Pycnogenol® improves cognitive function in post-stroke patients: a 6 month-study.

BACKGROUND: This pilot study in post-stroke patients evaluated the effects of supplementation with Pycnogenol® on alterations in cognitive functions (COFU) over a period of 6 months, starting 4 weeks after the stroke. METHODS: The effects of supplementation - possibly acting on residual brain edema, on global cognitive function, attention and on mental performance - were studied. A control group used standard management (SM) and the other group added Pycnogenol®, 150 mg daily to SM. RESULTS: 38 post-stroke patients completed the 6-month-study, 20 in the Pycnogenol® group and 18 in the control group. No side effects were observed with the supplement. The tolerability was very good. The patients included into the two groups were comparable for age, sex and clinical distribution. There were 2 dropouts in the control group, due to non-medical problems. Main COFU parameters (assessed by a cognitive questionnaire) were significantly improved (all single items) with the supplement compared to controls (P<0.05). Additional observations indicate that Pycnogenol® patients experienced significantly less mini-accidents (including falls) than controls (P<0.05). The incidences of (minor) psychotic episodes or conflicts and distress and other problems including rare occurrence of minor hallucinations, were lower with the supplementation than in controls (P<0.05). Single observations concerning daily tasks indicated a better effect of Pycnogenol® compared to controls (P<0.05). Plasma free radicals also decreased significantly with the supplement in comparison to controls (P<0.05). Globally, supplemented subjects had a better recovery than controls. CONCLUSIONS: In post-stroke subjects, Pycnogenol® supplementation resulted in better recovery outcome and faster COFU 'normalization' after the stroke in comparison with SM; it can be considered a safe, manageable post-stroke, adjuvant management possibly reducing local brain edema. Nevertheless, more patients and a longer period of evaluation are needed to confirm these results.

Prevention and control of jet lag symptoms and temporary impairment of cognitive function with Pycnogenol® in healthy individuals and in hypertensives.

BACKGROUND: The aim of this registry study was to evaluate the efficacy of Pycnogenol® in controlling signs/symptoms and temporary impairment of cognitive function (COFU) associated with jet lag. Previous flight studies have shown a decrease in the level of jet lag symptoms with Pycnogenol®. The control of jet lag signs/symptoms appeared to be correlated with flight-related microangiopathy and peripheral edema. Pycnogenol® - a standardized extract from the bark of French maritime pine - has significant antiedema, anti-inflammatory and antioxidant properties. METHODS: A group of subjects flying east in economy class for 10-12 hours used Pycnogenol® 150 mg/day and a similar group without supplementation served as controls. A subgroup of mild hypertensive subjects using a single ACE inhibitor was also included. RESULTS: One hundred twenty-seven subjects completed the study. Of the participants, 48 were aviation professionals like pilots, flight attendants or air company staff - 24 of them took Pycnogenol® and 24 served as controls. Forty-seven study participants were frequent flyers and non-staff professionals, 25 of which took Pycnogenol® and 22 served as controls. In addition, a group of 32 subjects with mild hypertension was included, 16 took Pycnogenol® and 16 served as controls. No side effects and a good tolerability were observed. The registry groups were comparable for baseline characteristics. Eastbound flights' duration was 11.22±0.4 hours in supplemented subjects and 11.14±0.32 in controls. Dropouts were due to logistical problems. Post flight Visual Analogue Scale (VAS) scores were significantly lower in all Pycnogenol® groups, including hypertensives for all signs and symptoms of jet lag compared to controls, showing prevention and improvement of jet lag symptoms. The duration of any sign/symptom of jet lag with Pycnogenol® intake was significantly shorter (P<0.05) post-flight compared to controls (P<0.05). The number of nights of altered/disturbed sleep was also lower in the Pycnogenol® groups compared to controls. Leg edema was present in almost all subjects with different degrees especially in the hypertensive group. The increase in ankle circumference before and after flight was significantly lower with Pycnogenol® compared to controls (P<0.05). After the flight, average scores of the single COFU tasks were significantly higher in the Pycnogenol® groups compared to controls, showing preserved cognitive function. CONCLUSIONS: In conclusion, in this registry study Pycnogenol® was effective in preventing jet lag-related symptoms and preserving cognitive functions without tolerability problems. These observations should be tested in a larger group of subjects including complex individuals prone to edema (i.e. diabetics, hypertensive or older patients).

The efficacy of telephone-delivered cognitive behavioral therapy in people with chronic illnesses and mental diseases: A meta-analysis.

COVID-19 pandemic led to an increase of remote treatments, such as telephone-delivery cognitive behavioral therapy (T-CBT). To our knowledge, no meta-analyses studied the effect of T-CBT in chronic and/or mental illnesses on multiple psychological outcomes. Therefore, our study aims to evaluating the efficacy of T-CBT compared to other interventions (treatment as usual, TAU, or face-to-face CBT). Each effect size (ES) was calculated in Hedges' g and pooled together to produce a mean ES for each outcome (depression, anxiety, mental and physical QoL, worry, coping, and sleep disturbances). The meta-analysis included 33 studies with a randomized controlled trial design. A large ES was found when comparing the efficacy of T-CBT against TAU on depression (g = 0.84, p < 0.001), whereas a moderate ES was found on anxiety (g = 0.57; p < 0.001), and a small effect on mental quality of life (g = 0.33, p < 0.001), sleep disturbances (g = 0.37, p = 0.042), coping (g = 0.20, p = 0.016) and worry (g = 0.43, p = 0.001). The meta-analysis comparing the efficacy of T-CBT and CBT on depression revealed a not significant pooled ES (g = 0.06, p = 0.466). The results provided evidence that T-CBT could be to be more effective than TAU conditions in multiple psychological outcomes, and as efficient as face-to-face CBT in treating depression.

Psychometric properties of a new instrument for the measurement of the perceived quality of distance learning during the coronavirus disease 2019 (COVID-19) pandemic.

Introduction: The lockdown restrictions due to the COVID-19 pandemic forced many students to use distance learning. Few studies have examined the psychological effects of distance learning during the pandemic on university or on non-university students using a specific psychometric tool. The principal aim of this study was the construction and validation of a new psychometric tool, the Perceived Quality of Distance Learning (PQDL), to measure students' appreciation and reaction to distance learning. The connection between anxiety, depression, perceived self-efficacy, and students' perception of distance learning was analyzed to assess the nomological validity of the new scale. Method: The sample consists of 429 students who attended university or training courses. The factor structure of the new instrument was analyzed through Exploratory and Confirmatory Factor Analyses and its nomological validity was analyzed through regression analysis. Conclusion: The results showed that PQDL consists of two subscales: Distance Learning Organization and Cognitive-Emotive Reaction to Distance Learning. Higher student's ability to organize and plan distance learning and higher student's positive cognitive-emotive reaction to distance learning, higher student's perceived quality of distance learning. Anxiety and depression scores were negatively correlated with students' perceived quality of distance learning. Furthermore, students' perceived emotional self-efficacy of negative emotions and perceived scholastic self-efficacy were positively correlated with students' perceived quality of distance learning. These data indicate that PQDL is a reliable questionnaire to assess student's perceived quality of distance learning.

Scholastic psychological well-being and irrational thoughts in students of primary and secondary school: An Italian study.

The period of pre-adolescence is a period of age transition during which undesirable feelings such as anxiety, shyness, guilt, depression and anger are experienced accompanied by physical and hormonal changes experienced during puberty. Therefore, during early adolescence the psychological well-being is a critical issue. This period of transition coincides to the passage from the primary to the secondary school in Italy. This transition could have some effects on the psychological well-being on children, in particular on their scholastic well-being. In addition, during early adolescence children develop irrational thoughts. We tested, therefore, the variation of scholastic well-being and irrational thoughts in children of the primary (n = 50; mean age 10.5; 56 % females) and secondary school (n = 61; mean age 11.5; 49 % females). Results showed that children of the secondary school have lower scholastic well-being and higher level of irrational thoughts than children of primary school. In particular, during the transition from the primary to the secondary school, children showed a lower level of satisfaction with academic results and the perception of a low support from their teachers. In addition, there was also a stronger reduction of self-esteem and an increment of distrust in achieving scholastic success. A scholastic psychological support, with particular attention to the emotional development of early-adolescents, is suggested.

Pycnogenol® supplementation alleviates symptoms of Parkinson's disease with mild cognitive impairment.

BACKGROUND: The aim of this pilot registry study was to assess the preventive effect of an 8-week Pycnogenol® (French maritime pine bark extract) supplementation on symptoms, such as cognitive and motor aspects, in subjects with Parkinson's disease (PD). METHODS: The study was based on five types of observations: a. Karnofsky performance scale index; b. oxidative stress markers in plasma (plasma free radicals, PFR); c. the main signs and symptoms, evaluated by a physician; d. face motion and expressions and their symmetry, recorded with a high-speed video camera. RESULTS: A total of 79 patients were included in the study: 39 controls using only standard management (SM) and 40 subjects supplemented with Pycnogenol® 150 mg/day. At inclusion, the two groups (SM and SM+Pycnogenol®) were comparable for age, symptoms, Karnofsky performance scale rating and for the management of PD. Likewise, oxidative stress and the presence of peripheral edema were also comparable between the two groups. No side effects of supplementation were observed. There were no tolerability problems. At the end of the study after 8 weeks, the Karnofsky performance index was significantly (P<0.05) higher with Pycnogenol® compared to controls. Also, the proportion of patients with a clinically visible peripheral edema decreased significantly over 8 weeks with Pycnogenol® compared to controls (P<0.05). Plasma oxidative stress was significantly lower with Pycnogenol® (P<0.05). The scores of PD main signs/symptoms like tremor, bradykinesia, alterations in cognitive functions, rigidity and speech impairment were significantly lower in the Pycnogenol® group compared to controls (P<0.05). Face expression evaluation showed a marked asymmetry at inclusion. Over 8-week supplementation, facial expression scores for visible and subliminal asymmetry, altered facial responses, altered shoulder motion and altered emotional pattern improved significantly in the Pycnogenol® group compared to controls (P<0.05) where the scores did not change significantly. CONCLUSIONS: In conclusion, according to this pilot registry study, Pycnogenol® supplementation helps patients with moderate, well-controlled PD - under stable treatment - to attenuate most signs and symptoms and life-relational aspects associated with Parkinson-related cognitive impairment.

Telerehabilitation proposal of mind-body technique for physical and psychological outcomes in patients with fibromyalgia.

Fibromyalgia (FM) syndrome is characterized by the close correlation of chronic widespread pain and other non-pain related symptoms. Aim of this study was to investigate whether telerehabilitation that provides physical and psychological support services of the mind-body techniques can affect the clinical profile and pain relief of FM patients. The study included twenty-eight female FM patients, mean aged 56.61 ± 8.56 years. All patients underwent a rehabilitation treatment (8 sessions, 1/week, 1 h/each) through Zoom platform, with the following principles of rehabilitation treatment: Anchoring to a positive emotion; listen and perceive your "own" body; conscious breathing; improve interoceptive awareness; relax. All patients then underwent clinical assessment of the physical distress and fear of movement for the Numeric Rating Scale (NRS); the Fatigue Assessment Scale (FAS); the Fear Avoidance Belief Questionnaire (FABQ); with measures of physical and mental disability for the Fibromyalgia Impact Questionnaire (FIQ); the 12-Items Short Form Survey; the Resilience Scale for Adults and the Coping Strategies Questionnaire-Revised. The evaluations were performed at T0 (baseline), T1 (after 8 weeks of treatment), and T2 (after 1 month of follow-up). The main finding was that telerehabilitation reduced physical and mental distress, fear, and disability (p < 0.001). Resilience and coping ability were less affected by the rehabilitative treatment. Our attempt of mind-body technique telerehabilitation has shown good results in the improvement of painful symptoms and quality of life for the FM patients but showed fewer positive impacts for the resilience and coping abilities aspects.

Connections between Children's Eating Habits, Mental Health, and Parental Stress.

Background: Obesity and eating disorders are increasing in occidental countries and can undermine physical and psychological health. Therefore, preventing the insurgency of unhealthy eating habits in childhood is fundamental. Parents can play an important role in assisting pediatricians, psychiatrists, and clinical psychologists in the diagnosis of eating disorders because they have an active role in observing and assessing the quality of their children's eating habits. Methods: In our study, we collected data from a sample of children (n = 125) and their parents (n = 161) without symptoms related to eating disorders. Parents assessed the eating habits, behavior problems, and mental health of their children and parental stress. In addition, we measured body mass index, anxiety, and lifestyle in children. Data were analyzed with bivariate correlation and MIMIC models. Results: Both mothers' and fathers' assessments of children's eating habits are reliable. Unhealthy eating habits are connected with children's behavioral problems and parental stress. We did not find significant differences in feeding styles and ways of assessing the quality of eating habits between mothers and fathers. Our study showed greater sensitivity of mothers toward the physical fitness of their children rather than fathers. Conclusions: Mothers and fathers both proved to be good observers of their children's eating behavior, and they could cooperate with medical and psychological operators in preventing the risk of obesity.

Intrinsic Shapes of Empathy: Functional Brain Network Topology Encodes Intersubjective Experience and Awareness Traits.

Trait empathy is an essential personality feature in the intricacy of typical social inclinations of individuals. Empathy is likely supported by multilevel neuronal network functioning, whereas local topological properties determine network integrity. In the present functional MRI study (N = 116), we aimed to trace empathic traits to the intrinsic brain network architecture. Empathy was conceived as composed of two dimensions within the concept of pre-reflective, intersubjective understanding. Vicarious experience consists of the tendency to resonate with the feelings of other individuals, whereas intuitive understanding refers to a natural awareness of others' emotional states. Analyses of graph theoretical measures of centrality showed a relationship between the fronto-parietal network and psychometric measures of vicarious experience, whereas intuitive understanding was associated with sensorimotor and subcortical networks. Salience network regions could constitute hubs for information processing underlying both dimensions. The network properties related to empathy dimensions mainly concern inter-network information flow. Moreover, interaction effects implied several sex differences in the relationship between functional network organization and trait empathy. These results reveal that distinct intrinsic topological network features explain individual differences in separate dimensions of intersubjective understanding. The findings could help understand the impact of brain damage or stimulation through alterations of empathy-related network integrity.

Prevention of work-related stress, fatigue, loss of cognitive function, improved attention and recovery of stamina with Robuvit® in professionals with increased oxidative stress.

BACKGROUND: The aim of this open, pilot supplement registry study was to evaluate the protective, preventive effects of Robuvit® on professional-related fatigue symptoms and on aspects of cognitive functions, professional attitudes and decision-making in healthy nurses under professional stress and with increased oxidative stress. METHODS: In total, 40 subjects, aged 30-37, completed the 4-week registry study. A control group of 20 subjects used only the standard management (SM) and one group of 20 subjects took 300 mg Robuvit® in addition. Safety and tolerability of Robuvit® were optimal. The two registry groups were comparable at inclusion. RESULTS: The overall scores of the real daily life and tasks questionnaire after 4 weeks were significantly higher in the Robuvit® group (P<0.05) as compared to controls. It increased from 4.3±0.4 at baseline to 6.78±0.8 after 4 weeks of Robuvit® intake and from 4.2±0.5 to 5.12±1.0 in the control group. The supplementation significantly improved the subjective perception of fatigue in comparison with controls (P<0.05). A practical professional score evaluation provided an indication of professional attitude and stamina, in difficult, stressful working conditions under continuous pressure. The results showed that after 4-week supplementation, all assessed parameters improved significantly and the difference with controls was statistically significant (P<0.05). Furthermore, oxidative stress as plasma free radicals decreased significantly in the Robuvit® group (P<0.05) but not in the control group. CONCLUSIONS: Robuvit® supplementation appears to improve most symptoms related to work-induced fatigue, stress and cognitive function and supports stamina. Further evaluations need to be planned according to the concept of this pilot registry in a field that requires more attention.

Fear of hypoglycemia in children with type 1 diabetes and their parents: Validation of the Italian version of the Hypoglycemia Fear Survey for Children and for Parents.

BACKGROUND: Currently, Italian versions of the Hypoglycemia Fear Survey for Children (CHFS) and for Parents (PHFS) quantifying Fear of Hypoglycemia (FoH) in pediatric diabetes are not available. OBJECTIVE: To validate the Italian version of the CHFS and PHFS. SUBJECTS AND METHODS: One hundred and seventy-four children with type 1 diabetes aged 6-18 and 178 parents completed the CHFS and PHFS, the PedsQL 3.0 Diabetes module and the KIDSCREEN-10. Internal consistency was good (α = 0.85 for CHFS, α = 0.88 for PHFS); validity was supported by correlations of CHFS total score (CHFS-T r = -0.50; p < 0.001, CI = -0.62 to -0.35) and Worry subscale (CHFS-W r = -0.49; p < 0.001, CI = -0.62 to -0.32) with measures of health-related quality of life (QoL), which were not related to PHFS scores. Factor analyses justified the structure and the separate scoring of Behavior and Worry subscales. Children's age was negatively correlated with CHFS-T (r = -0.16; p = 0.03, CI = -0.36 to 0.00), CHFS-W (r = -0.29; p = 0.02, CI = -0.39 to -0.07), PHFS-T (r = -0.20; p = 0.006, CI = -0.35 to -0.04), PHFS-B (r = -0.30; p = 0.001, CI = -0.43 to -0.17). Mean (SD) item scores of CHFS-T (1.47 ± 0.56 vs. 1.27 ± 0.57; p < 0.05) and CHFS-W (1.20 ± 0.73 vs. 0.96 ± 0.68; p < 0.05) were higher in children with HbA1c ≥7.5%. Higher levels of distress for upsetting hypoglycemia were associated with lower child's QoL scores as perceived by children (Peds-QL: 72.6 ± 12.8 vs. 80.4 ± 11.9; p < 0.001) and parents (Peds-QL: 70.6 ± 13.8 vs. 75.8 ± 12.9; p < 0.05). CONCLUSION: The Italian version of CHFS and PHFS appears to be a valid measure to assess FoH in clinical practice and factor analysis supports separate scoring for the Worry and Behavior subscales.

The location of emotional intelligence measured by EQ-i in the personality and cognitive space: Are there gender differences?

Introduction: Emotional Intelligence (EI) is first described by Salovey and Mayer as the ability to perceive and understand emotions and the ability to use them as supports for thoughts. Despite the great notoriety of EI, its definition remains not completely clear. An operative definition of EI can be achieved by studying its connection with other individual characteristics such as gender, personality traits, and fluid intelligence. Methods: The sample was composed of 1,063 Italian subjects. A total of 330 participants were employed (31.0%; 57.9% men) and 702 were university students (66.0%; 38.7% men). The Emotional Quotient Inventory (EQ-i), one of the most used questionnaires in literature, was used to measure EI. The exploratory structural equation modeling (ESEM) was used to assess the role of personality traits (five-factor model of personality) and fluid intelligence in EI. Statistical analyses on differences between men and women means of total and subscale EQ-i scores were estimated to evaluate whether EI, measured by EQ-i, is influenced by gender. Furthermore, a Multigroup Confirmatory Factor Analysis was conducted to assess measurement invariance in relation to gender groups. Results: Emotional Intelligence, measured by EQ-i, is prevalently connected with personality traits rather than fluid intelligence. Furthermore, men outperformed women in the Intrapersonal and Stress Management EI factors, and women outperformed men in the Interpersonal EI factor. No difference in the means of the EI total score and EI latent general factor did not differ between gender groups. Conclusion: Emotional Intelligence, measured by EQ-i, can be conceptually considered as a Trait EI. Furthermore, men are more capable to cope with negative events and to control impulses, while women are more able to distinguish, recognize, and comprehend others' emotions.

Association of COMT, BDNF and 5-HTT functional polymorphisms with personality characteristics.

Background: The real impact of genetic factors on personality is still unknown, even if in literature about 50% of variance in personality traits are considered genetically determined. The determination of the genetic variance in personality traits could promote psychological well-being and the prevention of psychopathologies, because there are many experimental evidences showing that mental illness is associated to personality. Numerous studies have showed that Catechol-O-methyltransferase (COMT), brain derived neurotrophic factor (BDNF) and serotonin transporter (5-HTT) are genes whose variants are associated with personality traits. This aim of this study is the investigation of the association between personality traits and 5-HTTLPR/rs255315-HTT promoter variant, COMT Val158Met and BDNF Val66Met gene polymorphisms. Methods: The sample was composed by 132 healthy female students. Genomic DNA was extracted from buccal swab, while personality was assessed with Cloninger's Temperament and Character Inventory-Revised (TCI-R). Linear discriminant analysis was used to analyze how personality characteristics can differentiate individuals in relation to their genetic polymorphisms. Results: Data showed that the temperament trait Reward Dependence discriminated individuals with different BDNF variants; Novelty Seeking and Harm Avoidance discriminated individuals with different 5HTTLPR variants; Persistence discriminated individuals with different COMT variants. Conclusions: Since these traits are connected to psychological diseases as depression, social anxiety, anorexia and obsessive-compulsive disorders of personality, the study of their genetic component can be used as intermediary issue to better define the connection between genes and predisposition toward maladaptive behavior and mental illness.

The Role of Gender in the Association Among the Emotional Intelligence, Anxiety and Depression.

Recent epidemiological data show an increase of depression and anxiety that cause a loss of about 3-4% of the gross domestic product in Europe, as a consequence of a reduced productivity and a premature death of people. Gender differences in both psychopathologies were found from mid-to-late adolescence until 55 years, and data indicate an increase of depression in women. Considering these data, new interventions focused on promoting psychological well-being were designed. A predictive factor of psychological disorders is Emotional Intelligence (EI), the ability to understand and regulate our own emotions, as well as those of others. EI is associated with psychological well-being, as well as with the treatment of mental illness, but gender differences in the association among EI, anxiety and depression remains unclear. The present study aims at analyzing the nomological associations among EI, anxiety and depression. Furthermore, the possible moderating role of gender in the relation between EI, depression and anxiety is investigated in a sample of 1725 healthy participants. Our results show that the ability to recognize and to control emotions in the social context helps us to reduce the risk to be affected by depression and anxiety. Moreover, our study shows that the association of EI with anxiety and depression wasn't gender moderated. In conclusion, the findings highlight that EI can help people to manage emotions linked to negative events and to successfully understand emotions in others. In addition, we found no moderation role of gender in the association between EI, anxiety and depression.

The Influence of Rehabilitation on Quality of Life in Breast Cancer Survivors: A Clinical Study.

BACKGROUND: Breast cancer survivors report negative impacts of cancer, augmented by specific vulnerabilities to body changes, negative self-assessment, and quality-of-life concerns. The main objective of our work was to test the effect of a rehabilitation program on breast cancer patients by evaluating the change in their physical well-being during an outpatient rehabilitation setting and, subsequently, in a home rehabilitation setting, considering the individual personality profile. METHODS: Patients who underwent total mastectomy with breast prostheses or tissue expanders were enrolled. Outcome assessments (Pain, Quality of Life, Personality traits for the Minnesota Multiphasic Personality Inventory-2) before treatment (T0), at the end of the rehabilitative treatment (T1 = 10 sessions 2/week, one hour/each), and after two months of follow-up (T2) were performed. RESULTS: The data of 38 included patients were analyzed. The quadratic trend of the Visual Analogue Scale can be explained by the fact that patients have a strong reduction in the perceived pain immediately after rehabilitation in the clinic. This reduction remains constant for the home period of the rehabilitation. The personality profiles of all the participants were substantially valid. Only three patients obtained scores higher than 65 points. CONCLUSIONS: The study evidenced that in the initial phase of the rehabilitation, psychological traits such as anxiety, depression, and preoccupation could have a strong association especially with the autonomous functions and the perceived physical symptoms. However, during the therapeutic process, this association decreased and these decrements were higher when patients performed their rehabilitation at home, in a more familiar and comfortable setting.

On the efficacy of the unified protocol for transdiagnostic treatment of emotional disorders: A systematic review and meta-analysis.

In recent years a large array of treatment protocols conceptualized as transdiagnostic have been developed with clinical and practical advantages compared to traditional single-disorder protocols. Within this panorama, the Transdiagnostic Unified Protocol (UP) of Emotional Disorders was developed aimed at treating the negative affective processes underlying several diagnostic categories, and accounting for the covariance of different emotional disorders. The UP has been found to efficiently target the roots of these disorders leading to a reduction in symptoms of co-occurring disorders. However, several questions have marginally addressed in the previous studies, and some UP features still remain unexplored. The present meta-analysis aims at evaluating whether the UP results to significant changes in anxiety and depression symptoms severity in children, adolescents, and adults. 19 RCTs and 13 uncontrolled pre-post trials comprising 2183 patients/clients met inclusion criteria for meta-analysis. Large to moderate combined overall effect size for both depression plus anxiety were detected in the uncontrolled pre-post studies (g = 0.756) and in RTCs studies (g = 0.452), respectively. Large effect size at pre-treatment to 3-6-month follow-up was observed for combined depression plus anxiety (g = 1.113). Subgroup analysis suggested that UP treatment does not differ across the anxiety and depression self-report measures. Moreover, UP intervention outperformed both passive and active control conditions to treat negative affective syndromes. Meta-regression confirmed the moderate effects of therapist level of experience, the sample characteristics, and the UP-protocol adaptations. The findings indicate that the manualized UP treatment has potential to contribute to improving mental health outcomes, particularly of anxiety and depression.

Does a Fundamentalist Mindset Predict a State or Trait Anxiety? The Covariate Role of Dogmatism.

Recent neuropsychological studies reported that fundamentalism beliefs and its cognitive mindset provoke sense of coherency and protection against the ambiguity as well as a rapid doubt resolution and thus offer relief from distress and uncertainty. In this study, we examined whether the need for closure dimensions predicted religious fundamentalism. Further, we tested if pronounced religious beliefs (also controlled for dogmatism) would be associated with a state or trait anxiety, in a sample of 388 Roman Catholics (females = 53.9%). Path analysis (SEM), with observed variables, was used to determine the pathways by which religious fundamentalism, need for closure dimensions, and dogmatism interacted to influence anxiety. The results revealed that religious fundamentalism was predicted by intolerance to ambiguity, preference for order, and closed-mindedness; in turn, high fundamentalism scores predicted state anxiety exclusively. Additionally, when controlling for dogmatism, the fundamentalism-anxiety path became nonsignificant. Although it seemed that fundamentalism beliefs "per se" have played no direct anxiolytic effect, they partially perform a function of avoiding chaos and disorder in order to maintain cognitive integrity.

Improving the psychometric properties of the dissociative experiences scale (DES-II): a Rasch validation study.

BACKGROUND: The Dissociative Experiences Scale-II (DES-II) is a self-report questionnaire that measures dissociative experiences such as derealization, depersonalization, absorption and amnesia. The DES-II has been prevalently used as a screening tool in patients suffering from psychotic disorders or schizophrenia. However, dissociative experiences can also be part of normal psychological life. Despite its popularity, the most problematic aspect of the DES-II is the inconsistency in its factor structure, which is probably due to the tendency to treat ordinal responses as responses on an interval scale, as it is assumed in the Classical Test Theory approach. In order to address issues related to the inconsistency of previous results, the aim of the present study was to collect new psychometric evidence to improve the properties of the DES-II using Rasch analysis, i.e. analyzing the functioning of the response scale. METHODS: Data were obtained on a sample composed by 320 Italian participants (122 inmates and 198 community-dwelling individuals) and were analyzed with the Rasch model. This model allows the estimation of participants' level of dissociation, the degree of misfit of each item, the reliability of each item, and their measurement invariance. Moreover, Rasch estimation allows to determine the best response scale, in terms of response modalities number and their discriminant power. RESULTS: Three items of the scale had strong misfit. After their deletion, the resulting scale was composed by 25 items, which had low levels of misfit and high reliability, and showed measurement invariance. Participants tended to select more often lower categories of the response scale. CONCLUSIONS: Results provided new knowledge on the DES-II structure and its psychometric properties, contributing to the understanding and measurement of the dissociation construct.

Physical and Psychological Impact of the Phase One Lockdown for COVID-19 on Italians.

The exceptional pandemic due to the 2019 coronavirus disease (COVID-19) has obliged all Italians to stay at home. In the literature, there are evidences that traumatic global events, such as natural catastrophes and pandemic, have negative effects on the physical and psychological health of the population. We carried out a survey to analyze the physical and psychological conditions of Italians during the pandemic. Due to the severe limitations in moving during the phase one lockdown, the survey was administered by internet. Results show that Italians followed the provisions established by the Italian government to avoid contamination, but 43% of them declared to have suffered from physical symptoms, in particular migraine, sleep disorders, persistent exhaustion, and difficulty of concentration. They have great fear to be contaminated or that relatives or friends can be contaminated, and they actively take actions to avoid contamination. Participants declared that they had suffered a lot of inconveniences due to restrictions in their movements, and that their life habits were strongly changed. They spent their time at home in different activities, but their psychological well-being was strongly impaired by the lockdown. The level of anxiety tripled, in relation to the prepandemic period, and 30% of males and 41% of females declared to have severe levels of depression. Participants with high levels of optimism and hopefulness show a stronger resilience against anxiety and depression. In addition, there is a negative correlation between anxiety and depression and the five factors of personality. These results show that psychological diseases must not be neglected, and that people in lockdown do need support for their psychological health, also with the help of internet and communication technologies.

The WeReha Project for an Innovative Home-Based Exercise Training in Chronic Stroke Patients: A Clinical Study.

BACKGROUND: Telerehabilitation (TR) in chronic stroke patients has emerged as a promising modality to deliver rehabilitative treatment-at-home. The primary objective of our methodical clinical study was to determine the efficacy of a novel rehabilitative device in terms of recovery of function in daily activities and patient satisfaction and acceptance of the medical device provided. METHODS: A 12-week physiotherapy program (balance exercises, upper and lower limb exercises with specific motor tasks using a biofeedback system and exergaming) was administered using the WeReha device. Twenty-five (N = 25) chronic stroke outpatients were enrolled, and the data of 22 patients was analyzed. Clinical data and functional parameters were collected by Berg Balance scale (BBS), Barthel Index (BI), Fugl-Meyer scale (FM), Modified Rankin scale (mRS), and Technology Acceptance Model (TAM) questionnaire at baseline (T0), after treatment (T1), and at the 12-week follow-up (T2). Statistical tests were used to detect significant differences (P < .05), and Cohen's (Co) value was calculated. RESULTS: BI scores improved significantly after treatment (P = .036; Co 0.776, medium), as well as BBS scores (P = .008; Co 1.260, high). The results in FM scale (P = .003) and mRS scores (P = .047) were significant post treatment. Follow-up scores remained stable across all scales, except the BI. The A and C sub-scales of the TAM correlated significantly to only a T2 to T1 difference for BI scores with P = .021 and P = .042. CONCLUSION: Currently, the WeReha program is not the conventional therapy for stroke patients, but it could be an integrative telerehabilitative resource for such patients as a conventional exercise program-at-home.ClinicalTrials.gov identifier: NCT03964662.