Illusory correlation and cognitive processes: a multinomial model of source-monitoring

The present research examines how the application of a multinomial source-monitoring model in the illusory correlation paradigm (Klauer & Meiser, 2000) can shed light on the cognitive processes underlying illusory correlation paradigm in children. A source-monitoring analysis allows assessing the roles of different factors (item memory, source memory and response bias) involved in the illusory correlation. In line with the previous source-monitoring analyses on adults (Klauer & Meiser, 2000; Meiser & Hewstone, 2001), illusory correlation phenomenon was caused by the guessing bias in source discrimination: a larger proportion of positive than negative behaviors was attributed to the majority group in a state of memory uncertainty. The results are discussed in terms of previously proposed theories of illusory correlation paradigm

Illusory correlation and cognitive processes: a multinomial model of source-monitoring

The present research examines how the application of a multinomial source-monitoring model in the illusory correlation paradigm (Klauer & Meiser, 2000) can shed light on the cognitive processes underlying illusory correlation paradigm in children. A source-monitoring analysis allows assessing the roles of different factors (item memory, source memory and response bias) involved in the illusory correlation. In line with the previous source-monitoring analyses on adults (Klauer & Meiser, 2000; Meiser & Hewstone, 2001), illusory correlation phenomenon was caused by the guessing bias in source discrimination: a larger proportion of positive than negative behaviors was attributed to the majority group in a state of memory uncertainty. The results are discussed in terms of previously proposed theories of illusory correlation paradigm

Hoarding Behaviour in an Italian Non-Clinical Sample

Background: Hoarding is associated with significant impairment. Although traditionally considered as a symptom of obsessive-compulsive disorder (OCD), some authors have proposed that pathological hoarding could be considered as a stand alone condition. The prevalence of pathological hoarding behaviour has been shown to be high in some countries, but little is known about the prevalence and correlates of hoarding in the non-clinical population in Italy. Method: We studied the prevalence of self-reported hoarding behaviour using the Italian version of the Saving Inventory-Revised, as well as the association between hoarding and various clinical correlates, including obsessive-compulsive symptoms, compulsive buying, anxiety, and depression. Results: The prevalence of pathological hoarding behaviour in two studies was between 3.7 and 6.0%. No differences were found between hoarding and non-hoarding participants with regard to gender, age, marital status, level of education, and employment status. Significant correlations were found between compulsive hoarding and obsessive-compulsive symptoms and also between hoarding and a measure of compulsive buying, even after controlling for anxiety and depressive symptoms. Conclusions: These results indicate that pathological hoarding may also be prevalent in Italy and highlight the need for further epidemiological studies using validated instruments to assess hoarding disorder

How can advance care planning support hope in patients with advanced cancer and their families: a qualitative study as part of the international ACTION trial

Objective Clinicians' fears of taking away patients' hope is one of the barriers to advance care planning (ACP). Research on how ACP supports hope is scarce. We have taken up the challenge to specify ways in which ACP conversations may potentially support hope. Methods In an international qualitative study, we explored ACP experiences of patients with advanced cancer and their personal representatives (PRs) within the cluster-randomised control ACTION trial. Using deductive analysis of data obtained in interviews following the ACP conversations, this substudy reports on a theme of hope. A latent thematic analysis was performed on segments of text relevant to answer the research question. Results Twenty patients with advanced cancer and 17 PRs from Italy, the Netherlands, Slovenia, and the United Kingdom were participating in post-ACP interviews. Three themes reflecting elements that provide grounds for hope were constructed. ACP potentially supports hope by being (I) a meaningful activity that embraces uncertainties and difficulties; (II) an action towards an aware and empowered position; (III) an act of mutual care anchored in commitments. Conclusion Our findings on various potentially hope supporting elements of ACP conversations provide a constructive way of thinking about hope in relation to ACP that could inform practice

Advance care planning, a multi-centre cluster randomised clinical trial: the research protocol of the ACTION study

Background: Awareness of preferences regarding medical care should be a central component of the care of patients with advanced cancer. Open communication can facilitate this but can occur in an ad hoc or variable manner. Advance care planning (ACP) is a formalized process of communication between patients, relatives and professional caregivers about patients’ values and care preferences. It raises awareness of the need to anticipate possible future deterioration of health. ACP has the potential to improve current and future healthcare decision making, provide patients with a sense of control, and improve their quality of life. Methods/Design: We will study the effects of the ACP program Respecting Choices on the quality of life of patients with advanced lung or colorectal cancer. In a phase III multicenter cluster randomised controlled trial, 22 hospitals in 6 countries will be randomised. In the intervention sites, patients will be offered interviews with a trained facilitator. In the control sites, patients will receive care as usual. In total, 1360 patients will be included. All participating patients will be asked to complete questionnaires at inclusion, and again after 2.5 and 4.5 months. If a patient dies within a year after inclusion, a relative will be asked to complete a questionnaire on end-of-life care. Use of medical care will be assessed by checking medical files. The primary endpoint is patients’ quality of life at 2.5 months ost-inclusion. Secondary endpoints are the extent to which care as received is aligned with patients’ preferences, patients’ evaluation of decision-making processes, quality of end-of-life care and cost-effectiveness of the intervention. A complementary qualitative study will be carried out to explore the lived experience of engagement with the Respecting Choices program from the perspectives of patients, their Personal Representatives, healthcare providers and facilitators. Discussion: Transferring the concept of ACP from care of the elderly to patients with advanced cancer, who on average are younger and retain their mental capacity for a larger part of their disease trajectory, is an important next step in an era of increased focus on patient centered healthcare and shared decision-making. Trial registration: International Standard Randomised Controlled Trial Number: ISRCTN63110516. Date of registration: 10/3/2014. Keywords: Advance care planning, Oncology, Quality of life, Medical decision-makin

Missing not at random in end of life care studies: multiple imputation and sensitivity analysis on data from the ACTION study

Background: Missing data are common in end-of-life care studies, but there is still relatively little exploration of which is the best method to deal with them, and, in particular, if the missing at random (MAR) assumption is valid or missing not at random (MNAR) mechanisms should be assumed. In this paper we investigated this issue through a sensitivity analysis within the ACTION study, a multicenter cluster randomized controlled trial testing advance care planning in patients with advanced lung or colorectal cancer. Methods: Multiple imputation procedures under MAR and MNAR assumptions were implemented. Possible violation of the MAR assumption was addressed with reference to variables measuring quality of life and symptoms. The MNAR model assumed that patients with worse health were more likely to have missing questionnaires, making a distinction between single missing items, which were assumed to satisfy the MAR assumption, and missing values due to completely missing questionnaire for which a MNAR mechanism was hypothesized. We explored the sensitivity to possible departures from MAR on gender differences between

The two dimensions of contamination fear in obsessive-compulsive disorder: Harm avoidance and disgust avoidance

Contamination fear has always been considered a homogeneous symptom dimension. Compensatory behaviors (e.g., washing) are considered attempts to remove the contagion and to protect the individual from threats of illness; however, they may also be motivated by feelings of distress that are unrelated to any perceived harmful outcome, such as the feeling of disgust. Our hypothesis was that OCD patients with fear of harm resulting from contamination (harm avoidance [HA]) and OCD patients with fear of disgusting substances/persons (disgust avoidance [DA]) could be distinguished. To test this hypothesis, the Contamination Fear Core Dimensions Scale (CFCDS), an 8-item self-report measure aimed at operazionalizing the two facets of contamination fear, was developed. The scale was administered to 176 Italian OCD patients, together with a series of other self-report measures, and to 86 non-clinical participants. Confirmatory factor analyses supported the hypothesized two-correlated-factor structure in the clinical sample. The CFCDS also showed adequate reliability, construct and criterion-related validity. In particular, DA and HA subscales showed different patterns of association with other measures. In conclusion, this study provides preliminary evidence of the separability of two motivational dimensions of contamination fear and of specific associations between these and other relevant constructs

The impact of ACP on patient's relationships

Background: In the period 2013-2018 an important European study (ACTION) involving six countries, financed according to the 7\ub0 European framework, has been performed. The ACTION study dealt with the issue of advance care planning (ACP) in oncology and searched for evidence of its impact on patient and family

Factor Congruence and Psychometric Properties of the Italian Version of the Dimensional Obsessive-Compulsive Scale (DOCS) Across Non-Clinical and Clinical Samples

The Dimensional Obsessive-Compulsive Scale (DOCS) is a self-report instrument that assesses the severity of the four most empirically supported OC symptom dimensions (Contamination, Responsibility, Unacceptable Thoughts, and Symmetry). The aim of this study was to investigate the psychometric properties of the Italian version of the DOCS and address associations with socio-demographical variables, psychometric properties in a community (i.e., non-student) sample, and congruence of factor solutions across non-clinical and patient samples. Factor structure, internal consistency, construct, and criterion validity were investigated in three samples of participants (315 from the general population, 106 OCD patients and 31 with other anxiety disorders [OADs]). Results supported the four-factor structure of the DOCS both in clinical and non-clinical sample, and adequate levels of factor congruence across the two samples were found. DOCS scores showed good internal consistency, temporal stability and construct validity, and could adequately discriminate between non-clinical participants, OCD and OADs patients. All the other variables kept constant, associations of DOCS total score with educational level, of Contamination with gender, and of Unacceptable Thoughts with age were also found. These findings suggest that the Italian version of the DOCS retains the adequate psychometric properties of the original, and can be confidently used as an assessment tool of OC symptoms in clinical and research settings