health and illness, stigmatization, stereotypes, behaviors, opinions, and attitudes. In general, the students had a reasonable knowledge of mental disorders and were able to distinguish these from somatic disorders. However, a large portion of the students nourished some misconceptions about mental disorders and was also rather skeptical about the effectiveness of treatment or the chance of recovery for people with severe mental disorders. Nevertheless, roughly half of the students reported being willing to provide help to someone with a mental disorder when in need. Poor mental health literacy is a major barrier to seeking help and receiving effective treatment. Young people are the ideal target of raising awareness and antistigma campaigns because they are at a higher risk for developing a psychopathology.

The "Reading the Mind in the Eyes" test: systematic review of psychometric properties and a validation study in Italy.

INTRODUCTION: The "Reading the Mind in the Eyes" test (henceforth, Eyes test) is a simple but advanced Theory of Mind test, and it is widely used across different cultures. This study assessed the reliability and construct (convergent and discriminant) validity of the Eyes test in Italy. METHODS: A sample of 18- to 32-year-old undergraduate students of both sexes (N=200, males=46%) were invited to fill in the Italian version of the Eyes test, the Empathy Quotient (EQ), the Toronto Alexithymia Scale (TAS), and the Marlowe-Crowne Social Desirability Scale (SDS). RESULTS: Internal consistency (Cronbach's alpha) was .605. Confirmatory factor analysis provided evidence for a unidimensional model, with maximal weighted internal consistency reliability=.719. Test-retest reliability for the Eyes test, as measured by intraclass correlation coefficient, was .833 (95% confidence interval=.745 to .902). Females scored significantly higher than males on both the Eyes test and the EQ, replicating earlier work. Those participants who scored lower than 30 on the EQ (n=10) also scored lower on the Eyes test than those who did not (p<.05). Eyes test scores were not related to social desirability. CONCLUSIONS: This study confirms the validity of the Eyes test. Both internal consistency and test-retest stability were good for the Italian version of the Eyes test.

Left-handedness is statistically linked to lifetime experimentation with illicit drugs.

Handedness has been linked to an enhanced risk of alcohol abuse, while less is known about other drugs. A convenience sample of 1004 male and female Italian participants (females=58%) from the general community (18 to 65 years old: average age = 30; standard deviation = 10, median = 25) was asked about: handedness (preference in writing); lifetime use of alcohol, tobacco, and illicit drugs; levels of psychological distress, as measured by the General Health Questionnaire (GHQ); and levels of delusion proneness, as measured by the Peters et al. Delusions Inventory (PDI). Overall, 92 individuals (9.2%) were classified as left-handed, with no significant difference reported among genders. Lifetime use of illicit drugs, primarily cannabis, was reported by 20% of the sample. In a multiple logistic regression analysis, after taking into account sex, age, and caseness on GHQ and PDI, left-handed people in the sample were statistically more likely to report lifetime experimentation with heroin, ecstasy/amphetamine, and, marginally, hallucinogens, but not alcohol or tobacco. Different mechanisms might contribute to an explanation of greater lifetime experimentation with some illicit drugs among left-handed people as compared to right-handed people. However, replications with clinical samples are necessary before any definitive statements can be made.

Male-female differences in left-handedness in Sardinia, Italy.

Males were consistently found to be more likely than females to report left-hand preference in single-hand tasks, but the literature reports negative results too. Using data from a large sample in Sardinia, we aimed at testing the links of left-handedness with sex, age, residence, and seasonality of birth. A total of 4239 participants (males = 1589; females = 2650) were recruited in public places such as high schools, university classes, or gyms in one of the major islands of Italy. Hand preference was established with the question: Which hand do you normally use to write legibly? The monthly distribution of births was studied with the Rayleigh test. In the sample, 270 female participants reported left-hand preference in writing (10.2%) versus 161 male participants (10.1%). Left-hand preference in writing was negatively related to age, with increasing left-hand preference in the younger generations. Left-hand preference in writing was not more common in urban than in suburban or rural settings. The month of birth was found to have a seasonal effect on the left-handed (p=.031) but not on the right-handed (p=.80) participants, and this seasonal effect was more evident in males (p=.04) than in females (p =.26). In our sample males were not more likely to report left-hand preference in writing than females. On the other hand, left-hand preference does vary by age and, in all likelihood, this is an effect of the reduced cultural pressure to write with the right hand in the younger generations.

The Empathy Quotient: a cross-cultural comparison of the Italian version.

INTRODUCTION: The Empathy Quotient (EQ) is a self-report questionnaire that was developed to measure the cognitive, affective, and behavioural aspects of empathy. We evaluated its cross-cultural validity in an Italian sample. METHODS: A sample of 18- to 30-year-old undergraduate students of both sexes (N=256, males=118) were invited to fill in the Italian version of the EQ, as well as other measures of emotional competence and psychological distress. Results. The EQ had an excellent reliability (Cronbach's alpha=.79; test-retest at 1 month: Pearson's r=.85), and was normally distributed. Females scored higher than males, and more males (n=14, 11.9%) than females (n=4, 2.9%) scored lower than 30, the cutoff score that best differentiates autism spectrum conditions from controls. EQ was negatively related to the Toronto Alexithymia Scale (TAS) and positively related to the Marlowe-Crowne Social Desirability Scale (SDS). Principal component analysis retrieved the three-factor structure of the EQ. Lower emotional reactivity correlated with higher scores in measures of risk in both the schizophrenia-like (Peters et al. Delusions Inventory) and the bipolar (Hypomanic Personality Scale) spectra. CONCLUSIONS: The Italian version of the EQ has good validity, with an acceptable replication of the original three-factor solution, yielding three subscales with high internal and test-retest reliability.

From disablement to enablement: conceptual models of disability in the 20th century.

PURPOSE: The aim of this work is to provide a general view of the conceptual elaborations on disablement in the 20th century and to discuss the role of these different contributions in developing the current concepts of disablement. METHOD: A review of the literature on conceptual models of disablement in the past century has been performed. RESULTS: The 20th century has witnessed important theoretical considerations on health, diseases and their consequences. These considerations have generated various conceptual models, some of which share the same focus and point of arrival, the so-called 'Disablement Process'. Among the models that were developed, two stand out, which were drafted and disseminated under the aegis of the World Health Organization, namely the International Classification of Impairments, Disabilities and Handicaps (ICIDH) and the International Classification of Functioning, Disability and Health (ICF), but these are just one part of the conceptual elaboration in the field. Further conceptualization was produced in health and social settings by specialists, self-advocacy associations and activist groups. CONCLUSIONS: The current ICF model of the World Health Organization has been translated and recognized in 191 countries; it also incorporates the contribution of self-advocacy associations and it is now recognized by most of them. This model has enjoyed higher visibility than other conceptual models, though its level of development was not higher or more original. To our opinion the ICF is not very clear on the essential choice of the model, i.e., to see disablement as a dynamic process that happens when personal limits collide with socio-environmental needs, rather than as a personal feature. This choice is instead clearer in other models, like Nagi's 1991, the Institute of Medicine (IOM) model by Brandt and Pope, where the identification of three dimensions (the individual, the environment and the individual-environment interaction) clarifies the role played by all three dimensions within the process of disablement and introduces major hints for further considerations on how to create virtuous processes of enablement.

Eating disorders among professional fashion models.

Fashion models are thought to be at an elevated risk for eating disorders, but few methodologically rigorous studies have explored this assumption. We have investigated the prevalence of eating disorders in a group of 55 fashion models born in Sardinia, Italy, comparing them with a group of 110 girls of the same age and of comparable social and cultural backgrounds. The study was based on questionnaires and face-to-face interviews, to reduce the bias due to symptom under-reporting and to social desirability responding. When compared on three well-validated self-report questionnaires (the EAT, BITE, BAT), the models and controls did not differ significantly. However, in a detailed interview (the Eating Disorder Examination), models reported significantly more symptoms of eating disorders than controls, and a higher prevalence of partial syndromes of eating disorders was found in models than in controls. A body mass index below 18 was found for 34 models (54.5%) as compared with 14 controls (12.7%). Three models (5%) and no controls reported an earlier clinical diagnosis of anorexia nervosa. Further studies will be necessary to establish whether the slight excess of partial syndromes of eating disorders among fashion models was a consequence of the requirement in the profession to maintain a slim figure or if the fashion modeling profession is preferably chosen by girls already oriented towards symptoms of eating disorders, since the pressure to be thin imposed by this profession can be more easily accepted by people predisposed to eating disorders.

Hallucinatory experiences, delusional thought proneness, and psychological distress in a nonclinical population.

Despite evidence that the reporting of delusion-like or hallucinatory experiences are predictive of the future development of a mental disorder in the spectrum of psychosis, the exact nature of such a kind of unusual subjective experience in the general population is still disputed. We investigated the multidimensionality of these experiences with the Peters et al. Delusions Inventory (PDI) and a modified Italian version of the Launay-Slade Hallucination Scale (LSHS-R) in 250 subjects of both genders drawn from the normal population, using the General Health Questionnaire (GHQ) as a measure of psychic distress of a clinically relevant nature. We found that GHQ scores are positively related to both the PDI and the LSHS-R scores, but the GHQ did not act as a mediator in the links between the 2 psychosis-proneness measures. Conversely, the LSHS-R scores fully mediated the links between GHQ and PDI scores. It can be argued that hallucination proneness and psychosis proneness do not overlap in the nonclinical population but can both cause distress separately.

Rural/urban differences in the distribution of eating disorder symptoms among adolescents from community samples.

OBJECTIVE: Rural/urban differences in the prevalence of mental disorders have often been reported in the last 30 years, among others in the distribution of eating disorder symptoms and suicide rates. The role of sex, age and socioeconomic status in the differences by place of residence has often been neglected in past studies. METHOD: Two independent community samples of students (mean age=17.4 years, SD=1.4), taken from among those attending high school in an urban district (Cagliari; n=817) and in a rural one (Carbonia; n=507) of south Sardinia, Italy, were invited to fill in the Eating Attitudes Test (EAT), the Bulimic Investigatory Test of Edinburgh (BITE), the Body Attitudes Test (BAT) and the revised Hopkins Symptom checklist (SCL-90-R). RESULTS: Female students scored higher than male students on all inventories. In male participants, the scores on the EAT were higher in the urban than in the rural sample. Conversely, in both male and female students the rural sample reported higher scores on the BITE symptoms subscale. When the comparison was confined to the fraction of those who scored higher than the suggested cut-off on the EAT and the BITE, students in the urban sample outnumbered those in the rural sample. No other differences were found. Socioeconomic status and age did not influence the differences in the reporting of eating disorder symptoms by place of residence. CONCLUSIONS: Although caution is required when reading the findings drawn from self-report instruments, it is evident that the factors influencing the distribution of eating disorder symptoms and their psychological correlates by place of residence are far more complex than currently thought.