I feel addicted to watching TV series: association between binge-watching and mental health.

Background: Binge-watching (BW) is the consecutive viewing of three or more episodes of the same series in one sitting. Although some negative effects on mental health were evidenced, the continuum of BW from leisure activity to problematic behavior is still unclear. This study aimed to analyze mental health (depression, trait anxiety, social anxiety, impulsivity, alexithymia) of people involved in different expressions of BW. Methods: A cross-sectional survey collected data from 482 respondents. According to a validated BW questionnaire, participants were divided into Problematic BW, Moderate BW, Non-BW, and No-viewer, and differences between groups were tested on psychological dimensions assessed via standardized questionnaires evaluating: trait and social anxiety, depression, impulsivity, and emotional dysregulation. Results: An association between problematic BW and worse mental health conditions was evidenced, and a positive effect of non-problematic BW was supported. A negative linear trend from the BW as a leisure activity to problematic BW was marked, indicating how a possible maladaptive behavior orientation of BW in specific mental health conditions could be figured out as a behavioral addiction.

Separate but Related: Dimensions of Healthcare Provider Social Support in Day-Treatment Oncology Units.

Social support by healthcare providers has been increasingly investigated during the past decade, but studies have made different choices concerning its measurement. To evaluate how social support from a healthcare provider impacts the perceived quality of care and patient outcomes, reliable and valid instruments capable of measuring specific aspects of the construct are needed. In study 1, we tested the factor structure and the psychometric properties of a new Healthcare Provider Social Support measure (HPSS) for oncology settings. One-hundred-sixty-two patients (89 females; M age = 58.97, SD age = 13.28) from religious and government-operated hospitals completed the HPSS during day treatment. We modeled the HPSS factor structure to represent four related aspects: Emotional, Informational, Appraisal, and Instrumental social support. Study 2 preliminarily assessed the concurrent validity of the HPSS with patient perceptions of the patient-doctor relationship. Sixty-nine patients (40 females; M age = 53.67, SD age = 13.74) completed the HPPS with scales assessing perceived doctor-patient communication and patient trust in the healthcare provider. Study 1, using Exploratory Structural Equation Modeling, showed that a bifactor model had an excellent fit. The analysis supported the use of subscale scores, which were more tenable than a single total score in terms of bifactor model indices. This conclusion was also supported by greater scalability of the subscales in a Mokken Scale Analysis. Oncology patients treated in the religious hospital perceived greater Emotional, Informational, and Instrumental social support from their healthcare provider than those treated in government-operated. Study 2 showed that patient ratings of healthcare provider social support, except Instrumental, were positively correlated with better doctor communication skills and greater trust in the physician. Multiple regression analyses showed that Informational and Emotional support provided a unique contribution to building trust in the physician, controlling for the doctor's communication skills. The study results showed that the four social support ratings were reliable and valid, sharpening the distinction between functional components in the formal healthcare system.

Do difficulties in emotional processing predict procedure pain and shape the patient's colonoscopy experience?

OBJECTIVES: Pain and fear of colonoscopy are inter-related; they make the colonoscopy experience unpleasant and impede adherence to colorectal cancer screening and prevention campaigns. According to previous research, fear and pain have been found to depend on patients' maladaptive cognitions and exaggerated emotional responses. The present study investigated whether emotional processing difficulties predicted colonoscopy pain and the associated catastrophising thoughts. DESIGN: Prospective, observational, blinded. METHOD: A sample of 123 patients was assessed for specific emotional processing difficulties (ie, suppression of emotions, unprocessed emotions, failure to control emotions, avoidance of emotional triggers and impoverished emotional experience) and anxiety-related variables (ie, worry, anxiety and depression) before colonoscopy. A trained medical doctor rated patients' behavioural manifestations of pain during colonoscopy. After complete recovery from sedation, the patients rated the endoscopy experience using perceived pain and situation-specific pain catastrophising scales. RESULTS: About half of the patients were above the cut-off for anxiety before the procedure. Notwithstanding sedation, behavioural manifestations of pain during colonoscopy indicated probable or moderate pain for about one-third of the patients. Failure to control emotions, poor emotional experience and avoiding emotional triggers were positively correlated with behavioural manifestations of pain, self-reported pain and pain catastrophising. Regression analyses, controlling for gender, age, colonoscopy experience and sedation, revealed that avoidance of emotional triggers uniquely contributed to predicting pain outcomes. CONCLUSIONS: Early identification of emotional processing difficulties associated with pain catastrophising can help define personalised psychological preparation paths to manage negative emotions in patients who fear colonoscopy pain.

The Perception of Water Contamination and Risky Consumption in El Salvador from a Community Clinical Psychology Perspective.

This study was carried out as part of the international cooperation project "Agua Futura" for the improvement of water resource management and the promotion of water, sanitation, and hygiene (WASH) behaviors in rural communities of Central America. Given the relevant healthcare problem of water pollution, especially in El Salvador, the aim was to detect some key factors affecting the perception of water contamination and its risky consumption from a community clinical psychological perspective. Ninety rural inhabitants of El Salvador were administered a structured interview exploring their perceptions about water quality and the impact of water consumption on health. Data were analyzed through a computer-aided thematic analysis-complemented by a qualitative analysis-allowing the detection of sense-making processes based on lexical variability. Different themes were identified with regard to the perception of water quality (i.e., mistrust, danger, and safety) and the beliefs about the impact of water consumption on health (i.e., rationalization, denial, awareness, displacement, and isolation of affect). The results showed heterogeneous perspectives about water quality and sanitation. However, the perceived negative impact of water consumption on health was mostly denied or minimized through massive distortions. Overall, the study highlights the role of defensive patterns in facing issues of water contamination, which may prevent the community from adopting healthy behaviors and adequate water management behaviors.

A systematic review of psychodynamic theories in community psychology: Discovering the unconscious in community work.

The aim of this systematic review is to provide a narrative synthesis of the peer-reviewed literature regarding the role of psychodynamics in community psychology. The authors screened 301 records on the topic, found in major citation databases (Scopus and Web of Science) without time or language restrictions. Ten articles addressing the review question were identified, showing the contributions of interpersonal psychoanalysis, Adlerian psychology, the Tavistock psychodynamic model, and Lacanian psychoanalysis. Several points of synergy between community psychology and psychodynamics were outlined mainly concerning empowerment theory, preventative and ecological perspective, power, and social order. Besides, the view on the community life, the role of emotion, and the conceptualization of the unconscious domain are discussed. Implications for community interventions are highlighted, regarding clients' demands, the role of community practitioners, and the use of transference/countertransference in consultative work. Limitations and future directions are also considered.

Procedural Anxiety, Pain Catastrophizing, and Procedure-Related Pain during EGD and Colonoscopy.

OBJECTIVES: Although sedatives and analgesic drugs defuse anxiety and relieve pain, digestive endoscopy still is uncomfortable and painful for some patients. Identifying patients who tolerate digestive endoscopy less well remains difficult. The present study evaluated the relations between procedural anxiety, catastrophizing thoughts, and pain, using a prospective design and multimodal assessments of pain. METHODS: A total of 118 consecutive patients were assessed for procedural anxiety before endoscopy. During endoscopy, a doctor rated the patients' pain behavior. Before discharge, the patients retrospectively rated endoscopy pain and related catastrophizing thoughts. RESULTS: Notwithstanding sedation, our study revealed large between-subject variability in pain. Catastrophizing thoughts mediated the relation between procedure-related pain observed by the doctor and pain intensity reported by the patient. Catastrophizing thoughts also mediated the effect of procedural anxiety. Our study showed that anxiety exacerbates endoscopy pain when the patient engages in ruminative thinking and feels unable to cope with unpleasant bodily sensations. CONCLUSIONS: This study shows that catastrophizing thoughts account for between-subject differences in endoscopy pain. Rumination and helplessness but not magnification explain how procedural anxiety may evolve in a painful endoscopy experience. To the extent that one can address catastrophizing thoughts, endoscopy pain can be mitigated, especially for patients who are difficult to sedate.

Intolerance of Uncertainty and Anxiety-Related Dispositions Predict Pain During Upper Endoscopy.

Although sedatives can defuse anxiety and relieve pain, Esophagogastroduodenoscopy (EGD) still is uncomfortable and threatening for some patients. Identifying patients who tolerate digestive endoscopy less well remains difficult. Using a prospective design and a multimodal assessment of pain, the present study evaluated how anxiety-related variables predicted subsequent pain outcomes. Sixty-two consecutive patients referred for elective EGD were assessed for intolerance of uncertainty (IU), procedure-related worries, anxiety sensitivity and health distress before endoscopy. During endoscopy, a doctor rated patients' pain behavior. After complete recovery from sedation, the patients retrospectively rated endoscopy pain and situation specific catastrophizing thoughts. Descriptive analyses showed that patients undergoing EGD for the first time were more distressed and anxious than patients accustomed to the procedure and needed a higher sedative dose. Notwithstanding sedation, the behavioral rating of pain was above the cut-off value for probable pain for more than half of the patients. IU assessed before endoscopy predicted situational pain catastrophizing (PC) and self-reported pain after endoscopy through procedure related worries. Situational PC not only mediated the effect of worry, but also female gender and younger age were associated with self-reported pain through increased catastrophizing thoughts. Health distress and anxiety sensitivity predicted PC only for women, younger patients, and those not accustomed to the procedure. Our study showed that psychological preparation before sedation is needed especially for first-timers, women, and younger patients, addressing maladaptive cognitive beliefs and acquainting patients with the somatic sensations that they might experience during the procedure.

Biopsychosocial Correlates of Adjustment to Cancer during Chemotherapy: The Key Role of Health-Related Quality of Life.

BACKGROUND: Patients adjust to cancer in a continuous process that follows the course of the disease. Previous research has considered several illness-related variables and demographics, quality of life, personality, and social factors as predictors of adjustment to cancer, which can be maladaptive (e.g., helplessness-hopelessness and anxious preoccupation) or adaptive (e.g., fighting spirit). AIMS: Assuming a biopsychosocial view, we test an empirical model in which disease stage, patient's age, and gender are viewed as the distal antecedents of positive and negative adjustment to cancer for chemotherapy patients. Health-related quality of life (HRQoL) has a key role, interposing between the distal antecedents and adaptational outcomes. Social support and positive thinking are also included in the model as related to adjustment. METHODS: One-hundred-sixty-two consecutive cancer patients receiving adjuvant or standard chemotherapy participated in the study. Patients completed the Mini-Mental Adjustment to Cancer, the Brief-COPE, the Social Provision Scale, and the SF-12 Health Survey. Partial least squares structural equation modeling (PLS-SEM) was applied for model building and hypotheses testing. RESULTS: We found a negative association between advanced stage and physical functioning, a strong positive link between physical functioning and mental health, and significant relations between mental health and helpless-hopelessness, anxious preoccupation, and cognitive avoidance. Social support and positive thinking were related to fighting spirit and fatalism. Cancer stage and female gender were indirectly associated with adaptational outcomes through HRQoL. The patient's age had no significant relationships in the model. DISCUSSION: HRQoL (both physical and mental) is a key factor for preventing maladjustment in chemotherapy patients. Social support and positive thinking coping style fosters fighting spirit and fatalism on health outcomes. Two potential lines of action seem promising: preventing maladaptive and promoting adaptive adjustments working on patient's mental health individually and involving significant others in supportive care, respectively.

The Impact Of Dispositional Variables Of Elders, Relatives, And Paid Caregivers On Elders' Empowerment And Life Satisfaction.

Background/Study Context: The impact of dispositional characteristic of elders' closest network members on elders' life satisfaction and empowerment has remained largely unexplored. This innovative study aimed to assess the impact of dispositional variables of elders, relatives, and paid caregivers on life satisfaction and empowerment of elders. METHODS: One hundred forty-three triads (one elder, one paid caregiver, and one relative) completed six scales measuring modifiable personality characteristics (loneliness, optimism, regulation of positive and negative emotions), life satisfaction, and sense of empowerment. RESULTS: Two dispositional variables of relatives (positivity and ability to set goals) and one dispositional variable of care workers (self-satisfaction) were significantly related to life satisfaction of elders. Positivity of elders and the capacity to set objectives of the family members affected empowerment of elders. CONCLUSION: Future interventions aiming to improve life satisfaction and empowerment of elders should focus on these modifiable dispositional variables.

Psychologist in Italian hospital settings: An exploratory analysis of hospital physicians' representations and demands of psychological intervention

Aunque la Organización Mundial de la Salud ha evidenciado la importancia de adoptar modelos integrados de asistencia basados en el enfoque bio-psico-social, en los servicios de salud, como los hospitales, existe todavía mucha resistencia para su implementación. Se presenta un estudio exploratorio cualitativo dirigido a comprender las representaciones y las demandas de los médicos hospitalarios con respecto a la intervención psicológica en los contextos hospitalarios italianos. Conforme a este objetivo se desarrolló un guión de entrevista semi-estructurada y se entrevistaron 15 médicos italianos divididos por género, edad y especialidad médica. Fueron investigados las representaciones de la enfermedad, el acercamiento a los pacientes y los modelos de intervención, la experiencia de colaboración con psicólogos, las representaciones de dónde, cuándo y cómo los psicólogos podrían ser útiles en el contexto hospitalario, las visiones generales del hospital y de su futuro, los puntos de fuerza y de debilidad de su trabajo, las estrategias utilizadas para superar las dificultades diarias y las estrategias propuestas para mejorar el sistema hospitalario. El análisis de contenido de las entrevistas ha revelado que la intervención psicológica está representada predominantemente como una intervención a nivel individual dirigida a contener el distrés emocional en relación con la enfermedad. Además se ha evidenciado la falta de consideración de la competencia psicológica como útil para promocionar el funcionamiento organizativo de los servicios hospitalarios. Estos resultados pueden apoyar la investigación futura en esta área y son utilizados para discutir las oportunidades de un diálogo constructivo entre ciencias médica y psicológica en los contextos hospitalarios.

During the years, the World Health Organization has been emphasising the importance of promoting integrated models of care consistent with a bio-psycho-social approach to health-illness. Nonetheless, healthcare services still show much resistance to the implementation of such models and the use of multidisciplinary teams. As a consequence, and despite the efforts made over the years by psychologists, the role and specificity of psychological competence in healthcare settings continues to remain unclear. This is particularly true as regards hospital settings. Based on these considerations, this article presents an exploratory qualitative study aimed at understanding hospital physicians' representations of, and demands for, psychological intervention in Italian hospital settings. The main argument on which the study was based is that the integration of psychological competence into hospital settings very much depends on other professionals' representation of the psychological profession, as well as on the emotional symbolization of their work context and professional practice. A key role is played by physicians, whose representations of the psychological intervention in hospital settings have been under studied at the international level, and almost not studied with regard to the Italian context. The purpose of this study was to respond to this gap in the literature. In this regard, a semi-structured interview script was developed and used to interview 15 Italian hospital physicians varying in gender, age, and medical speciality. Participants were selected by convenience and interviews were carried out individually in the hospital settings. Representations of disease; approach to patients and models of intervention; experiences of collaboration with psychologists; representations of where, when and how psychologists could be useful in the hospital context; overall visions of one's hospital and its future; strengths and weaknesses of one's own work; strategies used to overcome everyday difficulties and strategies advocated to improve the hospital were focus of analysis. The interviews, administered by two researchers, were audio-recorded and transcribed. Then a content analysis was developed by three analysts that coded the units of the text (sequences) according to the categories and subcategories identified. The categories were: (a) perspective on medical intervention; (b) problems and weaknesses; (c) strengths; (d) current and future strategies; (e) psychosocial component of disease, and (f) relationship between Medicine and Psychology. Transcripts were analyzed independently by the analysts, and the interrater agreement was 83%. Results revealed a widespread view that psychological science is of limited relevance in the hospital context. The difficulty in perceiving psychologists as a medical resource appeared to be largely related to physicians' endorsement of a bio-medical approach, as well as to their lack of opportunities for formal and / or informal collaboration with psychologists. Psychologists were thought of primarily as diagnosticians or therapists, and psychological intervention was mainly characterized as an individual- level intervention whose main objective is to support the patient and manage his / her emotional response to the disease (and the response of his / her family). Despite physicians felt the hospital system plagued by problems, especially at the structural and functional levels, they did not envisage psychological competence as useful for fostering hospital organisational functioning. On the contrary, they advocated a top-down change in the hospital system, delegating responsibility for change to hospital management or policy makers. As a consequence, an urgent demand for Psychology remains unexpressed. Although based on a small sample, the present study provides useful insights which may prompt further research in this area. Furthermore, it provides information about the demand for psychological intervention in the hospital context which can be used to develop strategies to promote multidisciplinary care and integrated mind-body interventions. Results suggest the necessity to rethink professional roles and to promote a constructive dialogue between medical and psychological science in Italian hospital settings.

Dispositional characteristics, relational well-being and perceived life satisfaction and empowerment of elders.

OBJECTIVES: The broad purpose of this research is to identify the key modifiable variables most related to elders' life satisfaction and empowerment in order to improve the efficacy of interventions projects. Our study aims to integrate the theoretical perspectives of personality and community psychology focusing both on dispositional characteristics and relational well-being of elders, investigating triads, composed by an elder, a paid caregiver and the most involved relative. This study explores the impact of (1) some socio-demographic characteristics of elders, (2) some modifiable dispositional variables of elders and (3) elders' relational well-being on elders' empowerment and life satisfaction. METHOD: The study involved 429 people in 143 triads. Semi-structured interviews with elders, paid caregiver and close relatives were used to construct a new pilot measure of elders' relational well-being. Life Satisfaction, Empowerment, Loneliness, Positivity, Humor and Emotions self-efficacy scales were also administered. Hierarchical multiple regressions were performed. RESULTS: Elders' positivity, relational well-being of elders and living alone were significantly related to empowerment. Elders' relational well-being and positivity significantly contributed to life satisfaction. DISCUSSION: Interventions to increase empowerment and life satisfaction should focus primarily on augmenting positivity and relational well-being integrating the theoretical premises of both personality and community psychology.