Background: Adverse life occurrences (e.g., severe accidents, violence/abuse, organic disorders s... more Background: Adverse life occurrences (e.g., severe accidents, violence/abuse, organic disorders such as COVID-19) can elicit traumatic responses that heighten fear, anxiety, and depression. However, scientific research has shown that certain variables, such as self-esteem, based on theories like terror management theory (TMT) and the anxiety-buffering hypothesis (ABH), can mitigate the negative effects of trauma. This study aimed to test the ABH by assessing the buffering role of selfesteem in the relationships among the impact of traumatic experiences, fear, anxiety, and depression. Method: An observational research design was used. This study involved 321 participants who experienced COVID-19 as a traumatic experience. A sequential multiple-mediation model with observed variables (path analysis) was used to test the impact of the traumatic experience on fear, anxiety, and depression, examining the protective role of self-esteem. Results: A path analysis revealed that fear and anxiety mediated the relationship between the impact of the traumatic experience of COVID-19 and depression. Additionally, in line with the ABH, self-esteem was found to mediate the relationship between the predictors and their adverse psychological consequences. This suggests that self-esteem played a buffering role, mitigating the negative impact of traumatic experiences on mental health outcomes. Conclusions: These findings underscore the central mediating role of self-esteem, as well as fear and anxiety, in the pathway from trauma-related factors to depression. These insights advocate for evidence-based interventions aimed at alleviating the psychological suffering associated with traumatic experiences, fostering adaptation, and supporting psychological health.
Adverse life events (e.g., severe accidents, violence/abuse, organic disorders) can elicit trauma... more Adverse life events (e.g., severe accidents, violence/abuse, organic disorders) can elicit traumatic responses characterized by intrusive thoughts, hyperarousal, and avoidance-highlighting the need for sound assessment tools. Also, these traumatic components could heighten anxiety and depression symptoms. This study aims included to: (1) assessing the psychometric properties of the Post-Traumatic Symptom Questionnaire (PTSQ) and delineating clinical cutoffs ; (2) investigating how distinct trauma components contribute to anxiety and depression symptoms. Involving 761 participants who experienced a traumatic event, Part I tested the PTSQ psychometric properties, defining clinical cutoffs. Part II tested the impact of traumatic components on anxiety and depression symptoms, using a multiple multivariate latent regression model. PTSQ exhibited exemplary fit indices and robust psychometric properties. Clinically relevant cutoffs were identified. The differential contributions of intrusion, avoidance, and hyperarousal to anxiety and depression symptoms were evaluated, elucidating the strength and nature of these relationships. This study reaffirms the PTSQ as a psychometrically sound and reliable instrument. It underscores the effects of intrusion, avoidance, and hyperarousal on anxiety and depression symptoms in individuals with traumatic experiences. These insights advocate for evidence-based interventions aimed at alleviating the psychological suffering associated with trauma components, fostering adaptation and supporting psychological health.
Self-esteem and emotion dysregulation appear to be important factors in the psychological well-be... more Self-esteem and emotion dysregulation appear to be important factors in the psychological well-being of trauma survivors. On the one hand, self-esteem may act as a shield against the psychological consequences of traumatic experiences; on the other hand, emotion regulation can affect the way individuals deal with post-traumatic affects (e.g., fear, terror, shame, and guilt). Consequently, the objective of this study was to investigate the role that emotion dysregulation and self-esteem play in the well-being of a sample of women after the traumatic experience of intimate partner violence (IPV). This study involved 282 women (mean age = 41.55, SD = 10.52) who experienced IPV in the last year. Conditional process analyses and Johnson-Neyman analysis for regions of significance were performed. The results showed that emotion dysregulation mediated the relationship between post-trauma affectivity (i.e., fear, terror, shame and guilt) and survivors' wellbeing. Furthermore, self-esteem negatively predicted lack of well-being and acted as a moderator of the relationship between emotion dysregulation and lack of well-being. In this regard, through the Johnson-Neyman analysis for regions of significance, it was possible to identify a cutoff value above which the relationship between emotion dysregulation and lack of well-being became non-statistically significant. This study contributed to understanding the role that emotion dysregulation and self-esteem play in the well-being of IPV survivors. In this regard, clinical implications will be presented.
Background: Orthorexia Nervosa (ON) is a condition characterized by an obsessive focus on healthy... more Background: Orthorexia Nervosa (ON) is a condition characterized by an obsessive focus on healthy eating, inflexible dietary rules, and persistent preoccupations with food. Despite it has been recently the subject of increasingly relevant studies, little is known about the mechanisms that might foster ON symptoms. Objective: This study used a structural equation modeling approach to test the mediating effect of thoughts, worries, and preoccupations about food on the relationship that eating disorders (EDs) attitudes (e.g., dieting) and obsessive-compulsive thoughts and symptoms have with ON in a large community sample. It was hypothesized that the effect of dieting and obsessive-compulsive thoughts and symptoms on ON would be partially mediated by the presence of thoughts, worries, and preoccupations about food. Methods: Data from a cross-sectional sample of 1328 participants (females = 976) recruited from the general population were asked to fill in an online survey comprising the Eating Attitude Test-26 (EAT-26), the Obsessivecompulsive subscale of the Symptom Checklist-90 Revised (SCL-90R-OC) and the Orthorexia Scale-15 (ORTO-15). Results: Structural equation models indicated that both obsessive-compulsive thoughts and symptoms and dieting had a direct effect on ON and that food preoccupation partially mediated these relationships. Conclusion: These findings provide novel insight into the nature of ON that could aid its conceptualization and treatment.
Background The Three Factor Eating Questionnaire-Revised 18 (TFEQ-R-18) is an extensively used qu... more Background The Three Factor Eating Questionnaire-Revised 18 (TFEQ-R-18) is an extensively used questionnaire to measure three transdiagnostic features of eating behavior: cognitive restraint, uncontrolled eating, and emotional eating. Objective This research aims to investigate the psychometric properties of the Italian version of the TFEQ-R-18 in three large community samples. Method Cross-sectional research designs were employed. In Study 1 (N = 537), an exploratory graph analysis (EGA) was used to examine item clustering within the TFEQ-R-18. In Study 2 (N = 645), a confirmatory factor analysis (CFA) was conducted to test its structural validity. In Study 3 (N = 346), a MANOVA was employed assessing mean differences across eating disorders (e.g., anorexia nervosa, bulimia nervosa, binge eating disorder). Results In Study 1, the EGA accurately identified the three original dimensions of the TFEQ-R-18. Study 2 showed that the Italian TFEQ-R-18 has good fit indexes (CFI = 0.989, RMSEA = 0.064; 90% CI [0.058, 0.070], SRMR = 0.062), and possesses robust psychometric properties. Study 3 reveals distinct, statistically significant differences among eating disorders. Conclusion The TFEQ-R-18 proves to be a concise and precise tool for measuring transdiagnostic eating behaviors. Its applicability in the Italian context, supported by robust psychometric properties, suggests its utility for both research and clinical purposes. The findings affirm its potential to inform interventions aimed at enhancing psychological health. Level of evidence Level V, descriptive study.
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Background: Gaining knowledge of the various reasons behind people's consumption of highly proces... more Background: Gaining knowledge of the various reasons behind people's consumption of highly processed foods has the potential to enhance obesity prevention initiatives and open avenues to tailor treatment approaches for obesity and binge eating at a more personalized level. This contribution aimed to test the psychometric properties and factor structure of the Palatable Eating Motives Scale (PEMS-IT) in a community sample of Italian adults. Methods: A confirmatory factor analysis was performed to test the factor structure of the Italian version of the PEMS (PEMS-IT) on a total of 616 respondents. Furthermore, the reliability and convergent validity analysis of the tool were evaluated. Results: The analysis confirmed the four-factor structure of PEMS-IT [(YBχ2 (164) = 537.901; p < 0.001, the CFI = 0.918, RMSEA = 0.072; 90%CI [0.065-0.078]; p(RMSEA < 0.05) < 0.001, and SRMR = 0.080] and satisfactory reliability on its subscales (Cronbach's α: 0.745-0.917). Positive correlations were also found with food addiction and binge-eating symptoms, compulsive eating behavior, and uncontrolled and emotional eating. Conclusions: The PEMS-IT appears to be an instrument with promising psychometric properties and potential applications in clinical settings. However, it also has some limitations, and future studies could focus on improving the semantic content of the elements to increase the overall utility and precision of the instrument.
Background The Three Factor Eating Questionnaire-Revised 18 (TFEQ-R-18) is an extensively used qu... more Background The Three Factor Eating Questionnaire-Revised 18 (TFEQ-R-18) is an extensively used questionnaire to measure three transdiagnostic features of eating behavior: cognitive restraint, uncontrolled eating, and emotional eating. Objective This research aims to investigate the psychometric properties of the Italian version of the TFEQ-R-18 in three large community samples. Method Cross-sectional research designs were employed. In Study 1 (N = 537), an exploratory graph analysis (EGA) was used to examine item clustering within the TFEQ-R-18. In Study 2 (N = 645), a confirmatory factor analysis (CFA) was conducted to test its structural validity. In Study 3 (N = 346), a MANOVA was employed assessing mean differences across eating disorders (e.g., anorexia nervosa, bulimia nervosa, binge eating disorder). Results In Study 1, the EGA accurately identified the three original dimensions of the TFEQ-R-18. Study 2 showed that the Italian TFEQ-R-18 has good fit indexes (CFI = 0.989, RMSEA = 0.064; 90% CI [0.058, 0.070], SRMR = 0.062), and possesses robust psychometric properties. Study 3 reveals distinct, statistically significant differences among eating disorders. Conclusion The TFEQ-R-18 proves to be a concise and precise tool for measuring transdiagnostic eating behaviors. Its applicability in the Italian context, supported by robust psychometric properties, suggests its utility for both research and clinical purposes. The findings affirm its potential to inform interventions aimed at enhancing psychological health. Level of evidence Level V, descriptive study.
Background: Increasing attention to the early stages of psychosis and the identification of sympt... more Background: Increasing attention to the early stages of psychosis and the identification of symptomatic prodromal states have led to the development of a growing number of screening tools. The 16-item version of the Prodromal Questionnaire (PQ-16) is a worldwide used self-administered tool for this purpose. However, to date, fundamental psychometric properties of PQ-16 were not thoroughly investigated. This study aimed to examine the structural validity, measurement invariance, reliability and other psychometrical properties of the Italian version of the PQ-16 (iPQ-16) in help-seeking individuals and in the general population. Methods: The iPQ-16 was administered to 449 young outpatients attending six community mental health services and to 318 control participants enrolled in educational environment. Confirmatory factor analyses (CFAs), measurement invariance (MI) between the help-seeking group and the general population sample, convergent validity, test-retest reliability, internal consistency, and prevalence analyses were performed. Lastly, the validity of the adopted PQ-16 cutoffs through Receiver Operating Characteristic (ROC) curves plotted against CAARMS diagnoses was also tested. Team involved in CCM2013 Project listed in 'Acknowledgements' section.
Abstract: Background: The ever-increasing spread of Internet-based systems for common mental diso... more Abstract: Background: The ever-increasing spread of Internet-based systems for common mental disorders has generated the need for brief online screening methods. This study aims to test the psychometric properties of the Web Screening Questionnaire (WSQ) to examine its suitability for screening for common mental health problems among a community sample of Italian adults. Methods: A total of 1282 subjects (F = 819; mean age = 42.05) answered the WSQ. Its discriminant characteristics were examined with other validated selected scales for measuring mental health widely used in the Italian population using sensitivity, specificity, and area under the curve (AUC), as well as positive (PPV) and negative predictive values (NPV). Results: Most of the WSQ subscales exhibited moderate to high specificity values. Specifically, the scales of ‘agoraphobia’ (0.947; 95%CI [0.934, 0.960]), ‘anxiety’ (0.959; 95%CI [0.946, 0.970]), and ‘panic disorder’ (0.973; 95%CI [0.964, 0.981]) showed the highest values whilst the ‘obsessive-compulsive’ dimension had the lowest value at 0.838, 95%CI [0.815, 0.861]. With exceptions observed for ‘depression’ (0.716; 95%CI [642, 798]) and ‘alcohol abuse’ (0.760; 95%CI [560, 920]), instead, the WSQ demonstrated critical sensitivity values (<0.6) in all dimensions. Conclusions: The WSQ was appropriate for discriminating between people with and without a psychiatric condition, as it helps to confirm the absence of disorders. However, further diagnostic procedures are required, in case of a positive WSQ
Self-esteem and emotion dysregulation appear to be important factors in the psychological well-be... more Self-esteem and emotion dysregulation appear to be important factors in the psychological well-being of trauma survivors. On the one hand, self-esteem may act as a shield against the psychological consequences of traumatic experiences; on the other hand, emotion regulation can affect the way individuals deal with post-traumatic affects (e.g., fear, terror, shame, and guilt). Consequently, the objective of this study was to investigate the role that emotion dysregulation and self-esteem play in the well-being of a sample of women after the traumatic experience of intimate partner violence (IPV). This study involved 282 women (mean age = 41.55, SD = 10.52) who experienced IPV in the last year. Conditional process analyses and Johnson-Neyman analysis for regions of significance were performed. The results showed that emotion dysregulation mediated the relationship between post-trauma affectivity (i.e., fear, terror, shame and guilt) and survivors' wellbeing. Furthermore, self-esteem negatively predicted lack of well-being and acted as a moderator of the relationship between emotion dysregulation and lack of well-being. In this regard, through the Johnson-Neyman analysis for regions of significance, it was possible to identify a cutoff value above which the relationship between emotion dysregulation and lack of well-being became non-statistically significant. This study contributed to understanding the role that emotion dysregulation and self-esteem play in the well-being of IPV survivors. In this regard, clinical implications will be presented.
Background: Orthorexia Nervosa (ON) is a condition characterized by an obsessive focus on healthy... more Background: Orthorexia Nervosa (ON) is a condition characterized by an obsessive focus on healthy eating, inflexible dietary rules, and persistent preoccupations with food. Despite it has been recently the subject of increasingly relevant studies, little is known about the mechanisms that might foster ON symptoms. Objective: This study used a structural equation modeling approach to test the mediating effect of thoughts, worries, and preoccupations about food on the relationship that eating disorders (EDs) attitudes (e.g., dieting) and obsessive-compulsive thoughts and symptoms have with ON in a large community sample. It was hypothesized that the effect of dieting and obsessive-compulsive thoughts and symptoms on ON would be partially mediated by the presence of thoughts, worries, and preoccupations about food. Methods: Data from a cross-sectional sample of 1328 participants (females = 976) recruited from the general population were asked to fill in an online survey comprising the Eating Attitude Test-26 (EAT-26), the Obsessivecompulsive subscale of the Symptom Checklist-90 Revised (SCL-90R-OC) and the Orthorexia Scale-15 (ORTO-15). Results: Structural equation models indicated that both obsessive-compulsive thoughts and symptoms and dieting had a direct effect on ON and that food preoccupation partially mediated these relationships. Conclusion: These findings provide novel insight into the nature of ON that could aid its conceptualization and treatment.
e24222 Background: Ever greater importance is given to psychological distress in oncological sett... more e24222 Background: Ever greater importance is given to psychological distress in oncological settings. Distress could have a severe adverse effect on adherence and compliance to therapies, medical treatments, and quality of life (NCCN, 2015). Moreover, psychological research is progressively increasing in oncological settings and psychological distress has rapidly gained popularity – leading to the development of scales aimed at its evaluation. In this regard, the revised version of the Psychological Distress Inventory – the PDI-R (Rossi et al., 2022) – has demonstrated excellent psychometric properties but its screening properties were limited to self-report questionnaires. Consequently, to fill this gap, this study aimed to evaluate the accuracy of the PDI-R in identifying the levels of distress of oncological outpatients compared to a diagnostic interview – using a machine learning approach. Methods: Oncological outpatients ( n = 603; mean age = 68.38, SD = 9.31; 316 males) were ...
Objective. The present study employs a profile analysis to identify and compare psychological fea... more Objective. The present study employs a profile analysis to identify and compare psychological features and core eating disorder (ED) symptoms in clinical samples of patients with anorexia nervosa (AN) and binge eating disorder (BED) and the general population (GP). Methods. A sample comprising 421 participants (142 patients with AN; 139 patients with BED; and 140 participants from the GP) was surveyed with the Eating Disorder Inventory-3 (EDI-3). Individuals with AN and BED were recruited and tested during their first week of a multidisciplinary inpatient program for weight loss and rehabilitation at the ‘Rete DCA USL Umbria 1′ (Eating Disorders Services), Italy. Results. The findings suggest distinct patterns of symptom presentation between the three samples across all the EDI-3 dimensions—with both the AN and BED groups scoring significantly higher than the GP. Patients with AN registered greater scores in all the psychological trait scales and the drive for thinness ED-specific d...
Background: Adverse life occurrences (e.g., severe accidents, violence/abuse, organic disorders s... more Background: Adverse life occurrences (e.g., severe accidents, violence/abuse, organic disorders such as COVID-19) can elicit traumatic responses that heighten fear, anxiety, and depression. However, scientific research has shown that certain variables, such as self-esteem, based on theories like terror management theory (TMT) and the anxiety-buffering hypothesis (ABH), can mitigate the negative effects of trauma. This study aimed to test the ABH by assessing the buffering role of selfesteem in the relationships among the impact of traumatic experiences, fear, anxiety, and depression. Method: An observational research design was used. This study involved 321 participants who experienced COVID-19 as a traumatic experience. A sequential multiple-mediation model with observed variables (path analysis) was used to test the impact of the traumatic experience on fear, anxiety, and depression, examining the protective role of self-esteem. Results: A path analysis revealed that fear and anxiety mediated the relationship between the impact of the traumatic experience of COVID-19 and depression. Additionally, in line with the ABH, self-esteem was found to mediate the relationship between the predictors and their adverse psychological consequences. This suggests that self-esteem played a buffering role, mitigating the negative impact of traumatic experiences on mental health outcomes. Conclusions: These findings underscore the central mediating role of self-esteem, as well as fear and anxiety, in the pathway from trauma-related factors to depression. These insights advocate for evidence-based interventions aimed at alleviating the psychological suffering associated with traumatic experiences, fostering adaptation, and supporting psychological health.
Adverse life events (e.g., severe accidents, violence/abuse, organic disorders) can elicit trauma... more Adverse life events (e.g., severe accidents, violence/abuse, organic disorders) can elicit traumatic responses characterized by intrusive thoughts, hyperarousal, and avoidance-highlighting the need for sound assessment tools. Also, these traumatic components could heighten anxiety and depression symptoms. This study aims included to: (1) assessing the psychometric properties of the Post-Traumatic Symptom Questionnaire (PTSQ) and delineating clinical cutoffs ; (2) investigating how distinct trauma components contribute to anxiety and depression symptoms. Involving 761 participants who experienced a traumatic event, Part I tested the PTSQ psychometric properties, defining clinical cutoffs. Part II tested the impact of traumatic components on anxiety and depression symptoms, using a multiple multivariate latent regression model. PTSQ exhibited exemplary fit indices and robust psychometric properties. Clinically relevant cutoffs were identified. The differential contributions of intrusion, avoidance, and hyperarousal to anxiety and depression symptoms were evaluated, elucidating the strength and nature of these relationships. This study reaffirms the PTSQ as a psychometrically sound and reliable instrument. It underscores the effects of intrusion, avoidance, and hyperarousal on anxiety and depression symptoms in individuals with traumatic experiences. These insights advocate for evidence-based interventions aimed at alleviating the psychological suffering associated with trauma components, fostering adaptation and supporting psychological health.
Self-esteem and emotion dysregulation appear to be important factors in the psychological well-be... more Self-esteem and emotion dysregulation appear to be important factors in the psychological well-being of trauma survivors. On the one hand, self-esteem may act as a shield against the psychological consequences of traumatic experiences; on the other hand, emotion regulation can affect the way individuals deal with post-traumatic affects (e.g., fear, terror, shame, and guilt). Consequently, the objective of this study was to investigate the role that emotion dysregulation and self-esteem play in the well-being of a sample of women after the traumatic experience of intimate partner violence (IPV). This study involved 282 women (mean age = 41.55, SD = 10.52) who experienced IPV in the last year. Conditional process analyses and Johnson-Neyman analysis for regions of significance were performed. The results showed that emotion dysregulation mediated the relationship between post-trauma affectivity (i.e., fear, terror, shame and guilt) and survivors&#39; wellbeing. Furthermore, self-esteem negatively predicted lack of well-being and acted as a moderator of the relationship between emotion dysregulation and lack of well-being. In this regard, through the Johnson-Neyman analysis for regions of significance, it was possible to identify a cutoff value above which the relationship between emotion dysregulation and lack of well-being became non-statistically significant. This study contributed to understanding the role that emotion dysregulation and self-esteem play in the well-being of IPV survivors. In this regard, clinical implications will be presented.
Background: Orthorexia Nervosa (ON) is a condition characterized by an obsessive focus on healthy... more Background: Orthorexia Nervosa (ON) is a condition characterized by an obsessive focus on healthy eating, inflexible dietary rules, and persistent preoccupations with food. Despite it has been recently the subject of increasingly relevant studies, little is known about the mechanisms that might foster ON symptoms. Objective: This study used a structural equation modeling approach to test the mediating effect of thoughts, worries, and preoccupations about food on the relationship that eating disorders (EDs) attitudes (e.g., dieting) and obsessive-compulsive thoughts and symptoms have with ON in a large community sample. It was hypothesized that the effect of dieting and obsessive-compulsive thoughts and symptoms on ON would be partially mediated by the presence of thoughts, worries, and preoccupations about food. Methods: Data from a cross-sectional sample of 1328 participants (females = 976) recruited from the general population were asked to fill in an online survey comprising the Eating Attitude Test-26 (EAT-26), the Obsessivecompulsive subscale of the Symptom Checklist-90 Revised (SCL-90R-OC) and the Orthorexia Scale-15 (ORTO-15). Results: Structural equation models indicated that both obsessive-compulsive thoughts and symptoms and dieting had a direct effect on ON and that food preoccupation partially mediated these relationships. Conclusion: These findings provide novel insight into the nature of ON that could aid its conceptualization and treatment.
Background The Three Factor Eating Questionnaire-Revised 18 (TFEQ-R-18) is an extensively used qu... more Background The Three Factor Eating Questionnaire-Revised 18 (TFEQ-R-18) is an extensively used questionnaire to measure three transdiagnostic features of eating behavior: cognitive restraint, uncontrolled eating, and emotional eating. Objective This research aims to investigate the psychometric properties of the Italian version of the TFEQ-R-18 in three large community samples. Method Cross-sectional research designs were employed. In Study 1 (N = 537), an exploratory graph analysis (EGA) was used to examine item clustering within the TFEQ-R-18. In Study 2 (N = 645), a confirmatory factor analysis (CFA) was conducted to test its structural validity. In Study 3 (N = 346), a MANOVA was employed assessing mean differences across eating disorders (e.g., anorexia nervosa, bulimia nervosa, binge eating disorder). Results In Study 1, the EGA accurately identified the three original dimensions of the TFEQ-R-18. Study 2 showed that the Italian TFEQ-R-18 has good fit indexes (CFI = 0.989, RMSEA = 0.064; 90% CI [0.058, 0.070], SRMR = 0.062), and possesses robust psychometric properties. Study 3 reveals distinct, statistically significant differences among eating disorders. Conclusion The TFEQ-R-18 proves to be a concise and precise tool for measuring transdiagnostic eating behaviors. Its applicability in the Italian context, supported by robust psychometric properties, suggests its utility for both research and clinical purposes. The findings affirm its potential to inform interventions aimed at enhancing psychological health. Level of evidence Level V, descriptive study.
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Background: Gaining knowledge of the various reasons behind people's consumption of highly proces... more Background: Gaining knowledge of the various reasons behind people's consumption of highly processed foods has the potential to enhance obesity prevention initiatives and open avenues to tailor treatment approaches for obesity and binge eating at a more personalized level. This contribution aimed to test the psychometric properties and factor structure of the Palatable Eating Motives Scale (PEMS-IT) in a community sample of Italian adults. Methods: A confirmatory factor analysis was performed to test the factor structure of the Italian version of the PEMS (PEMS-IT) on a total of 616 respondents. Furthermore, the reliability and convergent validity analysis of the tool were evaluated. Results: The analysis confirmed the four-factor structure of PEMS-IT [(YBχ2 (164) = 537.901; p < 0.001, the CFI = 0.918, RMSEA = 0.072; 90%CI [0.065-0.078]; p(RMSEA < 0.05) < 0.001, and SRMR = 0.080] and satisfactory reliability on its subscales (Cronbach's α: 0.745-0.917). Positive correlations were also found with food addiction and binge-eating symptoms, compulsive eating behavior, and uncontrolled and emotional eating. Conclusions: The PEMS-IT appears to be an instrument with promising psychometric properties and potential applications in clinical settings. However, it also has some limitations, and future studies could focus on improving the semantic content of the elements to increase the overall utility and precision of the instrument.
Background The Three Factor Eating Questionnaire-Revised 18 (TFEQ-R-18) is an extensively used qu... more Background The Three Factor Eating Questionnaire-Revised 18 (TFEQ-R-18) is an extensively used questionnaire to measure three transdiagnostic features of eating behavior: cognitive restraint, uncontrolled eating, and emotional eating. Objective This research aims to investigate the psychometric properties of the Italian version of the TFEQ-R-18 in three large community samples. Method Cross-sectional research designs were employed. In Study 1 (N = 537), an exploratory graph analysis (EGA) was used to examine item clustering within the TFEQ-R-18. In Study 2 (N = 645), a confirmatory factor analysis (CFA) was conducted to test its structural validity. In Study 3 (N = 346), a MANOVA was employed assessing mean differences across eating disorders (e.g., anorexia nervosa, bulimia nervosa, binge eating disorder). Results In Study 1, the EGA accurately identified the three original dimensions of the TFEQ-R-18. Study 2 showed that the Italian TFEQ-R-18 has good fit indexes (CFI = 0.989, RMSEA = 0.064; 90% CI [0.058, 0.070], SRMR = 0.062), and possesses robust psychometric properties. Study 3 reveals distinct, statistically significant differences among eating disorders. Conclusion The TFEQ-R-18 proves to be a concise and precise tool for measuring transdiagnostic eating behaviors. Its applicability in the Italian context, supported by robust psychometric properties, suggests its utility for both research and clinical purposes. The findings affirm its potential to inform interventions aimed at enhancing psychological health. Level of evidence Level V, descriptive study.
Background: Increasing attention to the early stages of psychosis and the identification of sympt... more Background: Increasing attention to the early stages of psychosis and the identification of symptomatic prodromal states have led to the development of a growing number of screening tools. The 16-item version of the Prodromal Questionnaire (PQ-16) is a worldwide used self-administered tool for this purpose. However, to date, fundamental psychometric properties of PQ-16 were not thoroughly investigated. This study aimed to examine the structural validity, measurement invariance, reliability and other psychometrical properties of the Italian version of the PQ-16 (iPQ-16) in help-seeking individuals and in the general population. Methods: The iPQ-16 was administered to 449 young outpatients attending six community mental health services and to 318 control participants enrolled in educational environment. Confirmatory factor analyses (CFAs), measurement invariance (MI) between the help-seeking group and the general population sample, convergent validity, test-retest reliability, internal consistency, and prevalence analyses were performed. Lastly, the validity of the adopted PQ-16 cutoffs through Receiver Operating Characteristic (ROC) curves plotted against CAARMS diagnoses was also tested. Team involved in CCM2013 Project listed in 'Acknowledgements' section.
Abstract: Background: The ever-increasing spread of Internet-based systems for common mental diso... more Abstract: Background: The ever-increasing spread of Internet-based systems for common mental disorders has generated the need for brief online screening methods. This study aims to test the psychometric properties of the Web Screening Questionnaire (WSQ) to examine its suitability for screening for common mental health problems among a community sample of Italian adults. Methods: A total of 1282 subjects (F = 819; mean age = 42.05) answered the WSQ. Its discriminant characteristics were examined with other validated selected scales for measuring mental health widely used in the Italian population using sensitivity, specificity, and area under the curve (AUC), as well as positive (PPV) and negative predictive values (NPV). Results: Most of the WSQ subscales exhibited moderate to high specificity values. Specifically, the scales of ‘agoraphobia’ (0.947; 95%CI [0.934, 0.960]), ‘anxiety’ (0.959; 95%CI [0.946, 0.970]), and ‘panic disorder’ (0.973; 95%CI [0.964, 0.981]) showed the highest values whilst the ‘obsessive-compulsive’ dimension had the lowest value at 0.838, 95%CI [0.815, 0.861]. With exceptions observed for ‘depression’ (0.716; 95%CI [642, 798]) and ‘alcohol abuse’ (0.760; 95%CI [560, 920]), instead, the WSQ demonstrated critical sensitivity values (<0.6) in all dimensions. Conclusions: The WSQ was appropriate for discriminating between people with and without a psychiatric condition, as it helps to confirm the absence of disorders. However, further diagnostic procedures are required, in case of a positive WSQ
Self-esteem and emotion dysregulation appear to be important factors in the psychological well-be... more Self-esteem and emotion dysregulation appear to be important factors in the psychological well-being of trauma survivors. On the one hand, self-esteem may act as a shield against the psychological consequences of traumatic experiences; on the other hand, emotion regulation can affect the way individuals deal with post-traumatic affects (e.g., fear, terror, shame, and guilt). Consequently, the objective of this study was to investigate the role that emotion dysregulation and self-esteem play in the well-being of a sample of women after the traumatic experience of intimate partner violence (IPV). This study involved 282 women (mean age = 41.55, SD = 10.52) who experienced IPV in the last year. Conditional process analyses and Johnson-Neyman analysis for regions of significance were performed. The results showed that emotion dysregulation mediated the relationship between post-trauma affectivity (i.e., fear, terror, shame and guilt) and survivors' wellbeing. Furthermore, self-esteem negatively predicted lack of well-being and acted as a moderator of the relationship between emotion dysregulation and lack of well-being. In this regard, through the Johnson-Neyman analysis for regions of significance, it was possible to identify a cutoff value above which the relationship between emotion dysregulation and lack of well-being became non-statistically significant. This study contributed to understanding the role that emotion dysregulation and self-esteem play in the well-being of IPV survivors. In this regard, clinical implications will be presented.
Background: Orthorexia Nervosa (ON) is a condition characterized by an obsessive focus on healthy... more Background: Orthorexia Nervosa (ON) is a condition characterized by an obsessive focus on healthy eating, inflexible dietary rules, and persistent preoccupations with food. Despite it has been recently the subject of increasingly relevant studies, little is known about the mechanisms that might foster ON symptoms. Objective: This study used a structural equation modeling approach to test the mediating effect of thoughts, worries, and preoccupations about food on the relationship that eating disorders (EDs) attitudes (e.g., dieting) and obsessive-compulsive thoughts and symptoms have with ON in a large community sample. It was hypothesized that the effect of dieting and obsessive-compulsive thoughts and symptoms on ON would be partially mediated by the presence of thoughts, worries, and preoccupations about food. Methods: Data from a cross-sectional sample of 1328 participants (females = 976) recruited from the general population were asked to fill in an online survey comprising the Eating Attitude Test-26 (EAT-26), the Obsessivecompulsive subscale of the Symptom Checklist-90 Revised (SCL-90R-OC) and the Orthorexia Scale-15 (ORTO-15). Results: Structural equation models indicated that both obsessive-compulsive thoughts and symptoms and dieting had a direct effect on ON and that food preoccupation partially mediated these relationships. Conclusion: These findings provide novel insight into the nature of ON that could aid its conceptualization and treatment.
e24222 Background: Ever greater importance is given to psychological distress in oncological sett... more e24222 Background: Ever greater importance is given to psychological distress in oncological settings. Distress could have a severe adverse effect on adherence and compliance to therapies, medical treatments, and quality of life (NCCN, 2015). Moreover, psychological research is progressively increasing in oncological settings and psychological distress has rapidly gained popularity – leading to the development of scales aimed at its evaluation. In this regard, the revised version of the Psychological Distress Inventory – the PDI-R (Rossi et al., 2022) – has demonstrated excellent psychometric properties but its screening properties were limited to self-report questionnaires. Consequently, to fill this gap, this study aimed to evaluate the accuracy of the PDI-R in identifying the levels of distress of oncological outpatients compared to a diagnostic interview – using a machine learning approach. Methods: Oncological outpatients ( n = 603; mean age = 68.38, SD = 9.31; 316 males) were ...
Objective. The present study employs a profile analysis to identify and compare psychological fea... more Objective. The present study employs a profile analysis to identify and compare psychological features and core eating disorder (ED) symptoms in clinical samples of patients with anorexia nervosa (AN) and binge eating disorder (BED) and the general population (GP). Methods. A sample comprising 421 participants (142 patients with AN; 139 patients with BED; and 140 participants from the GP) was surveyed with the Eating Disorder Inventory-3 (EDI-3). Individuals with AN and BED were recruited and tested during their first week of a multidisciplinary inpatient program for weight loss and rehabilitation at the ‘Rete DCA USL Umbria 1′ (Eating Disorders Services), Italy. Results. The findings suggest distinct patterns of symptom presentation between the three samples across all the EDI-3 dimensions—with both the AN and BED groups scoring significantly higher than the GP. Patients with AN registered greater scores in all the psychological trait scales and the drive for thinness ED-specific d...
Background: Psychological distress is one of the most important indexes of suffering in oncologic... more Background: Psychological distress is one of the most important indexes of suffering in oncological patients – due to its severe negative impacts on medical treatments. Thus, the attention to this topic has increased constantly – focusing on the observed outcomes of (psychological) cares. However, very few studies investigated the (latent) pattern (form) of change in distress within oncological patients receiving psychological intervention. The aim of the study was to test a Latent Growth Curve Model to explore the form of change in distress. Methods: A longitudinal research design was used. Patients (N= 122, mean age: 68.3, SD= 12.3, 63 female-59 male) were enrolled at the Department of Medical Oncology at Presidio Ospedaliero of Saronno, ASST Valle Olona, Italy, and assessed for the presence of distress with Psychological Distress Inventory (PDI). As clinical routine, all patients received a specific cancer-related psychological intervention (CBT, mainly; mean of sessions: 27.4, SD= 13.5) and were tested at the beginning (T1; α= .88) and at the end of treatment (T2; α= .86) and at timed-balanced follow-up (T3; α= .87). Results: First, longitudinal invariance of measurement was performed to test whether (A) factor structure of PDI and (B) factor loadings of indicators were constant across time. PDI showed metric measurement invariance: Δχ2= 20.4; Δχ2df= 24; p(Δχ2) = 0.67. Afterward, a LGCM was performed testing different trends of growth (no growth vs. linear vs. free) – controlling for age, number of sessions received, type and localization of tumor. The comparison of growth curves reveal that the linear trends of change had the best model fit to the data: χ2= 4.124, p= .248; RMSEA = .055(.000–.171), p(RMSEA < .05) = .372, CFI = .990, SRMR = .027. Conclusions: These findings highlight that the (latent) linear growth better explain true change of distress – among oncological patients receiving a specific cancer-related psychological intervention. These results outline the possibility to improve the structure of psychological and medical treatments for oncological settings, to reduce psychological suffering and increase quality of life.
Background: In psycho-oncological settings, psychologists often work to improve patient’s coping ... more Background: In psycho-oncological settings, psychologists often work to improve patient’s coping strategies to reduce cancer-related depression. However, the possible role of a core variable – such as anxiety – in the process leading from mental adjustment to cancer to depression it is not always considered. Thus, the aim of the study was to test a mediation analysis – with multiple predictors – in which anxiety mediates this psychological cancer-related process. Methods: An observational research design was used. Patients (n = 66) were consecutively enrolled at the Department of Medical Oncology at “Presidio Ospedaliero” of Saronno, ASST Valle Olona, Italy. Oncological patients were tested with MAC subscales [Fighting Spirit (FS – Alpha = .69); Anxious Preoccupations (AP – Alpha = .71); Hopelessness-Helplessness (HH – Alpha = .77)], STAI – state anxiety version (Alpha = .95), and Beck Depression Inventory (Alpha = .84). Results: A regression based mediation analysis shows model’s statistical significance [F = 22.31, p<.001; R2 = .57]. The relationship between coping strategies and depression was fully mediated (FS: beta = -.327, p = .003, 95%CI: -.949, -.205; AP: beta = .318, p = .003, 95%CI: .276, 1.25, and HH: beta = .288, p = .013, 95%CI: .187, 1.52) by state anxiety (beta = .726, p < .001, 95%CI: .371, .647). Conclusions: These findings highlight the role of anxiety in the process that lead to cancer-related depression. Results point out a possible way in which psycho-oncologists should structure a stronger intervention, based on the improvement of coping strategies and the reduction of state anxiety, in order to reduce the magnitude of cancer-related depression.
INTRODUCTION. Oncological patients are often unprotected to oppressive feelings of anxiety that c... more INTRODUCTION. Oncological patients are often unprotected to oppressive feelings of anxiety that could leads to depressive symptoms. However, several researches have widely demonstrated that a higher social functioning could be a shield against cancer-related depression. Thus, the aim of this study is to test if this variable could protect (buffer) oncological patients against strong depression symptomatology. METHODS. Using an observational research design, oncological patients (N = 60) were individually tested with: the social functioning scale of SF-36 (Cronbach’s Alpha = .75); Sate and Trait Anxiety Inventory – state anxiety version (Cronbach’s Alpha = .96); and the Beck Depression Inventory (Cronbach’s Alpha = .86). RESULTS. A regression-based two-way ANOVA shows a significant interaction: F = 8.67; beta = -.006; p = .005; CI 95%: -.011, -.002; delta-R2 = .041). As expected, the effect of anxiety (t = 6.07; beta = .387; p < .001; CI 95%: .259, .514) was buffered from social functioning (t = 1.69; beta = .158; p = .096; CI 95%: -.029, .345). CONCLUSIONS. These results suggest a possible way for clinical psycho(socio)logical intervention based on the empowerment of the social functioning variables in order to decrease depressive symptomatology due to feelings of anxiety in oncological patients.
Background. Despite an increased attention to psychosocial sphere of oncological patients, psycho... more Background. Despite an increased attention to psychosocial sphere of oncological patients, psychological distress still has a strong negative impact on medical treatments. Previous studies have identified different predictors on distress in oncological population; such as: aging, number of patients’ needs or/and the degree of hospitalization. The present study aimed to test the psychological process in which the number of needs may mediate the relationship between aging and distress; regardless of the degree of hospitalization. Methods. Using an observational research design, oncological patients (n = 120) were consecutively enrolled at the “Presidio Ospedaliero” of Saronno, Italy. During the first oncological examination, participants were split according to the degree of hospitalization required for their oncological care (low vs. high); afterward, patients were tested with PDI (Cronbach's Alpha = .81) and NEQ (Cronbach's Alpha = .89). Findings. Mediation analysis shows statistical significance exclusively for patients in low hospitalization condition [F = 7.24, p = .001; R2 = .17]. In particular, the relationship between age and distress (path c: beta = .341; p = .003; 95%CI: .072, .347) was partially mediated (path a: beta = .281, p < .017; 95%CI: .020, .194; and path b: beta = .249, p < .032; 95%CI: .035, .768) by the number of needs. Conclusion. These results showed a specific mental process based on both physical and psychological variables. These findings outline the possibility to investigate the psychosocial process that leads the oncological patient to experiencing distress. Moreover, these promising results suggest a possible way for the implementation of psychological intervention – based on patients’ degree of hospitalization – in order to reduce both mental and physical distress and to improve health and quality of life in oncological treatments.
Background. Psychological distress could be considered one of the most severe mental health issue... more Background. Psychological distress could be considered one of the most severe mental health issues – specifically at the time of diagnosis – in oncological treatments. The attention in helping the patient to cope with the diagnosis, treatment and its side effects becomes the primary focus. To face this problem, project HuCARE promote the humanization of cares offered to cancer patients based on the evidence of an immediate detection of psychological distress. The present research aimed to realize a portrait of severity of psychological distress of HuCARE patients. In particular, we aimed to test the distance between the HuCARE fixed cut-off for distress for the most frequents type of tumor both in inpatients and outpatients. Methods. Using an observational research design, oncological patients (N=211) were consecutively enrolled at the “Presidio Ospedaliero” of Saronno, Saronno (VA) and “Ospedale di Busto Arsizio”, Busto Arsizio (VA); in particular, participants were hospitalized either at the Department of Medical Oncology nor at DH. According to HuCARE guidelines patients were tested with PDI (Cronbach's alpha = .78) in order to understand the severity of their psychological distress. Findings. In order to determine oncological localization frequency and to measure their distance from a HuCare-based cut-off (= 35) analysis of frequencies and One-sample t-test was carried out. After stratifying patients for tumor localization, One-sample t-test showed that all groups have obtained a distance significantly lower than the cut-off. Contrariwise, hospitalized patients showed a non-significant distance from the cut-off; specifically for individuals affected by colon cancer (t = -1.971; p = .106); pancreatic cancer (t = -2.054; p = .064) and lung cancer (t = -1.453; p = .177). Conclusion. These results showed an interesting portrait of oncological patients in two different medical settings but – at the same time – in two different hospitals. These findings permit to evaluate clinical psychological resources that could be available for patients with a different localization of cancer. These results also allow to improve the development of the means and to create psychosocial intervention based on the specific location of the oncological pathology.
Background. In last few years, there was an increasing attention to the psychosocial sphere of on... more Background. In last few years, there was an increasing attention to the psychosocial sphere of oncological patients (e.i.: project HuCare). Despite of this carefulness – however – psychological distress still has a severe impact on medical care treatments. Several studies have identified different predictors of distress in oncological population; such as: aging, number of patients’ needs and the degree of hospitalization. The present study – carried out within project HuCare – aimed to test the psychological process in which the number of needs may mediate the relationship between aging and distress; in conjunction with the degree of hospitalization. Methods. Using an observational research design, oncological patients (n = 110) were consecutively enrolled at the “Presidio Ospedaliero” of Saronno, Saronno (VA) in conjunction with “Ospedale di Busto Arsizio”, Busto Arsizio (VA). During the first oncological examination, participants were split according to the degree of hospitalization required for their oncological care (low vs. high); afterward, patients were tested with PDI (Cronbach's Alpha = .80) and NEQ (Cronbach's Alpha = .87). Findings. Mediation moderation analysis (Hayes, 2013) shows statistical significance for the expected model [F = 7.98, p < .001; R2 = .22]. The relationship between age and distress (path c: beta = .576; p = .001; 95%CI: .233, .921) was partially mediated (path c’: beta = .417; p = .016; 95%CI: .078, .756) by the number of needs (path a: beta = .317, p = .004; 95%CI: .101, .534; and path b: beta = .503, p < .001; 95%CI: .225, .781). Moreover, this psychological process was partially moderated by the degree of hospitalization (interaction on path a: F = 8.14, p = .005, ΔR2 = .063; and interaction on path c’: F = 5.17, p = .024; ΔR2 = .035). Conclusion. These results showed a mental process based on both physical and psychological variables. These findings points out a possible way in order to investigate the psychosocial process that leads the oncological patient to experiencing distress. Moreover, these promising results suggest a mode for the implementation of psychological intervention in order to reduce physical and psychosocial distress and to improve health and quality of life in oncological treatments.
Background. An increasing rate of mental health illness linked to the current economic crisis has... more Background. An increasing rate of mental health illness linked to the current economic crisis has been recorded worldwide. The lack of perceived social support and lower quality of social relationships could leads to psychological disorders and suicidal ideation too. The aim of this study is to compare the quality of social sphere of patients affected by “crisis-related” psychological disorders with other people’s, who have asked assistance to the same Mental Health Care Center. Methods. Using an observational research design, patients (n = 45) of “Crisis and Psychopathology Observatory”–by Ospedale Maggiore Policlinico, Milan–have been investigated about the perceived quality of social relationships (Cronbach’s Alpha = .75), and the social support received (Cronbach’s Alpha = .76). Findings. MANOVA points out that “crisis-related” subjects showed a less quality of social relationships: F(1,44) = 7.01; p = .012 and–at the same time–a lower perception of psychological support received F(1,44) = 7.37; p = .01. Discussion. The results show that “crisis-related” patients have a lower quality of the social sphere. The results suggest a possible way to elaborate actions and therapies in order to improve change in psycho-social variables connected to this new psychological illness.
Background. Help requests for psychological disorders due specifically to the impact of the econo... more Background. Help requests for psychological disorders due specifically to the impact of the economic crisis have been constantly increased. The aim of the study is the identification of a distinctive symptomatology between subjects affected by “crisis-related” mental health illness and people who refer to the same Mental Health Care Center. Methods. An observational research design was used. Patients (n = 70) related to the “Crisis and Psychopathology Observatory”–Ospedale Maggiore Policlinico, Milan–were tested with: Beck Anxiety Inventory (Alpha = .86), Beck Depression Inventory II (Alpha = .85), Rosenberg’s Self-Esteem Scale (Alpha = .87) and Derogatis’ Brief Symptom Checklist (Alpha = .96). Findings. MANCOVA was used to test differences–controlling for diagnosis and the elapsed time between the onset of symptoms and the psychiatric visit. Results suggest that “crisis-related” patients show: higher anxiety [F(1,68) = 6.07; p = .02] and higher depression [F(1,69)=8.23; p = .012]; higher number of psychological symptoms [F(1,69) = 12.34; p < .001]; but an equivalent self-esteem [F(1,69) = 1.94; p = .069];. Discussion. Results points out that “crisis-related” patients showed a wider mental health illness’ symptomatology and important index as regards the acuteness; and also suggest a possible way in order to treat this new kind of suffering.
Background. Subjects affected by “crisis-related” mental health disorders often report strong psy... more Background. Subjects affected by “crisis-related” mental health disorders often report strong psychological suffering derived from hopelessness that sometimes could lead to suicidal ideation. However, this ideation could be curbed by social support. The aim of the study was to prove if social support could buffer the relationship between crisis-related hopelessness and suicidal ideation. Methods. Using an observational research design, patients (n = 50) related to the “Crisis and Psychopathology Observatory”–Ospedale Maggiore Policlinico, Milan–have been tested with: BDI II (Alpha = .91), BHS (Alpha=.92), and social support (Alpha = .86). Findings. Mediation analysis revealed that the observed relationship between hopelessness and suicidal ideation (path c: β = .637; p = 001) was indeed entirely mediated [95%CI: .0340 - .1254; R2 = .736; F = 30.27, p < .001] by social support (path c’: β = .188; p = .27). In fact, the effect of hopelessness on suicidal ideation passed through perceived support (path a: β = -.602, p = .003 and path b: β = -.746, p < .001). Discussion. Results point out the importance of social support as a protective factor from suicidal ideation in “crisis-related” patients and also suggest possible ways in treatments exploiting psychological support in this kind of economic crisis-related illness.
Background. An increasing psychological requests related to economic crisis has been recorded in ... more Background. An increasing psychological requests related to economic crisis has been recorded in the Italian population. Moreover “crisis-related” patients shows lower degree of perceived social support which could lead to psychological illness and suicidal ideation too. Methods. Using an observational research design, the aim of the present study was to investigate – in a sample of patients (n=91) from the “Crisis and Psychopathology Observatory” – the relationship between the demand analysis (crisis-related vs. ordinary mental health care), the tendency for externalizing psychological problems (Cronbach’s Alpha =. 88) and perceived social support (Cronbach’s Alpha = .81). In order to predict perceived social support ANOVA has been performed. Analysis. The results showed an interaction between the tendency for externalizing psychological symptoms and the demand analysis: F(1,90) = 5.38; p = .02. High psychological problems related to economic crisis combined to a low tendency of externalizing symptoms leads to a low perceived social support. Discussion. The present study gives prominence to psycho-social variables related to this new psychological complaint and suggest possible pathways in treating economic “crisis-related” patients.
Background. A deep mental health distress has been introduced by the current economic and social ... more Background. A deep mental health distress has been introduced by the current economic and social crisis. Methods. A control group observational research design has been used to point out the differences among the personality organization (Kernberg 1975, 1984) in subjects affected by “crisis-related” disorders who asked help to “Crisis and Psychopathology Observatory” of “Ospedale Maggiore Policlinico” of Milan, compared to the other subjects taken over the same Mental Health Care Center. Participants (n = 35) were tested at the first psychiatric visit with Inventory of Personality Organization (Lenzenweger et al., 2001) – Primitive Defense, α = .83; Reality Testing, α = .88; Identity Diffusion, α = .85. Findings. One-way ANOVA points out that “crisis-related” subjects show (A) higher identity diffusion: F(1,33)=10.48; p < .003; (B) higher use of primitive defenses: F(1,33) = 30,67; p < .001; (C) a lower reality testing: F(1,33) = 20.12; p < .001. Discussion. Results suggest that “crisis-related” patients show a particular configuration of personality organization. They also suggest a way in the research to better understand who the “crisis-related” subjects really are.
Background: Anxiety, depression and fear are all among oppressive emotions that oncological patie... more Background: Anxiety, depression and fear are all among oppressive emotions that oncological patients have to face almost every day. On one hand, these emotional problems seem to be triggered by both to physical, relational and practical problems; and to the other hand, these emotive troubles seem to lead to psychological distress – one of the most important indexes of mental health suffering in oncological patients (NCCN, 2002). The aim of the study was to test a multiple step mediation model (Hayes, 2013) in which emotional problems have a central role in the process that lead to psychological distress. Methods: An observational research design was used. Patients (N=211, mean age: 64.84, SD=11.35) were consecutively enrolled at the Department of Medical Oncology at “Presidio Ospedaliero” of Saronno, ASST Valle Olona, Italy. Oncological patients were tested with NCCN’s Distress Thermometer and Problem List (DT&PL; NCCN, 2003) which it investigates: (A) distress; (B) practical problems (α=.61); (C) social relations (α=.64); (D) emotional (α=.82) and (E) physical problems (α=.72). Results: First, a CFA was performed in order to test the structure of the proposed Problem List. The original five factor solution was supported by adequate fit indices: RMSEA=.055 (.048–.062), p(RMSEA<.05)=.118. Afterward, a multiple step mediation analysis (5000 bootstrap resampling) shows model’s statistical significance [F = 57.52, p < .001; R2 = .54; η2 = .288]. The relationship between physical problems and distress was fully mediated (path c’: β = .089; p = .306; 95%CI: -.083, .262), first by practical problems (path a1: β =.057, p<.001; 95%CI: .031, .084) hence by relationships problems (path d1: β=.207, p<.001; 95%CI: .097, .316), and finally from emotional problems (path d2: β=.962, p<.001; 95%CI: .544, 1.37; and path b3: β=.808, p<.001; 95%CI: .612, 1.01). Conclusions: These results highlight the role of emotions, practical and relational problems in the process that lead to distress. These results points out a possible way in which psycho-oncologists should structure psychological intervention, in order both to reduce psychological suffering and improve a better quality of life in oncological settings.
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Papers by Alessandro Alberto Rossi
Results: First, a CFA was performed in order to test the structure of the proposed Problem List. The original five factor solution was supported by adequate fit indices: RMSEA=.055 (.048–.062), p(RMSEA<.05)=.118. Afterward, a multiple step mediation analysis (5000 bootstrap resampling) shows model’s statistical significance [F = 57.52, p < .001; R2 = .54; η2 = .288]. The relationship between physical problems and distress was fully mediated (path c’: β = .089; p = .306; 95%CI: -.083, .262), first by practical problems (path a1: β =.057, p<.001; 95%CI: .031, .084) hence by relationships problems (path d1: β=.207, p<.001; 95%CI: .097, .316), and finally from emotional problems (path d2: β=.962, p<.001; 95%CI: .544, 1.37; and path b3: β=.808, p<.001; 95%CI: .612, 1.01). Conclusions: These results highlight the role of emotions, practical and relational problems in the process that lead to distress. These results points out a possible way in which psycho-oncologists should structure psychological intervention, in order both to reduce psychological suffering and improve a better quality of life in oncological settings.