Confirmatory validation of the Mesothelioma Psychological Distress Tool-Patients: A brief patient-reported outcome measure assessing psychological distress in malignant mesothelioma patients.

OBJECTIVE: Psychological suffering in patients with Malignant Mesothelioma (MM) is different from the one experienced by patients with other cancers due to its occupational or environmental etiology and its peculiar symptomatology and prognosis (i.e., poor prognosis, reduced effectiveness of the therapies, poor quality of residual life, and advanced age at the time of diagnosis). Therefore, the Mesothelioma Psychological Distress Tool-Patients (MPDT-P) has been developed to evaluate the specific profile of psychological suffering in this population. This paper describes the item selection, factor analysis, and psychometric evaluation of the revised MPDT-P. METHODS: The analyses of the current work aimed to confirm the factorial structure found in the first version of the MPDT-P. In the case of nonfit, it aimed to find an alternative structure and causes of nonfit in the model. The search for the fit of the factorial model was conducted using a Bayesian approach. RESULTS: The two-factor model reported in the first version of the instrument did not fit the data. Confirmatory Bayesian analyses showed adequate fit for the three-factor solution. Based on the content of the items, we labeled the factors as dysfunctional emotions, claims for justice, and anxieties about the future. CONCLUSIONS: Integrating the MPDT-P into clinical practice could help clinicians gain insight into the specific suffering related to MM and investigate potential differences related to different occupational and environmental exposure contexts.

Meta-analysis of the Difficulties in Emotion Regulation Scale and its short forms: A two-part study.

The Difficulties in Emotion Regulation Scale (DERS) is the most used self-report questionnaire to assess deficits in emotion regulation (ER), composed of 6 dimensions and 36 items. Many studies have evaluated its factor structure, not always confirming the original results, and proposed different factor models. A possible way to try to identify the dimensionality of the DERS could be through a meta-analysis with structural equation models (MASEM) of its factor structure. The MASEM indicated that a six-factor model with 32 items (DERS-32) was the most suitable to represent the dimensionality of the DERS (χ2 = 2095.96, df = 449, p < .001; root mean square error of approximation [RMSEA] = 0.024, 95% confidence interval [CI]: 0.023-0.025; comparative fit index [CFI] = 0.97; Tucker Lewis index [TLI] = 0.96; standardized root mean squared residual [SRMR] = 0.04). This result was also confirmed by a confirmatory factor analysis (χ2 = 3229.67, df = 449, p < 0.001; RMSEA = 0.075, 95% CI: 0.073-0.078; CFI = 0.94; TLI = 0.93; SRMR = 0.05) on a new sample (1092 participants; mean age: 28.28, SD = 5.82 years) recruited from the Italian population. Analyses and results from this sample are reported in the second study of this work. The DERS-32 showed satisfactory internal consistency (i.e., ordinal α, Molenaar Sijtsma statistic, and latent class reliability coefficient) for all its dimensions and correctly categorized individuals with probable borderline symptomatology. In conclusion, the DERS-32 has demonstrated to be the best model for the DERS among all the others considered in this work, as well as a reliable tool to assess deficits in ER.

Psychometric Properties of the Detachment and Compartmentalization Inventory (DCI) in an Italian Community Sample.

The Detachment and Compartmentalization Inventory (DCI) is a valid and reliable self-report instrument that assesses these two distinct forms of dissociative symptoms. However, there is limited research on the cross-cultural validation of the DCI. Therefore, this study aimed to develop an Italian translation of the DCI and examine its internal structure and psychometric properties (including internal consistency, convergent validity, and test-retest reliability) within an Italian-speaking community sample. The sample consisted of 1276 adults (887 females; mean age: 29.57 ± 10.96 years), who completed the DCI and other self-report measures evaluating dissociative experiences and childhood trauma. Confirmatory factor analyses supported the original two-factor model (χ2169 = 1312.80, RMSEA = 0.073, 95%CI 0.069-0.077; CFI = 0.94; TLI = 0.94; SRMR = 0.04). Additionally, the DCI exhibited good internal consistency, test-retest reliability, and convergent validity with another measure of dissociation. The study also confirmed the association between DCI scores and the severity of childhood trauma. Finally, a Receiver Operating Characteristic (ROC) curve analysis demonstrated that the DCI effectively distinguishes individuals who screened positively for dissociative disorders. Overall, these findings indicate that the Italian translation of the DCI possesses satisfactory psychometric properties, suggesting its utility as a screening tool for assessing detachment and compartmentalization experiences.

Interpersonal Needs, Mental Pain, and Hopelessness in Psychiatric Inpatients with Suicidal Ideation.

INTRODUCTION: Suicide is a leading cause of death worldwide and models may help the understanding of the phenomenon and ultimately reduce its burden through effective suicide prevention strategies. The Interpersonal Theory of Suicide and Shneidman's Model have tried to describe different unmet needs related to suicidal ideation. The study aims to assess the association between thwarted belongingness, perceived burdensomeness, and suicidal ideation in a sample of psychiatric inpatients and the mediating role of hopelessness and mental pain in this association. METHODS: 112 consecutive adult psychiatric inpatients were administered the Columbia Suicide Severity Rating Scale (C-SSRS), the Italian version of the Interpersonal Needs Questionnaire-15-I (INQ-15-I), the Physical and Psychological Pain Scale, and the Beck Hopelessness Scale (BHS). RESULTS: Mediation models indicated a significant indirect effect of perceived burdensomeness (with thwarted belongingness as covariates) on suicidal ideation intensity with hopelessness as a mediator. When thwarted belongingness (controlling for perceived burdensomeness as a covariate) was included in a model as an independent variable, direct and indirect effects on suicidal ideation intensity were not significant. CONCLUSIONS: Psychosocial interventions focusing on identifying and decreasing the perception of being a burden for others and the feeling hopeless could represent a powerful pathway for reducing suicidal ideation. Moreover, the attention toward unmet interpersonal needs may help increase and focus clinical discussions on risk factors, which may help engagement toward psychiatric care and downsize the stigma related to suicide. Raising awareness toward mental health topics is a goal of healthcare services globally.

Exploring risk factors for re-hospitalization in a psychiatric inpatient setting: a retrospective naturalistic study.

BACKGROUND: The reduction of multiple psychiatric hospitalizations is an important clinical challenge in mental health care. In fact, psychiatric re-hospitalization negatively affects the quality of life and the life expectancy of patients with psychiatric disorders. For these reasons, identifying predictors of re-hospitalization is important for better managing psychiatric patients. The first purpose of the present study was to examine the readmission rate in a large sample of inpatients with a psychiatric disorder. Second, we investigated the role of several demographical and clinical features impacting re-hospitalization.  METHOD: This retrospective study enrolled 1001 adult inpatients (510 men and 491 women) consecutively admitted to the University Psychiatric Clinic, Sant'Andrea Hospital, Sapienza University of Rome between January 2018 and January 2022. To identify risk factors for psychiatric re-hospitalization, we divided the sample into 3 subgroups: the Zero-Re group which had no readmission after the index hospitalization, the One-Re group with patients re-admitted only once, and the Two-Re with at least two re-admissions.  RESULTS: The groups differed according to previous hospitalizations, a history of suicide attempts, age at onset, and length of stay. Furthermore, the results of the regression model demonstrated that the Two-Re group was more likely to have a history of suicide attempts and previous hospitalizations. DISCUSSION: These results indicate the importance of assessing risk factors in psychiatric hospitalized patients and implementing ad hoc prevention strategies for reducing subsequent re-hospitalizations.

Are Affective Temperaments, Emotional Abuse, and Neglect Involved in Mentalization Abilities in Patients With Psychiatric Disorders?

ABSTRACT: Patients who have experienced emotional abuse and neglect often develop psychiatric disorders in adulthood. However, whether emotional abuse, neglect, and mentalization abilities relate to one another and the role of possible mediators of this relationship in psychiatric patients are still unknown. We evaluated the potential role of affective temperament as a mediator of the relationship between emotional abuse and neglect and mentalization. We performed a cross-sectional study of 252 adult psychiatric inpatients. The Childhood Trauma Questionnaire, Mentalization Questionnaire, and Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A) were administered. Results showed a significant indirect effect of emotional abuse and neglect on scores on the Mentalization Questionnaire through the TEMPS-A (b = 0.25, 95% confidence interval [0.143-0.375]), demonstrating that affective temperament mediates the relationship among emotional abuse, neglect, and mentalization impairment in psychiatric patients. A careful evaluation of mentalization abilities in patients with psychiatric disorders and who have a history of emotional abuse and neglect is necessary for a better understanding of psychopathology and for the choice of therapeutic strategies.

Psychometric Properties of the Italian Mentalization Questionnaire: Assessing Structural Invariance and Construct Validity.

Mentalization is an important interpersonal ability, necessary for adaptive interpersonal relationships and emotion regulation. Deficits in mentalization have been associated with poor psychological outcomes and have been observed in patients with Borderline Personality Disorder. The Mentalization Questionnaire (MZQ) has been developed as self-report measure of mentalization deficit. The aim of the study was to investigate the dimensionality of the MZQ in a nonclinical sample composed of Italian adults from the general population and to analyze its performance in categorizing individuals with higher risk of borderline symptoms. A non-clinical sample of 1,015 adults (709 women and 306 men) was administered the Italian versions of the MZQ, the Reflective Functioning Questionnaire (RFQ), and a measure of borderline psychopathology. A revised single-factor solution fitted the data well and demonstrated metric invariance across gender. The internal consistency (Ordinal α = 0.87) and stability (r = 0.84) were satisfactory. The MZQ was moderately associated with the RFQ dimensions. The ROC curve analysis showed that the MZQ was able to discriminate satisfactorily people with higher risk for borderline symptomatology from those with lower risk. The MZQ may, therefore, be considered a reliable and valid measure of mentalization for categorizing people at higher risk for borderline pathology.

The association between adult ADHD and food addiction: A mediation analysis.

OBJECTIVES: The aim of this study was to investigate the association between food addiction severity (FA) and ADHD symptomatology. Furthermore, we investigated whether emotional distress, and the mentalization deficits could mediate this relationship. METHODS: Three hundred eighty-five Italian adults (307 women and 78 men) participated in the study and completed the Italian versions of the Modified Yale Food Addiction Scale version 2.0, the Adult ADHD Self-Report Scale, the Depression Anxiety Stress Scales 21 and the Mentalization Questionnaire. RESULTS: ADHD symptoms severity and general distress were significantly and independently associated with FA. Emotional distress partly mediated the relationship between FA and ADHD symptoms severity. In addition, mentalization deficits partly mediated this relationship only when evaluating the influence of FA on ADHD symptoms severity. LIMITATIONS: This is a cross-sectional study and causal interpretations of the relationships among the variables are speculative. CONCLUSIONS: It is important to assess emotional distress and mentalization deficits in individuals at risk of ADHD and FA because these conditions could increase the risk for the presence of disordered eating patterns.

Are Demoralization and Insight Involved in Suicide Risk? An Observational Study on Psychiatric Inpatients.

INTRODUCTION: Several features contribute to determining suicide risk. This study was designed with the aim of evaluating whether insight into illness and demoralization are involved in suicide risk (active suicidal ideation or behavior). METHODS: For this purpose, in a sample of 100 adult psychiatric inpatients, we used the Columbia Suicide Severity Rating Scale to assess suicide risk, the Demoralization Scale for demoralization symptoms, and the Insight Scale to assess illness insight. We also investigated several demographic and clinical features, including gender, age, duration of untreated illness, previous suicide attempts, and nonsuicidal self-injurious behavior. RESULTS: The results demonstrated that patients with higher scores on the insight-high dimension had 1.35 greater odds of having a higher suicide risk, and those with lifetime suicide attempts had 7.45 greater odds of having a higher suicide risk. Among the various clinical factors, the study indicated that only nonsuicidal self-harm behaviors in the last 3 months was a risk factor for suicide risk. CONCLUSIONS: The results indicated that greater illness insight is involved in suicide risk regardless of demoralization.

Structural validity, measurement invariance, reliability and diagnostic accuracy of the Italian version of the Yale Food Addiction Scale 2.0 in patients with severe obesity and the general population.

PURPOSE: To examine the structural validity, measurement invariance, reliability, and some other psychometrical properties of the Italian version of the Yale Food Addiction Scale 2 (I-YFAS 2.0) in patients with severe obesity and the general population. METHODS: 704 participants-400 inpatients with severe obesity and 304 participants enrolled from the general population-completed the I-YFAS 2.0 and questionnaires measuring eating disorder symptoms. A first confirmatory factor analysis (CFA) tested a hierarchical structure in which each item of the I-YFAS 2.0 loaded onto one of the twelve latent symptoms/criteria which loaded onto a general dimension of Food Addiction (FA). The second CFA tested a first-order structure in which symptoms/criteria of FA simply loaded onto a latent dimension. Measurement invariance (MI) between the group of inpatients with severe obesity and the sample from the general population was also tested. Finally, convergent validity, test-retest reliability, internal consistency, and prevalence analyses were performed. RESULTS: CFAs confirmed the structure for the I-YFAS 2.0 for both the hierarchical structure and the first-order structure. Configural MI and strong MI were reached for hierarchical and the first-order structure, respectively. Internal consistencies were shown to be acceptable. Prevalence of FA was 24% in the group of inpatients with severe obesity and 3.6% in the sample from the general population. CONCLUSIONS: The I-YFAS 2.0 represents a valid and reliable questionnaire for the assessment of FA in both Italian adult inpatients with severe obesity and the general population, and is a psychometrically sound tool for clinical as well as research purposes. LEVEL OF EVIDENCE: Level V, descriptive study.

Assessing psychopathology in bariatric surgery candidates: discriminant validity of the SCL-90-R and SCL-K-9 in a large sample of patients.

PURPOSE: Pre-surgical psychosocial evaluation of bariatric surgery (BS) patients should identify psychiatric issues that could worsen after surgery and those requiring additional ongoing intervention. In this view, the use of reliable, appropriate and concise evaluating instruments is of critical importance. The aim of the present study was to investigate the clinical utility of both the Symptom Checklist 90-Revised (SCL-90-R) and its brief unidimensional version, the so-called Symptom-Checklist-K-9 (SCL-K-9) in detecting the presence of psychiatric disorders among bariatric surgery (BS) candidates. METHODS: Seven-hundred-and-ninety-eight BS candidates (563 women and 235 men; mean age: 44.15 ± 11.45) were enrolled in the present study. All participants underwent a full psychiatric interview and were administered the SCL-90-R. RESULTS: Three-hundred-and-sixty-two patients (45.4%) met the criteria for a diagnosis of at least one psychiatric disorder and ninety-nine patients (12.4%) had psychiatric comorbidities. In the current sample, 219 patients (27.4%) met the criteria for binge eating disorders (BED), 158 (19.8%) met the criteria for major depressive disorder (MDD), and 67 (8.4%) met both criteria. A receiver operating characteristic (ROC) curves procedure showed that both the SCL-90-R and the SCL-K-9 satisfactorily categorize patients with any psychiatric disorder, both BED and MDD (area under the ROC curve ≥ 0.70, p < 0.001). CONCLUSION: Our results suggest that the SCL-90-R and the SCL-K-9 may represent first-level screening tests identifying at-risk patients, eligible for a more expensive or time-consuming clinical assessment. LEVEL OF EVIDENCE: Level V, cross-sectional, descriptive study.

Suicidal ideation, hopelessness, and affective temperament in patients with blepharospasm.

OBJECTIVE: The aim of this study was to investigate the relationship between suicidal ideation and neurological, psychological, and psychiatric features in patients with blepharospasm (BSP). METHODS: We enrolled 70 BSP patients and 80 control subjects. All participants underwent a psychiatric and psychometric evaluation: Structured Clinical Interview, Clinical Global Impression, Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale, Columbia-Suicide Severity Rating Scale, Beck Hopelessness Scale, Temperament Evaluation of Memphis, Pisa, San Diego Auto-questionnaire. BSP severity was assessed using the Blepharospasm Severity Rating Scale. RESULTS: Suicidal ideation was reported in 18% of BSP patients and 6% had current suicidal ideation. 83% of BSP patients had severe hopelessness. BSP patients presented an increased sense of hopelessness (OR= 1.39, 95% CI = 1.13/1.70) and a pronounced depressive temperament (OR= 1.36, 95% CI = 1.12/1.65). Suicidal ideation in BSP patients correlated with psychiatric disorders (OR = 3.96, 95% CI = 1.23/12.74) and higher scores on the HAM-A (OR = 1.11, 95% CI = 1.02/1.20), HAM-D (OR = 1.18, 95% CI = 1.05/1.32), CGI (OR = 1.85, 95% CI = 1.18/2.90), TEMPS-A Cyclothymia (OR = 1.16, 95% CI = 1.02/1.31). CONCLUSION: Our findings suggest the presence of suicidal ideation and severe hopelessness in BSP patients.KEY POINTSBSP patients as compared to controls more frequently reported the presence of a psychiatric disorder and more severe anxiety and depressive symptoms, psychopathology on the CGI, suicidal ideation, and hopelessness.BSP patients with prevalent cyclothymic temperament had more severe suicidal ideation, suggesting an increased suicide risk most likely due to difficulties in psychological adaptation to changing environments, including the neurological disease.A psychiatric assessment is recommended for patients with this condition, with possible referral to a suicide prevention centre.

Tryptophan and Kynurenine Metabolites: Are They Related to Depression?

BACKGROUND: Some previous studies found decreased concentrations of L-tryptophan (TRY) and increased L-kynurenine (KYN), or its metabolites, in the body fluids of subjects with major depressive disorder (MDD), sometimes in association with suicidal behavior. Such changes might indicate a shift of TRY away from serotonin production, possibly via the effects of inflammatory peptides which activate indoleamine-2,3-dioxygenase. However, these findings have been inconsistent and require replication. METHODS: We used sensitive liquid-chromatography mass spectrometry methods to assay plasma concentrations of TRY, 5-hydroxyindoleacetic acid (5-HIAA), and KYN and its metabolites (anthranilic acid and xanthurenic acid). We compared 49 hospitalized, depressed subjects diagnosed with MDD (n = 37) or bipolar disorder (BD, n = 12), with (n = 22) or without (n = 27) previous suicide attempts, to 78 healthy, ambulatory controls of similar age and sex (total n = 127). FINDINGS: Contrary to expectation, TRY plasma concentrations were higher, KYN plasma concentrations were lower, and their ratio much higher in depressed subjects, with no relationship to suicidal history. Concentrations of 5-HIAA and the kynurenine metabolites did not differ between depressed and healthy subjects. CONCLUSIONS: These findings are opposite to expectations and not consistent with a hypothesized increased conversion from TRY to KYN in depressed subjects. In addition, we found no evidence of altered production of serotonin as 5-HIAA concentration was unchanged. None of the observed changes was associated with a history of suicide attempt.

Psychometric properties of the modified Yale Food Addiction Scale Version 2.0 in an Italian non-clinical sample.

PURPOSE: To assess the dimensionality and psychometric properties of the modified Yale Food Addiction Scale 2.0 (mYFAS 2.0) in an Italian non-clinical sample. METHODS: 262 adults (184 women) were administered the Italian versions of the mYFAS 2.0, and questionnaires measuring binge eating severity, anxiety and depression symptoms, and emotional dysregulation. RESULTS: 15 individuals (5.7%) met the criteria for a diagnosis of food addiction according to the mYFAS 2.0. Bayesian confirmatory factor analysis supported a single-factor solution for the mYFAS 2.0. The mYFAS 2.0 had good internal consistency (Ordinal α = 0.91), and convergent validity with binge eating severity (r = 0.67, p < 0.001), both anxiety (r = 0.31, p < 0.001) and depressive (r = 0.35, p < 0.001) symptoms, and difficulties in emotion regulation (r = 0.35, p < 0.001). Finally, both discriminant validity with dietary restraint (Gamma = 0.11; p = 0.52) and incremental validity in predicting binge eating severity over emotion dysregulation and psychopathology (b = 0.52; t = 11.11; p < 0.001) were confirmed. CONCLUSIONS: The Italian mYFAS 2.0 has satisfactory psychometric properties and can be used as a brief instrument for the assessment of addictive eating behaviors when time constraints prevent the use of the original version. LEVEL OF EVIDENCE: Level V, cross-sectional descriptive study.

Factors associated with suicide: Case-control study in South Tyrol.

BACKGROUND: As suicide is related to many factors in addition to psychiatric illness, broad and comprehensive risk-assessment for risk of suicide is required. This study aimed to differentiate nondiagnostic risk factors among suicides versus comparable psychiatric patients without suicidal behavior. METHODS: We carried out a pilot, case-control comparison of 131 cases of suicide in South Tyrol matched for age and sex with 131 psychiatric controls, using psychological autopsy methods to evaluate differences in clinically assessed demographic, social, and clinical factors, using bivariate conditional Odds Risk comparisons followed by conditional regression modeling controlled for ethnicity. RESULTS: Based on multivariable conditional regression modeling, suicides were significantly more likely to have experienced risk factors, ranking as: [a] family history of suicide or attempt≥[b] recent interpersonal stressors≥[c] childhood traumatic events≥[d] lack of recent clinician contacts≥[e] previous suicide attempt≥[f] non-Italian ethnicity, but did not differ in education, marital status, living situation, or employment, nor by psychiatric or substance-abuse diagnoses. CONCLUSIONS: Both recent and early factors were associated with suicide, including lack of recent clinical care, non-Italian cultural subgroup-membership, familial suicidal behavior, and recent interpersonal distress.

Suicidal ideation, perceived disability, hopelessness and affective temperaments in patients affected by Parkinson's disease.

BACKGROUND: Previous studies investigating the risk of suicide in patients with Parkinson's disease (PD) have reported conflicting results. This study evaluated suicide risk in PD and investigated the relationship between suicide risk and perceived disability, hopelessness and affective temperaments in PD. METHODS: One-hundred and twenty PD patients were consecutively enrolled. The diagnosis of PD was based on clinical criteria. All patients underwent a psychiatric evaluation that included the administration of the Columbia-Suicide Severity Rating Scale, the Italian Perceived Disability Scale, the Beck Hopelessness Inventory and the TEMPS-A questionnaire. The results were compared with those of a control group of 91 patients affected by another chronic disease, ie, open angle glaucoma. RESULTS: Parkinson's disease patients had higher suicidal ideation, higher perceived disability and lower hyperthymia than the control group. In PD, higher perceived disability was associated with higher current and lifetime suicidal ideation, lower hyperthymia, older age and higher scores on negative temperaments. Suicidal ideation, negative temperaments and hopelessness were risk factors for perceived disability, while hyperthymia was a protective factor for perceived disability. DISCUSSION: Patients with PD have an increased risk of suicidal ideation. Increased suicidal ideation in PD is associated with the increased perceived disability. A psychiatric assessment that includes the investigation of suicide risk and perceived disability is recommended in patients with PD.

Body uneasiness is associated with food addiction symptoms: A cross-sectional study.

The main aim of the present study was to investigate the association between food addiction (FA) symptoms and body uneasiness in a nonclinical sample, while controlling for potential confounding variables. Participants (N = 395; 123 men) were administered self-report measures assessing FA, binge eating severity, body uneasiness, depressive symptoms, emotion dysregulation and socio-demographic variables. Body uneasiness was independently associated with FA symptoms (standardized beta coefficients ranging between 0.41 [p < 0.001] and 0.22 [p < 0.001]), even when controlling for the presence of other variables. This finding suggests that body uneasiness may be a crucial symptom in the development and/or maintenance of FA symptoms.

Childhood Traumatic Experiences and Dissociative Phenomena in Eating Disorders: Level and Association with the Severity of Binge Eating Symptoms.

The aim of the current study is to evaluate the presence of childhood trauma, psychoform, and somatoform dissociation in eating disorders (ED). Eighty-six ED outpatients participated in this study, 20 of them were diagnosed with restrictive anorexia (AN-R), 10 of them with anorexia nervosa binge-purging subtypes (AN-B), 25 with bulimia nervosa (BN), and 31 with binge eating disorder (BED). They were matched by sex and age with a control group consisting of 86 healthy subjects (HC). Traumatic experiences were assessed by means of the Childhood Trauma Questionnaire (CTQ), psychological, and somatoform dissociation, respectively, by means of the Dissociative Experience Scale (DES-II) and Somatoform Dissociation Questionnaire (SDQ-20), and binge eating symptoms by means of Binge Eating Scale (BES). ED subjects showed higher levels of childhood trauma, and both psychoform and somatoform dissociation compared to HC subjects. ED patients showed higher levels of childhood trauma compared to the HC group. No significant differences were shown between ED subgroups with respect to all forms of childhood trauma. BN and AN-B subgroups showed higher levels of both psychological and somatoform dissociation. Dissociation and childhood trauma predicted the severity of binge eating symptoms. Our results confirm previous studies in the same field.

Validation of the Italian Yale Food Addiction Scale in postgraduate university students.

PURPOSE: This study was aimed to examine the structural and construct validity of the Italian version of the Yale Food Addiction Scale in a multisite sample of postgraduate students. METHODS: Two hundred and fifty-six subjects (78.1% females) aged from 18 to 53 years (mean = 23.93, SD = 4.96) and attending different postgraduate university programs at multiple Italian universities completed the Italian YFAS, the Italian Binge Eating Scale (BES), the Italian Eating Attitudes Test-26 and the Italian Dutch Eating Behavior Questionnaire (DEBQ) online through Qualtrics. RESULTS: Confirmatory Factor Analysis showed that the single-factor model of the Italian YFAS including all original items had adequate fit indexes (χ2252 = 454.183; p < 0.001; normed χ2 = 1.802; RMSEA = 0.056; 90% CI 0.048-0.076; CFI = 0.761; WRMR = 1.592). However, item analysis revealed that item#25 had zero variance (all subjects were assigned the same score after item dichotomization) and item#24 had a low factor loading, and were thus removed. Furthermore, item#10 and item#11 showed to be almost perfectly correlated (r = 0.998) and were thus parceled. The resulting 19-item single-factor model revealed a better fit to the data (χ2152 = 235.69; p < 0.001; normed χ2 = 1.556; RMSEA = 0.046; 90% CI 0.034-0.058; CFI = 0.858; WRMR = 1.236) and its internal consistency was acceptable (KR-20 = 0.72). Also, a single-factor model including the seven diagnostic symptoms was tested and showed adequate fit values (χ220 = 41.911; p < 0.003; normed χ2 = 2.09; RMSEA = 0.065; 90% CI 0.037-0.093; CFI = 0.946; WRMR = 1.132). Statistically significant and small-to-high correlations were found with all convergent measures, in particular with the BES. CONCLUSION: The Italian 19-item YFAS resulted to be a valid and reliable tool for the assessment of food addiction in postgraduate students. LEVEL OF EVIDENCE: Level V, descriptive study.

"A disease of our time": The Catholic Church's condemnation and absolution of psychoanalysis (1924-1975).

The present paper is focused on the evolution of the position of the Catholic Church toward psychoanalysis. Even before Freud's The Future of an Illusion (1927), psychoanalysis was criticized by Catholic theologians. Psychoanalysis was viewed with either contempt or with indifference, but nonpsychoanalytic psychotherapy was accepted, especially for pastoral use. Freudian theory remained for most Catholics a delicate and dangerous subject for a long time. From the center to the periphery of the Vatican, Catholic positions against psychoanalysis have varied in the way that theological stances have varied. In the middle decades of the twentieth century, some Catholics changed their attitudes and even practiced psychoanalysis, challenging the interdict of the Holy Office, which prohibited psychoanalytic practice until 1961. During the Cold War, psychoanalysis progressively became more and more relevant within Catholic culture for two main reasons: changes in psychoanalytic doctrine (which began to stress sexuality to a lesser degree) and the increasing number of Catholic psychoanalysts, even among priests. Between the 1960s and the 1970s, psychoanalysis was eventually accepted and became the main topic of a famous speech by Pope Paul VI. This paper illustrates how this acceptance was a sort of unofficial endorsement of a movement that had already won acceptance within the Church. The situation was fostered by people like Maryse Choisy or Leonardo Ancona, who had advocated within the Church for a sui generis use of psychoanalysis (e.g., proposing a desexualized version of Freudian theories), despite warnings and prohibitions from the hierarchies of the Church.