On the Implementation of Computerized Adaptive Observations for Psychological Assessment.

The use of observational tools in psychological assessment has decreased in recent years, mainly due to its personnel and time costs, and researchers have not explored methodological innovations like adaptive algorithms in observational assessment. In the present study, we introduce the behavior-driven observation procedure to develop, test, and implement observational adaptive instruments. In Study 1, we use a preexisting observational checklist to evaluate nonverbal behaviors related to psychotic symptoms and to specify the adaptive algorithm's model. We fit the model to observational data collected from 114 participants. The results support the model's goodness of fit. In Study 2, we use the estimated model parameters to calibrate the adaptive procedure and test the algorithm for accuracy and efficiency in adaptively reconstructing 58 nonadaptively collected response patterns. The results show the algorithm's good accuracy and efficiency, with a 40% average reduction in the number of administered items. In Study 3, we used real raters to test the adaptive checklist built with behavior-driven observation. The results indicate adequate intrarater agreement and good consistency of the observed response patterns. In conclusion, the results support the possibility of using behavior-driven observation to create accurate and affordable (in terms of resources) observational assessment tools.

An instrument for the evaluation of muscle dysmorphia: The Italian validation of the adonis complex questionnaire.

BACKGROUND AND AIMS: Muscle dysmorphia (MDM), or bigorexia, is a subcategory of body dysmorphic disorder (BDD), also known as "Adonis Complex" in nonscientific contexts. One of the most used tools to investigate MDM is the Adonis Complex Questionnaire (ACQ). The ACQ is a 13-item US questionnaire, designed for male subjects only, related to the dissatisfaction and concerns about physical appearance. The aim of the current study was to evaluate the validity of the Italian version of the ACQ. METHODS: The instrument was administered to a sample of 322 male adults, recruited from the general population. We used the maximum-likelihood confirmatory factorial analysis (CFA), analyzing the covariance matrices with AMOS 24.0, to evaluate the different factorial models proposed in the literature. RESULTS: The evaluation of the factorial structure of the Italian version of the ACQ demonstrates the greater stability and internal consistency of the two-factor model, compared to the original three-factor model. The factors have no correlation with the demographic characteristics of the sample. CONCLUSIONS: The present study confirms the validity and the reliability of the Italian two-factor version of the ACQ and highlights the general tendency, among Italian males, to have concerns about their own physical appearance with recurring thoughts and eating behaviors finalized to improve it. Our study represents an advance in the use of adequate and reliable instruments to assess concerns about physical appearance in the Italian male population.

Could the severity of symptoms of schizophrenia affect ability of self-appraisal of cognitive deficits in patients with schizophrenia? Lack of insight as a mediator between the two domains.

The relationship between subjective appraisal of cognitive deficits and symptom severity in schizophrenia is unclear. Insight reportedly affects both factors. Our aim is to further asses the relationship between subjective perception of cognitive deficits, symptom severity and lack of insight as a mediator variable. 109 subjects with schizophrenia were evaluated. Positive and Negative Syndrome Scale (PANSS) was modelled as independent variable, Subjective Scale to Investigate Cognition in Schizophrenia (SSTICS) as dependent and "Lack of Insight" (LoI) PANSS Item as mediator one. Mediation was assessed using bootstrap estimation approach. LoI acts as a suppressor variable (i.e., it enhances the relation between the independent and dependent variable) between Negative Symptoms and SSTICS, while showing a mediation effect between Depressive symptoms and SSTICS. LoI has a central role in mediating the relationship between negative and depressed symptoms on the one hand and self-appraisals of cognitive deficits (SACD) assessed with SSTICS on the other. Its suppressor role between negative symptoms and STICSS favour a direct effect of negative symptoms on SACD. On the other hand, its mediator role between depression and SSTICS is consistent with several reports of the 'insight paradox' of an enhanced severity of depression in patients with higher awareness of their disability.

Source monitoring task in a sample of in-patients with verbal auditory hallucinations compared to control sample.

Patients with psychosis, especially those with specific positive symptoms such as auditory verbal hallucinations, show a source monitoring deficit, the cognitive process involved in the recognition of the information source. This defect can lead to the erroneous conclusion that self-generated thoughts are not "proper" but derive from an external source. We evaluated 37 patients diagnosed with psychotic disorder and 40 healthy controls using a modified version of the Reality Monitoring Task developed by Larøi et al. in 2004. The patients were also evaluated with PANSS, VGF, PSP. We have found that the performance of the Source Monitoring Task differs between patients with hallucinations and controls. According to the literature we can therefore state that patients with hallucinations are characterized by a difficulty in identifying the source of the information they perceive. Our study also adds a new finding to the literature: the source monitoring dysfunction is not due to the presence of current hallucinatory symptomatology but could be considered a stable trait in psychotic patients.

Psychodynamically Oriented Psychopharmacotherapy: Towards a Necessary Synthesis.

The discovery of psychoanalysis and of psychotropic medications represent two radical events in understanding and treatment of mental suffering. The growth of both disciplines together with the awareness of the impracticality of curing mental suffering only through pharmacological molecules-the collapse of the "Great Illusion"-and the experience of psychoanalysts using psychotropic medications along with depth psychotherapeutic treatment, have led to integrated therapies which are arguably more effective than either modality alone. The authors review studies on the role of pharmacotherapy with psychoanalysis, and the role of the analyst as the prescriber. The psychotic disorders have specifically been considered from this perspective.