[New questionnaire to evaluate psychological treatment effects]. / Proposta di un nuovo strumento per la verifica dell'efficacia nella pratica dei trattomenti psicologici e psicoteropeutici.

A new questionnaire named CBA-VE (Cognitive Behavioral Assessment for outcome evaluation) was developed to evaluate psychological treatment intervention--especially for counseling and psychotherapy. The questionnaire has 80 items and a 5 point Likert-like scale ranging from 1 = nothing to 5 = a lot. The aim of this study was to evaluate the validity and the reliability of the five constructs of the questionnaire both in normal and clinical subjects. Participants. Two samples were analyzed: a "Normal" group composed of 250 normal adults plus 51 university students; and a "Clinical" group including 261 adults undergoing psychotherapy and psychological counseling provided by the public health service. The questionnaire includes five scales: three of them are related to important psychological aspects (anxiety, depression, and psychological distress); the remaining two are measurements of psychological wellbeing and self-perception of a positive change. The questionnaire has excellent psychometric characteristics, both for normal and clinical subjects. We observed a good reliability, good internal consistency, and an excellent structural validity for the five interrelated dimensions. The normalized factorial loadings are consistent, significant (from around 0.6 up), and similar in both the groups. The so-called Clinical group showed higher scores in anxiety, depression, and psychological distress and smaller scores in wellbeing and change perception. This is coherent with what the authors assumed a priori.

[Burnout syndrome among health workers caring for AIDS patients: predictive variables]. / La sindrome del burnout in operatori sanitari a contatto con malati di AIDS: variabili predittive.

UNLABELLED: Psychological stress and coping strategies in staff working with AIDS patients were assessed using self report methods. MEASURES: Maslach Burnout Inventory (MBI), Coping Orientations to Problems Experiences (COPE), State-Trait Anxiety Inventory (STAI) and Depression Questionnaire (DQ) were completed by staff from 20 hospitals of North-Center Italy, including 329 doctors and nurses working with people with AIDS. The results suggested important correlations among burnout, coping style, depression and anxiety. Inadequate strategies used as Focusing on and Venting of emotion, Behavioral Disengagement and depression predicted high level of Emotional Exhaustion and Depersonalization, while Personal Accomplishment were predicted by more adequate strategies (Planning, Restrain coping and Seeking social support) and low level of anxiety.

Psychological and emotional aspects and pain.

A patient's psychological condition can be influenced by symptoms and, at the same time, it can influence the perception of symptoms. In psychological assessment, pain can modify the results of a questionnaire, so a patient's state at the moment of the evaluation should be taken into account. Questionnaires used in assessment do not always provide clear-cut answers concerning the individual psychological component. Moreover, difficulties in classifying headache patients does not permit correct comparisons between population samples whenever patients are not classified into well defined homogeneous groups. Overall, in the three groups examined - migraine, tension-type headache and cluster headache - it can be affirmed that with self-report assessment based on questionnaires, the tension-type headache subjects present a more interesting psychological profile for its clinical implications.

Compulsive checking and selective processing of threatening information.

Threatening stimuli are processed differently from neutral ones by anxious and obsessive-compulsive subjects. In the present research, processing of threatening words was compared with that of neutral words for two groups of Italian students, one with high mean and one with low mean score on Checking, a subscale of the Padua Inventory. Two tests were given, a computerized version of the emotional Stroop task and a later recognition test under incidental learning conditions. The expected interference effect on the Stroop task for those scoring high on Checking was confirmed. These results suggest an association between compulsive checking and bias in the first automatic stages of processing of threatening stimuli.

Coping and cognitive processing style in HIV-positive subjects.

BACKGROUND: People's reactions to traumatic events are mediated by their subjective style of coping. This is of particular importance for HIV+ patients, mainly in the first phases of the disease. This work aimed at examining whether an 'acceptance' style of coping, as opposed to a 'mental disengagement' style, selectively influences the first stages of the processing of neutral, emotional and HIV-related information. METHOD: Two groups of 11 HIV+ asymptomatic subjects were chosen according to their coping strategies, acceptance or mental disengagement, as measured by Coping Orientations to the Problems Experienced (COPE). Twenty-two patients completed the Emotional Stroop Task and an incidental memory recognition task containing neutral, emotional and HIV-related stimuli. RESULTS: Analysis of reaction times (RTs) on the Emotional Stroop Task showed that HIV+ subjects have longer RTs for emotional and HIV-related than for neutral words. Instead, no effect was found as regards interaction with style of coping. CONCLUSION: Results confirmed a processing bias of emotional information, whereas Acceptance and Mental disengagement strategies, as measured by the COPE scales, did not appear to influence information processing.

Internal structure and validity of the multidimensional pain inventory, Italian language version.

OBJECTIVE: The aim of the study is an investigation of the psychometric characteristics of the Italian translation of the Multidimensional Pain Inventory and a comparison with the American, German, Swedish and Dutch versions of the MPI. METHOD: The Italian translation of the MPI was administered together with Melzack McGill Pain Inventory, Beck Depression Inventory, Spielberger State-Trait Anxiety Inventory, and Visual Analog Scales. Confirmatory factor analyses were accomplished on the MPI scores. Furthermore, reliability, intercorrelations, and convergent validity of MPI were evaluated. PATIENTS: Participants were 220 patients suffering from a variety of chronic pain syndromes (cephalalgia 45.8%; low-back pain 30.5%). RESULTS: Confirmatory factor analyses suggest changes to all 3 sections of the MPI-IV. Factor structure, after having excluded several items sorted according to the 3 sections of the questionnaire, is basically the same as in other versions of the MPI. Internal consistency analyses yielded acceptable reliability (Cronbach alpha coefficients) for 11 out of 13 scales. CONCLUSIONS: After making appropriate changes in all 3 sections of the inventory, the MPI is substantially suitable for use in cross-cultural and international research.

Neuroticism and type A behaviour pattern in healthy Italian blue-collar workers.

BACKGROUND: Even if type A behavior pattern is not a typical pattern of specific social class, in Italy no research study has been conducted on blue-collar workers. In the present study we sought to identify differences in the psychological profiles of type A and non-type A Italian blue-collar subjects. METHODS: Seventy-three healthy male blue-collar workers, aged 35-59 years, completed the CBA-2.0 Primary Scales (a battery of standardized questionnaires) and the Jenkins Activity Survey (JAS). Following the Structured Interview each subject was classified as type A1, A2, X, or B. In the present study, type X and B subjects were considered within the group referred to as type 'non-A'. RESULTS: The analysis of variance showed that the A1 subjects had higher neuroticism scores than the A2 and non-A subjects but revealed no differences in extraversion, anxiety, depression, obsession-compulsion scores. In the JAS only the 'speed and impatience' scale differentiated the three groups: the highest scores being obtained by the A1 subjects. Among the JAS scales, only correlations (Pearson) between speed and impatience, trait anxiety and neuroticism were found. CONCLUSION: In our Italian blue-collar sample, type A1 seems to define a subject with high neuroticism score. Finally, our results do not recommend the use of the JAS in Italy for measuring the type A behavior pattern.

A computerized approach to cognitive behavioural assessment: an introduction to CBA-2.0 primary scales.

The Cognitive Behavioural Assessment-2.0 (CBA-2.0) Primary Scales is an automated assessment package investigating the cognitive-verbal response system. It consists of: (1) self-reports and questionnaires aimed at identifying and specifying patients' problems; (2) a group of programs and logical rules, implemented on personal computers, providing an editor with items, questionnaire scoring and an analysis of responses; (3) an intelligent program which analyzes the responses emerging from the questionnaires and forms hypotheses for the selection of Secondary Scales and for further assessment. The package is part of a research project aimed at reducing part of the decision-making process to an operational language and simulating behavioral therapists decisions in cases of clinical assessment.

An operant approach to the treatment of writer's cramp.

A theoretical model of writer's cramp is presented. In addition to the original emotional arousal and subsequent conditioned stimuli inherent in a classical conditioning paradigm, this model stresses the role of operant behaviors in the maintenance of the disorder. The immediate consequences of the actual cramp and subsequent escape behaviors are emphasized. An extinction procedure consisting of response-cost and response-prevention measures is tested using an A-B-A-B design. Two patients totally unable to write, were able to increase cramp latency and were gradually retrained to write. Follow-up assessments at 6, 9 and 12 months confirmed the treatment gains.

Observational learning in Japanese quail.

In spite of interest in the cultural transmission of animal behaviour, observational learning has not previously been demonstrated in Japanese quail. In the present experiment three groups of 10 quail were trained to peck for reinforcement under discriminative stimulus control. The group which was allowed to observe performance of skilled companions learned faster than a group observing no-pecking models and a group learning without observational experience. Furthermore, observation of no-pecking models can inhibit learning. A sensory-sensory conditioning model can account for the results.