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Bode A, Kowal M, Cannas Aghedu F, Kavanagh PS. Romantic Love and Sexual Frequency: Challenging Beliefs. JOURNAL OF SEX & MARITAL THERAPY 2024; 50:894-905. [PMID: 39175258 DOI: 10.1080/0092623x.2024.2394670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/24/2024]
Abstract
Common conceptions of romantic love suggest that romantic love is associated with increased sexual activity with more frequent sex in the earlier stages of a romantic relationship. To our knowledge, no studies have investigated individual-level factors and sexual frequency using a validated measure of romantic love. This study tested a number of hypotheses about the factors associated with sexual frequency among 720 sexually active young adults experiencing romantic love from the Romantic Love Survey 2022. We hypothesized that relationship duration, the intensity of romantic love and obsessive thinking about a loved one, commitment, and hypomanic-like features would be associated with sexual frequency. Using hierarchical linear regression, controlling for known covariates, we found no significant associations between any of our variables of interest and the sexual frequency and our entire model of 14 well-reasoned predictors explained only 4.06% of the variation in sexual frequency. The findings are surprising and highlight how little is currently known about sexual activity and sexual desire among individuals experiencing romantic love.
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Affiliation(s)
- Adam Bode
- School of Archaeology and Anthropology, ANU College of Arts and Social Sciences, The Australian National University, Canberra, ACT, Australia
| | - Marta Kowal
- IDN Being Human Lab, University of Wrocław, Wrocław, Poland
| | | | - Phillip S Kavanagh
- Discipline of Psychology, Faculty of Health, University of Canberra, Bruce, ACT, Australia
- Justice and Society, University of South Australia, Magill, SA, Australia
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2
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Marazziti D. Response to the letter to the editor: "The price of love: how sleep, and dysregulated clocks may account for its obsessive-compulsive related behaviors" by Miguel Meira e Cruz. CNS Spectr 2023; 28:651-652. [PMID: 36852707 DOI: 10.1017/s1092852923000068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Affiliation(s)
- Donatella Marazziti
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
- Unicamillus-Saint Camillus International University of Health Sciences, Rome, Italy
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Bode A, Kavanagh PS. Romantic Love and Behavioral Activation System Sensitivity to a Loved One. Behav Sci (Basel) 2023; 13:921. [PMID: 37998668 PMCID: PMC10669312 DOI: 10.3390/bs13110921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/31/2023] [Accepted: 11/07/2023] [Indexed: 11/25/2023] Open
Abstract
Research investigating the mechanisms that contribute to romantic love is in its infancy. The behavioral activation system is one biopsychological system that has been demonstrated to play a role in several motivational outcomes. This study was the first to investigate romantic love and the behavioral activation system. In study 1, the Behavioral Activation System-Sensitivity to a Loved One (BAS-SLO) Scale was validated in a sample of 1556 partnered young adults experiencing romantic love. In study 2, hierarchical linear regression was used to identify BAS-SLO Scale associations with the intensity of romantic love in a subsample of 812 partnered young adults experiencing romantic love for two years or less. The BAS-SLO Scale explained 8.89% of the variance in the intensity of romantic love. Subject to further validation and testing, the BAS-SLO Scale may be useful in future neuroimaging and psychological studies. The findings are considered in terms of the mechanisms and evolutionary history of romantic love.
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Affiliation(s)
- Adam Bode
- School of Archaeology and Anthropology, ANU College of Arts and Social Sciences, The Australian National University, Canberra, ACT 2601, Australia
| | - Phillip S. Kavanagh
- Discipline of Psychology, Faculty of Health, University of Canberra, Bruce, ACT 2617, Australia;
- Justice and Society, University of South Australia, Magill, SA 5072, Australia
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Bode A. Romantic love evolved by co-opting mother-infant bonding. Front Psychol 2023; 14:1176067. [PMID: 37915523 PMCID: PMC10616966 DOI: 10.3389/fpsyg.2023.1176067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 09/18/2023] [Indexed: 11/03/2023] Open
Abstract
For 25 years, the predominant evolutionary theory of romantic love has been Fisher's theory of independent emotion systems. That theory suggests that sex drive, romantic attraction (romantic love), and attachment are associated with distinct neurobiological and endocrinological systems which evolved independently of each other. Psychological and neurobiological evidence, however, suggest that a competing theory requires attention. A theory of co-opting mother-infant bonding sometime in the recent evolutionary history of humans may partially account for the evolution of romantic love. I present a case for this theory and a new approach to the science of romantic love drawing on human psychological, neurobiological, and (neuro)endocrinological studies as well as animal studies. The hope is that this theoretical review, along with other publications, will generate debate in the literature about the merits of the theory of co-opting mother-infant bonding and a new evolutionary approach to the science of romantic love.
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Bode A, Kuula L. Romantic Love and Sleep Variations: Potential Proximate Mechanisms and Evolutionary Functions. BIOLOGY 2021; 10:923. [PMID: 34571801 PMCID: PMC8468029 DOI: 10.3390/biology10090923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 09/07/2021] [Accepted: 09/10/2021] [Indexed: 11/16/2022]
Abstract
This article provides a narrative review of what is known about romantic love and sleep variations and provides possible explanations for the association. Romantic love and sleep are described using a comprehensive, unifying framework advocated by Tinbergen. We summarise the findings of studies investigating the relationship between romantic love and sleep. Sleep variations are associated with romantic love in adolescents and young adults. We then detail some proximate mechanisms that may contribute to sleep variations in people experiencing romantic love before considering potential evolutionary functions of sleep variations in people experiencing romantic love. The relationship between symptoms of psychopathology and sleep variations in people experiencing romantic love is described. With the current state of knowledge, it is not possible to determine whether sleep variations associated with romantic love are adaptations or by-products of romantic love. We conclude by proposing areas for future research.
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Affiliation(s)
- Adam Bode
- School of Archaeology and Anthropology, ANU College of Arts and Social Sciences, The Australian National University, Canberra ACT 0200, Australia
| | - Liisa Kuula
- SleepWell Research Program, Faculty of Medicine, University of Helsinki, 00100 Helsinki, Finland
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6
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Bode A, Kushnick G. Proximate and Ultimate Perspectives on Romantic Love. Front Psychol 2021; 12:573123. [PMID: 33912094 PMCID: PMC8074860 DOI: 10.3389/fpsyg.2021.573123] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 03/12/2021] [Indexed: 12/20/2022] Open
Abstract
Romantic love is a phenomenon of immense interest to the general public as well as to scholars in several disciplines. It is known to be present in almost all human societies and has been studied from a number of perspectives. In this integrative review, we bring together what is known about romantic love using Tinbergen’s “four questions” framework originating from evolutionary biology. Under the first question, related to mechanisms, we show that it is caused by social, psychological mate choice, genetic, neural, and endocrine mechanisms. The mechanisms regulating psychopathology, cognitive biases, and animal models provide further insights into the mechanisms that regulate romantic love. Under the second question, related to development, we show that romantic love exists across the human lifespan in both sexes. We summarize what is known about its development and the internal and external factors that influence it. We consider cross-cultural perspectives and raise the issue of evolutionary mismatch. Under the third question, related to function, we discuss the fitness-relevant benefits and costs of romantic love with reference to mate choice, courtship, sex, and pair-bonding. We outline three possible selective pressures and contend that romantic love is a suite of adaptions and by-products. Under the fourth question, related to phylogeny, we summarize theories of romantic love’s evolutionary history and show that romantic love probably evolved in concert with pair-bonds in our recent ancestors. We describe the mammalian antecedents to romantic love and the contribution of genes and culture to the expression of modern romantic love. We advance four potential scenarios for the evolution of romantic love. We conclude by summarizing what Tinbergen’s four questions tell us, highlighting outstanding questions as avenues of potential future research, and suggesting a novel ethologically informed working definition to accommodate the multi-faceted understanding of romantic love advanced in this review.
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Affiliation(s)
- Adam Bode
- Human Behavioural Ecology Research Group, School of Archaeology and Anthropology, ANU College of Arts and Social Sciences, The Australian National University, Canberra, ACT, Australia
| | - Geoff Kushnick
- Human Behavioural Ecology Research Group, School of Archaeology and Anthropology, ANU College of Arts and Social Sciences, The Australian National University, Canberra, ACT, Australia
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Barton J, Kyle SD, Varese F, Jones SH, Haddock G. Are sleep disturbances causally linked to the presence and severity of psychotic-like, dissociative and hypomanic experiences in non-clinical populations? A systematic review. Neurosci Biobehav Rev 2018; 89:119-131. [DOI: 10.1016/j.neubiorev.2018.02.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 01/26/2018] [Accepted: 02/12/2018] [Indexed: 12/15/2022]
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Riela S, Bajoghli H, Xu X(M, Farnia V, Golshani S, Shakeri J. Falling in love and passionate love in an Iranian sample. INTERPERSONA: AN INTERNATIONAL JOURNAL ON PERSONAL RELATIONSHIPS 2018. [DOI: 10.5964/ijpr.v11i2.272] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Romantic relationships and passionate love are topics of perennial interest to scientists and the lay public alike. While there is evidence of romantic love across many cultures, with some suggesting it is a universal human experience, the majority of research has been conducted in Western countries (e.g., the U.S.). When other cultures have been researched, the focus has typically been on Eastern countries (e.g., Japan). Much less is known about love experiences in countries such as Iran. The current study sought to address this gap and assessed 220 Iranian students. Participants completed a set of measures (translated into Farsi) and reported both qualitatively and quantitatively about love experiences (e.g., narrative account of their most recent falling in love experience, ratings about their relationship if they were currently in one). The majority of participants reported having fallen in love, although this was a notably smaller proportion (55%) than seen in past research. Similarly, content-analysis of narratives revealed fewer instances of 12 common precursors to falling in love found in past samples, though Iranian participants did highly endorse precursors when explicitly asked about them. Those in a relationship reported passionate love and high levels of closeness to their partner. This study highlights the need for additional love research in under-studied cultures, including research that can elucidate whether these results are due to actual differences in experiences, differences in reporting norms, third variables, or some combination.
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Jahangard L, Rahmani A, Haghighi M, Ahmadpanah M, Sadeghi Bahmani D, Soltanian AR, Shirzadi S, Bajoghli H, Gerber M, Holsboer-Trachsler E, Brand S. "Always Look on the Bright Side of Life!" - Higher Hypomania Scores Are Associated with Higher Mental Toughness, Increased Physical Activity, and Lower Symptoms of Depression and Lower Sleep Complaints. Front Psychol 2017; 8:2130. [PMID: 29312026 PMCID: PMC5733035 DOI: 10.3389/fpsyg.2017.02130] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 11/22/2017] [Indexed: 12/20/2022] Open
Abstract
Background: In the present study, we explored the associations between hypomania, symptoms of depression, sleep complaints, physical activity and mental toughness. The latter construct has gained interest for its association with a broad variety of favorable behavior in both clinical and non-clinical samples. Subjects and Methods: The non-clinical sample consisted of 206 young adults (M = 21.3 years; age range: 18–24 years; 57.3% males). They completed questionnaires covering hypomania, mental toughness, symptoms of depression, physical activity, and sleep quality. Results: Higher hypomania scores were associated with higher mental toughness, increased physical activity, lower symptoms of depression and lower sleep complaints. No gender differences were observed. Higher hypomania scores were predicted by higher scores of mental toughness subscales of control and challenge, and physical activity. Conclusion: The pattern of results suggests that among a non-clinical sample of young adults, self-rated hypomania scores were associated with higher scores on mental toughness and physical activity, along with lower depression and sleep complaints. The pattern of results further suggests that hypomania traits are associated with a broad range of favorable psychological, behavioral and sleep-related traits, at least among a non-clinical sample of young adults.
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Affiliation(s)
- Leila Jahangard
- Research Center for Behavioral Disorders and Substances Abuse, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Anahita Rahmani
- Research Center for Behavioral Disorders and Substances Abuse, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohammad Haghighi
- Research Center for Behavioral Disorders and Substances Abuse, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohammad Ahmadpanah
- Research Center for Behavioral Disorders and Substances Abuse, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Dena Sadeghi Bahmani
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric Clinics (UPK), University of Basel, Basel, Switzerland
| | - Ali R Soltanian
- Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Shahriar Shirzadi
- Research Center for Behavioral Disorders and Substances Abuse, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Hafez Bajoghli
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Markus Gerber
- Division of Sport and Psychosocial Health, Department of Sport, Exercise and Health, Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Edith Holsboer-Trachsler
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric Clinics (UPK), University of Basel, Basel, Switzerland
| | - Serge Brand
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric Clinics (UPK), University of Basel, Basel, Switzerland.,Division of Sport and Psychosocial Health, Department of Sport, Exercise and Health, Faculty of Medicine, University of Basel, Basel, Switzerland.,Substance Abuse Prevention Research Center, Department of Psychiatry, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Sleep Disorder Research Center, Department of Psychiatry, Kermanshah University of Medical Sciences, Kermanshah, Iran
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10
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Positive affect and sleep: A systematic review. Sleep Med Rev 2017; 35:21-32. [DOI: 10.1016/j.smrv.2016.07.006] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Revised: 07/13/2016] [Accepted: 07/18/2016] [Indexed: 01/19/2023]
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11
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Talero-Gutierrez C, Durán-Torres F, Ibañez-Pinilla M, Perez-Olmos I, Echeverria-Palacio CM. Sleep quality perception and romantic relationships in university students: cross-sectional study. REVISTA DE LA FACULTAD DE MEDICINA 2017. [DOI: 10.15446/revfacmed.v65n2.58396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introducción. El sueño en adolescentes está influenciado de manera especial por los estados emocionales presentes en las relaciones románticas. Esto puede ser determinante en la percepción de calidad del sueño.Objetivo. Evaluar la asociación entre la percepción de la calidad del sueño y las características de las relaciones románticas en estudiantes universitarios adolescentes y adultos jóvenes.Materiales y métodos. Estudio de corte transversal realizado en 443 sujetos. La percepción de calidad del sueño, los estilos de apego, estar en una relación romántica y sus características se determinaron utilizando medidas validadas.Resultados. La percepción de calidad del sueño se determinó utilizando cinco modelos multivariados que incluyeron características estadísticamente significativas de las relaciones románticas. El nivel de satisfacción del individuo con su relación de pareja y la atracción hacia esta se asoció con su nivel de percepción de calidad del sueño (p=0.035). La prevalencia de las relaciones románticas fue del 64% (IC95%: 59.4-68.9). Los que no estaban en una relación experimentaron latencia del sueño significativamente más prolongada (p<0.05).Conclusión. Las relaciones sentimentales románticas y sus características se asocian con la calidad de sueño percibida por los individuos. Estos aspectos pueden ser identificados e intervenidos y ser útiles para los sistemas de apoyo de las instituciones educativas.
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Bajoghli H, Farnia V, Joshaghani N, Haghighi M, Jahangard L, Ahmadpanah M, Sadeghi Bahmani D, Holsboer-Trachsler E, Brand S. "I love you forever (more or less)" - stability and change in adolescents' romantic love status and associations with mood states. ACTA ACUST UNITED AC 2017; 39:323-329. [PMID: 28380109 PMCID: PMC7111418 DOI: 10.1590/1516-4446-2016-2126] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 01/03/2017] [Indexed: 12/03/2022]
Abstract
Objective: Experiencing romantic love is an important part of individual development. Here, we investigated stability and change in romantic love and psychological correlates, including mood states, anxiety, and sleep, among Iranian adolescents over a period of 8 months. Method: Two hundred and one adolescents who had taken part in a previous study were contacted; 157 responded. Participants completed a questionnaire covering sociodemographic data, current state of love, and mood, including symptoms of depression, anxiety (state and trait), and hypomania. They also completed a sleep and activity log. Results: Of 64 participants formerly in love, 45 were still in love; of 86 participants not in love at baseline, 69 were still not in love (overall stability, 76%); 17 had fallen in love recently while 19 were no longer in love. Significant and important changes in mood and anxiety were observed in that experiencing romantic love was associated with higher anxiety scores. Hypomania scores increased in those newly in love, and decreased in those in a longer-lasting romantic relationship. Sleep and sleep-related variables were not associated with romantic love status. Conclusion: These findings suggest that, among Iranian adolescents, the state of love is fairly stable, and that love status seems to be associated with specific states of mood and anxiety.
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Affiliation(s)
- Hafez Bajoghli
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | - Vahid Farnia
- Substance Abuse Prevention Research Center, Psychiatry Department, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Narges Joshaghani
- Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Haghighi
- Behavioral Disorders and Substances Abuse Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Leila Jahangard
- Behavioral Disorders and Substances Abuse Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohammad Ahmadpanah
- Behavioral Disorders and Substances Abuse Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Dena Sadeghi Bahmani
- Stress and Sleep Disorders (ZASS), University of Basel, Psychiatric Clinics (UPK), Center for Affective, Basel, Switzerland
| | - Edith Holsboer-Trachsler
- Stress and Sleep Disorders (ZASS), University of Basel, Psychiatric Clinics (UPK), Center for Affective, Basel, Switzerland
| | - Serge Brand
- Stress and Sleep Disorders (ZASS), University of Basel, Psychiatric Clinics (UPK), Center for Affective, Basel, Switzerland.,Exercise and Health, Division of Sport Science and Psychosocial Health, University of Basel, Department of Sport, Basel, Switzerland
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13
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Benarous X, Mikita N, Goodman R, Stringaris A. Distinct relationships between social aptitude and dimensions of manic-like symptoms in youth. Eur Child Adolesc Psychiatry 2016; 25:831-42. [PMID: 26650482 PMCID: PMC4967092 DOI: 10.1007/s00787-015-0800-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2015] [Accepted: 11/17/2015] [Indexed: 01/28/2023]
Abstract
Difficulties with interpersonal relationships have been reported in children and adolescents with manic symptoms, even if they do not fulfil criteria for a manic episode. The role of social aptitude (SA) in youths with manic symptoms has never been examined in the general population. Moreover, no study has examined whether SA is differentially associated with dimensions of manic symptoms. We hypothesised that youth with predominantly undercontrol manic symptoms (characterised by irritability) would show lower levels of SA; conversely, youth with predominantly exuberant symptoms would show better than average social skills. Our sample comprised 5325 participants from the 2004 British Child and Adolescent Mental Health Survey (B-CAMHS04), mean age 10.3 years, SD = 3.3, 48 % girls. Manic symptoms were assessed with the Development and Wellbeing Assessment by interviewing parents and young people. Children and adolescents with manic symptoms had a lower SA score, compared to the general population by parent report, but not by self-report. SA score was higher in youths with predominantly exuberant manic symptoms compared to the general population; whereas the youths with predominantly undercontrol manic symptoms had lower SA scores by parent and self-report. Our results provide further evidence for the distinction between exuberant and undercontrol manic symptoms and highlight the need to focus on SA in future research.
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Affiliation(s)
- Xavier Benarous
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Box P085, De Crespigny Park, Denmark Hill, London, SE5 8AF, UK. .,Department of Child and Adolescent Psychiatry, Hôpital Pitié-Salpêtrière, 47-83, Boulevard de l'Hôpital, 75013, Paris, France. .,, 19 rue de Turenne, 75004, Paris, France.
| | - Nina Mikita
- King’s College London, Institute of Psychiatry, Psychology and Neuroscience, Box P085, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
| | - Robert Goodman
- King’s College London, Institute of Psychiatry, Psychology and Neuroscience, Box P085, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
| | - Argyris Stringaris
- King’s College London, Institute of Psychiatry, Psychology and Neuroscience, Box P085, De Crespigny Park, Denmark Hill, London, SE5 8AF UK
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14
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Fornaro M, De Berardis D, Mazza M, Pino M, Favaretto E, Bedani F, Wieser C, Indelicato L, Paternò VF, Lo Monaco F, Dugo F, Ventriglio A, Mungo S, Selle V, Valchera A, Elassy M, Martinotti G, De Bartolomeis A, Iasevoli F, Tomasetti C, Avvisati L, Tartaglione S, Perna G, Cattaneo CI, Consoli G, Romano A, Del Debbio A, Martino M, D' Angelo E, De Pasquale C, Koshy AS, Angst J. Factor structure and reliability of the Italian adaptation of the Hypomania Check List-32, second revision (HCL-32-R2). J Affect Disord 2015; 178:112-20. [PMID: 25805403 DOI: 10.1016/j.jad.2015.03.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 02/25/2015] [Accepted: 03/01/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To assess the psychometric properties of the Italian adaptation of the Hypomania-Check-List 32-item, second revision (HCL-32-R2) for the detection of bipolarity in major depressive disorder (MDD) treatment-seeking outpatients. METHODS A back-to-back Italian adaption of the "Bipolar Disorders: Improving Diagnosis, Guidance, and Education" English module of the HCL-32-R2 was administered between March 2013 and October 2014 across twelve collaborating sites in Italy. Diagnostic and Statistical Manual Fourth edition (DSM-IV) diagnoses were made adopting the mini-international neuropsychiatric interview, using bipolar disorder (BD) patients as controls. RESULTS In our sample (n=441, of whom, BD-I=68; BD-II=117; MDD=256), using a cut-off of 14 allowed the HCL-32-R2 to discriminate DSM-IV-defined MDD patients between "true unipolar" (HCL-32-R2(-)) and "sub-threshold bipolar depression" (HCL-32-R2(+)) with sensitivity=89% and specificity=79%. Area under the curve was .888; positive and negative predictive values were 75.34% and 90.99% respectively. Owing to clinical interpretability considerations and consistency with previous adaptations of the HCL-32, a two-factor solution (F1="hyperactive/elated" vs. F2="irritable/distractible/impulsive") was preferred using exploratory and confirmatory factor analyses, whereas items n.33 ("I gamble more") and n.34 ("I eat more") introduced in the R2 version of the scale slightly loaded onto F2 and F1 respectively. Cronbach׳s α=.88 for F1 and .71 for F2. LIMITATIONS No cross-validation with any additional validated screening tool; treatment-seeking outpatient sample; recall bias; no systematic evaluation of eventual medical/psychiatric comorbidities, current/lifetime pharmacological history, neither record of severity of current MDE. CONCLUSIONS Our results seem to indicate fair accuracy of HCL-32 as a screening instrument for BD, though replication studies are warranted.
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Affiliation(s)
- Michele Fornaro
- Department of Education Science, University of Catania, Catania, Italy; Polyedra Research Group, Italy.
| | - Domenico De Berardis
- Polyedra Research Group, Italy; National Health Service, Department of Mental Health, Psychiatric Service of Diagnosis and Treatment, Hospital "G. Mazzini", ASL 4, Teramo, Italy.
| | - Monica Mazza
- Polyedra Research Group, Italy; Department of Life, Health and Environmental Sciences, University of L׳Aquila, L׳Aquila, Italy.
| | - Mariachiara Pino
- Department of Life, Health and Environmental Sciences, University of L׳Aquila, L׳Aquila, Italy.
| | - Ettore Favaretto
- Department of Psychiatry of Bressanone (Brixen), Bolzano (Bozen), Italy.
| | - Fulvio Bedani
- Department of Psychiatry of Bressanone (Brixen), Bolzano (Bozen), Italy.
| | - Christian Wieser
- Department of Psychiatry of Bressanone (Brixen), Bolzano (Bozen), Italy.
| | - Luisa Indelicato
- Department of Education Science, University of Catania, Catania, Italy.
| | - Vito Fabio Paternò
- Centro siciliano per la cura di Depressione e Ansia (CESIDEA), Catania, Italy; Ospedale San Raffaele, Milano, Italy.
| | | | - Febronia Dugo
- Department of Education Science, University of Catania, Catania, Italy.
| | - Antonio Ventriglio
- Section of Psychiatry, University of Foggia, Department of Clinical and Experimental Medicine, Foggia, Italy.
| | - Sergio Mungo
- Department of Psychiatry, University of Genova, Genoa, Italy.
| | | | - Alessandro Valchera
- Polyedra Research Group, Italy; Casa di Cura Villa San Giuseppe, Via dei Girasoli, n.6, 63100 Ascoli Piceno, Italy.
| | - Mai Elassy
- Department of Psychiatry, Mansoura Faculty of Medicine, Mansoura City, Egypt.
| | - Giovanni Martinotti
- Polyedra Research Group, Italy; Department of Neuroscience and Imaging, University "G. d׳Annunzio", Chieti, Italy.
| | - Andrea De Bartolomeis
- Section of Psychiatry - Department of Neuroscience - University School of Naples "Federico II", Naples, Italy.
| | - Felice Iasevoli
- Polyedra Research Group, Italy; Section of Psychiatry - Department of Neuroscience - University School of Naples "Federico II", Naples, Italy.
| | - Carmine Tomasetti
- Polyedra Research Group, Italy; Section of Psychiatry - Department of Neuroscience - University School of Naples "Federico II", Naples, Italy; National Health Service, Department of Mental Health, Unit of Psychiatry, Isernia, Italy.
| | - Livia Avvisati
- Section of Psychiatry - Department of Neuroscience - University School of Naples "Federico II", Naples, Italy.
| | - Sergio Tartaglione
- National Health Service, Department of Mental Health, Unit of Psychiatry, Isernia, Italy.
| | - Giampaolo Perna
- Polyedra Research Group, Italy; Department of Clinical Neuroscience, San Benedetto Hospital, Hermanas Hospitalarias, Albese con Cassano, Como, Italy.
| | | | | | - Anna Romano
- Department of Psychiatry, University of Pisa, Pisa, Italy.
| | | | - Matteo Martino
- Department of Psychiatry, University of Genova, Genoa, Italy.
| | | | | | - Ann Sarah Koshy
- St. John׳s National Academy of Health Sciences, Bangalore, India.
| | - Jules Angst
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland.
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