Cognitive inflexibility and over-attention to detail: The Italian validation of the DFlex Questionnaire in patients with eating disorders.

OBJECTIVE: Cognitive inflexibility and over-attention to detail are two cognitive styles common to eating disorders (ED) and other psychopathologies characterized by rigid perfectionism. Despite many options to assess the above styles, the only self-report tool that simultaneously permits their specific assessment is the Detail and Flexibility Questionnaire (DFlex), originally developed to investigate the ED domain. The aim of this study was to validate the Italian version of the DFlex. METHOD: 170 patients (149 females) with ED and 148 controls (100 females) completed the Italian version of the DFlex. RESULTS: A Confirmatory Factor Analysis showed that the two-factor model originally proposed in the literature was a good fit to the data. Item factor loadings were largely equivalent across clinical and control groups, with intercept distributions showing higher values for the clinical group compared to controls. Both DFlex subscales showed good internal reliability and were able to predict membership to the group condition. CONCLUSIONS: The DFlex is a reliable tool for investigation in the ED population. However, because DFlex items do not explicitly assess food and body shape domains, it is possible to extend its use to other psychopathologies characterized by rigid perfectionism. We propose the use of the DFlex in research and clinical practice as a useful tool for better understanding patients' cognitive functioning and in order to support treatment planning.

Pathways to specialist care for eating disorders: An Italian multicentre study.

Two hundred forty six patients with eating disorders (EDs) recruited from eight Italian specialized treatment centres were administered with the World Health Organization "Encounter Form," a standardized schedule that makes it possible to characterize the clinical pathways that patients follow to reach specialized care. The median time from symptoms onset to specialized care was 114 weeks. Primary "points of access to care" were general practitioners (25%), psychiatrists (18%), and clinical nutritionists (17%), followed by various other carers. All patients received specific psychotherapy, whereas only 11% of them were given psychotropic drugs. EDs are characterized by complex care pathways, with low rates of direct access to specialized care. Although the role of general practitioners remains crucial, they tend to follow different clinical routes to refer ED patients. Educational programmes on EDs should be addressed to general practitioners and clinical nutritionists, in order to ease the transition of ED patients to a mental health care setting.