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Zaccari V, Mancini F, Rogier G. State of the art of the literature on definitions of self-criticism: a meta-review. Front Psychiatry 2024; 15:1239696. [PMID: 38439797 PMCID: PMC10910096 DOI: 10.3389/fpsyt.2024.1239696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 01/24/2024] [Indexed: 03/06/2024] Open
Abstract
Background Several authors have developed important theoretical models on an important transdiagnostic factor in psychopathology: self-criticism (SC). Currently, there are substantial variations in the theoretical definition of SC. The lack of awareness of similarities and differences between models may in turn impact the comparison between empirical results, limiting their clinical implications. Purpose The purpose of this study was to identify current trends in the field of SC and to explore whether these were approached and shaped by different conceptualizations of SC. Methods Core components of the most influential models of SC were identified. A meta-review was conducted searching for systematic reviews and/or meta-analyses in the following databases: PsycINFO, PsycARTICLES, MEDLINE, Scopus, Web of Science, and PubMed (all years up to 28 April 2023). Results Contributions were heterogeneous with respect to the definition of SC and the theoretical framework. Almost all systematic reviews poorly addressed the multidimensionality of SC. In addition, discrepancies between the definitions of SC provided and their operationalizations emerged. Conclusions The lack of dialogue between the different theoretical perspectives emerged from key contributions in the field of SC. Potential research questions to answer to stimulate this dialogue are proposed.
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Affiliation(s)
- Vittoria Zaccari
- School of Cognitive Psychotherapy, Rome, Italy
- Department of Human Sciences, Guglielmo Marconi University, Rome, Italy
| | - Francesco Mancini
- School of Cognitive Psychotherapy, Rome, Italy
- Department of Human Sciences, Guglielmo Marconi University, Rome, Italy
| | - Guyonne Rogier
- Department of Educational Sciences, University of Genoa, Genoa, Italy
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Saliani AM, Perdighe C, Zaccari V, Luppino OI, Mancini A, Tenore K, Mancini F. Treating Guilt-Inducing Self-Talk in Ocd with Dramatized Socratic Dialogue: A Step by Step Intervention. Clin Neuropsychiatry 2024; 21:63-78. [PMID: 38559430 PMCID: PMC10979789 DOI: 10.36131/cnfioritieditore2023060104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Objective Fear of moral guilt and conseque:nt increased attention to personal actions and intentions are the main ingredients of the self-criticism in patients suffering from obsessive-compulsive disorder (OCD). This pathogenic attitude takes shape in a typical guilt-inducing self-talk.The purpose of this work is to describe in detail a novel cognitive therapeutic procedure for OCD called "Dramatized Socratic Dialogue" (DSD). Method DSD is a theory-oriented intervention that combine elements of Socratic dialogue, chairwork, and cognitive acceptance strategies derived from Mancini's model, which posits that obsessive-compulsive (OC) symptoms stem from a fear of deontological guilt. Results DSD appears to have many strengths, being a theory-oriented treatment and focusing, as a therapeutic target, on the cognitive structures that determine pathogenic processes and OC symptoms. Furthermore, it is a short, flexible and tailor-made intervention. Conclusions Detailed description of the intervention could foster future research perspectives and thus be used in evidence-based effectiveness studies to establish whether DSD reduces OC symptoms and to investigate its mechanism of action.
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Affiliation(s)
| | | | - Vittoria Zaccari
- School of Cognitive Psychotherapy (APC-SPC), Rome, Italy
- Department of Human Sciences, Guglielmo Marconi University, Rome, Italy
| | - Olga Ines Luppino
- School of Cognitive Psychotherapy (APC-SPC), Rome, Italy
- Italian Academy of Schema Therapy (IAST), Rome, Italy
| | - Alessandra Mancini
- School of Cognitive Psychotherapy (APC-SPC), Rome, Italy
- Italian Academy of Schema Therapy (IAST), Rome, Italy
| | - Katia Tenore
- School of Cognitive Psychotherapy (APC-SPC), Rome, Italy
- Italian Academy of Schema Therapy (IAST), Rome, Italy
| | - Francesco Mancini
- School of Cognitive Psychotherapy (APC-SPC), Rome, Italy
- Department of Human Sciences, Guglielmo Marconi University, Rome, Italy
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Zaccari V, Rogier G, Pulsinelli D, Mancini F, D’Olimpio F. Explaining Interaction of Guilt and Obsessive-Compulsive Symptoms in Not Just Right Experiences. Clin Neuropsychiatry 2022; 19:39-44. [PMID: 35360469 PMCID: PMC8951168 DOI: 10.36131/cnfioritieditore20220106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Objective "Not Just Right Experiences" (NJREs) are currently considered a characteristic of Obsessive-Compulsive Disorder (OCD). Significant associations have been found between NJREs and Obsessive-Compulsive (OC) symptoms in nonclinical and clinical populations. Literature support a significant relationship between NJREs, feelings of guilt and OC features. This study aims to clarify the role of the potential interplay between guilt and OC symptomatology in NJREs and verify if high levels of guilt will predict NJREs and OC symptoms and trait guilt levels will positively interact in their prediction of NJREs. Method One hundred and eighty-nine adults recruited from normal population were assessed with questionnaires of NJREs and OC symptoms and proneness to experience guilt. Results All the variables involved in the study (NJREs severity, guilt and OCI-R scores) were positively and significantly correlated and showed that guilt and OCI-R scores significantly and positively interact in the prediction of NJREs levels. Guilt predicted NJREs only when levels of OCI-R were high. Conclusions These results support the association between guilt sensitivity or OC symptoms and NJREs in clinical and nonclinical participants and that a disposition toward high levels of guilt and OC symptoms have a particular sensitivity to NJREs corroborating centrality of guilt in OC symptoms.
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Affiliation(s)
- Vittoria Zaccari
- School of Cognitive Psychotherapy, Rome, Italy, Department of Psychology, University Guglielmo Marconi, Rome, Italy,Corresponding author Vittoria Zaccari E-mail:
| | - Guyonne Rogier
- Educational Sciences Unit, University of Genoa, Genova, Italy
| | - Daniela Pulsinelli
- School of Cognitive Psychotherapy, Rome, Italy, Department of Psychology, University Guglielmo Marconi, Rome, Italy
| | - Francesco Mancini
- School of Cognitive Psychotherapy, Rome, Italy, Department of Psychology, University Guglielmo Marconi, Rome, Italy
| | - Francesca D’Olimpio
- Department of Psychology, University of Campania “Luigi Vanvitelli”, Caserta, Italy
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Zaccari V, D'Arienzo MC, Caiazzo T, Magno A, Amico G, Mancini F. Narrative Review of COVID-19 Impact on Obsessive-Compulsive Disorder in Child, Adolescent and Adult Clinical Populations. Front Psychiatry 2021; 12:673161. [PMID: 34054624 PMCID: PMC8158808 DOI: 10.3389/fpsyt.2021.673161] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 04/01/2021] [Indexed: 12/19/2022] Open
Abstract
Background: The COVID-19 pandemic and quarantine had a significant impact on mental health which resulted in an increase of anxiety and depression in adult, child and adolescent clinical populations. Less is known about the potential effect of pandemic on obsessive-compulsive disorder (OCD) so there is a lack of review work to illustrate the impact of the COVID-19 pandemic on OCD. Purpose: The main objective is to review all the empirical contributions published after March 2020 that dealt with the impact of the COVID-19 pandemic on OCD in adults, children and adolescents, investigating the state-of-the-art literature concerning the impact on OCD and detailing limitations. Methods: The literature search was conducted using PsycINFO, PsycARTICLES, MEDLINE, Scopus, Web of Science, PubMed, and Google Scholar. This review analyzed all studies from January 2020 to 8 January 2021, focusing on clinical populations of children, adolescents, and adults with OCD. Results: A total of 102 articles were screened, resulting in the identification of 64 full-text articles to be further scrutinized. Upon closer examination, there was consensus that 39 articles met the study inclusion criteria and 14 of these were selected for study. Analysis of the results revealed that COVID-19 had an impact on OCD in both adults and young people and seems to have caused exacerbation of symptoms, especially of the contamination/washing subtypes. Eight studies in adult samples showed an increase in the severity of obsessive-compulsive symptoms; two studies underlined a minimal impact of COVID-19 on OCD patients and one study showed a slight improvement in symptoms. Two out of three studies on children and adolescents showed an exacerbation of OCD and a worsening even in the presence of an ongoing treatment. Conclusions: The studies reviewed are few. There are more studies on adult OCD than on children and adolescents. The results are controversial: few studies examined OCD subtypes; in most studies the typology of treatment was not clear and the samples covered a wide age range; a large number of studies did not use the same monitoring period or quantitative measures, both of which make it difficult to compare or rely on the results.
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Affiliation(s)
- Vittoria Zaccari
- School of Cognitive Psychotherapy, Rome, Italy
- Department of Human Sciences, Marconi University, Rome, Italy
| | | | | | | | | | - Francesco Mancini
- School of Cognitive Psychotherapy, Rome, Italy
- Department of Human Sciences, Marconi University, Rome, Italy
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Zaccari V, Santonastaso O, Mandolesi L, De Crescenzo F, Foti F, Crescentini C, Fabbro F, Vicari S, Curcio G, Menghini D. Clinical application of mindfulness-oriented meditation in children with ADHD: a preliminary study on sleep and behavioral problems. Psychol Health 2021; 37:563-579. [PMID: 33678073 DOI: 10.1080/08870446.2021.1892110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE High incidence of sleep problems in children and adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD) has been described. Mindfulness meditation has emerged as a novel approach to sleep disturbances and insomnia remediation. This preliminary study tested the efficacy of Mindfulness-Oriented Meditation (MOM) training on sleep quality and behavioral problems in children with ADHD. DESIGN Twenty-five children with ADHD aged 7-11 years underwent two programs three times per week for eight-weeks: the MOM training (15 children) and an Active Control Condition (10 children). MAIN OUTCOME MEASURES Objective and subjective measures of sleep quality and behavioral measures were collected before and after the programs. RESULTS Positive effects on sleep and behavioral measures were found only in the MOM group. CONCLUSION Although they are preliminary, our results indicate that MOM training is a promising tool for ameliorating sleep quality and behavioral manifestations in ADHD.
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Affiliation(s)
- Vittoria Zaccari
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS, Roma, Italy
| | - Ornella Santonastaso
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS, Roma, Italy
| | - Laura Mandolesi
- Department of Humanities, University of Naples Federico II, Napoli, Italy
| | - Franco De Crescenzo
- Department of Psychiatry, University of Oxford, Oxford, UK.,Clinical Trial Unit, University Department of Paediatrics, Bambino Gesù Children's Hospital, IRCCS, Roma, Italy.,Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Francesca Foti
- Department of Medical and Surgical Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Cristiano Crescentini
- Department of Languages and Literatures, Communication, Education and Society, University of Udine, Udine, Italy
| | - Franco Fabbro
- Department of Languages and Literatures, Communication, Education and Society, University of Udine, Udine, Italy
| | - Stefano Vicari
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS, Roma, Italy.,Department of Life Science and Public Health, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Giuseppe Curcio
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Deny Menghini
- Child and Adolescent Neuropsychiatry Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, IRCCS, Roma, Italy
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Zaccari V, Gragnani A, Pellegrini V, Caiazzo T, D'Arienzo MC, Magno A, Femia G, Mancini F. An Observational Study of OCD Patients Treated With Cognitive Behavioral Therapy During the COVID-19 Pandemic. Front Psychiatry 2021; 12:755744. [PMID: 34744841 PMCID: PMC8569247 DOI: 10.3389/fpsyt.2021.755744] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 09/23/2021] [Indexed: 12/30/2022] Open
Abstract
Background and Objectives: While the consequences of the COVID-19 pandemic for general mental health and the increase in anxiety and depression are clear, less is known about the potential effect of the pandemic on OCD. The purpose of this study is to collect new data to monitor the symptomatic status of patients with OCD during the period of emergency due to COVID-19 and to make a comparison between two psychodiagnostic evaluations. Methods: Eleven OCD patients and their psychotherapists were recruited. All patients had a specific psychodiagnostic assessment for OCD (SCL-90; OCI-R; Y-BOCS self-report) performed between December 2019 and January 2020 (t0), and undertook cognitive behavioral therapy (CBT) and exposure and prevention of response protocol (ERP) before the lockdown. The psychodiagnostic assessment carried out at t0 was re-administered (t1) to all patients, together with a set of qualitative questions collected through an online survey. The respective therapists were asked to document the status of the therapy and the monitoring of symptoms through use of a semi-structured interview (Y-BOCS) and a qualitative interview. Non-parametric analyses were conducted. Results: Patients reported a significant decrease in OCD symptoms. Data analysis showed a decrease in the scores across t0 and at t1 on the Y-BOCS (SR) total self-report, and on OCD symptoms' severity assessed by means of the OCI-r and SCL-90 r OC subscale, for 11 participants. Relating to the measures detected by psychotherapists, marginally significant improvements and lower scores were found in the Y-BOCS (I). An improvement in symptoms was noticed by 90.9% of the clinical sample; this was confirmed by 45.4% of the therapists, who claimed moderate progress in their patients. Conclusions: The data collected through standardized measurements at two different times, albeit relative to a small sample, assume relevance from a clinical point of view. In the literature, some studies document the worsening of OCD. However, in many studies, the type of treatment, the detection time, and the intervention period are not well-specified. These results confirm the effectiveness of CBT/ERP as an elective treatment for OCD through a specific intervention procedure.
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Affiliation(s)
- Vittoria Zaccari
- Associazione Scuola di Psicoterapia Cognitiva (APC-SPC), Rome, Italy.,Department of Human Sciences, Marconi University, Rome, Italy
| | - Andrea Gragnani
- Associazione Scuola di Psicoterapia Cognitiva (APC-SPC), Rome, Italy
| | - Valerio Pellegrini
- Department of Social and Developmental Psychology Sapienza, University of Rome, Rome, Italy
| | - Tecla Caiazzo
- Associazione Scuola di Psicoterapia Cognitiva (APC-SPC), Rome, Italy
| | | | - Antonella Magno
- Associazione Scuola di Psicoterapia Cognitiva (APC-SPC), Rome, Italy
| | - Giuseppe Femia
- Associazione Scuola di Psicoterapia Cognitiva (APC-SPC), Rome, Italy
| | - Francesco Mancini
- Associazione Scuola di Psicoterapia Cognitiva (APC-SPC), Rome, Italy.,Department of Human Sciences, Marconi University, Rome, Italy
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Zaccari V, Aceto M, Mancini F. A Systematic Review of Instruments to Assess Guilt in Children and Adolescents. Front Psychiatry 2020; 11:573488. [PMID: 33362597 PMCID: PMC7755888 DOI: 10.3389/fpsyt.2020.573488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 10/27/2020] [Indexed: 11/22/2022] Open
Abstract
Background: Guilt feelings have received considerable attention in past psychological theory and research. Several studies have been conducted that represent a range of views and propose various implications of guilt in children and adolescents. Variations in theoretical definitions of guilt, emphasizing a lack of measurement convergence, make it difficult to derive a comprehensive definition of the construct in childhood and adolescence. Research shows substantial variability in instruments used to measure guilt in children and adolescents. Purpose: The aim is to discuss existing contributions, illustrating the empirical validity of the available instruments used to measure guilt and identifying the nature of their theoretical backgrounds among children and adolescents. Methods: A systematic search was conducted using the following databases: PsycINFO, PsycARTICLES, MEDLINE, Scopus, Web of Science, and PubMed (all years up to February 19, 2020). Search terms were compiled into three concepts for all databases: "measure," "guilt," and "childhood/adolescence." In addition, a search was conducted to detect the gray literature. Results: After removing the duplicates, a total of 1,408 records were screened, resulting in the identification of 166 full-text articles to be further scrutinized. Upon closer examination, there was consensus that 148 of those studies met the study inclusion criteria or were not retrieved. Twenty-five studies were included in the quality assessment. The data were organized on three main categories: (1) interpersonal or prosocial guilt; (2) intrapunitive guilt or that referring to an excessive sense of responsibility; (3) not specifying a theoretical construct. A great heterogeneity in psychometric evaluations and substantial variability in guilt construct emerged. The construct most represented and supported by valid instruments was interpersonal or prosocial guilt. Analysis of the gray literature showed that some instruments were not immediately available to the clinical and scientific communities. Conclusions: The studies analyzed and selected for qualitative review employed various instruments to measure guilt. Results confirmed what is widely documented in the literature about substantial variability in instruments used to measure guilt. We argue the need to develop measures that assess currently overlooked dimensions of guilt and to provide further additional information about the psychometric proprieties of the available developed instruments.
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Affiliation(s)
- Vittoria Zaccari
- Associazione Scuola di Psicoterapia Cognitiva (APC - SPC), Rome, Italy.,Department of Human Sciences, Marconi University, Rome, Italy
| | - Marianna Aceto
- Associazione Scuola di Psicoterapia Cognitiva (APC - SPC), Rome, Italy
| | - Francesco Mancini
- Associazione Scuola di Psicoterapia Cognitiva (APC - SPC), Rome, Italy.,Department of Human Sciences, Marconi University, Rome, Italy
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Gatta F, Zaccari V, Huidobro-Toro JP, Chiavarelli S. [Pyrazino (1,2-a)- and 1,4-diazepino(1,2-a)indoles. II. Synthesis of 1-substituted 10-phenyl-3,4-dihydropyrazino(1,2-a)indoles and of 11-phenyl-4,5-dihydro-4H-diazepino(1,2-a)indoles]. Farmaco Sci 1975; 30:58-69. [PMID: 1116593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The AA. describe the synthesis of some 1-substituted 10-phenyl-3,4-dihydropyrazino(1,2-a)indoles and 11-phenyl-4,5-dihydro-3H-1,4-diazepino(1,2-a)indoles. Preliminary pharmacological tests indicate that these products, have lower sedative and antiadrenergic activity than the compounds reported in our previous paper.
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Gatta F, Zaccari V, Huidobro-Toro JP, Landi Vittory R. [Pyrazine-1,2-a-and 1,4-diazepino-1-2-1-indoles. I. Synthesis of 10-phenyl-1,2,3,4-yrytshyftopytsxino-1,2-a-indoles and of 11-phenyl-2,3,4,5-tetrahydro-1H-1,4-diazepino-1,2-a-indoles]. Farmaco Sci 1974; 29:386-97. [PMID: 4838294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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