A driving simulation study on the effects of different wine types on the performance of young drivers.

BACKGROUND: Alcohol consumption is responsible for a significant number of road fatalities. To contrast this phenomenon, a more responsible attitude to the wine consumption, especially among young, inexperienced drivers prone to risky behaviour on the road must be promoted. METHOD: This is a simplified single-blind, placebo-controlled experiment aimed at evaluating 44 young drivers monitored during a driving simulation following the consumption of natural and conventional wines, with a reference blood alcohol concentration (BAC) of 0.5 g/l. Two hypotheses are tested: (1) the legal consumption of wine has no significant impact on young drivers' performance in both ordinary and unusual road events; (2) natural and conventional wines are expected to produce negligible and acceptable impairments in young drivers the same BAC. Two reference groups (BAC = 0 g/l), one a placebo-controlled group with drivers treated with a dealcoholized wine, were included. RESULTS AND CONCLUSIONS: Significant differences between the groups in terms of perception and reaction times (PRT) to visual and auditory stimuli, and to speeding were observed, with young drivers treated with conventional wine displaying more aggressive behaviours. In contrast, participants treated with natural wine showed PRT which were not significantly different from those belonging to control groups. The gaze attention levels of wine treated drivers were found to be dose dependant, with young drivers of the two control groups and those of the treated ones with BAC < 0.3 g/l able to focus on wider area ahead and, thereby, collect more information from the road environment.

Dysfunctional coping is related to impaired skin-related quality of life and psychological distress in patients with neurofibromatosis type 1 with major skin involvement.

BACKGROUND: Low skin-related quality of life (QoL) is usually associated with low levels of self-confidence and self-esteem and with high levels of anxiety and depression symptoms. The way patients cope with a physical disease impacts significantly on their psychosocial adjustment to the disorder and on their emotional functioning. OBJECTIVES: To explore how coping strategies, skin-related QoL, psychological distress and self-esteem interact in a sample of individuals with neurofibromatosis type 1 (NF1). METHODS: Seventy-two adult patients with NF1 completed the following questionnaires: Coping Orientation to Problem Experiences (COPE), Skindex-29, Padua Skin-Related QoL questionnaire (PSRQ), State-Trait Anxiety Inventory-X2 form (STAI-X2), Depression Questionnaire (DQ) and Rosenberg Self-Esteem Scale (RSES). The k-modes algorithm was used to identify clusters of patients based on four variables: sex, NF1 severity, number and distribution of cutaneous neurofibromas. Individuals in different clusters were compared with regard to their scores; correlations between scores were analysed within each cluster. RESULTS: Two main clusters were identified: individuals in Cluster 1 had a larger number and more widespread distribution of neurofibromas compared with Cluster 2. Patients in Cluster 1 scored higher only on several PSRQ and Skindex-29 scales. Among patients in Cluster 1, the COPE 'avoidance strategies' scale was significantly correlated with the PSRQ 'physical distress and impairments' scale, the Skindex-29 'physical symptoms' and 'functioning' scales, the STAI-X2, the DQ and the RSES. CONCLUSIONS: Patients with major skin involvement have reduced skin-related QoL. Among them, current findings tentatively suggest that the higher the use of dysfunctional coping, the more impaired are QoL, psychological distress and self-esteem. What's already known about this topic? Neurofibromatosis type 1 (NF1) can affect the quality of life (QoL) in adolescent and adult patients. Low skin-related QoL is usually associated with low levels of self-confidence and self-esteem and with high levels of anxiety and depression symptoms. Questionnaires evaluating skin-related QoL, anxiety, depression, self-esteem and coping are available. What does this study add? Patients with a large number and a widespread distribution of cutaneous neurofibromas have reduced skin-related QoL compared with patients with minor skin involvement. The newly developed Padua Skin-Related QoL questionnaire allows the simultaneous evaluation of discomfort and comfort skin-related QoL dimensions in patients with NF1. Among patients with major skin involvement, the higher the use of dysfunctional coping, the more impaired are skin-related QoL, psychological distress and self-esteem. Our data suggest that patients with NF1 with major skin involvement who endorse dysfunctional beliefs about their own coping abilities might benefit from psychological counselling and coping skills treatments aiming to both improve perceived self-efficacy and learn more adaptive coping strategies.

Psychosocial functioning, self-image, and quality of life in children and adolescents with neurofibromatosis type 1.

BACKGROUND: Neurofibromatosis type 1 (NF1) is a genetic disorder associated with neurocutaneus manifestations, as well as attention and learning problems. The aim of this study was to examine the psychosocial functioning, quality of life, and self-image of children with NF1. METHOD: Two hundred forty participants were recruited, comprising 60 children and adolescents with NF1, 60 parents of children with NF1, 60 children and adolescents without NF1, and 60 parents of children without NF1. The children/adolescents completed the Self-administered Psychiatric Scales test for Children and Adolescents and the human figure drawing test, whereas parents completed the Child Behavior Checklist. Both children and parents completed the Pediatric Quality of Life Inventory. RESULTS: Compared to healthy subjects, individuals with NF1 reported anxiety problems, poorer quality of life, and greater distortions in terms of self-image. When compared to healthy participants' parents, the parents of NF1 participants reported having more concerns about the quality of life, sociality, school performance, and attention span of their children. CONCLUSIONS: Results show that the psychological functioning, behavior, self-image, and quality of life of children and adolescents with NF1 are compromised. Health services should take into account the psychosocial difficulties associated with NF1 and design rehabilitation programs aimed at increasing NF1 children's interpersonal skills, improving their social life and quality of life, and promoting more adaptive behaviors. In addition, health care interventions should also involve the parents of children with NF1.

Alexithymic characteristics in pediatric patients with primary headache: a comparison between migraine and tension-type headache.

BACKGROUND: Alexithymia is a personality construct characterized by difficulties in verbal emotional expression and a limited ability to use one's imagination. Evidence of alexithymic characteristics was found in adults suffering from headache, while little is known about children. The aim of this study was to establish the prevalence of alexithymia in two different subgroups of children and adolescents suffering from primary headache. We also looked for correlation between alexithymia in children and in their mothers. METHODS: This study involved 89 participants: 47 (11 males, 36 females, aged 8 to 17 years) suffering from tension-type headache (TTH), and 42 (18 males, 24 females, aged 8 to 17 years) suffering from migraine (M), based on the International Classification of Headache Disorders (ICHD 2013). A control group of 32 headache-free subjects (26 females and 6 males, aged 8 to 17 years) was also considered. Two questionnaires were administered to measure alexithymia: the Alexithymia Questionnaire for Children to young patients and controls, and the Toronto Alexithymia Scale (TAS-20) to the mothers. RESULTS: Higher rates of alexithymia emerged in the TTH group compared to the M group. In particular, TTH sufferers had difficulty identifying their feelings. The mothers of children with headaches didn't score higher in alexithymia compared to other mothers. In the M and in the control group, there was a significant correlation between the rates of alexithymia in young people and in their mothers. CONCLUSIONS: To date no other study has investigated alexithymia in subgroups of primary headaches in developmental age. Our results suggest that patients suffering from TTH are more alexithymic than M patients. This pave the way to etiopathogenetic and clinical considerations, calling for a comprehensive and multidisciplinary approach to tackle the problem of headache.

[Formal representation of the cognitive-behavioral assessment in obsessive-compulsive disorder]. / Rappresentazione formale dell'assessment cognitivo-comportamentale per il disturbo ossessivo-compulsivo.

Psychological assessment is a crucial and important part of psychologist's work. Despite this, tools utilized by clinicians are often inadequate and methods used to investigate and make decisions on the basis of collected data are even logically incorrect. In this paper two mathematical psychology theories (Knowledge Space Theory and Formal Concept Analysis) are employed to propose a method for collecting diagnostic information. The conjoint application of these two theories allows to build a hierarchical structure composed by diagnostic elements. This structure is very similar to the one determined by the clinical diagnostic process. Correct logical inferences on the patient's situation, and an exact depiction of those diagnostic elements presented or not by the patient, represent the potential advantages of such a methodology. An applicative example on Obsessive-Compulsive Disorder (using the background determined by two shared diagnostic tools i.e. DSM IV-TR and CBA 2.0) is presented. Finally, the opportunity to build an adaptive assessment procedure from the derived structure is investigated.

[Structural equation model in the study of risk factors in the maintenance of binge eating]. / Un modello di equazioni strutturali per Lo studio dei fattori di rischio nel mantenimento del disturbo da alimentazione incontrollata.

This study investigated, in a sample of 483 adolescent girls, a number of risk factors associated with Binge Eating (BE) disorder, i.e. negative feelings, dieting behaviour, social influence and body dissatisfaction. Participants completed the following questionnaires: Bulimia Test, Depression Questionnaire, Dieting Self-Efficacy Measure, Dieting Success, Dieting Status Measure, Dutch Eating Behavior Questionnaire, Eating Disorder Inventory, Positive and Negative Affect Scale Revised, Rosenberg Self-Esteem Scale and Socio-cultural Attitudes Towards Appearance Questionnaire. Structural equation modeling was used in the data analysis to verify the hypothesized relations among the variables, with the aim of identifying the main predictors of BE. This methodology explains the correlation between the considered variables, and determines, using quantitative good fit indexes, both the strength of the correlations and the plausibility of the causal links between the hypothesized factors. Our findings confirm that negative feelings (Negative Affect) are the primary predictor for the maintenance of BE and highlight the significant role played by Social Influence. While Dieting Behaviour is not a primary predictor for the maintenance of BE it appears to influence it through its link with Negative Affect.