Usefulness of psychoeducational intervention in chronic insomnia: an actigraphic study.

Background: Chronic Insomnia is a severe and disabling condition characterized by difficulty in initiating or maintaining sleep, waking up too early, despite adequate opportunity and circumstances for sleep. Maladaptive thoughts and dysfunctional beliefs about sleep are considered crucial factors in developing and perpetuating this disorder.Aims: The aim of the study was to explore the usefulness, in patients with chronic insomnia, of a one-session psychoeducational intervention on sleep-related maladaptive thoughts and beliefs, and on sleep perception.Methods: Thirty-eight patients with chronic insomnia were enrolled in the study and randomly assigned to receive psychoeducational intervention (PI+) or to act as controls (PI-). Patients wore an actigraph and compiled a sleep diary for 14 d. After the first 7 d, only PI+ patients received one session of psychoeducational intervention.Results: A significant reduction of sleep related preoccupations, a reduction of dysfunctional beliefs about sleep, and an improvement of subjective perception of sleep were observed in the PI+ group, but not in the PI- group. No significant modification was observed for objective total sleep time.Conclusions: Our results suggest that one-session psychoeducational intervention is associated with a decrease of sleep-related maladaptive thoughts and beliefs, and with an improvement on subjective sleep perception.

Emotion Regulation and Mentalization in People at Risk for Food Addiction.

Researchers investigated the association among food addiction, difficulties in emotion regulation, and mentalization deficits in a sample of 322 Italian adults from the general population. All participants were administered the Italian versions of the Yale Food Addiction Scale (I-YFAS), the Difficulties in Emotion Regulation Scale, the Mentalization Questionnaire, the Binge Eating Scale, and the Michigan Alcohol Screening Test. Of respondents, 7.1% reported high food-addiction symptoms (ie, 3 or more symptoms of food addiction on the I-YFAS). In bivariate analyses, high food-addiction symptoms were associated with more difficulties in emotion regulation and mentalization deficits. In the multivariate analysis, high food-addiction symptoms remained independently associated with mentalization deficits, but not with difficulties in emotion regulation. Our data suggest that mentalization may play an important role in food addiction by making it difficult for an individual to understand his or her own inner mental states as well as the mental states of others, especially when powerful emotions arise.

Psychometric properties of the Italian Food Cravings Questionnaire-Trait-reduced (FCQ-T-r).

PURPOSE: The aim of the present study was to investigate dimensionality and psychometric properties of the Italian Food Cravings Questionnaire-Trait-reduced (FCQ-T-r) in a sample of obese and overweight patients seeking weight loss treatment. METHODS: Participants were 504 (416 women and 88 men) overweight and obese patients (BMI ≥ 25 kg/m(2)), and 289 (215 women and 74 men) Italian adults not currently seeking weight loss treatment. All participants were administered the Food Cravings Questionnaire-Trait (FCQ-T) and the Binge Eating Scale. RESULTS: The fifteen items included in the FCQ-T-r explained 93% of the variance of the 39-item FCQ-T total score (R(2) = 0.93). A principal axis factoring analysis indicated a one-factor solution, explaining 55.6% of the variance of the data. The FCQ-T-r had high internal consistency and was also able to differentiate between individuals with various severities of binge eating behavior. CONCLUSIONS: The FCQ-T-r may be considered a useful instrument for measuring trait food craving, when time constraints impede the use of the 39-item FCQ-T.

Psychometric properties of the Italian Yale Food Addiction Scale in overweight and obese patients.

AIM: To assess the dimensionality and psychometric properties of an Italian version of the Yale Food Addiction Scale (YFAS) in a sample of obese/overweight patients attending low-energy diet therapy. METHODS: Participants were 300 overweight and obese patients who were admitted to a private medical center in Rome, Italy. Controls were 300 (231 women and 69 men) adults from the general population. All of the participants were administered the YFAS and the binge eating scale (BES). RESULTS: The one-factor model of the YFAS reported in previous studies did not fit the data χ(2)(209) = 466.69, p < 0.001, root mean square error of approximation (RMSEA) = 0.07; 90% CI: 0.06/0.08; comparative fit index (CFI) = 0.91; weighted root mean square residual (WRMR) = 1.40]. Through item analysis, it was suggested that five items (items #10, #11, #22, #24, and #25) with low item-total correlations should be removed from the measure. A 16-item one-factor model revealed a better fit to the data (χ(2)(104) = 174.56; p < 0.001; RMSEA = 0.05; 90% CI: 0.04/0.07; CFI = 0.96), although the WRMR was slightly higher than that suggested as an indicator of good fit (WRMR = 1.01). The YFAS-16 had satisfactory internal consistency; it was able to discriminate obese patients from controls and strongly correlated with BES scores. CONCLUSION: The YFAS-16 assesses all of the "symptoms" represented in the original version and has satisfactory psychometric properties, although the percentage of food addiction diagnoses according to the YFAS-16 is lower than the percentage of diagnoses according to the original version of the questionnaire.

The association among food addiction, binge eating severity and psychopathology in obese and overweight patients attending low-energy-diet therapy.

Several studies have shown that food addiction (FA) is strongly related with psychopathology. However, this relationship may be partly mediated by the presence and severity of binge eating. The aim of the current study was to assess the strength of the association between FA and psychopathology, and whether this relationship was mediated by the presence and severity of binge eating. Participants were 112 patients seeking weight loss interventions. All the participants were administered the Yale Food Addiction Scale (YFAS), The Symptom Check list-90-R (SCL-90), and the Binge Eating Scale (BES). Thirty-eight (33.9%) individuals were diagnosed as having FA. FA severity was strongly associated with binge eating, whereas both FA and binge eating were positively and moderately associated with psychopathology. A mediational model analyzing direct and indirect (through the mediating role of binge eating) effects of FA on psychopathology indicated that the relation between FA and psychopathology was fully mediated by the severity of binge eating. This finding suggests that FA may contribute to the development of psychopathology through its effect on binge eating.

Food Cravings Questionnaire-Trait (FCQ-T) discriminates between obese and overweight patients with and without binge eating tendencies: the Italian version of the FCQ-T.

Food craving (FC) might play an important role in the course of eating disorders and obesity. The question of its measurement has particular importance in relation to the dramatic growth in obesity rates and its relevance for public health. The aim of this study was to investigate the psychometric properties of the Italian version of the Food Cravings Questionnaire-Trait (FCQ-T) in overweight and obese patients who were attending weight loss programs, and its efficiency in discriminating patients with binge eating. Participants were 497 (411 women, 86 men) overweight and obese patients in treatment with low-energy diet therapy. We used structural equation modeling to compare 3 factor models tested in previous studies (a 6-factor model, an 8-factor model, and a 9-factor model), which indicated that the 9-factor model has a better fit over the competing models. The FCQ-T had good internal consistency (Cronbach's α of.96 for the total score, and between.76 and.92 for subfactors), and was able to discriminate patients with clinical-level binge eating from those with probable and without binge eating with an efficiency of.74 (sensitivity =.64, specificity =.78). FCQ-T scores were sensitive to changes associated with treatment only for patients who started dietary restriction between the baseline and the follow-up assessment, but not for patients who were already observing dietary restrictions at the time of the baseline assessment. These results suggest that the FCQ-T could be a potentially useful measure for the screening of binge eating problems in overweight and obese patients while in treatment.

Gender differences in food craving among overweight and obese patients attending low energy diet therapy: a matched case-control study.

This case-control study examined gender differences in food craving among a sample of overweight and obese patients attending low energy diet therapy. To disentangle the specific role of gender from the role of confounders, we paired groups for BMI, age and severity of binge eating as assed by the Binge Eating Scale (BES). The participants were 73 pairs of patients who were attending low energy diet therapy. All the participants were administered the State and Trait Food Cravings Questionnaire, trait version (FCQ-T) and the BES. Female patients had higher mean scores on six out of nine dimensions of the FCQ-T. When controlling for the effect of other variables, obese and overweight female patients were 1.1 times more likely to report higher anticipation of relief of negative states and feelings from eating than their male pairs. Obese and overweight female patients experience more cravings for food than their male pairs despite comparable severity of binge eating and obesity suggesting the need for tailored interventions.

Quality of life and personality traits in patients with malignant pleural mesothelioma and their first-degree caregivers.

Asbestos exposure causes significant pleural diseases, including malignant pleural mesothelioma (MPM). Taking into account the impact of MPM on emotional functioning and wellbeing, this study aimed to evaluate the quality of life and personality traits in patients with MPM and their first-degree caregivers through the World Health Organization Quality of Life-BREF (WHOQOL-BREF) and the Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF). The sample was composed of 27 MPM patients, 55 first-degree relatives enrolled in Casale Monferrato and Monfalcone (Italy), and 40 healthy controls (HC). Patients and relatives reported poorer physical health than the HC. Patients had a higher overall sense of physical debilitation and poorer health than relatives and the HC, more numerous complaints of memory problems and difficulties in concentrating, and a greater belief that goals cannot be reached or problems solved, while often claiming that they were more indecisive and inefficacious than the HC. First-degree relatives reported lower opinions of others, a greater belief that goals cannot be reached or problems solved, support for the notion that they are indecisive and inefficacious, and were more likely to suffer from fear that significantly inhibited normal activities than were HC. In multinomial regression analyses, partial models indicated that sex, physical comorbidities, and the True Response Inconsistency (TRIN-r), Malaise (MLS), and Behavior-Restricting Fears (BRF) dimensions of the MMPI-2-RF had significant effects on group differences. In conclusion, health care providers should assess the ongoing adjustment and emotional wellbeing of people with MPM and their relatives, and provide support to reduce emotional distress.

Psychometric Properties of the Attitudes toward Self-Revised in Italian Young Adults.

Objectives and Methods. Several researchers have provided support for the critical role of cognitive vulnerabilities in the development of depression. The Attitudes toward Self-Revised (ATS-R) was designed to assess three potential self-regulatory vulnerabilities to depression: High Standards (HS), Self-Criticism (SC), and Negative Generalization (NG). The aim of the study was to assess the psychometric properties of the ATS-R in the Italian young adult population. The ATS-R, the Beck Depression Inventory-II (BDI-II), the Beck Hopelessness Scale (BHS), and the Teate Depression Inventory (TDI) were administered to 857 (320 men and 537 women) young adults. Results. The best-fitting solution for the ATS-R was a 2-factor model, which obtained satisfactory homogeneity of content (HS/SC: Cronbach α = 0.81; mean interitem correlation = 0.46. NG: Cronbach α = 0.75; mean interitem correlation = 0.43) and significant correlation with the BDI-II (NG: Pearson r = 0.29, P < 0.01), the TDI (HS/SC: Pearson r = -0.26, P < 0.01), and the BHS (HS/SC: Pearson r = -0.29, P < 0.01; NG: Pearson r = 0.22, P < 0.01). Conclusions. The Italian version of the ATS-R seems to be a valid instrument for the study of the role of cognitive tendencies as potential vulnerability for depression.

[Difficulties in emotion regulation and personal distress in young adults with social anxiety]. / Difficoltà nella regolazione delle emozioni e disagio personale nei giovani adulti con ansia sociale.

BACKGROUND: The aim of this study was to assess the association between social anxiety and difficulties in emotion regulation in a sample of Italian young adults. METHODS: Our convenience sample was composed of 298 Italian young adults (184 women and 114 men) aged 18-34 years. Participants were administered the Interaction Anxiousness Scale (IAS), the Audience Anxiousness Scale (AAS), the Difficulties in Emotion Regulation Scale (DERS), and the Interpersonal Reactivity Index (IRI). A Two Step cluster analysis was used to group subjects according to their level of social anxiety. RESULTS: The cluster analysis indicated a two-cluster solution. The first cluster included 163 young adults with higher scores on the AAS and the IAS than those included in cluster 2 (n=135). A generalized linear model with groups as dependent variable indicated that people with higher social anxiety (compared to those with lower social anxiety) have higher scores on the dimension personal distress of the IRI (p<0.01), and on the DERS non acceptance of negative emotions (p<0.001) and lack of emotional clarity (p<0.05). CONCLUSIONS: The results are consistent with models of psychopathology, which hypothesize that people who cannot deal effectively with their emotions may develop depressive and anxious disorders.