- Bari, Apulia, Italy
- Università degli Studi "La Sapienza" di Roma, Clinical Psychology, Faculty Memberadd
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Objective To investigate whether and the extent to which psychosomatic syndromes and psychopathology are associated to psoriasis severity. Method Consecutive 282 outpatients with chronic psoriasis were assessed for psychopathology (with... more
Objective To investigate whether and the extent to which psychosomatic syndromes and psychopathology are associated to psoriasis severity. Method Consecutive 282 outpatients with chronic psoriasis were assessed for psychopathology (with the Mini International Neuropsychiatric Interview), psychosomatic conditions (with the Diagnostic Criteria for Psychosomatic Research, DCPR), severity of psoriatic symptoms (with the Psoriasis Area and Severity Index, PASI), and illness-related quality of life (with the Dermatology Life Quality Index, DLQI). Results Psychopathology was diagnosed in 26.6% patients while at least one DCPR syndrome in 67% of them and higher psychosomatic severity (>1 DCPR syndrome) in 29.1%. Higher symptom severity (PASI>20) was significantly more prevalent in patients with greater psychosomatic severity (29.1%) (d=1.25) - particularly, alexithymia (29.4%; d=0.83) - and poorer quality of life (DLQI>10) (d=0.86). Furthermore, after controlling for psychopatholog...
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Supplemental material, Table_S3 for Sense of meaning influences mental functioning in chronic renal patients by Luca Iani, Marco Lauriola, Angeramo AR, Elena Malinconico and Piero Porcelli in Journal of Health Psychology
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The use of the Rorschach test allows the body image to be examined using the Body-Image Index formulated by Fisher-Cleveland. This index is obtained by calculating the responses to Penetration and Barrier. The hypothesis is that the... more
The use of the Rorschach test allows the body image to be examined using the Body-Image Index formulated by Fisher-Cleveland. This index is obtained by calculating the responses to Penetration and Barrier. The hypothesis is that the diseases which affect the inside of the body are more greatly correlated to a high P score and a low B score (high P-low B type personality). The paper examines the Body-Image Index in a sample of 41 patients suffering from ulcerous rectocolitis comprising 24 males and 17 females with a mean age of 32 years. The personality profile obtained is of the "high P-low B" type with a P/R% ratio which is clearly higher than the central mean value (28.7% vs 8%) and a B/R% ratio which is clearly lower than the central mean value (4.2% vs 18%). The personality of the patients in this group was marked by a tendency to anxiety and a tendency to express aggression within their bodies (anger-in) which was field-dependent, difficulty in tolerating stress, a te...
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The current COVID-19 pandemic is causing direct and indirect effects in the global population. In this paper, fear and its possible forthcoming consequences on health will be investigated and discussed. Fear is an innate reactive emotion... more
The current COVID-19 pandemic is causing direct and indirect effects in the global population. In this paper, fear and its possible forthcoming consequences on health will be investigated and discussed. Fear is an innate reactive emotion to the immediate threats produced by danger. It is hardwired within subcortical survival circuits and originally had to defend the organism from predators. Besides, fear is a cognitive emotional process mediated by the cortical structures, and implies a subjective evaluation both at implicit (subsymbolic, unconscious) and explicit (symbolic, conscious) levels. Within a defensive taxonomy framework, fear can be defined as a reflex triggering a prompt behavior aimed at surviving from predating attacks (freezing), whereas anxiety as a deliberate pattern aimed at planning behaviors for anticipating and avoiding future harm. Fear and anxiety overlap at a subjective level, but are generated by different neurobiological networks and serve different evoluti...
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Il caso dell’ulcera peptica e particolarmente significativo per comprendere l’evoluzione della medicina psicosomatica negli ultimi 50-60 anni. L’ulcera peptica e stata considerata una delle classiche malattie psicosomatiche, per la quale... more
Il caso dell’ulcera peptica e particolarmente significativo per comprendere l’evoluzione della medicina psicosomatica negli ultimi 50-60 anni. L’ulcera peptica e stata considerata una delle classiche malattie psicosomatiche, per la quale si riteneva che i fattori psicologici giocassero un ruolo causale nel generare la malattia. Nel corso dell’ultimo decennio, l’ulcera peptica e stata spostata dal campo psicosomatico a quello biomedico grazie al ruolo etiopatogenetico attribuito all’Helicobacter Pylori. Tuttavia numerose ricerche empiriche hanno evidenziato che lo stress psicologico gioca un ruolo importante nello sviluppo della malattia, come uno dei fondamentali fattori di rischio. La ricerca di un unico meccanismo causale nel campo infettivologo puo condurre allo stesso errore commesso nell’epoca psicosomatica classica in cui si cercava una causa psicologica. L’«antico» modello psicogenetico e il «nuovo» modello biomedico dimorano entrambi all’interno di un modo di pensare per dic...
Research Interests: Humanities and Art
La psicoterapia in medicina psicosomatica e fra gli aspetti meno sviluppati di questa disciplina. In questo lavoro vengono presentati alcuni modelli psicoterapeutici applicati alla psicosomatica (psicoanalitico, cognitivo-comportamentale... more
La psicoterapia in medicina psicosomatica e fra gli aspetti meno sviluppati di questa disciplina. In questo lavoro vengono presentati alcuni modelli psicoterapeutici applicati alla psicosomatica (psicoanalitico, cognitivo-comportamentale e dei fattori aspecifici) che consistono fondamentalmente nell’applicazione degli assunti di base delle rispettive teorie. Gli autori passano in rassegna anche gli studi empirici sulla efficacia delle psicoterapie in psicosomatica, discutendo i risultati raggiunti ed i problemi metodologici. Su questa base, viene presentata una proposta (attualmente ancora in fase di ricerca) di utilizzare i concetti della integrazione psicoterapeutica in medicina psicosomatica, focalizzata su tre significati principali di psicoterapia integrata: uso combinato di tecniche diverse, capacita integrativa della funzione psicoterapeutica e ricerca dei fattori comuni. [Parole chiave: psicosomatica, integrazione psicoterapeutica, psicoanalisi, psicoterapia, terapia cogniti...
Research Interests: Humanities and Art
The pandemic of 2019 coronavirus disease (COVID-19) has burdened extraordinary psychological stress on the healthcare workforce. The present survey aimed to examine the personal resources and psychological symptoms associated with burnout... more
The pandemic of 2019 coronavirus disease (COVID-19) has burdened extraordinary psychological stress on the healthcare workforce. The present survey aimed to examine the personal resources and psychological symptoms associated with burnout in 933 healthcare workers in Italy during the COVID-19 outbreak period. Sociodemographic and occupational data, depression, anxiety, burnout, and post-traumatic symptoms, as well as psychological well-being, were cross-sectional assessed through an online questionnaire. A considerable part of the sample scored over the clinical levels of depression (57.9%), anxiety (65.2%), post-traumatic symptoms (55%), and burnout (25.61%). Working in the front-line (p < 0.05), being part of the medical staff (p < 0.05), experiencing lower levels of psychological well-being (p < 0.001), and higher levels of post-traumatic symptoms (p < 0.001) independently explained 38% of burnout variance. The healthcare industry, services, and professionals should b...
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Sulla base del concetto di peso relativo dei fattori biologici e psicologici, la psicosomatica puň essere concepita all'interno di due assi ortogonali di "malattia" e "personalitŕ". Le ultime ricerche sulla... more
Sulla base del concetto di peso relativo dei fattori biologici e psicologici, la psicosomatica puň essere concepita all'interno di due assi ortogonali di "malattia" e "personalitŕ". Le ultime ricerche sulla multifattorialitŕ delle malattie e sul rapporto gene-ambiente stanno evidenziando l'importanza dei fattori infantili di attaccamento e maltrattamento nella vulnerabilitŕ a diverse patologie mediche attraverso l'interazione con il sistema immunitario e i fattori proinfiammatori. Gli studi sulla personalitŕ hanno evidenziato che i fattori psicologici di vulnerabilitŕ alla somatizzazione possono esser presenti in modo trasversale in differenti patologie mediche e disturbi psicopatologici. Alcuni costrutti recenti, come l'alexithymia, tentano di spiegare fenomeni complessi quali il rapporto tra emozioni e sentimenti, i correlati neurobiologici delle emozioni, i percorsi evolutivi della mentalizzazione nascosti nella relazione madre-figlio.
Research Interests: Psychology and Humanities
Purpose It is well known that body mass index (BMI) affects how individuals perceive their well-being and that obese individuals tend to report poorer levels of subjective health status. The aim of this study was to compare subjects with... more
Purpose It is well known that body mass index (BMI) affects how individuals perceive their well-being and that obese individuals tend to report poorer levels of subjective health status. The aim of this study was to compare subjects with and without FSD and to examine the direct and indirect impact of BMI on female sexual dysfunction (FSD) in overweight/obese and normal-weight women. Methods A cross-sectional study was conducted on 186 overweight/obese and 233 normal-weight women. FSD assessed with the Female Sexual Function Index (FSFI) was investigated in relation to body satisfaction assessed with the Body Uneasiness Test (BUT-A) and self-esteem assessed with the Rosenberg Self-Esteem scale (RSE). Results No difference in the prevalence of FSD was found between overweight/obese (44.4%) and normal-weight women (55.6%), even though significant between-group differences in body image were found. Structural Equation Modelling (SEM) showed that BMI contribute to FSD only through the m...
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Research Interests: Philosophy and PNEI
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In this preliminary study, we examined whether aspects of spiritual well-being accounted for mental and physical health-related quality of life in 68 patients with end-stage renal disease, when controlling for age, type of treatment,... more
In this preliminary study, we examined whether aspects of spiritual well-being accounted for mental and physical health-related quality of life in 68 patients with end-stage renal disease, when controlling for age, type of treatment, physical symptoms, and worries. Hierarchical multiple regressions showed that meaning was associated with better mental health, while worry and physical symptoms also accounted for poor mental health. Faith and peace did not contribute to mental health. Older age, type of treatment (hemodialysis), and physical symptoms accounted for poor physical health. Our findings suggest that clinicians should include spiritual well-being in future interventions for end-stage renal disease patients.
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Alexithymia is a multifaceted personality construct that represents a deficit in the cognitive processing of emotions and is currently understood to be related to a variety of medical and psychiatric conditions. The present review aims to... more
Alexithymia is a multifaceted personality construct that represents a deficit in the cognitive processing of emotions and is currently understood to be related to a variety of medical and psychiatric conditions. The present review aims to investigate the relationship of alexithymia with gastrointestinal (GI) disorders as functional gastrointestinal disorders (FGID, as irritable bowel syndrome (IBS) and functional dyspepsia) and inflammatory bowel disease (IBD) [ulcerative colitis (UC) and Crohn's disease (CD)] and liver diseases as chronic hepatitis C (CHC), cirrhosis, and liver transplantation. The articles were selected from the main electronic databases (PsycInfo, Medline, PubMed, Web of Science, Scopus, Cochrane, and ScienceDirect) using multiple combinations of relevant search terms (defined GI and liver diseases, articles in English, use of the Toronto scales [TAS] for alexithymia). The TAS was selected as inclusion criterion because it is the most widely used measure, thu...
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It has been suggested that the Rorschach human movement (M) response could be associated with an embodied simulation mechanism mediated by the mirror neuron system (MNS). To date, evidence for this hypothesis comes from two... more
It has been suggested that the Rorschach human movement (M) response could be associated with an embodied simulation mechanism mediated by the mirror neuron system (MNS). To date, evidence for this hypothesis comes from two electroencephalogram studies and one repetitive transcranial magnetic stimulation study. To provide additional data on this topic, the Rorschach was administered during fMRI to a sample of 26 healthy adult volunteers. Activity in MNS-related brain areas temporally associated with M responses was compared with such activity for other, non-M Rorschach responses. Data analyses focused on MNS regions of interest identified by Neurosynth, a web-based platform for large scale, automated meta-analysis of fMRI data. Consistent with the hypothesis that M responses involve embodied simulation and MNS activity, univariate region of interest analyses showed that production of M responses associated with significantly greater activity in MNS-related brain areas when compared ...
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Human movement responses (M) on the Rorschach have been traditionally viewed as lying neither completely in the inkblot (external reality) nor within the subject's mind (inner world). The authors contend that M is not reducible to the... more
Human movement responses (M) on the Rorschach have been traditionally viewed as lying neither completely in the inkblot (external reality) nor within the subject's mind (inner world). The authors contend that M is not reducible to the "body that I have" but to the "body that I am," which is a higher level organization of bottom-up and top-down brain networks, integrating body implicit awareness, psychological functioning, and social cognition. Two sources of evidence suggest the close relationship among M, psychological functions, and brain mechanisms. One comes from meta-analytical evidence supporting the close association between M and higher level cognitive functioning or empathy. The second comes from some preliminary studies showing that M activates brain circuits included in the mirror neuron system (MNS). Two conclusions can be drawn: (a) M is related to the effective use of the mentalization function; and (b) future neuroscientific investigations coul...
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Research Interests: Philosophy and Humanities
Background: The Diagnostic Criteria for Psychosomatic Research (DCPR) are a set of 12 psychosomatic syndromes and are provided with a reliable diagnostic structured interview. The DCPR have been proposed 20 years ago as an integrative... more
Background: The Diagnostic Criteria for Psychosomatic Research (DCPR) are a set of 12 psychosomatic syndromes and are provided with a reliable diagnostic structured interview. The DCPR have been proposed 20 years ago as an integrative assessment strategy that supplements the traditional psychiatric nosography for identifying patients within a given illness population whose psychosocial factors have clinical significance. This paper reviews their clinical utility, conceived as the degree and the amount of influence that the instrument has on multiple decisions and outcomes in clinical practice. Methods: Published reports which involved the use of the DCPR were identified by searching electronic databases. Studies which best displayed the clinical utility of the DCPR system were then selected and reviewed. Results: The DCPR system showed its clinical utility regarding the following clinical issues: (1) subtyping medical patients, (2) identifying subthreshold or undetected syndromes, (...
Research Interests: Psychology, Applied Psychology, Clinical Psychology, Depression, Medicine, and 11 moreAlexithymia, Psychosomatic Medicine, Humans, Biomedical Research, Somatization, Differential Diagnosis, Somatoform disorders, Mental Health and Psychiatry Nursing, Illness Behavior, Demoralization, and Clinical utility
Background: Previous studies have shown that alexithymia is associated with gene polymorphisms that regulate the availability of serotonin (5-HT) in the brain. Since the 5-HT network is involved in interferon (IFN)-induced depression,... more
Background: Previous studies have shown that alexithymia is associated with gene polymorphisms that regulate the availability of serotonin (5-HT) in the brain. Since the 5-HT network is involved in interferon (IFN)-induced depression, this paper aimed to investigate the role of alexithymia and the functional gene variants of the 5-HT1A receptor (HTR1A) and the 5-HT transporter (5-HTTLPR) in induction of depression during antiviral treatment. Methods: The depressive symptoms of 130 consecutive patients with chronic hepatitis C and no current psychopathology were measured during treatment with IFN and ribavirin (6-12 months) and at a 6-month follow-up. At baseline, alexithymia and 2 genotypes (5-HTTLPR and HTR1A) were also assessed. Results: Patients with homozygosity for HTR1A-G and 5-HTTLPR long alleles had significantly higher levels of alexithymia. After controlling for sociodemographic and disease-related factors, alexithymia and HTR1A-G polymorphism, both separately (20-22%) and...
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Fifty consecutive adult outpatients (23 men and 27 women, mean age = 49.06, SD = 12.84 years) with established diagnoses of MDD (n = 28, 56%) and BP I–II types (n = 22, 44%) were recruited from the community mental health services in... more
Fifty consecutive adult outpatients (23 men and 27 women, mean age = 49.06, SD = 12.84 years) with established diagnoses of MDD (n = 28, 56%) and BP I–II types (n = 22, 44%) were recruited from the community mental health services in Foggia (Italy) between January and December 2013. The duration of illness ranged from 1 to 41 years (median 11.5 years). Twenty-one (42%) patients had at least one co-occurring medical condition, mostly pain (67%), cardiovascular (38%), endocrine (38%), and gastrointestinal (29%) disorders. Exclusion criteria were pregnancy, neurological or severe medical illness limiting individual participation, substance abuse in the last 6 months, and acute MDD/BD episodes in the last 4 weeks. Written informed consent to participate was obtained from each subject. The study was approved by the local Ethics Committee in accordance with the Declaration of Helsinki. Psychopathology was diagnosed with the Structured Clinical Interview for DSM-IV (SCID) [3] . Psychosomatic syndromes were assessed with the Structured Interview for DCPR [4] that includes 12 psychosomatic syndromes related to clusters of abnormal illness behavior, somatization, irritability, demoralization, and alexithymia. The severity of symptoms was assessed with the 17-item Hamilton Rating Scale for Depression (HRSD) [5] and the BechRafaelsen Mania Scale (BRMS) [6] . Psychosocial functioning (outcome measure) was assessed with the Physical Component Summary (PCS) and Mental Component Summary (MCS) scores of the Short Form-12 Health Survey (SF-12) [7] . The relevance of subclinical and psychosomatic factors in explaining impaired psychosocial functioning, poorer quality of life, and medical comorbidity in patients with psychiatric disorders, including mood disorders, is getting increasing recognition [1, 2] . In this study, we investigated the role of psychosomatic factors, assessed with the Diagnostic Criteria for Psychosomatic Research (DCPR), in predicting psychosocial functioning in patients with major depressive (MDD) and bipolar disorder (BD), over and above psychiatric symptoms. Received: April 2, 2015 Accepted after revision: June 23, 2015 Published online: September 25, 2015
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Research Interests: Psychology, Quality of life, Medicine, Alexithymia, Mood, and 15 moreHumans, Major Depressive Disorder, Female, Male, Clinical Sciences, Mood Disorders, Middle Aged, Combination drug therapy, Recombinant Proteins, Polyethylene Glycols, Ribavirin, Antiviral Agents, Interferon Alpha, Adverse effect, and Affective symptoms
The evaluation of psychologic states is very useful in the management of inflammatory bowel disease (IBD) patients, particularly when related to disease activity (DA). Our aim was to prospectively evaluate the relationship between... more
The evaluation of psychologic states is very useful in the management of inflammatory bowel disease (IBD) patients, particularly when related to disease activity (DA). Our aim was to prospectively evaluate the relationship between psychologic distress and DA. DA and psychologic distress were evaluated in 104 IBD outpatients by means of clinical criteria and the Hospital Anxiety and Depression Scale (HADS) at base line and after 6 months. Patients were grouped in unchanged, improved, and worsened DA from base line to follow-up. Repeated-measures ANOVA showed a significant group-by-time interaction for HADS anxiety (F = 89.6, P = 0.0001) and depression (F = 3.67, P = 0.03) subscales. Over time changes in DA significantly affect psychologic distress and are closely related to corresponding increases and decreases in anxiety and depression in IBD patients. Our findings therefore suggest that the assessment of psychologic distress, particularly anxiety, should be included in the clinical management of IBD patients.
Research Interests: Depression, Medicine, Distress, Anxiety, Inflammatory Bowel Disease, and 15 moreProspective studies, Humans, Female, Disease, Male, Hospital Anxiety and Depression Scale, Clinical Sciences, Adult, Analysis of Variance, ANXIETY, Disease Activity, Prospective Study, Inflammatory Bowel Diseases, Psychiatric Status Rating Scales, and Prospective Cohort Study
BackgroundThe classification of psychological distress and illness behavior in the setting of medical disease is still controversial. Current psychiatric nosology does not seem to cover the spectrum of disturbances. The aim of this... more
BackgroundThe classification of psychological distress and illness behavior in the setting of medical disease is still controversial. Current psychiatric nosology does not seem to cover the spectrum of disturbances. The aim of this investigation was to assess whether the joint use of DSM-IV categories and the Diagnostic Criteria for Psychosomatic Research (DCPR), that provide identification of syndromes related to somatization, abnormal illness behavior, irritable mood, type A behavior, demoralization and alexithymia, could yield subtyping of psychosocial variables in the medically ill.MethodA cross-sectional assessment using both DSM-IV and the DCPR was conducted in eight medical centers in the Italian Health System. Data were submitted to cluster analysis. Participants were consecutive medical out-patients and in-patients for whom a psychiatric consultation was requested. A total of 1700 subjects met eligibility criteria and 1560 agreed to participate.ResultsThree clusters were id...
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... provare alcun potere del simbolismo inconscio. Ora, se si elimina il corpo biologico, se si eliminano i sintomi della RCU (diversi dai sintomi funzionali di diarrea), cosaresta di questa paziente? o meglio: cosa si può legittimamente... more
... provare alcun potere del simbolismo inconscio. Ora, se si elimina il corpo biologico, se si eliminano i sintomi della RCU (diversi dai sintomi funzionali di diarrea), cosaresta di questa paziente? o meglio: cosa si può legittimamente ...
Research Interests: Psychology and Medicine
... di tre indicatori: sintomi valutati con un questionario specifico per il lutto, disturbi significativi sul piano sociale e durata di almeno 3 mesi. ... Dopo una serie di analisi di regressione, gli autori hanno concluso che... more
... di tre indicatori: sintomi valutati con un questionario specifico per il lutto, disturbi significativi sul piano sociale e durata di almeno 3 mesi. ... Dopo una serie di analisi di regressione, gli autori hanno concluso che l'alexi-thymia è risultata significativamente associata tanto agli esiti ...
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IFN-induced depression is a suitable model for investigating vulnerability to depression. We aimed at investigating the role of two vulnerability factors, lifetime mood disorder (LMD) and 5-HT-related gene polymorphisms in treated... more
IFN-induced depression is a suitable model for investigating vulnerability to depression. We aimed at investigating the role of two vulnerability factors, lifetime mood disorder (LMD) and 5-HT-related gene polymorphisms in treated patients with infection by Hepatitis C Virus (HCV). Depressive symptoms of 130 consecutive HCV patients with no current psychopathology were measured during treatment with interferon and ribavirin. At baseline, LMD and 3 genotypes (5-HTTLPR, HTR1A, and TPH2) were also assessed. Subgroups of 43 patients with LMD, 96 with HTR1A-G allele, and 12 with both LMD and HTR1A-G homozigosity scored significantly higher to depression compared to the remaining patients during antiviral therapy. At the multiple regression analysis, LMD and HTR1A-G, whether separately or combined together, explained a similar amount of 10-22% of depression score variance, after controlling for the associated variables (age and gender). HCV patients referred to a tertiary care center are not representative of all patients with chronic hepatitis C. Mediating factors, including proinflammatory cytokines and other potentially relevant gene polymorphisms, could not be evaluated. Patients were not stratified by degree of liver inflammation. LMD diagnoses were not cross-checked with medical records and IFN-induced depression was measured with a self-report scale only. History of mood disorders and HTR1A G allele variation, the C-1019G polymorphism of the transcriptional control region of the 5-HT1A receptor, independently predicted the incidence of IFN-induced depression in HCV patients, whether separately or jointly considered and although not reciprocally associated.
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Gastrointestinal-specific anxiety (GSA) and alexithymia are two psychological constructs that may contribute to severity of irritable bowel syndrome (IBS). We aimed to investigate their independent contribution in predicting the level of... more
Gastrointestinal-specific anxiety (GSA) and alexithymia are two psychological constructs that may contribute to severity of irritable bowel syndrome (IBS). We aimed to investigate their independent contribution in predicting the level of severity in a group of patients with moderate to severe IBS. A sample of 177 consecutive IBS patients (49.2% with moderate and 50.8% with severe IBS), diagnosed with Rome III criteria, were evaluated for IBS symptoms, alexithymia, GSA, psychological distress, and psychosocial functioning with validated scales. IBS severity was highly associated to both alexithymia (r=0.61) and GSA (r=0.66), that were also associated to each other (r=0.64). Severe IBS patients scored significantly different than moderate IBS patients to all scales in the expected direction. Multiple and hierarchical regression analyses showed that IBS severity was predicted at a similar degree by alexithymia and GSA, controlled for IBS symptoms, psychological distress, and psychosocial functioning. Effect sizes showed that the highest IBS severity scores were obtained by patients with high alexithymia alone (d=1.16) or combined with higher GSA (d=1.45). Alexithymia and GSA were closely related to each other and associated to IBS severity, thus suggesting a common basis of emotional dysregulation. However, alexithymia (particularly the facets of difficulty identifying and describing feelings) resulted to be a stronger predictor of IBS severity than GSA, thus suggesting that impaired affective awareness may reflect on the clinical manifestations of IBS.
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... demonstration of this because of the robust nature of the external criterion used (stability of alexithymia ... the behav-ioral measure (adherence) was obtained using a self-descriptive, retro-spective technique (change before/after... more
... demonstration of this because of the robust nature of the external criterion used (stability of alexithymia ... the behav-ioral measure (adherence) was obtained using a self-descriptive, retro-spective technique (change before/after ... Use of the Rorschach Method in Somatic Illnesses ...