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Cheng C, Zheng M, Yan F, Wu Y, Li T, Cao Z, Yue J, Chen P, Zheng Z, Fan T, Li C, Cui P. A chain mediation model reveals the association between metacognition and quality of life in hematologic tumor patients. Sci Rep 2024; 14:18446. [PMID: 39117715 PMCID: PMC11310524 DOI: 10.1038/s41598-024-69027-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 07/30/2024] [Indexed: 08/10/2024] Open
Abstract
The study aims to explore the relationship among metacognition (MC), fear of disease of progression (FoP), psychological distress (PD), and quality of life (QoL), and verify whether FoP and PD have a chain mediating effect between MC and QoL. 231 hematologic tumor patients in a large tertiary hospital were investigated by using Meta-Cognitions Questionnaire-30, Fear of Progression Questionnaire-Short Form, Hospital Anxiety and Depression Scale, and Functional Assessment of Cancer Therapy scale. Data analyses were performed using IBM SPSS (version 25.0) and the PROCESS macro (version 4.1). The results showed that the direct impact of MC on QoL was not statistically significant. However, the indirect influence of MC on QoL manifest through the independent influences of PD and FoP, as well as the chain mediating effect of "PD → FoP." In addition, all four dimensions of QoL (physical, social and family, emotional, and functional) satisfy the chain mediation model, except for the social and family domain. These insights advance our comprehension of the intricate interplay between MC and QoL, underscoring the importance of improving MC to alleviate patients' PD, mitigate FoP, and ultimately improve the QoL of hematologic tumor patients.
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Affiliation(s)
- Chunyan Cheng
- Hematology department, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Meiqiong Zheng
- Hematology department, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Fan Yan
- Hematology department, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Yanrong Wu
- Hematology department, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Ting Li
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Zhengfang Cao
- Hematology department, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Jiaojiao Yue
- Hematology department, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Pan Chen
- Hematology department, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Zhongxia Zheng
- Hematology department, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Tongfang Fan
- Hematology department, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Chunpeng Li
- Intensive Care Medicine Department, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China
| | - Panpan Cui
- Department of Nursing, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China.
- Henan Provincial Intelligent Nursing and Transformation Engineering Research Center, Henan Provincial Key Medicine Laboratory of Nursing, No. 7 Weiwu Road, Zhengzhou, China.
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Vassou C, Tsiampalis T, Georgousopoulou EN, Chrysohoou C, Yannakoulia M, Pitsavos C, Cropley M, Panagiotakos DB. Association Between Family History of Diabetes, Irrational Beliefs, and Health Anxiety with 10-Year Risk of Type 2 Diabetes Mellitus: the ATTICA Epidemiological Study (2002-2012). Int J Behav Med 2024; 31:516-526. [PMID: 37322363 PMCID: PMC11269384 DOI: 10.1007/s12529-023-10189-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND This study aimed to examine the relationship between family history of diabetes, irrational beliefs, and health anxiety in the development of type 2 diabetes mellitus (T2DM). METHOD ATTICA is a prospective, cohort study (2002-2012). The working sample included 845 participants (18-89 years), free of diabetes at baseline. Α detailed biochemical, clinical, and lifestyle evaluation was performed, while participants' irrational beliefs and health anxiety were assessed through the Irrational Beliefs Inventory and the Whiteley index scale, respectively. We evaluated the association between the participants' family history of diabetes mellitus with the 10-year risk of diabetes mellitus, both in the total study's sample and separately according to their levels of health anxiety and irrational beliefs. RESULTS The crude 10-year risk of T2DM was 12.9% (95%CI: 10.4, 15.4), with 191 cases of T2DM. Family history of diabetes was associated with 2.5 times higher odds (2.53, 95%CI 1.71, 3.75) of T2DM compared to those without family history. Among participants with family history of diabetes, the highest likelihood of developing T2DM, regarding their tested psychological features (i.e., low/high irrational beliefs in the entire group, low/high health anxiety in the entire group, and low/high irrational beliefs, low/high healthy anxiety), had people with high irrational beliefs, low health anxiety (OR 3.70, 95%CI 1.83, 7.48). CONCLUSIONS The findings underline the important moderating role of irrational beliefs and health anxiety in the prevention of T2DM, among participants at increased risk of T2DM.
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Affiliation(s)
- Christina Vassou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 70 Eleftheriou Venizelou Ave., Kallithea, Athens, 176 76, Greece
| | - Thomas Tsiampalis
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 70 Eleftheriou Venizelou Ave., Kallithea, Athens, 176 76, Greece
| | | | - Christina Chrysohoou
- First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 70 Eleftheriou Venizelou Ave., Kallithea, Athens, 176 76, Greece
| | - Christos Pitsavos
- First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece
| | - Mark Cropley
- School of Psychology, University of Surrey, Guildford, UK
| | - Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 70 Eleftheriou Venizelou Ave., Kallithea, Athens, 176 76, Greece.
- Faculty of Health, University of Canberra, Canberra, Australia.
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Havnen A, Anyan F, Nordahl H. Metacognitive strategies mediate the association between metacognitive beliefs and perceived quality of life. Scand J Psychol 2024; 65:656-664. [PMID: 38448717 DOI: 10.1111/sjop.13015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 02/13/2024] [Accepted: 02/22/2024] [Indexed: 03/08/2024]
Abstract
Quality of life may be understood as a multidimensional evaluation of life circumstances in relation to values, expectations, and perceived well-being. Quality of life is thus dependent on the subjective perception of the current life situation, not only objective circumstances. According to metacognitive theory, metacognition guides the appraisal of inner experiences (i.e., thoughts and feelings) and influences how one relates to external stressors. Hence, dysfunctional metacognitive beliefs and the cognitive attentional syndrome (CAS), which includes perseverative thinking, threat monitoring and ineffective coping strategies, may negatively influence subjective quality of life. Therefore, we aimed to investigate if metacognitive beliefs and CAS strategies were associated with quality of life. A sample of 503 participants (77.1% women, mean age 41.0, SD = 11.5) completed the metacognitions questionnaire 30 (MCQ-30), the CAS-1 and the quality of life scale (QOLS). We used structural equation modelling (SEM) to estimate associations between the variables founded in metacognitive theory. The results of the SEM showed a significant direct relationship between metacognitive beliefs and quality of life. CAS strategies mediated the effect of metacognitive beliefs on quality of life. Higher level of metacognitive beliefs was associated with greater use of CAS strategies, which in turn was associated with lower quality of life. Further, more CAS strategies were associated with lower quality of life. The results support the generic metacognitive model and suggest that stronger endorsement of dysfunctional metacognitive beliefs and corresponding CAS strategies are associated with lower quality of life. This observation held even when controlling for relevant covariates and suggests that modifying metacognitive beliefs may impact on subjective quality of life.
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Affiliation(s)
- Audun Havnen
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
- Nidaros Community Mental Health Centre, Division of Psychiatry, St. Olavs University Hospital, Trondheim, Norway
| | - Frederick Anyan
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Henrik Nordahl
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
- Nidaros Community Mental Health Centre, Division of Psychiatry, St. Olavs University Hospital, Trondheim, Norway
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Pedersen SG, Anke A, Friborg O, Ørbo MC, Løkholm MT, Kirkevold M, Heiberg G, Halvorsen MB. Metacognitive beliefs, mood symptoms, and fatigue four years after stroke: An explorative study. PLoS One 2024; 19:e0305896. [PMID: 38917133 PMCID: PMC11198774 DOI: 10.1371/journal.pone.0305896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 06/05/2024] [Indexed: 06/27/2024] Open
Abstract
OBJECTIVE This cross-sectional study investigated the relationship between metacognition and mood symptoms four years post-stroke and examined fatigue as a potential moderator for this relationship. METHODS A number of 143 participants completed a survey that included the Hospital Anxiety and Depression Scale (HADS), the Metacognition Questionnaire-30 (MCQ-30), the Fatigue Severity Scale (FSS), and the modified Rankin Scale (mRS) (functional status) four years after stroke. Multiple regression analyses adjusting for demographic and stroke-specific covariates were performed with anxiety and depression as dependent variables and fatigue as a moderator. RESULTS The proportions of participants satisfying the caseness criteria for anxiety and depression were 20% and 19%, respectively, and 35% reported severe fatigue. Analysed separately, all MCQ-30 subscales contributed significantly to anxiety, whereas only three MCQ-30 subscales contributed significantly to depression. In the adjusted analyses, the MCQ-30 subscales 'positive beliefs' (p < 0.05) and 'uncontrollability and danger' (p < 0.001), as well as fatigue (p < 0.001) and functional status at four years (p < 0.05) were significantly associated with anxiety symptoms. Similarly, the MCQ-30 subscales 'cognitive confidence' (p < 0.05) and 'self-consciousness' (p < 0.05), as well as fatigue (p < 0.001), stroke severity at baseline (p < 0.01), and functional status at four years (p < 0.01) were significantly associated with depression symptoms. Fatigue did not significantly moderate the relationship between any MCQ-30 subscale and HADS scores. CONCLUSION Maladaptive metacognitions were associated with the mood symptoms of anxiety and depression, independent of fatigue, even after controlling for demographic and stroke-specific factors. Future studies should implement longitudinal designs to determine whether metacognitions precede anxiety or depression after a stroke, and more strongly indicate the potential of metacognitive therapy for improving the mental health of individuals after a stroke.
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Affiliation(s)
- Synne G. Pedersen
- Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway
| | - Audny Anke
- Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway
- Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Model and Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Clinical Medicine, Faculty of Health Sciences, UiT–The Arctic University of Norway, Tromsø, Norway
| | - Oddgeir Friborg
- Department of Psychology, Faculty of Health Sciences, UiT–The Arctic University of Norway, Tromsø, Norway
| | - Marte C. Ørbo
- Department of Psychology, Faculty of Health Sciences, UiT–The Arctic University of Norway, Tromsø, Norway
| | - Mari T. Løkholm
- Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway
| | - Marit Kirkevold
- Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Model and Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
- Faculty of Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Guri Heiberg
- Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway
| | - Marianne B. Halvorsen
- Department of Pediatric Rehabilitation, University Hospital of North Norway, Tromsø, Norway
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Kołodziejczyk A, Krawczyk J, Tkaczyszyn-Mika E, Gniewczyńska J, Ziarko M, Zozulińska-Ziółkiewicz D, Pawłowski T. The Role of Metacognition in the Prediction of Depressive and Anxiety Symptoms in Chronically Ill Patients. J Clin Med 2024; 13:1306. [PMID: 38592170 PMCID: PMC10932318 DOI: 10.3390/jcm13051306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 02/18/2024] [Accepted: 02/23/2024] [Indexed: 04/10/2024] Open
Abstract
INTRODUCTION Cancer, diabetes, and heart diseases are frequent causes of depression and anxiety. The study explored the metacognitive beliefs manifested by chronically ill patients and the presence of depressive or anxiety symptoms and the predictive role of metacognition in both. METHODS A total of 254 chronically ill patients participated in the study. The Metacognitive Questionnaire was used to measure the patients' metacognitive beliefs, whereas the Hospital Anxiety and Depression Scale was applied to evaluate their psychopathological symptoms. A correlation analysis was performed to explore the relationships between metacognition and psychopathological symptoms. Regression analyses were conducted to examine the predictive role of metacognition in anxiety and depression. RESULTS The Negative Beliefs about Uncontrollability and Danger scale correlated with both anxiety and depression scales, and the Cognitive Confidence scale correlated with the depression scale. Linear regression analyses indicated that metacognitive beliefs were responsible for 32.2% of the variance of anxiety symptoms among all the chronically ill. Metacognitive beliefs accounted for 48.8% of the variance in anxiety symptoms and 36.6% in depressive symptoms among diabetes patients. CONCLUSIONS There are specific correlations between psychopathological symptoms and metacognition among chronically ill patients. Metacognitions have a moderate role in developing and sustaining anxiety and depressive symptoms.
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Affiliation(s)
- Agata Kołodziejczyk
- Division of Psychotherapy and Psychosomatic Medicine, Department of Psychiatry, Wroclaw Medical University, 50-367 Wrocław, Poland
- Lower Silesian Oncology, Pulmonology and Hematology Center, 53-413 Wroclaw, Poland
| | - Julia Krawczyk
- Department of Health and Clinical Psychology, University of Adam Mickiewicz, 60-568 Poznan, Poland
- Department and Clinic of Internal Medicine and Diabetology, Medical University of Karol Marcinkowski, 61-701 Poznan, Poland
| | | | | | - Michał Ziarko
- Department of Health and Clinical Psychology, University of Adam Mickiewicz, 60-568 Poznan, Poland
| | - Dorota Zozulińska-Ziółkiewicz
- Department and Clinic of Internal Medicine and Diabetology, Medical University of Karol Marcinkowski, 61-701 Poznan, Poland
| | - Tomasz Pawłowski
- Division of Psychotherapy and Psychosomatic Medicine, Department of Psychiatry, Wroclaw Medical University, 50-367 Wrocław, Poland
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Yalım E, Ünsal C, Gündoğmuş İ. The Relationship Between Occupational Functionality and Metacognition in Patients with Obsessive-Compulsive Disorder. Cureus 2024; 16:e51738. [PMID: 38318544 PMCID: PMC10840066 DOI: 10.7759/cureus.51738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2024] [Indexed: 02/07/2024] Open
Abstract
OBJECTIVE Obsessive-compulsive disorder (OCD) is one of the most common mental disorders with a loss of functionality in many areas of life. The current study aims to reveal the relationship between occupational functionality and metacognition in OCD patients. MATERIALS AND METHODS The cross-sectional study sample consisted of 183 participants diagnosed with OCD according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria. Participants were evaluated with the Yale-Brown Obsession and Compulsion Scale (Y-BOCS), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Metacognition Scale (MCQ-30). The occupational functioning of the participants was determined by the basic version of the semi-structured Longitudinal Follow-up Evaluation form (LIFE-BASE) in interviews with the clinician. The LIFE-BASE form divided the study sample into functional (n=92) and non-functional (n=91). RESULTS It was determined that the mean age of the study sample was 32.49±8.65 years, and 54.1% (n=99) of them were female. When the two groups were compared, statistically significant differences were found in gender (p<0.001), education (p=0.012), Y-BOCS compulsion (p=0.003), and total scores (p=0.006). In the comparison of the groups, a statistical difference was found between the MCQ-30 Positive Beliefs subscale (p<0.05). However, no statistical difference was found between uncontrollability and danger, cognitive confidence, belief in controlling thoughts, and cognitive awareness. In addition, it was found that gender and the MCQ-30 positive beliefs score could predict occupational functioning. CONCLUSION The present study is important because it was the first study to show the effects of positive beliefs on occupational functioning in OCD patients. However, further studies are needed on the underlying causes of this effect.
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Affiliation(s)
- Esra Yalım
- Psychiatry, Çankırı State Hospital, Çankırı, TUR
| | - Cansu Ünsal
- Psychiatry, Silifke State Hospital, Mersin, TUR
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7
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Mansueto G, Jarach A, Caselli G, Ruggiero GM, Sassaroli S, Nikčević A, Spada MM, Palmieri S. A systematic review of the relationship between generic and specific metacognitive beliefs and emotion dysregulation: A metacognitive model of emotion dysregulation. Clin Psychol Psychother 2024; 31:e2961. [PMID: 38357852 DOI: 10.1002/cpp.2961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 01/28/2024] [Accepted: 01/29/2024] [Indexed: 02/16/2024]
Abstract
Although a probable association between metacognitive beliefs (also termed 'metacognitions') and emotion dysregulation has been suggested in the literature, the evidence is still sparse and inconclusive. The current study aims to present a comprehensive evaluation of the literature examining the association between metacognitive beliefs and emotion dysregulation. In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria, a search was conducted on PubMed and Ebsco. A manual search of reference lists was also run. Search terms were 'metacognitions/metacognitive beliefs/positive metacognitive beliefs/negative metacognitive beliefs/cognitive self-consciousness/beliefs about the need to control thoughts/cognitive confidence/negative beliefs about thoughts concerning uncontrollability and danger/AND difficulties emotion regulation/emotion dysregulation'. A total of 19 studies met the inclusion criteria. In both non-clinical and clinical populations, a higher endorsement of dysfunctional metacognitive beliefs was found to be associated with emotion dysregulation and vice versa. A higher endorsement of metacognitive beliefs may be associated, either directly or via maladaptive forms of mental control (e.g., worry, rumination and suppression) to emotion dysregulation. Metacognitive beliefs could be the potential therapeutic target in clinical interventions aimed at reducing emotion regulation difficulties.
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Affiliation(s)
- Giovanni Mansueto
- Department of Health Sciences, University of Florence, Florence, Italy
- School of Applied Sciences, London South Bank University, London, UK
| | | | - Gabriele Caselli
- Department of Psychology, Sigmund Freud University, Milan, Italy
- Cognitive Studies, Cognitive Psychotherapy School and Research Center, Milan, Italy
| | - Giovanni Maria Ruggiero
- Department of Psychology, Sigmund Freud University, Milan, Italy
- Cognitive Studies, Cognitive Psychotherapy School and Research Center, Milan, Italy
| | - Sandra Sassaroli
- Department of Psychology, Sigmund Freud University, Milan, Italy
- Cognitive Studies, Cognitive Psychotherapy School and Research Center, Milan, Italy
| | - Ana Nikčević
- Department of Psychology, School of Law, Social and Behavioural Sciences, Kingston University, London, UK
| | | | - Sara Palmieri
- School of Applied Sciences, London South Bank University, London, UK
- Department of Psychology, Sigmund Freud University, Milan, Italy
- Cognitive Studies, Cognitive Psychotherapy School and Research Center, Milan, Italy
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8
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Palmieri S, Mansueto G, Marchant AP, Sassaroli S, Caselli G, Ruggiero GM, Spada MM. The Metacognitions about Binge Eating Questionnaire: Investigation of the association between specific metacognitions and Binge Eating Disorder. Clin Psychol Psychother 2023; 30:780-794. [PMID: 36754777 DOI: 10.1002/cpp.2839] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/05/2023] [Accepted: 02/06/2023] [Indexed: 02/10/2023]
Abstract
Literature suggested that metacognitions are involved in eating problems and may be relevant to the understanding of Binge Eating Disorder (BED). The goal of the current studies was to develop the first self-report instrument on metacognitions about binge eating. In Study 1, a community sample completed the Metacognitions about Binge Eating Questionnaire (MBEQ); an Exploratory Factor Analysis (EFA) was performed. In study 2, a community sample completed the MBEQ and measures assessing severity of binge eating, irrational food beliefs, anxiety, depression, impulsiveness. A Confirmatory Factor Analysis (CFA) was performed. Concurrent and incremental validity were assessed. In study 3, a clinical sample of participants with a diagnosis of BED completed the MBEQ and other measures. Bivariate correlational analysis and hierarchical linear regression were performed. Participants from the general population and participants with a diagnosis of BED were compared. EFA and CFA supported a two-factor solution consisting of positive and negative metacognitions about binge eating. Concurrent and incremental validity were acceptable. The metacognitions factors correlated positively with anxiety, depression, irrational food beliefs, impulsiveness in the community sample, and anxiety, irrational food beliefs, impulsiveness in clinical sample. The metacognitions factors contributed to the prediction of BEDs symptoms, in community and clinical samples, over and above age, gender, impulsiveness, anxiety, depression, irrational food beliefs. The MBEQ possesses good psychometric properties and appears a reliable and valid measure of positive and negative metacognitions about binge eating. Metacognitions about binge eating could be a therapeutic target to reduce the severity of binge eating episodes.
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Affiliation(s)
- S Palmieri
- Division of Psychology, School of Applied Sciences, London South Bank University, London, UK
- Department of Psychology, Sigmund Freud University, Milan, Italy
- Studi Cognitivi, Cognitive Psychotherapy School and Research Center, Milan, Italy
| | - G Mansueto
- Department of Psychology, Sigmund Freud University, Milan, Italy
- Studi Cognitivi, Cognitive Psychotherapy School and Research Center, Milan, Italy
- Department of Health Sciences, University of Florence, Florence, Italy
| | - A P Marchant
- Division of Psychology, School of Applied Sciences, London South Bank University, London, UK
| | - S Sassaroli
- Department of Psychology, Sigmund Freud University, Milan, Italy
- Studi Cognitivi, Cognitive Psychotherapy School and Research Center, Milan, Italy
| | - G Caselli
- Department of Psychology, Sigmund Freud University, Milan, Italy
- Studi Cognitivi, Cognitive Psychotherapy School and Research Center, Milan, Italy
| | - G M Ruggiero
- Department of Psychology, Sigmund Freud University, Milan, Italy
- Studi Cognitivi, Cognitive Psychotherapy School and Research Center, Milan, Italy
| | - M M Spada
- Division of Psychology, School of Applied Sciences, London South Bank University, London, UK
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9
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Bagherzadeh R, Sohrabineghad R, Gharibi T, Mehboodi F, Vahedparast H. Effects of mindfulness-based stress reduction training on rumination in patients with breast cancer. BMC Womens Health 2022; 22:552. [PMID: 36575482 PMCID: PMC9795671 DOI: 10.1186/s12905-022-02124-y] [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: 06/29/2022] [Accepted: 12/12/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Breast cancer has been a serious public health dilemma for women worldwide, with not only physical and social impairments but also psychological stress responses such as rumination. Rumination is a constant preoccupation with thoughts. The present study aimed to investigate the effectiveness of mindfulness-based stress reduction training in lowering rumination among women diagnosed with breast cancer. METHOD This randomized controlled trial with a pretest, posttest, control group, and one-month follow-up design included 46 female breast cancer survivors, recruited from the clinics and hematology wards of Bushehr, Iran. The inclusion criterion was that at least three months should have passed since the last chemotherapy/radiotherapy. The participants were randomly assigned to two experimental and control groups. The experimental group received eight sessions of mindfulness-based stress reduction training. A demographic information form and a rumination questionnaire were used for data collection, and the participants completed the questionnaire in the pretest, posttest, and follow-up stages. Chi-square, Mann-Whitney U, and repeated-measures ANOVA were used to analyze the data. P < 0.05 was considered statistically significant. RESULTS There was no significant difference in the rumination scores of the experimental group at three measurement stages. For the control group, the mean rumination scores on the posttest and follow-up were both significantly higher than on the pre-test (P < 0.001). The control group's mean follow-up rumination score was significantly higher than that of the post-test (P = 0.02). A comparison of the two groups adjusted for the baseline showed a significant difference between them in terms of the mean rumination score on the post-test (P = 0.01) and follow-up (P < 0.001). CONCLUSION The experimental group was more successful in avoiding increased rumination than the control group, an ability that can be attributed to the effect of mindfulness training. The use of this method is recommended because it is non-invasive, non-pharmacological, free from complications, and can be easily performed by women. However, future studies should consider larger samples and long-term follow-ups.
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Affiliation(s)
- Razieh Bagherzadeh
- grid.411832.d0000 0004 0417 4788Department of Midwifery, Nursing and Midwifery Faculty, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Rezvan Sohrabineghad
- grid.411832.d0000 0004 0417 4788Department of Nursing, Nursing and Midwifery Faculty, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Taiebeh Gharibi
- grid.411832.d0000 0004 0417 4788Department of Midwifery, Nursing and Midwifery Faculty, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Farkhondeh Mehboodi
- grid.411832.d0000 0004 0417 4788Department of Nursing, Nursing and Midwifery Faculty, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Hakimeh Vahedparast
- grid.411832.d0000 0004 0417 4788Department of Nursing, Nursing and Midwifery Faculty, Bushehr University of Medical Sciences, Bushehr, Iran
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10
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Keen E, Kangas M, Gilchrist PT. A systematic review evaluating metacognitive beliefs in health anxiety and somatic distress. Br J Health Psychol 2022; 27:1398-1422. [PMID: 35746856 PMCID: PMC9796692 DOI: 10.1111/bjhp.12609] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 05/30/2022] [Indexed: 01/07/2023]
Abstract
PURPOSE Increasing evidence suggests metacognitive beliefs may underpin transdiagnostic mechanisms maintaining psychopathology. The objective of this systematic review was to evaluate published studies investigating the role of metacognitive beliefs in somatic distress in adult samples. METHOD A systematic review was conducted, spanning five data bases. Studies meeting eligibility criteria were qualitatively synthesized. RESULTS Thirty-six studies (N = 12,390) met inclusion criteria with results suggesting a relatively consistent positive relationship between metacognitive beliefs and somatic distress. Both general and syndrome-specific metacognitive beliefs demonstrated relationships with not only emotional distress, but also physical symptoms themselves. CONCLUSIONS Results are discussed in terms of conceptualizing somatic distress through the Self-Regulatory Executive Function (S-REF) Model. Future research into metacognitive therapy for somatic populations is recommended.
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Affiliation(s)
- Edwina Keen
- School of Psychological SciencesMacquarie UniversitySydneyNSWAustralia,Centre for Emotional HealthMacquarie UniversitySydneyNSWAustralia
| | - Maria Kangas
- School of Psychological SciencesMacquarie UniversitySydneyNSWAustralia,Centre for Emotional HealthMacquarie UniversitySydneyNSWAustralia
| | - Philippe T. Gilchrist
- School of Psychological SciencesMacquarie UniversitySydneyNSWAustralia,Centre for Emotional HealthMacquarie UniversitySydneyNSWAustralia
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11
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Hughes SE, Boisvert I, McMahon CM, Steyn A, Neal K. Perceived listening ability and hearing loss: Systematic review and qualitative meta-synthesis. PLoS One 2022; 17:e0276265. [PMID: 36282860 PMCID: PMC9595527 DOI: 10.1371/journal.pone.0276265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 10/04/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Hearing loss (HL) can affect communication in complex ways. Understanding how adults with HL reflect on and conceptualise the way they listen (metacognition) is required if interventions, and the outcome measures used to evaluate them, are to address barriers to functional communication arising from HL. OBJECTIVES This study describes how adults with HL experience and report the processes, behaviours, and components of listening, as presented in published studies. DESIGN Systematic review and meta-synthesis of qualitative studies. METHODS Systematic searches identified English-language, peer-reviewed journal articles reporting the results of qualitative or mixed-methods studies of adults' with HL perceived listening abilities. Medline, PsychInfo, Web of Science, Embase, and Google Scholar were searched from inception to November 2021. Handsearching reference lists of included studies identified additional studies for inclusion. The Critical Appraisal Skills Programme (CASP) qualitative checklist was used to appraise studies' methodological quality. Data from included studies were analysed using thematic meta-synthesis. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) Confidence in the Evidence from Reviews of QUALitative (CERQual) approach assessed confidence in the review findings. Two reviewers independently completed all screening and quality appraisal. Thematic meta-synthesis and GRADE CERQual assessment was completed by one reviewer and confirmed by a second reviewer. Discrepancies were resolved through discussion. RESULTS Data from 46 studies were included in the review. Thematic meta-synthesis identified six descriptive themes: 1) perceived listening ability; 2) external modifiers; 3) psychosocial impacts of hearing loss; 4) communication partner perspectives; 5) self-efficacy for listening; and 6) cognitive load. GRADE CERQual ratings for descriptive themes ranged from low to moderate confidence. Descriptive themes were related by analytic themes of liminality and reciprocity. CONCLUSIONS Adults with HL provide in-depth accounts of components and processes of listening, with studies reporting both cognitive and affective experiences consistent with theoretical models of metacognition. The findings will inform content generation for a hearing-specific patient-reported outcome measure of perceived listening ability in everyday communication.
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Affiliation(s)
- Sarah E. Hughes
- Centre for Patient Reported Outcome Research, Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
- National Institute for Health and Care Research (NIHR) Applied Research Collaboration (ARC), West Midlands, United Kingdom
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, United Kingdom
- National Institute of Health and Care Research (NIHR) Blood and Transplant Research Unit (BTRU) in Precision Therapeutics, University of Birmingham, Birmingham, United Kingdom
- Narra Consulting Limited, Wales, United Kingdom
- Faculty of Medicine, Health, and Life Science, Swansea University, Swansea, United Kingdom
- * E-mail:
| | - Isabelle Boisvert
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
- HEAR Centre, Macquarie University, Sydney, Australia
| | - Catherine M. McMahon
- HEAR Centre, Macquarie University, Sydney, Australia
- Department of Linguistics, Macquarie University, Sydney, NSW, Australia
| | | | - Katie Neal
- HEAR Centre, Macquarie University, Sydney, Australia
- Department of Linguistics, Macquarie University, Sydney, NSW, Australia
- The Shepherd Centre, Sydney, NSW, Australia
- The Listening Lab, Sydney, NSW, Australia
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12
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Sardella A, Lenzo V, Basile G, Martino G, Quattropani MC. Emotion regulation strategies and difficulties in older adults: A systematic review. Clin Gerontol 2022; 46:280-301. [PMID: 36163629 DOI: 10.1080/07317115.2022.2128706] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES The purpose of this systematic review was to assess the types of emotion regulation (ER) strategies used and difficulties in emotion regulation experienced by older adults, within the theoretical frameworks proposed by Gross, and by Gratz and Roemer, respectively. METHODS A systematic search was conducted using principal electronic scientific databases (PubMed, Scopus, and Web of Science). The systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta Analyses guidelines. RESULTS The final number of articles included was 44. Older adults reported a higher use of adaptive ER strategies, as well as fewer difficulties in ER, compared with younger adults. Findings from this review also suggest that the use of maladaptive ER strategies can also expose older adults to psychological distress, and may affect their adaptation to negative disease-related outcomes more common in later life. CONCLUSIONS Older adults generally showed a greater emotional control compared with younger subjects. Adaptive control strategies, rather than maladaptive control strategies, were correlated with more positive outcomes for psychological distress and adaptation to chronic diseases. CLINICAL IMPLICATIONS Understanding the nature of ER processes in older adults may contribute to implement tailored interventions aimed at reinforcing adaptive ER processes.
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Affiliation(s)
- Alberto Sardella
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Vittorio Lenzo
- Department of Social and Educational Sciences of the Mediterranean Area, University for Foreigners "Dante Alighieri" of Reggio Calabria, Reggio, Italy
| | - Giorgio Basile
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Gabriella Martino
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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13
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Burston A, Miles SJ, Fulbrook P. Patient and carer experience of living with a pressure injury: A meta-synthesis of qualitative studies. J Clin Nurs 2022. [PMID: 35768933 DOI: 10.1111/jocn.16431] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 05/23/2022] [Accepted: 06/14/2022] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Pressure injuries are a significant cause of harm, contributing to increased mortality and financial burden on the healthcare system. Significant research on pressure injury risk assessment, prevention and treatment exists, but limited research exploring the patient and carer experience of living with pressure injury. AIMS The aim of this meta-synthesis was to describe the patient and carer experience of living with a pressure injury. DESIGN Meta-synthesis. METHODS A prospective review protocol was registered, and systematic search conducted across five electronic databases. The PRISMA 2020 checklist for reporting systematic reviews was used. Two reviewers independently undertook screening and review of articles, using the CASP checklist for evaluating qualitative research. A meta-synthesis using thematic content analysis was undertaken. RESULTS Twelve studies met the inclusion criteria. Meta-synthesis led to the construction of three primary themes: loss of autonomy and independence, psychological effects, and adjustment. Within these primary themes, sub-themes of dependence, social isolation and social avoidance behaviours, feelings and emotions, loss, managing, physical consequences, service provision, and functional challenges, were identified. CONCLUSION The psychology and mindset of those involved, and support to navigate the challenges that arise are two unique and clinically relevant categorisations to guide provision of pressure injury care. Adaptation to a pressure injury is multi-faceted and contextual, challenges to adaptation create additional psychological burden. Interventions encompassing all facets of the experience are necessary. Current research into experiences is limited, and further research to support interventions is necessary.
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Affiliation(s)
- Adam Burston
- Nursing Research and Practice Development Centre, The Prince Charles Hospital, Chermside, Queensland, Australia.,Faculty of Health Sciences, School of Nursing, Midwifery and Paramedicine (Brisbane), Australian Catholic University, Brisbane, Australia
| | - Sandra J Miles
- Nursing Research and Practice Development Centre, The Prince Charles Hospital, Chermside, Queensland, Australia.,Faculty of Health Sciences, School of Nursing, Midwifery and Paramedicine (Brisbane), Australian Catholic University, Brisbane, Australia
| | - Paul Fulbrook
- Nursing Research and Practice Development Centre, The Prince Charles Hospital, Chermside, Queensland, Australia.,Faculty of Health Sciences, School of Nursing, Midwifery and Paramedicine (Brisbane), Australian Catholic University, Brisbane, Australia.,Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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14
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The Network That Unites a Qualitative Study on Clinical Psychological Intervention for Women with a History of Breast Cancer and Chronic Pain. Eur J Investig Health Psychol Educ 2022; 12:619-630. [PMID: 35735467 PMCID: PMC9221617 DOI: 10.3390/ejihpe12060046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 06/04/2022] [Accepted: 06/08/2022] [Indexed: 11/16/2022] Open
Abstract
The aim of this qualitative research is to deepen the knowledge in the field of psycho-oncology and the consequences of chronic and persistent pain by listening to patients’ experiences, their emotions and difficulties in facing this hard condition, and assessing their perception of the role of the psychologist in pain management. In this qualitative study, a semistructured interview was used, designed from three research questions: chronic pain and quality of life; chronic pain and psychological well-being; and the role and perception of the psychologist in pain management. The sample consists of 29 women who suffered or have recovered from breast carcinoma, and who currently report having chronic pain due either to the presence of the cancer or as a result of surgery or treatment. Three themes emerged from the thematic analysis: quality of life and psychological well-being, relational well-being, and perception and role of the psychologist. Two subthemes have been identified for each theme: common features of chronic pain and consequences and resilience for the first theme; not feeling understood and willingness to protect loved ones for the second theme; and improvements perceived by users and reasons for not making use of the service for the last theme. In conclusion, the results obtained from the literature and those from the analysis of the interviews are discussed and compared, and reflections are made on possible future implications.
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15
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Shibata Y, Matsushima M, Takeuchi M, Kato M, Yabe I. Inappropriate Metacognitive Status Increases State Anxiety in Genetic Counseling Clients. Front Psychol 2022; 13:871416. [PMID: 35645862 PMCID: PMC9133628 DOI: 10.3389/fpsyg.2022.871416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 04/26/2022] [Indexed: 12/25/2022] Open
Abstract
Background Many genetic counseling (GC) studies have focused on anxiety status because clients of GC often feel anxious during their visits. Metacognition is known to be one of the causes of having an inappropriate thinking style. In this study, we examined the relationship between anxiety and the metacognitive status of GC clients according to their characteristics. Methods The participants were 106 clients who attended their first GC session in our hospital from November 2018 to March 2021. The survey items were the clients’ characteristics, anxiety status at the time of the visit, and metacognitive status. Results High state anxiety and high trait anxiety were observed in 34.9 and 11.3% of clients, respectively. Clients who were a relative or had a family history were significantly more likely to have high state anxiety. As for metacognitive status, only negative beliefs about thoughts concerning uncontrollability and danger were associated with having an anxiety status. Furthermore, multivariate analysis showed that negative beliefs about thoughts concerning uncontrollability and danger were an independent determinant of higher state anxiety, but not being a relative or having a family history. Metacognitive status scores were significantly lower in clients than in the control group. Conclusion State anxiety was shown to be more dependent on negative beliefs about thoughts concerning uncontrollability and danger of GC clients than their characteristics such as being a relative or having a family history. The results of this study will contribute to the development of new GC psychosocial support measures to address the anxiety of GC clients.
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Affiliation(s)
- Yuka Shibata
- Division of Clinical Genetics, Hokkaido University Hospital, Sapporo, Japan
| | - Masaaki Matsushima
- Division of Clinical Genetics, Hokkaido University Hospital, Sapporo, Japan
- Faculty of Medicine, Graduate School of Medicine, Department of Neurology, Hokkaido University, Sapporo, Japan
| | - Megumi Takeuchi
- Faculty of Medicine, Graduate School of Medicine, Department of Neurology, Hokkaido University, Sapporo, Japan
| | - Momoko Kato
- Division of Clinical Genetics, Hokkaido University Hospital, Sapporo, Japan
| | - Ichiro Yabe
- Division of Clinical Genetics, Hokkaido University Hospital, Sapporo, Japan
- Faculty of Medicine, Graduate School of Medicine, Department of Neurology, Hokkaido University, Sapporo, Japan
- *Correspondence: Ichiro Yabe,
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16
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Demirdogen ES, Orak I, Cansever OM, Warikoo N, Yavuz M. The associations between metacognition problems, mindfulness, and internalizing symptoms in university students quarantined due to Covid-19 in Turkey. Perspect Psychiatr Care 2022; 58:560-567. [PMID: 35020211 DOI: 10.1111/ppc.13027] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 12/23/2021] [Accepted: 01/04/2022] [Indexed: 12/20/2022] Open
Abstract
PURPOSE To investigate the associations between internalizing problems, metacognition problems, and mindfulness levels in university students during the COVID-19 pandemic. DESIGN AND METHODS Depression, anxiety, and stress levels were compared between university students quarantined in dormitories and their homes under curfew conditions. The direct and indirect associations between internalizing problems, metacognition problems, and mindfulness levels of students under quarantine were evaluated. FINDINGS Metacognition problems and low mindfulness levels were associated with higher depression, anxiety, and stress symptoms under quarantine conditions. PRACTICE IMPLICATIONS Therapeutic interventions focusing on metacognition problems and mindfulness levels may reduce the negative psychological effects of quarantine.
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Affiliation(s)
- Ezgi S Demirdogen
- Department of Child and Adolescent Psychiatry, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Irem Orak
- Department of Psychology, Katip Celebi University, Izmir, Turkey
| | - Ozlem M Cansever
- Department of Psychology, Istanbul Aydin University, Istanbul, Turkey
| | - Nishchint Warikoo
- Department of Child and Adolescent Psychiatry, Child and Adolescent Mental Health Services, Aldershot Centre for Health, Aldershot, Hampshire, United Kingdom
| | - Mesut Yavuz
- Department of Child and Adolescent Psychiatry, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
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17
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Lenzo V, Sardella A, Barberis N, Isgrò C, Torrisi R, Giunta S, Petralia MC, Verrastro V, Quattropani MC. The Interplay of Attachment Styles and Defense Mechanisms on Eating Disorders Risk: Cross-Sectional Observation in the Community Population. CLINICAL NEUROPSYCHIATRY 2022; 18:296-303. [PMID: 35126531 PMCID: PMC8808290 DOI: 10.36131/cnfioritieditore20210603] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Eating Disorders (Eds) are considered a broad group of pathological conditions characterized by dysregulated eating-related behaviors and habits. Attachment styles and defense mechanisms appear to be linked to the development of EDs-related unhealthy behaviors; however, these factors have been seldom investigated jointly. This study aimed at exploring the shared association between attachment styles, defense mechanisms, and EDs-related behaviors; additionally, we aimed at investigating whether defense mechanisms might be potential mediators of the association between attachment and Eds behaviors. METHOD A community-based sample was recruited (88% females, mean age= 22.33 ± 4.81 years) and underwent a comprehensive evaluation protocol assessing attachment styles, defense mechanisms, and risk of eating disorders. RESULTS Several shared associations between attachment styles, defense mechanisms, and eating disorders scores were found. Additionally, a maladaptive defense style appeared to be a significant mediator of the association between attachment styles and EDs-related symptoms. CONCLUSIONS The integrated evaluation of attachment and defense mechanisms could generate a more comprehensive framework of the psychological antecedents related to Eating Disorders, and it could be a beneficial factor involved in therapies.
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Affiliation(s)
- Vittorio Lenzo
- Department of Social and Educational Sciences of the Mediterranean Area, University for Foreigners "Dante Alighieri" of Reggio Calabria, Reggio Calabria, Italy
| | - Alberto Sardella
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Nadia Barberis
- Department of Surgical and Medical Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Carmen Isgrò
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Roberta Torrisi
- Department of Surgical and Medical Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | | | | | - Valeria Verrastro
- Department of Surgical and Medical Sciences, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Maria C Quattropani
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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18
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Caldarone F, Gebhardt P, Hoeper MM, Olsson KM, Fuge J, Park DH, Meltendorf T, Kamp JC, Stapel B, Richter MJ, Gall H, Ghofrani HA, Kahl KG, Heitland I. Metacognitions in Patients With Frequent Mental Disorders After Diagnosis of Pulmonary Arterial Hypertension. Front Psychiatry 2022; 13:812812. [PMID: 35492699 PMCID: PMC9046848 DOI: 10.3389/fpsyt.2022.812812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 03/24/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The prevalence of mental disorders, particularly adjustment disorder (AD), major depressive disorder (MDD) and panic disorder (PD) is increased in patients with pulmonary arterial hypertension (PAH). However, it is unclear which pathogenic mechanisms determine their development and could therefore be targeted in prevention or therapeutic interventions. Here, we assessed metacognitions in a sample of PAH patients with and without MDD and PD. Moreover, we reconstructed the course of mental illnesses following the PAH diagnosis. METHODS Two hundred seventeen PAH patients were included in this cross-sectional study. The prevalence of AD was assessed retrospectively using DSM-V criteria. Current mental disorders were assessed using the structured clinical interview for DSM-V. Additionally, metacognitive beliefs and processes were assessed using established questionnaires (MCQ-30, AnTI). RESULTS Patients with an AD consecutive to the PAH diagnosis more frequently developed MDD (37.5 vs. 13.9%, p < 0.001) and PD (26.3 vs. 8.8%, p = 0.001) later on compared to PAH patients without a former AD. Moreover, patients with current MDD/PD displayed more dysfunctional metacognitions than those without current MDD/PD (p < 0.001). Patients with current MDD/PD in the context of former AD had more dysfunctional metacognitive worries and beliefs compared to patients with current MDD/PD without former AD (p = 0.009). CONCLUSION Our results suggest that in the context of PAH, dysfunctional metacognitions are associated with MDD and PD. Therefore, a metacognitive approach to treat and prevent those mental illnesses seems promising and should be investigated in future studies.
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Affiliation(s)
- Flora Caldarone
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Philippa Gebhardt
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Marius M Hoeper
- Department of Respiratory Medicine, Hannover Medical School, Member of the German Center for Lung Research (DZL/BREATH), Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany
| | - Karen M Olsson
- Department of Respiratory Medicine, Hannover Medical School, Member of the German Center for Lung Research (DZL/BREATH), Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany
| | - Jan Fuge
- Department of Respiratory Medicine, Hannover Medical School, Member of the German Center for Lung Research (DZL/BREATH), Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany
| | - Da-Hee Park
- Department of Respiratory Medicine, Hannover Medical School, Member of the German Center for Lung Research (DZL/BREATH), Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany
| | - Tanja Meltendorf
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany.,Department of Respiratory Medicine, Hannover Medical School, Member of the German Center for Lung Research (DZL/BREATH), Hannover, Germany
| | - Jan C Kamp
- Department of Respiratory Medicine, Hannover Medical School, Member of the German Center for Lung Research (DZL/BREATH), Hannover, Germany.,Biomedical Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany
| | - Britta Stapel
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Manuel J Richter
- Department of Internal Medicine, German Center for Lung Research (DZL), Justus Liebig University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Giessen, Germany
| | - Henning Gall
- Department of Internal Medicine, German Center for Lung Research (DZL), Justus Liebig University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Giessen, Germany
| | - Hossein A Ghofrani
- Department of Internal Medicine, German Center for Lung Research (DZL), Justus Liebig University Giessen, Universities of Giessen and Marburg Lung Center (UGMLC), Giessen, Germany.,Department of Pneumology, German Center for Lung Research (DZL), Kerckhoff Heart, Rheuma and Thoracic Center, Universities of Giessen and Marburg Lung Center, Bad Nauheim, Germany
| | - Kai G Kahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
| | - Ivo Heitland
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hannover, Germany
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Vitale E. Gender Gap in Mindfulness Assessment Among Italian Nurses: A Pilot Descriptive Study. JOURNAL OF EVIDENCE-BASED PSYCHOTHERAPIES 2021. [DOI: 10.24193/jebp.2021.2.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
"Purpose: The present study aimed to explore gender differences in the
mindfulness tendency, specifically in the awareness and attention
dimensions and also in the observing, describing, acting with awareness and
accepting without judgement in Italian nurses.
Methods: In June 2020 an on-line questionnaire was administered to nurses
in order to analyze any differences both in the Mindfulness Attention
Awareness Scale (MAAS) and the Kentucky Inventory of Mindfulness Skills
(KIMS) according to gender variable.
Findings: 200 questionnaires were collected. Findings showed significant
higher MAAS total score in males than females (p=.004). Additionally, by
considering the four sub dimensions in the Mindfulness tendency, females
reported significant higher levels in some items of “Observe” (p=.004) and
“Act with awareness” (p=.001) than males, while males reported significant
higher scores in the “Accept without judgement” than females (p<.001).
Conclusions: The present study was a pilot research on exploring gender
differences in mindfulness in Italian nurses in order to hope that it will be
only the beginning of empirical research on this topic and to better address
future mindfulness training courses addressed to nurses by emphasizing
certain aspects of mindfulness for females compared to males and vice versa."
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Affiliation(s)
- Elsa Vitale
- Department of Mental Health, Local Health Authority Bari, Italy
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20
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Brown RL, Wood A, Carter JD, Kannis-Dymand L. The metacognitive model of post-traumatic stress disorder and metacognitive therapy for post-traumatic stress disorder: A systematic review. Clin Psychol Psychother 2021; 29:131-146. [PMID: 34155731 DOI: 10.1002/cpp.2633] [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: 01/06/2021] [Revised: 06/08/2021] [Accepted: 06/09/2021] [Indexed: 11/11/2022]
Abstract
The metacognitive model of post-traumatic stress disorder (PTSD) implicates metacognitive beliefs, meta-memory beliefs and metacognitive control strategies in perpetuating and maintaining symptoms of PTSD. Despite this expanding area of research, the evidence for the metacognitive model of PTSD has not been reviewed. A systematic review according to the PRISMA statement was conducted. Searches across MEDLINE, PubMed and PsycNET, as well as reference lists of the included studies (2004 to March 2020), yielded 221 records. Two independent reviewers screened articles, which were included where the impact of the constructs of interest on PTSD symptoms was investigated within the framework of the metacognitive model for PTSD. Eighteen articles were included in the review. Eleven studies were determined to have good methodological robustness. Metacognitive therapy for PTSD demonstrated reductions in symptoms from pretreatment to post-treatment, which were maintained at follow-up. Predictors of greater PTSD symptom severity included metacognitive beliefs, meta-memory beliefs, and worry, punishment, thought suppression, experiential avoidance, and rumination. Overall, support was found for the validity of the metacognitive model of PTSD.
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Affiliation(s)
- Renee L Brown
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sunshine Coast, Queensland, Australia
| | - Andrew Wood
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sunshine Coast, Queensland, Australia
| | - Janet D Carter
- Department of Psychology, Speech and Hearing, University of Canterbury, Christchurch, New Zealand
| | - Lee Kannis-Dymand
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Sunshine Coast, Queensland, Australia
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21
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Martino G, Caputo A, Vicario CM, Feldt-Rasmussen U, Watt T, Quattropani MC, Benvenga S, Vita R. Alexithymia, Emotional Distress, and Perceived Quality of Life in Patients With Hashimoto's Thyroiditis. Front Psychol 2021; 12:667237. [PMID: 34045997 PMCID: PMC8144453 DOI: 10.3389/fpsyg.2021.667237] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 03/23/2021] [Indexed: 12/15/2022] Open
Abstract
Emotion-processing impairment represents a risk factor for the development of somatic illness, affecting negatively both health-related quality of life (HRQoL) and disease management in several chronic diseases. The present pilot study aims at (i) investigating the associations between alexithymia and depression, anxiety, and HRQoL in patients with Hashimoto's thyroiditis (HT); (ii) examining the association between these three psychological conditions together with HRQoL, and thyroid autoantibodies status as well as thyroid echotexture in patients with HT; and (iii) comparing the intensity of all these clinical psychological features in patients with HT versus controls. Twenty-one patients with serologically or ultrasonographically verified HT and 16 controls with non-toxic goiter or postsurgical hypothyroidism were recruited for this study. Serum thyrotropin (TSH) and free thyroxine, as well as thyroid autoantibodies (thyroglobulin antibodies and thyroid peroxidase antibodies), were assayed. Alexithymia, depression, anxiety, and HRQoL were assessed with Toronto Alexithymia Scale; Beck Depression Inventory, second edition; Hamilton Anxiety Rating Scale; and Health Survey Short-Form 36, respectively. A negative relationship between the difficulty to describe feelings and the cognitive component of depression was found (r = -0.46, p = 0.04). Besides, patients with seronegative HT had lower somatic anxiety than patients with HT who tested positive (r = -0.68, p = 0.01 and r = -0.59, p = 0.04, respectively). Besides, no statistically significant difference was found between patients with HT and controls with regard to somatic anxiety. The present study suggests the relevance of alexithymia in patients suffering from HT, which may be intertwined with a possible state of underreported depression that is mainly expressed through physical complaints. Promoting the capability to describe and communicate feelings could contribute to psychological elaboration and coping with the disease and, consequently, to the improvement of self-management and perceived HRQoL.
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Affiliation(s)
- Gabriella Martino
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Andrea Caputo
- Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Carmelo M. Vicario
- Department of Cognitive Sciences, Psychological, Pedagogical and Cultural Studies, University of Messina, Messina, Italy
| | - Ulla Feldt-Rasmussen
- Department of Medical Endocrinology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Clinical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Torquil Watt
- Department of Medical Endocrinology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Clinical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Maria C. Quattropani
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Salvatore Benvenga
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
- Master Program on Childhood, Adolescent and Women’s Endocrine Health, University of Messina, Messina, Italy
- Interdepartmental Program of Molecular and Clinical Endocrinology and Women’s Endocrine Health, University Hospital, AOU Policlinico “G. Martino,” Messina, Italy
| | - Roberto Vita
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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Sardella A, Bellone F, Morabito N, Minisola S, Basile G, Corica F, Catalano A. The association between hypoparathyroidism and cognitive impairment: a systematic review. J Endocrinol Invest 2021; 44:905-919. [PMID: 32926396 DOI: 10.1007/s40618-020-01423-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 09/08/2020] [Indexed: 12/01/2022]
Abstract
CONTEXT AND PURPOSE Hypocalcemia and low parathyroid hormone levels have been commonly suggested as factors able to induce central nervous system disturbances. However, evidences on the occurrence of cognitive impairment are limited or underestimated. The aim of this review is, therefore, to systematically summarize the available evidence concerning the occurrence of cognitive impairment among subjects suffering from idiopathic or secondary hypoparathyroidism. METHODS A systematic selection of the available literature was performed by searching the online databases PubMed, Scopus and Web of Knowledge. RESULTS The present systematic review included sixteen case report articles and one cross-sectional controlled study. Case reports were the most representative literature sources and involved ten women and seven men. The presence of cognitive impairment was mostly discussed in association with idiopathic hypoparathyroidism (HPT); five articles described the occurrence of cognitive impairment following postsurgical HPT. The case-controlled study reported a significant presence of peculiar cognitive deficits (e.g. reduced inhibitory control, impairment in visuo-spatial functioning among, and psychomotor retardation) among HPT subjects compared to healthy controls, with serum total calcium and its product with phosphorus as independent predictors of neuropsychological dysfunctions. CONCLUSION Even though mostly based on single case reports, the presence of neuropsychological dysfunctions in the context of HPT appears to be a consistent core finding.
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Affiliation(s)
- A Sardella
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - F Bellone
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - N Morabito
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - S Minisola
- Department of Internal Medicine and Medical Disciplines, "Sapienza" Rome University, Rome, Italy
| | - G Basile
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - F Corica
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - A Catalano
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
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Abstract
OBJECTIVE The unprecedented occurrence of a global pandemic is accompanied by both physical and psychological burdens that may impair quality of life. Research relating to COVID-19 aims to determine the effects of the pandemic on vulnerable populations who are at high risk of developing negative health or psychosocial outcomes. Having an ongoing medical condition during a pandemic may lead to greater psychological distress. Increased psychological distress may be due to preventative public health measures (e.g. lockdown), having an ongoing medical condition, or a combination of these factors. METHODS This study analyses data from an online cross-sectional national survey of adults in Ireland and investigates the relationship between comorbidity and psychological distress. Those with a medical condition (n = 128) were compared to a control group without a medical condition (n = 128) and matched according to age, gender, annual income, education, and work status during COVID-19. Participants and data were obtained during the first public lockdown in Ireland (27 March 2020-8 June 2020). RESULTS Individuals with existing medical conditions reported significantly higher levels of anxiety (p < .01) and felt less gratitude (p ≤ .001). Exploratory analysis indicated that anxiety levels were significantly associated with illness perceptions specific to COVID-19. Post hoc analysis revealed that psychological well-being was not significantly related to condition type (e.g. respiratory disorders). CONCLUSION This research supports individualised supports for people with ongoing medical conditions during the COVID-19 pandemic, and has implications for the consideration of follow-up care specifically for mental health. Findings may also inform future public health policies and post-vaccine support strategies for vulnerable populations.
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Conversano C. The Psychodynamic Approach During COVID-19 Emotional Crisis. Front Psychol 2021; 12:670196. [PMID: 33897574 PMCID: PMC8062854 DOI: 10.3389/fpsyg.2021.670196] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 03/15/2021] [Indexed: 12/13/2022] Open
Affiliation(s)
- Ciro Conversano
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Pisa, Italy
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25
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Zahedian E, Bahreini M, Ghasemi N, Mirzaei K. Group meta-cognitive therapy and depression in women with breast cancer: a randomized controlled trial. BMC Womens Health 2021; 21:111. [PMID: 33736617 PMCID: PMC7977266 DOI: 10.1186/s12905-021-01258-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 03/10/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Breast cancer is one of the most common cancers in Iranian women. They will experience a mental health problem like depression before, during or after treatment. This study aimed to determine the effectiveness of group metacognitive therapy on depression, cognitive-emotional regulation, and meta-cognitive beliefs in women with breast cancer. METHODS In this randomized controlled clinical trial, a total of 24 depressed patients with breast cancer were randomly allocated to experimental and control groups. The experimental group received meta-cognitive therapy in 8 weekly sessions, but the control group received treatment as usual. Beck Depressive Inventory, cognitive emotion regulation questionnaire, and meta-cognitions questionnaire were completed before, after and one month after the intervention. Data were analyzed using Wilcoxon and Chi-square tests. RESULTS The mean score of depression in the experimental group was reduced from 21.6 ± 4.83 in the pre-test to 13.83 ± 8.12 in one-month follow-up (p = 0.16); however, there was no significant difference in the control group. The mean score of cognitive emotion regulation did not show a significant change in the two groups during the study and follow-up period. The mean score of meta-cognitive beliefs reached 68.75 ± 15.74 from 79.51 ± 10.72 in the experimental group during the follow-up period (p = 0.006); however, there was no significant difference in the control group in the score of metacognitive beliefs. CONCLUSION These findings support the efficacy of meta-cognitive therapy as a viable psychosocial intervention in depressed patients with breast cancer. Trial registration IRCT201606288473N5. Registered on: 05/09/2016 https://www.irct.ir/trial/8946 .
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Affiliation(s)
- Elham Zahedian
- Nursing and Midwifery School, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Masoud Bahreini
- Nursing and Midwifery School, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Nezamaddin Ghasemi
- Department of Psychology, Salman Farsi University of Kazerun, Kazerun, Iran
| | - Kamran Mirzaei
- Community Medicine, Medical School, Bushehr University of Medical Sciences, Bushehr, Iran
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Mothers' and children's metacognitions and the development of childhood anxiety: a longitudinal investigation of transmission. Eur Child Adolesc Psychiatry 2021; 30:451-459. [PMID: 32303854 DOI: 10.1007/s00787-020-01531-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 04/06/2020] [Indexed: 10/24/2022]
Abstract
Theory and preliminary evidence suggests that parental beliefs and cognitions may be transmitted to their offspring. Transmission of maladaptive cognitions may play a role in the development of anxiety disorders in childhood. However, few studies have investigated such transmission using longitudinal designs. The objective of this study was to investigate the interaction between maternal and child metacognitions and their role in the development of childhood anxiety. We used a longitudinal design with self-report measures of maternal and child anxiety symptoms and metacognitions. Participants were 107 mothers and their children who were assessed when the children were between 7 and 12 years old and again 3 years later. Child metacognitions at baseline did not predict later child anxiety symptoms. Baseline maternal metacognitions approached significance in predicting anxiety symptoms in children at the follow-up, when controlling for known risk factors, including female gender and higher levels of anxiety in mother and child at baseline. Mediation analyses revealed that child metacognitions at baseline, as well as at follow-up fully mediated the relationship between maternal baseline metacognitions and child anxiety 3 years later. Examinations of how child and maternal metacognitions affect child anxiety levels after three years revealed that current levels of child metacognitions play a greater role in predicting child anxiety than child and maternal metacognitions at baseline.
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Lenzo V, Quattropani MC, Sardella A, Martino G, Bonanno GA. Depression, Anxiety, and Stress Among Healthcare Workers During the COVID-19 Outbreak and Relationships With Expressive Flexibility and Context Sensitivity. Front Psychol 2021; 12:623033. [PMID: 33692724 PMCID: PMC7937736 DOI: 10.3389/fpsyg.2021.623033] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 01/26/2021] [Indexed: 12/18/2022] Open
Abstract
This study aimed at investigating depression, anxiety, and stress symptoms among healthcare workers and examine the role of expressive flexibility and context sensitivity as key components of resilience in understanding reported symptoms. We hypothesized a significant and different contribution of resilience components in explaining depression, anxiety, and stress. A total sample of 218 Italian healthcare workers participated in this study through an online survey during the lockdown, consequently to the COVID-19. The Depression Anxiety Stress Scales-21 (DASS-21) was used to measure depression, anxiety, and stress; the Flexible Regulation of Emotional Expression (FREE) scale was used to measure the ability to enhance and suppress emotional expression; the Context Sensitivity Index (CSI) was used to measure the ability to accurately perceive contextual cues and determine cue absence. Demographic and work-related data were also collected. DASS-21 cut-off scores were used to verify the mental status among the respondents. Correlational analyses examined relationships between DASS-21, FREE, and CSI, followed by three regression analyses with depression, anxiety, and stress as dependent variables, controlling for age, gender, and work experience. Enhancement and suppression abilities, cue presence, and cue absence served as independent variables. The results showed a prevalence of moderate to extremely severe symptoms of 8% for depression, 9.8% for anxiety, and 8.9% for stress. Results of correlational analysis highlighted that enhance ability was inversely associated with depression and stress. Suppression ability was inversely associated with depression, anxiety, and stress. The ability to perceive contextual cues was inversely associated with depression and anxiety. The regression analysis showed that the ability to enhance emotional expression was statistically significant to explain depression among healthcare workers. In predicting anxiety, age, and the ability to accurately perceive contextual cues and determine cue absence made substantial contributions as predictors. In the last regression model, age, work experience, and the ability to suppress emotional expression were significant predictors of stress. This study’s findings can help understand the specific contributions of enhancement and suppression abilities and sensitivity to stressor context cues in predicting depression, anxiety, and stress among healthcare workers. Psychological interventions to prevent burnout should consider these relationships.
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Affiliation(s)
- Vittorio Lenzo
- Department of Social and Educational Sciences of the Mediterranean Area, University for Foreigners "Dante Alighieri" of Reggio Calabria, Reggio Calabria, Italy.,Sisifo - Consortium of Social Cooperatives, Catania, Italy
| | - Maria C Quattropani
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Alberto Sardella
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Gabriella Martino
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - George A Bonanno
- Teachers College, Columbia University, New York, NY, United States
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28
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Sorrenti L, Filippello P. Interventions to Promote the Quality of Life and Psychological Well-being in Chronic and Developmental Psychopathologies. Front Psychol 2021; 12:640175. [PMID: 33643171 PMCID: PMC7907596 DOI: 10.3389/fpsyg.2021.640175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 01/25/2021] [Indexed: 11/18/2022] Open
Affiliation(s)
- Luana Sorrenti
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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29
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Expressive Flexibility and Dispositional Optimism Contribute to the Elderly's Resilience and Health-Related Quality of Life during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041698. [PMID: 33578873 PMCID: PMC7916547 DOI: 10.3390/ijerph18041698] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/03/2021] [Accepted: 02/07/2021] [Indexed: 12/22/2022]
Abstract
The COVID-19 outbreak had a negative impact on psychological status among elderly subjects, negatively affecting their health-related quality of life (HRQoL). Psychological factors that promote resilience might beneficially contribute also to promoting a better HRQoL among elderly subjects. The main purpose of the present study was to investigate the contribution of dispositional optimism and expressive flexibility on the HRQoL of elderly outpatients during the COVID-19 outbreak. The outpatients were recruited from October 2018 to October 2019, and then followed-up during April 2020, by evaluating their HRQoL. The baseline sample consisted of 141 elderly outpatients (mean age 80.31 ± 6.84 years); the final number of outpatients included in the follow-up evaluation was 104 (mean age 80.26 ± 6.39). Univariate and multivariate linear regressions were developed to explore significant associations with the physical and mental component of HRQoL. Baseline dispositional optimism was a predictor of the mental component of HRQoL at follow-up; the flexible suppression of emotional expression was a predictor of the physical component of HRQoL at follow-up. From a psychogeriatric perspective, the accurate assessment of psychological factors, such as dispositional optimism and expressive flexibility, might help physicians and psychologists to recognize additional patients' vulnerabilities during the current emergency.
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Conversano C, Di Giuseppe M. Psychological Factors as Determinants of Chronic Conditions: Clinical and Psychodynamic Advances. Front Psychol 2021; 12:635708. [PMID: 33584488 PMCID: PMC7876054 DOI: 10.3389/fpsyg.2021.635708] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 01/08/2021] [Indexed: 12/11/2022] Open
Affiliation(s)
| | - Mariagrazia Di Giuseppe
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Pisa, Italy
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31
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Sardella A, Lenzo V, Bonanno GA, Martino G, Basile G, Quattropani MC. Dispositional Optimism and Context Sensitivity: Psychological Contributors to Frailty Status Among Elderly Outpatients. Front Psychol 2021; 11:621013. [PMID: 33519646 PMCID: PMC7838363 DOI: 10.3389/fpsyg.2020.621013] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 12/16/2020] [Indexed: 12/24/2022] Open
Abstract
The association of resilience-related factors with frailty is a recent research topic. Dispositional optimism and context sensitivity are two psychological factors that differently contribute to individual resilience. This study aimed at investigating whether dispositional optimism and context sensitivity might contribute to a multifactorial model of frailty, together with established relevant factors such as cognitive and physical factors. This cross-sectional study involved 141 elderly outpatients (42 males and 99 females) aged ≥65 years, who were referred to the Geriatrics and Multidimensional Evaluation Clinic of the University Hospital of Messina. We used the following measures: the Mini-Mental State Examination (MMSE) to screen for global cognitive functioning; 4-m gait speed and handgrip strength to measure physical performance; a 35-item Frailty Index (FI) to evaluate patients’ frailty status; the revised Life Orientation Test (LOT-R) to gauge dispositional optimism; and the Context Sensitivity Index (CSI) to measure context sensitivity. We found that LOT-R (β = −0.190, p = 0.038), CSI (β = −0.191, p = 0.035), and MMSE (β = −0.466, p < 0.001) were all significantly associated with FI. Gait speed was only marginally associated with FI (β = −0.184, p = 0.053). The present study showed a novel association of dispositional optimism and context sensitivity with frailty among elderly outpatients. These preliminary findings support a multidimensional approach to frailty in which even peculiar psychological features might provide a significant contribution.
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Affiliation(s)
- Alberto Sardella
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Vittorio Lenzo
- Department of Social and Educational Sciences of the Mediterranean Area, University for Foreigners "Dante Alighieri" of Reggio Calabria, Reggio Calabria, Italy
| | - George A Bonanno
- Department of Clinical Psychology, Teachers College, Columbia University, New York, NY, United States
| | - Gabriella Martino
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Giorgio Basile
- School and Unit of Geriatrics, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Maria C Quattropani
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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Natalini E, Fioretti A, Riedl D, Moschen R, Eibenstein A. Tinnitus and Metacognitive Beliefs-Results of a Cross-Sectional Observational Study. Brain Sci 2020; 11:brainsci11010003. [PMID: 33374519 PMCID: PMC7822113 DOI: 10.3390/brainsci11010003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 12/14/2020] [Accepted: 12/21/2020] [Indexed: 12/14/2022] Open
Abstract
Recent research has highlighted the role of metacognitions as a moderator for psychological distress in patients with chronic diseases. The present study investigates the role of metacognitions and worry in the association between tinnitus distress, anxiety, and depression. A cross-sectional study was carried out with a sample of tinnitus-outpatients who completed the Tinnitus-Handicap Inventory, Beck Anxiety Inventory, Beck Depression Inventory, Metacognition Questionnaire-30, Penn-State-Worry-Questionnaire. Associations of metacognitions, worries, tinnitus distress, anxiety and depression were investigated using structural equation models (SEMs). A sample of n = 107 patients was included in the study. In the first SEM, tinnitus distress significantly predicted depression (β = 0.68, p < 0.001) and anxiety (β = 0.47, p < 0.001). In the second model, worries and meta-cognitions were added as moderators. The explained variance substantially increased for depression (46 to 53%) and anxiety (22 to 35%) and the association of tinnitus distress with depression (β = 0.57, p < 0.001) and anxiety was weakened (β = 0.32, p < 0.001). Negative beliefs significantly predicted worries (β = 0.51, p < 0.001) and explained 41% of its variance. A good model fit for the final model was found (comparative fit index (CFI) = 0.98; (Tucker Lewis index) TLI = 0.96; root mean square error of approximation (RMSEA) = 0.067). Anxiety and depression in tinnitus patients might be influenced by worries, which is mainly predicted by negative beliefs about uncontrollability and danger of worries. Thus, psychotherapeutic approaches focused on alterations of metacognitions in patients with tinnitus should be investigated in future studies.3 (List three to ten pertinent keywords specific to the article yet reasonably common within the subject discipline.)
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Affiliation(s)
- Eleonora Natalini
- Tinnitus Center, European Hospital, 00149 Rome, Italy; (E.N.); (A.E.)
| | - Alessandra Fioretti
- Tinnitus Center, European Hospital, 00149 Rome, Italy; (E.N.); (A.E.)
- Correspondence: ; Tel.: +39-3393-276-971
| | - David Riedl
- University Clinic of Medical Psychology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (D.R.); (R.M.)
| | - Roland Moschen
- University Clinic of Medical Psychology, Medical University of Innsbruck, 6020 Innsbruck, Austria; (D.R.); (R.M.)
| | - Alberto Eibenstein
- Tinnitus Center, European Hospital, 00149 Rome, Italy; (E.N.); (A.E.)
- Department of Applied Clinical and Biotechnological Sciences, University of Aquila, 67100 L’Aquila, Italy
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Lenzo V, Quattropani MC, Musetti A, Zenesini C, Freda MF, Lemmo D, Vegni E, Borghi L, Plazzi G, Castelnuovo G, Cattivelli R, Saita E, Franceschini C. Resilience Contributes to Low Emotional Impact of the COVID-19 Outbreak Among the General Population in Italy. Front Psychol 2020; 11:576485. [PMID: 33250818 PMCID: PMC7672208 DOI: 10.3389/fpsyg.2020.576485] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 10/15/2020] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The COVID-19 outbreak is severely affecting the overall mental health with unknown psychological consequences. Although a strong psychological impact is possible, scant evidence is available to date. Past studies have shown that resilience decreases the negative effects of stress. This study aimed to examine depression, anxiety, and stress among the Italian general population during the phase characterized by lockdown, and to investigate the role of resilience as a potential predictor. METHODS A total sample of 6,314 Italian people participated in this study. Participants were recruited between March 29 and May 04 2020 through an online survey. The Depression Anxiety Stress Scales-21 (DASS-21) and the Resilience Scale (RS) were administered. Demographic data and lockdown related information were also collected. A correlational analysis was carried out to examine relationships between psychopathological domains and resilience. Three hierarchical regression analyses were conducted using the depression, anxiety, and stress as dependent variables and the resilience as independent variable controlling for age, gender, and education. COVID-19 specific variables were also included in the three regression analyses. A further exploratory analysis was carried out to examine which aspects of resilience predict depression, anxiety, and stress. RESULTS The prevalence of moderate to extremely severe symptoms among participants was 32% for depression, 24.4% for anxiety, and 31.7% for stress. The sample mean scores on depression, anxiety, and stress were higher than the normal scores reported in the literature. Results of correlational analysis showed that resilience factors, such as meaningfulness, self-reliance, existential aloneness, and equanimity, are inversely associated with depression, anxiety, and stress. Results of regression analyses indicated that resilience was statically significant in predicting depression, anxiety, and stress. Geographic area of residence and infected acquaintances were also significant predictors. Regarding the resilience factors, results revealed that meaningfulness, perseverance, and equanimity were statistically significant in predicting all the DASS-21 scales. CONCLUSION About a third of respondents reported moderate to extremely severe depression, anxiety, and stress. The present study suggests that psychological resilience may independently contribute to low emotional distress and psychological ill-being. These findings can help explain the variability of individual responses during the COVID-19 outbreak.
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Affiliation(s)
- Vittorio Lenzo
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Maria C. Quattropani
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Italy
| | - Corrado Zenesini
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | | | - Daniela Lemmo
- Department of Humanistic Studies, University of Naples Federico II, Naples, Italy
| | - Elena Vegni
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Lidia Borghi
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Giuseppe Plazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Gianluca Castelnuovo
- Department of Psychology, Catholic University of Milan, Milan, Italy
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Ospedale San Giuseppe, Verbania, Italy
| | - Roberto Cattivelli
- Department of Psychology, Catholic University of Milan, Milan, Italy
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, Ospedale San Giuseppe, Verbania, Italy
| | - Emanuela Saita
- Department of Psychology, Catholic University of Milan, Milan, Italy
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Conversano C, Di Giuseppe M, Miccoli M, Ciacchini R, Gemignani A, Orrù G. Mindfulness, Age and Gender as Protective Factors Against Psychological Distress During COVID-19 Pandemic. Front Psychol 2020; 11:1900. [PMID: 33013503 PMCID: PMC7516078 DOI: 10.3389/fpsyg.2020.01900] [Citation(s) in RCA: 139] [Impact Index Per Article: 34.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 07/09/2020] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE Mindfulness disposition is associated with various psychological factors and prevents emotional distress in chronic diseases. In the present study, we analyzed the key role of mindfulness dispositions in protecting the individual against psychological distress consequent to COVID-19 social distancing and quarantining. METHODS An online survey was launched on March 13, 2020, with 6,412 responses by April 6, 2020. Socio-demographic information, exposure to the pandemic, and quarantining were assessed together with psychological distress and mindfulness disposition. Multivariate linear regression analysis was performed to study the influence of predictive factors on psychological distress and quality of life in Italian responders during the early days of lockdown. Pearson correlations were calculated to study the relationship between mindfulness and psychiatric symptoms. RESULTS Multivariate linear regression run on socio-demographics, COVID-19-related variables, and mindfulness disposition as moderators of overall psychological distress showed that mindfulness was the best predictor of psychological distress (β = -0.504; p < 0.0001). High negative correlations were found between mindfulness disposition and the overall Global Severity Index (r = -0.637; p < 0.0001), while moderate to high associations were found between mindfulness and all SCL-90 sub-scales. DISCUSSION Findings showed that high dispositional mindfulness enhances well-being and helps in dealing with stressful situations such as the COVID-19 pandemic. Mindfulness-based mental training could represent an effective intervention to stem post-traumatic psychopathological beginnings and prevent the onset of chronic mental disorders.
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Affiliation(s)
- Ciro Conversano
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Pisa, Italy
| | - Mariagrazia Di Giuseppe
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Pisa, Italy
| | - Mario Miccoli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Rebecca Ciacchini
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Pisa, Italy
| | - Angelo Gemignani
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Pisa, Italy
| | - Graziella Orrù
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Pisa, Italy
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Capobianco L, Faija C, Husain Z, Wells A. Metacognitive beliefs and their relationship with anxiety and depression in physical illnesses: A systematic review. PLoS One 2020; 15:e0238457. [PMID: 32911486 PMCID: PMC7500039 DOI: 10.1371/journal.pone.0238457] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 08/17/2020] [Indexed: 02/06/2023] Open
Abstract
Anxiety and depression are common among patients with chronic physical illnesses
and have a significant impact on morbidity, quality of life, and health service
utilisation. Psychological treatment of anxiety and depression has small to
moderate efficacy in this group and is not commonly based on a model of causal
mechanisms. A novel approach to understanding and improving mental health
outcomes in physical illnesses is needed. One approach may be to explore the
role of metacognitive beliefs which are reliably associated with anxiety and
depression in individuals with mental health difficulties. The current
systematic review aimed to evaluate the contribution of metacognitive beliefs to
anxiety and depression across physical illnesses. Systematic searches were
conducted on Web of Science, PsychINFO, MEDLINE, Embase, and CINAHL of studies
published between 1997 and January 2019. 13 eligible studies were identified
that in sum comprised 2851 participants. Metacognitive beliefs were found to
have reliable, moderate, positive and significant associations with anxiety and
depression symptoms across a range of physical illnesses. There appeared to be
commonality and some specificity in the relationships. Negative metacognitive
beliefs concerned with uncontrollability and danger of worry were associated
with both anxiety and depression across all physical illnesses assessed, whilst
more specific associations emerged for individual medical conditions where
positive beliefs about worry, cognitive confidence and cognitive
self-consciousness were unique correlates. Negative metacognitive beliefs of
uncontrollability and danger significantly and positively predicted symptoms of
anxiety and depression after controlling for factors including age, gender,
disease factors and cognition (illness perceptions and intolerance of
uncertainty). The results suggest that the metacognitive model of psychological
disorder is applicable to psychological symptoms of anxiety and depression
across a range of chronic medical conditions, implying that metacognitive
therapy might be helpful in improving outcomes in multiple morbidities that
involve poor mental and medical health.
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Affiliation(s)
- Lora Capobianco
- Research and Innovation, Greater Manchester Mental Health NHS Foundation
Trust, Manchester, United Kingdom
- * E-mail:
| | - Cintia Faija
- Division of Nursing, Midwifery & Social Work, Faculty of Biology,
Medicine and Health, Manchester Academic Health Science Centre, The University
of Manchester, Manchester, United Kingdom
| | - Zara Husain
- Research and Innovation, Greater Manchester Mental Health NHS Foundation
Trust, Manchester, United Kingdom
| | - Adrian Wells
- Research and Innovation, Greater Manchester Mental Health NHS Foundation
Trust, Manchester, United Kingdom
- Faculty of Biology, Medicine and Health, School of Psychological
Sciences, Manchester Academic Health Science Centre, The University of
Manchester, Manchester, United Kingdom
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Martino G, Caputo A, Vicario CM, Catalano A, Schwarz P, Quattropani MC. The Relationship Between Alexithymia and Type 2 Diabetes: A Systematic Review. Front Psychol 2020; 11:2026. [PMID: 32982843 PMCID: PMC7484475 DOI: 10.3389/fpsyg.2020.02026] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 07/21/2020] [Indexed: 12/14/2022] Open
Abstract
Background: This systematic review analyzed the relationship between alexithymia, considered as the inability to recognize and express thoughts and emotions, and type 2 diabetes mellitus (T2DM), one of the most common chronic illness, characterized by a metabolic disorder burdened by high morbidity and mortality worldwide due to its outcomes. Methods: PRISMA guidelines were followed throughout this systematic review of the recent literature indexed in the databases PubMed, PsycInfo, Scopus, and Web of Science. Search terms for eligible studies were: "Type 2 diabetes" OR "T2DM" AND "Toronto Alexithymia Scale" OR "TAS-20"[All Fields]. Results: The initial search identified 61 indexed scientific publications. After screening we found that seven publications met the established scientific inclusion and exclusion criteria. It emerged that alexithymic patients ranged from 25 to 50% across the examined publications and it appeared that patients with T2DM generally reflected greater values of alexithymia, revealing particular differences among TAS domains. Moreover, emlpoyed participants were alexithymic to a greater extent compared to non-working participants (77.8 vs. 35.4%) and alexithymia was 2.63 times more severe among working participants when examining predictors of alexithymia. When evaluating the correlations between alexithymia and HbA1c or fasting blood glucose levels we found strong associations equal to 0.75 and 0.77 for TAS-20 total scores, respectively. While alexithymic participants showed significantly higher levels of HbA1c and blood glucose when compared to the non-alexithymic participants. Conclusions: The results of this systematic review of the current literature highlight the need of alexithymia evaluation in patients with T2DM. The high prevalence in T2DM and strong associations with poorly regulated diabetes and psychological distress, indicate a significant relationship between poor glycemic control and psychological distress, such as anxiety and depression, and quality of life. Further studies are needed focusing on age and gender differences in order to be able to improve clinical psychological care and prevention.
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Affiliation(s)
- Gabriella Martino
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Andrea Caputo
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
| | - Carmelo M. Vicario
- Department of Cognitive Sciences, Psychology, Education and Cultural Studies, University of Messina, Messina, Italy
| | - Antonino Catalano
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Peter Schwarz
- Department of Medical Endocrinology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Maria C. Quattropani
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
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Di Giuseppe M, Perry JC, Lucchesi M, Michelini M, Vitiello S, Piantanida A, Fabiani M, Maffei S, Conversano C. Preliminary Reliability and Validity of the DMRS-SR-30, a Novel Self-Report Measure Based on the Defense Mechanisms Rating Scales. Front Psychiatry 2020; 11:870. [PMID: 33005160 PMCID: PMC7479239 DOI: 10.3389/fpsyt.2020.00870] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 08/10/2020] [Indexed: 12/26/2022] Open
Abstract
Defense mechanisms are psychological factors that influence emotional distress and quality of life. There are a number of measures assessing the construct of defense mechanisms, but only few available instruments reflect the gold-standard theoretical hierarchical organization of defenses. We report on the development of a novel 30 item self-report questionnaire, the DMRS-SR-30, based on the parent instrument, the Defense Mechanism Rating Scales (DMRS). This study tested preliminary reliability and validity of the Italian version of the DMRS-SR-30. We first extracted 30 items from the DMRS Q-sort version (DMRS-Q) and adapted them for a self-reported format. We then applied the DMRS quantitative scoring algorithms to provide proportional scores for the 28 individual defenses and summary scores for seven defense levels and overall defensive functioning (ODF) scores. A dynamic interview was used for assessing participant's defense mechanisms with the observer-rated DMRS and DMRS-Q. We examined internal consistency of the scales along with criterion, concurrent, convergent and discriminant validity among participants (N = 94) who completed the DMRS-SR-30, SCL-90, BDI, and IES-R. Results showed very good internal consistency for ODF (Cronbach's alpha = .890) and the high adaptive defense level, whereas some subscales with few items had lower values. Correlation analyses between DMRS-SR-30 and the two DMRS-based observer-rated measures showed very good criterion and concurrent validity for ODF and moderate to high for defense levels subscales. Correlations between the DMRS-SR-30 ODF and SCL-90 GSI, BDI and IES=R (r = -.456, r= -.540, r = -.402, respectively, all p <.001), indicated good convergent validity. Despite the well-known limitations of self-report methods of psychodynamic phenomena, self-report measures are highly practicable for assessing large samples. The DMRS-SR-30 is the first self-assessed measure describing the whole hierarchy of 28 defense mechanisms and providing scores for ODF, defensive categories, defense levels, and individual defenses. Preliminary examination of the Italian version of the DMRS-SR-30 showed promising results of internal consistency, criterion and concurrent validity, and convergent validity and of the measure. Further validation is needed to confirm these findings and explore other aspects of validity and reliability.
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Affiliation(s)
- Mariagrazia Di Giuseppe
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Pisa, Italy
| | - John Christopher Perry
- Department of Psychiatry, Institute of Community and Family Psychiatry, Jewish General Hospital, McGill University, Montreal, QC, Canada
| | - Matilde Lucchesi
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Pisa, Italy
| | - Monica Michelini
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Pisa, Italy
| | - Sara Vitiello
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Pisa, Italy
| | - Aurora Piantanida
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Pisa, Italy
| | - Matilde Fabiani
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Pisa, Italy
| | - Sara Maffei
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Pisa, Italy
| | - Ciro Conversano
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Pisa, Italy
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Martino G, Caputo A, Schwarz P, Bellone F, Fries W, Quattropani MC, Vicario CM. Alexithymia and Inflammatory Bowel Disease: A Systematic Review. Front Psychol 2020; 11:1763. [PMID: 32973596 PMCID: PMC7466427 DOI: 10.3389/fpsyg.2020.01763] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 06/26/2020] [Indexed: 12/11/2022] Open
Abstract
Background: Given the role of alexithymia—as the inability to identify, differentiate, and express emotions—in chronic and immune-mediated illness, this systematic review analyzed the prevalence of alexithymia in patients with inflammatory bowel diseases (IBDs), mainly represented by Crohn's disease (CD) and ulcerative colitis (UC). Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed throughout this systematic review of the literature published between 2015 and 2020 in indexed sources from PubMed, PsycINFO, Scopus, and Web of Science databases. Search terms for eligible studies were: “Inflammatory bowel disease” AND “Alexithymia” [Titles, Abstract, Keywords]. Inclusion criteria were: articles written and published in English from 2015 and up to April 2020, reporting relevant and empirical data on alexithymia and IBD. Results: The initial search identified 34 indexed scientific publications. After screening, we found that five publications met the established scientific inclusion criteria. Overall, the mean value of alexithymia ranged from 39 to 53.2 [Toronto Alexithymia Scale (TAS-20) score], thus mostly falling in non-clinical range for alexithymia (≤51). Comparisons of alexithymia between patients with UC and CD highlighted that patients with CD showed externally oriented thinking and difficulties identifying feelings to a greater extent. Regarding comparisons with other samples or pathologies, patients with IBD were more alexithymic than healthy controls and less alexithymic than patients with major depressive disorder, but no difference was found when compared with patients with irritable bowel syndrome (IBS). Then, regarding correlations with other variables, alexithymia was positively associated with anxiety and depression, as well as with psychopathological symptoms and somatic complaints. Conclusion: This systematic review suggests that patients with IBD cannot be generally considered alexithymic at a clinically relevant extent. However, their greater alexithymic levels and its associations with psychological variables and somatic distress may suggest a reactivity hypothesis, in which living with IBD may progressively lead to impaired emotion recognition over time. Specifically, the relationship between IBD and IBS should be further explored, paying deeper attention to the clinical psychological functioning of CD, as IBD requires more emotional challenges to patients.
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Affiliation(s)
- Gabriella Martino
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Andrea Caputo
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
| | - Peter Schwarz
- Department of Medical Endocrinology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Federica Bellone
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Walter Fries
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - M C Quattropani
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - C M Vicario
- Department of Cognitive Sciences, Psychology, Education and Cultural Studies, University of Messina, Messina, Italy
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Conversano C, Di Giuseppe M, Miccoli M, Ciacchini R, Di Silvestre A, Lo Sterzo R, Gemignani A, Orrù G. Retrospective Analyses of Psychological Distress and Defense Style Among Cancer Patients. CLINICAL NEUROPSYCHIATRY 2020; 17:217-224. [PMID: 34908997 PMCID: PMC8629055 DOI: 10.36131/cnfioritieditore20200403] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Psychological distress is common in cancer patients during the diagnostic phase. Research demonstrated that anxiety, depression and defense mechanisms may influence physical and psychological well-being in patients with malignant tumors. The present retrospective study investigated the associations between clinical and psychological characteristics of cancer patients waiting for the diagnosis, focusing on metastatic cancer (MC) and breast cancer (BC). METHOD Patients with a new diagnosis of cancer referring to a Clinical Oncology Unit in Central Italy were interviewed during the 2017 for psychological assessment. Double-blind information about anxiety, depression, sleep disorders, defense style, and cancer diagnosis were available for the 567 patients included in this study. T-test, chi-squared and regression analyses were performed to detect associations between psychological variables and the presence of metastasis (MC) in the whole sample and in the subgroup of breast cancer (BC) patients. RESULTS Female gender and younger age were associated with anxiety, depression, and maladaptive defense style. A significant positive relationship was found between presence of metastasis and symptoms of anxiety. Depression resulted significantly more frequent in BC, while there was a trend close to statistical significance in MC. Immature defense style was widely used by BC women, with a score close to statistical significance. CONCLUSIONS This retrospective study provided empirical evidence of the relationship between psychological functioning and clinical characteristics of cancer. In line with previous research, our findings confirmed the peculiar psychological functioning of BC patients. Further investigations are needed to understand how the diagnosis of cancer may influence the individual psychological functioning and vice versa.
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Affiliation(s)
- Ciro Conversano
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Italy
| | - Mariagrazia Di Giuseppe
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Italy
| | - Mario Miccoli
- Department of Clinical and Experimental Medicine, University of Pisa, Italy
| | - Rebecca Ciacchini
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Italy
| | | | | | - Angelo Gemignani
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Italy
| | - Graziella Orrù
- Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, Italy
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Conversano C, Ciacchini R, Orrù G, Di Giuseppe M, Gemignani A, Poli A. Mindfulness, Compassion, and Self-Compassion Among Health Care Professionals: What's New? A Systematic Review. Front Psychol 2020; 11:1683. [PMID: 32849021 PMCID: PMC7412718 DOI: 10.3389/fpsyg.2020.01683] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 06/22/2020] [Indexed: 12/30/2022] Open
Abstract
Health care professionals (HCPs) are a population at risk for high levels of burnout and compassion fatigue. The aim of the present systematic review was to give an overview on recent literature about mindfulness and compassion characteristics of HCPs, while exploring the effectiveness of techniques, involving the two aspects, such as MBSR or mindfulness intervention and compassion fatigue-related programs. A search of databases, including PubMed and PsycINFO, was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines and the methodological quality for this systematic review was appraised using AMSTAR-2 (A MeaSurement Tool to Assess systematic Reviews-2). The number of articles that met the inclusion criteria was 58 (4 RCTs, 24 studies with pre-post measurements, 12 cross-sectional studies, 11 cohort studies and 7 qualitative studies). MBSR intervention was effective at improving, and maintaining, mindfulness and self-compassion levels and to improve burnout, depression, anxiety, stress. The most frequently employed interventional strategies were mindfulness-related trainings that were effective at improving mindfulness and self-compassion, but not compassion fatigue, levels. Compassion-related interventions have been shown to improve self-compassion, mindfulness and interpersonal conflict levels. Mindfulness was effective at improving negative affect and compassion fatigue, while compassion satisfaction may be related to cultivation of positive affect. This systematic review summarized the evidence regarding mindfulness- and compassion-related qualities of HCPs as well as potential effects of MBSR, mindfulness-related and compassion-related interventions on professionals' psychological variables like mindfulness, self-compassion and quality of life. Combining structured mindfulness and compassion cultivation trainings may enhance the effects of interventions, limit the variability of intervention protocols and improve data comparability of future research.
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Wang X, Tang L, Howell D, Shao J, Qiu R, Zhang Q, Ye Z. Psychometric Testing of the Chinese Version of the Coping and Adaptation Processing Scale-Short Form in Adults With Chronic Illness. Front Psychol 2020; 11:1642. [PMID: 32849006 PMCID: PMC7396654 DOI: 10.3389/fpsyg.2020.01642] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 06/17/2020] [Indexed: 12/17/2022] Open
Abstract
Background Adaptive capacity may serve as an indicator of the individuals’ coping behaviors toward illness management and may contribute to day-to-day living with chronic illness and improved quality of life. Practical and well-constructed instruments for measuring adaptation have not been adequately explored. An English 15-item Coping and Adaptation Processing–Short Form (CAPS-SF) for assessing adaptation has been created and validated in line with the underlying tenets of Coping and Adaptation Processing theory, but there is no applicable Chinese version. Methods The CAPS-SF was translated and culturally adapted into simplified Chinese. Among Chinese adults with chronic illness, 81 patients were selected for cultural adaptation and 288 patients were approached for psychometric testing. Content validity was evaluated by an expert panel. Construct validity was tested by confirmatory factor analysis. Concurrent validity and predictive validity were analyzed by Spearman correlation coefficient. Reliability was assessed by internal consistency and test–retest coefficients. Floor/ceiling effect was calculated. Results Adequate content validity was ensured by the expert panel. A four-factor structure (resourceful and focused, self-initiated and knowing-based, physical and fixed, and positive and systematic) describing individuals’ coping strategies was identified and verified. Concurrent validity and predictive validity were demonstrated by strong correlations with the confrontation of coping mode (r = 0.46) and a quality-of-life measure (r = 0.58). The McDonald’s omega coefficient of total scale was 0.82. Split-half reliability and test–retest reliability were 0.87 and 0.87. No floor/ceiling effect was present. Conclusion The Chinese version CAPS-SF is a theoretically based and culturally acceptable instrument with sound psychometric properties. Further studies are advocated to refine its four-factor structure.
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Affiliation(s)
- Xiyi Wang
- Department of Nursing, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, China
| | - Leiwen Tang
- Department of Nursing, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, China
| | - Doris Howell
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Jing Shao
- Department of Nursing, Zhejiang University School of Medicine, Hangzhou, China
| | - Ruolin Qiu
- Department of Nursing, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, China
| | - Qi Zhang
- Department of Nursing, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, China
| | - Zhihong Ye
- Department of Nursing, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, China.,Department of Nursing, Zhejiang University School of Medicine, Hangzhou, China
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Martino G, Catalano A, Agostino RM, Bellone F, Morabito N, Lasco CG, Vicario CM, Schwarz P, Feldt-Rasmussen U. Quality of life and psychological functioning in postmenopausal women undergoing aromatase inhibitor treatment for early breast cancer. PLoS One 2020; 15:e0230681. [PMID: 32214378 PMCID: PMC7098625 DOI: 10.1371/journal.pone.0230681] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Accepted: 03/05/2020] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Aromatase inhibitors (AIs) dramatically increased breast cancer (BC) survival, leading to enhanced attention to their long-term consequences on psychological functioning. Conflicting data has been examined regarding the association between AIs administration and the clinical psychological features in BC survivors (BCSs). PURPOSE As psychological symptoms often occur in such chronic diseases, our study aimed at exploring anxious and depressive symptoms and the perceived quality of life (QoL) in BCSs assessed for osteoporosis. METHODS The total sample consisted of a clinical sample of 51 outpatient postmenopausal women, diagnosed with BC, and a control group composed of 51 healthy postmenopausal women. All recruited participants were evaluated through the clinical gold standard interview and completed the following self-rating scales: the Hamilton Anxiety Rating Scale, Beck Depression Inventory II edition, and 36-Item Short Form Health Survey, which were administered at baseline and after 6 months in BCSs in AIs treatment, compared with controls. Moreover, all participants were assessed for vitamin D status, bone mineral density (BMD) and subclinical vertebral fractures. Data regarding age, age at menopause, body mass index (BMI), smoking habits and alcohol consumption was collected. RESULTS BCSs (n = 51) showed higher anxious and depressive symptoms, and lower perceived QoL vs. controls (n = 51) (p<0.05 for all). After 6 months of treatment with AIs, BCSs showed significant reduction of anxious and depressive symptoms and a significantly higher perceived QoL for both physical and mental components, vs. controls. CONCLUSIONS The improvement of clinical psychological features and perceived QoL was associated with AIs treatment in women being treated with, for early breast cancer. Further studies are needed to obtain a deeper comprehension of the correlation between clinical psychological and physical features in BCSs.
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Affiliation(s)
- Gabriella Martino
- Department of Clinical and Experimental Medicine, University Hospital of Messina, Messina, Italy
- * E-mail:
| | - Antonino Catalano
- Department of Clinical and Experimental Medicine, University Hospital of Messina, Messina, Italy
| | - Rita Maria Agostino
- Unit of Medical Oncology, Grand Metropolitan Hospital Bianchi Melacrino Morelli, Reggio-Calabria, Italy
| | - Federica Bellone
- Department of Clinical and Experimental Medicine, University Hospital of Messina, Messina, Italy
| | - Nunziata Morabito
- Department of Clinical and Experimental Medicine, University Hospital of Messina, Messina, Italy
| | - Carmen Giulia Lasco
- Department of Clinical and Experimental Medicine, University Hospital of Messina, Messina, Italy
| | - Carmelo Mario Vicario
- Department of Cognitive Sciences, Psychology, Education and Cultural Studies, University of Messina, Messina, Italy
| | - Peter Schwarz
- Department of Medical Endocrinology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Ulla Feldt-Rasmussen
- Department of Medical Endocrinology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
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Martino G, Caputo A, Bellone F, Quattropani MC, Vicario CM. Going Beyond the Visible in Type 2 Diabetes Mellitus: Defense Mechanisms and Their Associations With Depression and Health-Related Quality of Life. Front Psychol 2020; 11:267. [PMID: 32174865 PMCID: PMC7054284 DOI: 10.3389/fpsyg.2020.00267] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 02/04/2020] [Indexed: 12/11/2022] Open
Abstract
Introduction Clinical psychological features may impact a person’s aptitude to deal with chronic diseases, leading to emotional distress, suffering, and a worse perceived quality of life (QoL). Chronic diseases are largely represented, and their incidence is constantly increasing all over the world. Type 2 Diabetes Mellitus (T2DM) is one of the most common chronic diseases and it is very difficult to manage, demanding long term self-management, which improves the perceived QoL. The aim of this study was to explore defense mechanisms, depression, QoL, time since diagnosis, and metabolic control in T2DM patients. Methods 51 patients with T2DM were assessed through a psychodiagnostic battery: Beck Depression Inventory-II, the 36-Item Short Form Health Survey, including indexes of Physical and Mental Component Summary and the Defense Mechanisms Inventory. Times since DM diagnosis and glycated hemoglobin values were detected. Results Participants were mainly female (62.74%), with a mean age of 66.1 years. T2M time since diagnosis was 11.77 years (SD = 7.1). Mild depression was detected (with an overall score between 13 and 19). Projection was significantly associated with higher depression and with lower physical well-being; Principalization was negatively associated with depression and positively with both physical and mental well-being. Turning Against Self correlated positively with physical well-being and negatively with mental well-being. Reversal was associated with lower depression and higher mental well-being. A negative high correlation emerged between depression and mental well-being. Finally, a significant relationship was found between Projection and higher time since diagnosis (r = 0.31, p < 0.05). Conclusion The correlations between defense mechanisms, depression and health-related QoL highlight the potential personification and protagonization, which may increase over time due to the illness intrusiveness and worsening of diabetes symptoms. The positive association between defensive strategies and well-being measures should be cautiously considered.
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Affiliation(s)
- Gabriella Martino
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Andrea Caputo
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, Rome, Italy
| | - Federica Bellone
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Maria C Quattropani
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Carmelo M Vicario
- Department of Cognitive Sciences, Psychology, Education and Cultural Studies, University of Messina, Messina, Italy
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