Gender differences and long-term outcome of over 75 elderlies in cardiac rehabilitation: highlighting the role of psychological and physical factors through a secondary analysis of a cohort study

Assessing Discriminant Validity through Structural Equation Modeling: The Case of Eating Compulsivity

Food addiction (FA) and disordered eating behaviors related to obesity are gaining attention in clinical and research fields. The modified Yale Food Addiction Scale 2.0 (mYFAS2.0) is the gold standard questionnaire to measure FA, while another tool is the Measure of Eating Compulsivity 10 (MEC10). Discriminant validity is present when two measures of similar but distinct constructs show a correlation that is low enough for the factors to be regarded as distinct. However, the discriminant validity of these measures has never been tested. Through a cross-sectional study design, 717 inpatients (females: 56.20%, age: 53.681 ± 12.74) with severe obesity completed the MEC10, Binge Eating Scale (BES), and mYFAS2.0. A structural equation model (SEM) was fitted, freely estimating latent correlations with 95% confidence intervals (95% CI). The results confirmed the scales' excellent psychometric properties. Importantly, latent factor correlations between MEC10 and mYFAS2.0 (est = 0.783, 95% CI [0.76, 0.80]) supported their discriminant validity. In contrast, the latent correlation of MEC10 and BES (est = 0.86, 95% CI [0.84, 0.87]) exceeded the recommended thresholds, indicating the absence of discriminant validity and suggesting a potential overlap, consistent with previous evidence. In conclusion, MEC10 demonstrates excellent psychometric properties but is more a measure of BED and not FA.

The role of the COVID-19 impersonal threat strengthening the associations of right-wing attitudes, nationalism and anti-immigrant sentiments

Literature showed that the link between right-wing attitudes and ethnocentric attitudes gets stronger under existential threats, but the role exerted by an impersonal threat - as COVID-19 - on right-wing attitudes is still unclear. This study aimed to highlight the role of anxiety exerted by the impersonal COVID-19 threat on the relationship between right-wing attitudes and ethnocentric attitudes, as nationalism and anti-immigrants' sentiments. As part of an international project to evaluate the impact of COVID-19, this study administered an online survey to a representative sample (n 1038). The anxiety generated by an impersonal threat as COVID-19 - thus not exerted by any outgroup - can moderate the relationship among personal Right-Wing Authoritarianism, social dominance orientation, and ethnocentric attitudes. This is the first study demonstrating that existential threat is effective also when exerted by an impersonal agent (as COVID-19) rather than by an outgroup. Second, these findings disclose useful implications for preventive psychological interventions and for social policy makers.

Supplementary information

The online version contains supplementary material available at 10.1007/s12144-023-04305-w.

Weight stigma in patients with overweight and obesity: validation of the Italian Weight Self-Stigma Questionnaire (WSSQ)

PURPOSE

This study aimed to explore the factorial structure of the Italian Weight Self-Stigma Questionnaire (WSSQ) (Study1); and to test structural validity, internal consistency, test-retest reliability, and measurement invariance of the questionnaire across gender, Body Mass Index (BMI), age and occurrence of previous hospitalization for obesity (Study2).

METHODS

At admission into a hospital-based program for weight reduction and rehabilitation, 150 inpatients with overweight/obesity (68% females) completed the WSSQ (Study1). In Study2, in addition to the WSSQ, 446 inpatients (61.9% females) completed the Weight Bias Internalization Scale (WBIS), the Body Uneasiness Test (BUT), and the Center for Epidemiologic Studies Depression Scale (CES-D). A subsample of 40 patients also re-completed the WSSQ at discharge from the hospital.

RESULTS

The Italian WSSQ showed good overlap with the original factorial structure (Study1) and results were confirmed in Study2. Test-retest reliability and convergent validity showed adequate values. Measurement invariance revealed that WSSQ was perfectly invariant across both BMI and the occurrence of previous hospitalizations for obesity. In both studies, the internal consistency of the questionnaire was deemed acceptable.

CONCLUSIONS

The Italian WSSQ is a valid, reliable, and invariant tool for the assessment of weight-related self-stigma among patients with overweight/obesity. Future studies should assess its longitudinal invariance as well as its responsiveness to weight reduction treatments.

LEVEL OF EVIDENCE

V, descriptive study.

Assessment of perceived support in the context of emergency: Development and validation of the psycho-social support scale

In research and clinical contexts, it is important to briefly evaluate perceived Psychological and Social Support (PSS) to plan psychological interventions and allocate efforts and resources. However, an appropriate brief assessment tool for PSS was lacking. This study aimed at developing a brief and accurate scale to specifically measure PSS in clinical and emergency contexts, with specific, relevant, targeted, and irredundant items. Experienced clinicians developed the perceived Psycho-Social Support Scale (PSSS) and administered it to a clinical sample (N = 112) seeking psychological help during the COVID-19 emergency. A Confirmatory Factor Analysis examined the PSSS internal structure, and a Multiple Indicator and Multiple Causes model investigated its association with the number of sessions and emotional symptoms. The PSSS showed good psychometric properties and the Confirmatory Factor Analysis provided acceptable fit indexes for a unidimensional structure. The Multiple Indicators and Multiple Causes revealed that more sessions and emotional symptoms were associated with lower PSSS scores. The PSSS is a reliable brief tool to measure PS and could be useful to individualize treatments (i.e., number of sessions) to efficiently allocate efforts and resources in clinical contexts and emergencies (e.g., earthquake, COVID-19 pandemic).

Supplementary Information

The online version contains supplementary material available at 10.1007/s12144-022-03344-z.

Screening for Distress in Oncological Patients: The Revised Version of the Psychological Distress Inventory (PDI-R)

Background

Psychological research in oncological settings is steadily increasing and the construct of psychological distress has rapidly gained popularity-leading to the development of questionnaires aimed at its measurement. The Psychological Distress Inventory (PDI) is one of the most used instruments, but its psychometric properties were not yet deeply evaluated. The present studies aimed at investigating the psychometric properties of the PDI (Study 1) and providing a revised version of the tool (Study 2).

Methods

Oncological outpatients were enrolled at the Department of Medical Oncology of the Presidio Ospedaliero of Saronno, ASST Valle Olona, Italy. For the first study (N = 251), an Exploratory Graph Analysis was used to explore the item structure of the PDI. In the second study (N = 902), the psychometric properties of the revised PDI (PDI-R) were deeply assessed.

Results

Study 1 showed that the PDI has a not clear structure and it should be reconsidered. On the opposite, Study 2 showed that the revised version (PDI-R) has a solid factorial structure, it is invariant across gender and age, and it has good psychometric properties.

Conclusion

Results suggest that the PDI-R is a reliable measure of psychological distress in different samples of oncological patients, with stronger psychometric properties than the original version. Its use in the clinical and research field is therefore recommended to improve the quality of both assessment and treatment of psychological distress in patients with oncological problems.

The Prevalence and the Impact of Frailty in Hepato-Biliary Pancreatic Cancers: A Systematic Review and Meta-Analysis

Background: Frailty has been associated with increased mortality among hepatobiliary pancreatic (HBP) cancer patients. Nevertheless, estimates of frailty prevalence in HBP cancers and the precise average effect regarding mortality remains uncertain. The present systematic review and meta-analysis aimed to quantify: (1) the prevalence of frailty in patients with liver and pancreatic cancers and (2) the impact of frailty on mortality in patients affected by liver and pancreatic cancers. Methods: MEDLINE/PubMed database search was conducted from inception until 1 November 2021, the pooled prevalence and relative risk (RR) estimate were calculated. Results: A total of 34,276 patients were identified and the weighted prevalence of frailty was 39%; (95% [C.I.] 23–56; I2 = 99.9%, p < 0.0001). Frailty was significantly associated with increased mortality RR 1.98 (95% [C.I.] 1.49–2.63; I2 = 75.9%, p = 0.006). Conclusions: Frailty prevalence is common among HBP cancer patients and exerts a significant negative impact on survival. These findings are characterized by significant heterogeneity and caution is warranted on their interpretation. However, stratification of patients with HBP cancer by frailty status may provide prognostic information and may inform priorities for decision-making strategy.

Psychological difficulties of LVAD patients and caregivers: A follow up over 1 year from discharge

Background

After the rehabilitation program, patients with left ventricular assist device (LVAD) are discharged home, but the adaption to the daily life with the implant is challenging, both with practical and psychological consequences. Literature is lacking detailed information about the quality of life of LVAD patients and caregivers after discharge to home.

Objective

This study aimed at evaluating the post‐discharge outcomes of both LVAD patients and their caregivers in terms of quality of life, affectivity, and psychological health.

Methods

In this observational follow‐up study, LVAD dyads discharged home from 1 year to 6 years were re‐contacted by phone and received by mail an envelope with self‐report questionnaires. Responses of 39 complete dyads of patients (mean age 68.59 ± 4.31; males: 92.31%) and their caregivers (mean age 61.59 ± 11.64; males: 17.95%) were analyzed.

Results

Patients and caregivers reported the moderate levels of anxiety, depression, and caregiver strain, and Illness denial and conscious avoidance were associated between them. The couples often reported that the LVAD has impairments for their sleep and for their affective–sexual relationship. Caregivers often reported impairment in social life and self‐care.

Discussions

Despite the satisfaction for the medical and territorial assistance, patients showed psychological difficulties such as anxious and depressive symptoms and caregivers tend to neglect themselves. Even after a long time from discharge to home, the psychological distress of LVAD patients and caregivers is still considerable. Structured and continuous psychological interventions are required to support their psychological health overtime after the discharge to home.

Factors impacting resilience as a result of exposure to COVID-19: The ecological resilience model

Despite the severe psychological impact of the COVID-19 pandemic, some individuals do not develop high levels of psychological distress and can be termed resilient. Using the ecological resilience model, we examined factors promoting or hindering resilience in the COVID-19 pandemic. Of the 1034 participants (49.9±16.2 years; females 51.2%) from Italian general population, 70% displayed resilient outcomes and 30% reported moderate-severe anxiety and/or depression. A binary regression model revealed that factors promoting resilience were mostly psychological (e.g., trait resilience, conscientiousness) together with social distancing. Conversely, factors hindering resilience included COVID-19-anxiety, COVID-19-related PTSD symptoms, intolerance of uncertainty, loneliness, living with children, higher education, and living in regions where the virus was starting to spread. In conclusion, the ecological resilience model in the COVID-19 pandemic explained 64% of the variance and identified factors promoting or hindering resilient outcomes. Critically, these findings can inform psychological interventions supporting individuals by strengthening factors associated with resilience.

From Fear to Hopelessness: The Buffering Effect of Patient-Centered Communication in a Sample of Oncological Patients during COVID-19

Background: COVID-19 represents a threat both for the physical and psychological health of oncological patients experiencing heightened distress levels to which the fear of the virus is also added. Moreover, fear of COVID-19 could lead oncological patients to experience feelings of hopelessness related to their medical care. Patient-centered communication may act as a buffer against the aforementioned variables. This study aimed to test the role of doctor–patient communication in the relationship between fear of COVID-19 and hopelessness. Methods: During the COVID-19 pandemic, a sample of 90 oncological outpatients was recruited (40 males (44.4%) and 50 females (55.6%), mean age = 66.08 (SD = 12.12)). A structured interview was developed and used during the pandemic to measure the patients’ perceived (A) fear of COVID-19, and (B) feelings of hopelessness, and (C) physicians’ use of empathetic and (D) clear language during the consultation. A multiple mediation model was tested, and the effects between males and females were also compared. Results: Empathetic and clear doctor–patient communication buffered the adverse effect of the fear of COVID-19 on hopelessness through a full-mediation model. The effects did not differ between males and females in the overall model but its indirect effects. Discussions: Patient-centered communication using empathy and clear language can buffer the adverse effect of the fear of COVID-19 and protect oncological patients from hopelessness during the pandemic. These findings might help to improve clinical oncological practice.