Mindfulness, age and gender as protective factors against psychological distress during COVID-19 pandemic

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

Defensive responses to stressful life events associated with cancer diagnosis

Objectives: Stressful life events (SLEs) are common in patients who developed both physical and psychological syndromes. Research shown the role of psychological defense mechanisms in cancer progression and survival probability. The present study analyzed recent SLEs and defense mechanisms as characteristic of cancer patients and tested their role as potential predisposing factors to cancer development. Methods: This cross-sectional study enrolled 145 participants: 48 recently diagnosed cancer patients (CP), 43 recently diagnosed benignant tumor patients (BT), and 54 healthy subjects (HC). Non-blinded raters assessed participants’ defense mechanisms using the Defense Mechanisms Rating Scales Q-sort version (DMRS-Q). Groups were compared on the presence of SLEs and on the maturity of defensive functioning. Associations between SLE and defense mechanisms as statistically associated with cancer diagnosis was explored. Results: Higher overall defensive functioning was associated with good physical conditions. Recent SLEs, higher use of neurotic defenses and lower use of obsessional defenses characterized cancer patients. CP showed higher use of suppression, repression, dissociation, rationalization and passive aggression and lower use of affiliation, sublimation, undoing, and devaluation of self-image as compared to controls. Hierarchical regression analysis showed that recent SLEs and defense mechanisms of suppression, repression, dissociation, displacement and omnipotence were associated with cancer diagnosis. Discussion: Recent SLEs and repressive defensive functioning characterized the CP’s defensive response to stress. Despite the relevance of present findings, this study shows several limitations. Prospective and longitudinal studies are needed to confirm these results and to investigate the potential role played by SLEs and defense mechanisms in cancer development

Retrospective analyses of psychological distress and defense style among cancer patients

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). Methods: 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, depres-sion, 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

Case report: Gastroenterological management in a case of cardio-facio-cutaneous syndrome

Backgroundcardio-facio-cutaneous syndrome is a rare genetic disorder affecting less than 900 people in the world. It is mainly characterized by craniofacial, dermatologic and cardiac defects, but also gastroenterological symptoms may be present, ranging from feeding difficulties to gastroesophageal reflux and constipation.In this report we describe a case of this syndrome characterized by severe feeding and growth difficulties, with a particular focus on the management of gastroenterological complications.Case presentationthe patient was a caucasian male affected by Cardio-Facio-Cutaneous syndrome who presented feeding difficulties already a few hours after birth. These symptoms worsened in the following months and lead to a complete growth arrest and malnutrition. He was first treated with a nasogastric tube placement. Subsequently, a laparoscopic Nissen fundoplication and a laparoscopic Stamm gastrostomy were performed. The child was fed with nocturnal enteral nutrition and diurnal oral and enteral nutrition. Eventually the patient resumed feeding validly and regained adequate growth.Conclusionthis paper aims to bring to light a complex rare syndrome that infrequently comes to the attention of the pediatricians and whose diagnosis is not always straightforward. We also highlight the possible complications under a gastroenterologic point of view. Our contribution can be helpful to the pediatrician in the first diagnostic suspect of this syndrome. In particular, it is worth highlighting that -in an infant with Noonan-like features- symptoms like suction or swallowing problems, vomiting and feeding difficulties should orient towards the diagnosis of a Cardio-facio-cutaneous syndrome. It is also important to stress that its related gastroenterological issues may lead to severe growth failure and therefore the role of the gastroenterologist is key to manage supplemental feeding and to establish whether a nasogastric or gastrostomic tube placement is necessary

Trattamento MBSR per la fibromialgia: uno studio pilota

La Fibromialgia (FM) è una malattia reumatica a carattere cronico che causa dolore diffuso in tutto il corpo al quale si legano frequentemente affaticamento intenso, disturbi del sonno, disturbi cognitivi e mnestici con un notevole impatto sul livello di stress percepito. I pazienti con FM presentano comorbilità con disturbi psichiatrici e psicologici di vario tipo, inclusi disturbi alimentari, d'ansia e disturbi del tono dell'umore. Il dolore cronico influenza in modo negativo la qualità della vita dei pazienti, il sonno, le relazioni sociali e soprattutto la sfera lavorativa con un impatto quasi catastrofico sul senso di autoefficacia. In questo contesto, negli ultimi anni, sono emerse delle psicoterapie mindfulness-based per il trattamento e la gestione dello stress che si sono dimostrate efficaci in questo ambito. Questo studio ha riguardato N=9 pazienti affette da fibromialgia che sono state sottoposte ad un protocollo MBSR, della durata di due mesi circa. Le pazienti sono state testate a mezzo di reattivi in sei aree differenti (qualità del sonno, tono dell'umore, consapevolezza del momento presente, ansia di stato e di tratto, stress percepito e qualità della vita) prima e dopo il trattamento. Nell'interpretare i risultati è emerso un miglioramento statisticamente significativo di tutto il gruppo per quanto riguarda il tono dell'umore e gli stati affettivi, mentre N=6 partecipanti mostrano livelli inferiori di ansia e di stress percepito oltre che un aumento della qualità del sonno. La presente ricerca mostra risultati incoraggianti che dovrebbero ispirare ricerche future sull'argomento, con l'indicazione di aumentare la numerosità del campione

Mindfulness dispositions and defense style as positive responses to psychological distress in oncology professionals

Purpose: Working in oncology departments is a stressful and emotionally consuming experience and oncology professionals are particularly at risk for developing stress-related syndromes. Defense mechanisms (high-adaptive)and mindfulness dispositions are known as facilitators of well-being and adaptation. In this study we analysed the role of these unconscious and conscious strategies in protecting the oncology clinicians from stress-related symptoms. Method: A convenience sample of 63 oncology professionals was assessed on defense style, mindfulness disposition, depression and anxiety symptoms using self-reported questionnaires. Demographic and professional information was included in data collection. Results: Results did not show significance differences in demographic and professional characteristics among all studied variables. Mature defense style and mindfulness were highly and negatively correlated with depression and anxiety, while a positive association was found between immature defense style and both depression and anxiety symptoms. Hierarchical multiple regression analyses found defense styles and mindfulness as predictors of depression, whereas only immature defense style predicted anxiety. Conclusions: The present study provides the first empirical evidence of the influence of unconscious defense mechanisms and conscious mindfulness dispositions in protecting oncology professionals from depression and anxiety symptoms. Defense mechanisms and mindfulness share several common-points and should be seen as complementary in enhancing physical and psychological well-being. Further studies are required for a deeper understanding of the impact of mindfulness and defenses in improving adaptation

Mindfulness, compassion, and self-compassion among health care professionals: What’s new? a systematic review

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 aboutmindfulness 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

Does impulsivity increase the risk of developing a pathological condition?

Background: With the term addiction, the scientific community refers to a psychopathological category related to a rather variable series of addictions to different substances and behaviors, among which we can find common generic elements. The most important part in the definition of addiction is represented by the continuous research for gratification. The psychopathological manifestation of the disease consists of three key symptoms: craving, relapse and loss of control (impulsivity). Discovering and studying a factor of vulnerability in the development towards this psychopathology would certainly represent a goal and would have both predictive and explanatory importance. Methods: This short review is an attempt to explore impulsivity concept and its relations with addiction, in particular cocaine addiction. Results: In literature, there are numerous studies that indicate the excessive amount of impulsivity and the non tendency to control impulses as pre-existing factors and possible predictors of vulnerability for the development of an addiction. Furthermore, some neurocognitive studies have shown how cocaine-addicted subjects show more impulsivity towards both movements (impulsive action) and, cognitively, in the decision-making capacity (impulsive choice). Conclusions: It is rather common to find higher impulsivity traits in gamblers than in the general population; therefore, this trait could represent an important risk factor and predisposition to the development of a clinical picture of dependence

A psychoeducational intervention is a treatment for fibromyalgia syndrome

Although the mechanisms underlying fibromyalgia are not yet clear, many attempts have been made to implement pharmacological therapy and help patients manage its psychological and physical symptoms. Recent evidence has shown that an interdisciplinary multidimensional approach encompassing psychological factors, emotion regulation strategies and education on illness is more effective in improving quality of life, both in the short- and long-term, than usual treatments alone. The purpose of this review is to provide an updated overview of the available literature regarding the role of psychoeducation on fibromyalgia symptoms and health outcomes. We searched on PubMed Database with the keywords “fibromyalgia”, “education” and “psychology” and then divided the results of our research into four main categories: effectiveness of psychoeducational programs versus treatment as usual, psychoeducational interventions versus other non-pharmacological treatments, Online-based education programs and specific characteristics of the participants. Our research highlighted that most of the considered studies found significant positive results on patients' condition, suggesting that an interdisciplinary intervention containing psychoeducation is an effective strategy in managing fibromyalgia symptoms