Anxiety Sensitivity in Patients with Alcohol Dependence: A Cross-Sectional Case-Control Study

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Religious affiliation and obsessive cognitions and symptoms: A comparison between Jews, Christians, and Muslims in non-clinical groups in Italy.

Growing interest has been dedicated by researchers on obsessive–compulsive disorder across different religious affiliations. Increasing migration in Italy is making the country progressively multireligious but is a relatively new phenomenon, consequently this research area is still young. The present study aimed at examining differences on obsessive–compulsive (OC) cognitions and symptoms between Jews, Christians, and Muslims living in Italy. Another purpose was to investigate whether potential differences on these OC features between groups could be moderated by the level of religiosity. Three hundred fifty-four nonclinical individuals, including Jews (n = 97), Christians (n = 139), and Muslims (n = 118), completed the OBQ-87, the III, the PI, the BAI, and the BDI-II. After controlling for anxiety and depression, Muslims had more severe OC symptoms and cognitions compared to Jews and Christians. Conversely, the level of religiosity did not appear to be significantly associated with OC symptoms and cognitions severity. Theoretical explanations and clinical implications are discussed

“Was it real or did I imagine it?” Perfectionistic beliefs are associated with dissociative absorption and imaginative involvement in obsessive-compulsive disorder

Background and objectives In the literature there are inconsistent data regarding the role of dissociation in OCD. No study explored the association between obsessive beliefs and dissociative symptoms in OCD. It is important to understand which clinical factors are related to dissociation in OCD as more severe dissociative symptoms, particularly absorption, have been found to be predictors of treatment non-response. In the present short report we describe the results of an exploratory study aimed to investigate the role of the obsessive beliefs as predictors of the different dissociative symptoms controlling for anxiety and OCD severity in a group of OCD patients. Methods Sixty treatment-seeking patients consecutively referred to psychiatric services were included (mean age=31.17 years, 53.30% females). The Dissociative Experiences Scale-II, the Obsessive Beliefs Questionnaire-46, the Yale-Brown Obsessive-Compulsive Scale, and the Beck Anxiety Inventory were administered. Results Higher anxious symptoms predicted higher Dissociative Amnesia, Depersonalization/Derealization, and Absorption/Imaginative Involvement. Higher OCD severity predicted higher Dissociative Amnesia. More severe Perfectionism predicted higher Absorption/Imaginative Involvement. Conclusion Perfectionism in OCD patients may be associated with a higher tendency to absorption and imaginative involvement. Future research should explore whether a psychotherapeutic intervention on perfectionism might improve the outcomes of the OCD patients with higher absorption tendencies. © 2019 Pozza and Dèttore

Le distorsioni cognitive negli stati mentali a rischio

Un’area oggetto di sempre maggiore interesse nel campo dello studio degli stati mentali a rischio e dei meccanismi implicati nello sviluppo dei disturbi psicotici, è rappresentata dall’indagine delle distorsioni cognitive. Già da vari anni un ampio volume di ricerche evidenzia il ruolo di specifici stili di pensiero quali elemento centrale di vulnerabilità e di mantenimento nei disturbi psicotici conclamati, in particolare nei processi che conducono alla formazione di convinzioni deliranti (eg, Luzón et al., 2009; Moritz & Woodward, 2005). Tali stili cognitivi porterebbero il paziente a raccogliere dati in modo distorto e prendere decisioni basate su errori logici, dei quali spesso non è consapevole. In ricerche sperimentali su pazienti con disturbi psicotici, Freeman e colleghi (2006) evidenziano che, nonostante l'adozione di bias legati al processo di raccolta di evidenze ed alla falsificazione dei propri pensieri, i pazienti tendono a ritenersi decisori riflessivi in grado di valutare adeguatamente i pro ed i contro delle diverse prospettive. Un'attenzione crescente negli ultimi anni è stata dedicata al riconoscimento dei bias cognitivi anche nelle condizioni di stato mentale a rischio (Broome et al., 2007). Il miglioramento della consapevolezza dei pazienti rispetto a tali trappole della mente può divenire un bersaglio-chiave dell'intervento psicologico di prevenzione con i giovani classificati a rischio di psicosi (van der Gaag et al., 2013). Di seguito, si riportano i principali bias cognitivi tipici degli stati mentali a rischio, come evidenziato da studi recenti

Modular cognitive‐behavioral therapy for affective symptoms in young individuals at ultra‐high risk of first episode of psychosis: Randomized controlled trial.

Objectives: Individuals at ultra‐high risk of psychosis often present concurrent affective symptoms (depression/anxiety). This study investigated whether modular cognitive‐behavioral therapy (CBT) targeting both ultra‐high risk and affective symptoms (a) reduced/delayed risk of a first psychotic episode at posttreatment and 14‐month follow‐up compared with a supportive intervention, (b) was more effective than control condition in producing remission on depression/anxiety. Methods: Fifty‐eight ultrahigh risk individuals were randomly assigned to CBT or control condition. CBT consisted of 30 sessions, including CBT for psychotic experiences and depression/anxiety. Results: In the CBT group, the cumulative number of participants who developed a first psychotic episode (n = 3, 10.34%) at follow‐up was lower than in the control group (n = 8, 27.60%; logrank χ2(1) = 3.68, p = .05). In the CBT group, a higher number of participants achieved remission than in control condition on affective symptoms at posttreatment/follow‐up. Conclusion: CBT can prevent psychosis risk and produce better outcomes on depression/anxiety than supportive intervention

The CBQ-p: A confirmatory study on factor structure and convergent validity with psychotic-like experiences and cognitions in adolescents and young adults

The Cognitive Biases Questionnaire for psychosis (CBQ-p) is a recently developed self-report measure assessing cognitive distortions relevant to psychotic symptoms and experiences, specifically for the onset and maintenance of delusional ideas. In Italy, there is a lack of assessment tools measuring these aspects. In addition, no international study investigated the relations of CBQ-p with subthreshold psychotic-like experiences. The current study assessed the factor structure of the Italian CBQ-p with confirmatory analyses in community adolescents and young adults. A further aim was to examine its convergent validity with measures of aberrant salience, cognitive biases specific to psychosis, inferential confusion, worry, and subthreshold psychotic-like experiences. Three hundred eighty-eight adolescents and young adults of the community (mean age= 19.22, 55% females) completed the CBQ-p, measures of cognitive distortions of psychosis, aberrant salience, inferential confusion, worry and subthreshold psychotic-like experiences. Confirmatory factor analysis, internal consistency and Pearson's correlations were computed. The Italian CBQ-p demonstrated good psychometric properties; the total scale and subscales reported convergent validity with subthreshold psychotic experiences

Drop-out and efficacy of group versus individual cognitive behavioural therapy: What works best for Obsessive-Compulsive Disorder? A systematic review and meta-analysis of direct comparisons.

Cognitive behavioural therapy (CBT) is the first-line psychological treatment for Obsessive-Compulsive Disorder (OCD). However, a relevant proportion of individuals with OCD remain untreated or inadequately treated. Group cognitive behavioural therapy (GCBT) may be an alternative treatment modality. Little knowledge is available about the efficacy between GCBT versus individual CBT, particularly on long-term secondary outcomes including anxiety and depression. In addition, drop-out rates have not been investigated by previous meta-analyses. The current systematic review and meta-analysis summarized evidence comparing drop-out rates between GCBT and individual CBT and efficacy at post-treatment and follow-up on OCD symptoms, depression and anxiety. A systematic review and meta-analysis according to PRISMA guidelines was conducted. Online databases were searched. Studies were included if using randomized designs comparing GCBT versus individual CBT. Six studies were included (n = 327). No difference was found between GCBT and individual CBT on drop-out rates with a medium non-significant effect. No difference resulted at post-treatment on OCD symptoms, depression, and anxiety. Analyses on a smaller number of studies indicated no difference at follow-up. Findings provided preliminary evidence that GCBT can be as effective as individual CBT. Further trials are required with higher quality and long-term assessments of quality of life

Muscle dysmorphia in different degrees of bodybuilding activities: validation of the Italian version of Muscle Dysmorphia Disorder Inventory and Bodybuilder Image Grid

The purpose of the study was to validate two measures of muscle dysmorphia (MD) into the Italian language. The sample included three participant groups: (1) competing bodybuilders, (2) non-competing bodybuilders, and (3) non-bodybuilding controls. In general the Italian versions of the scales showed psychometric utility that is consistent with the original instruments. The severity of MD was greater for competing bodybuilders than non-competing bodybuilders and controls

Does time-intensive ERP attenuate the negative impact of comorbid personality disorders on the outcome of treatment-resistant OCD?

Background and objectives: There is growing interest regarding patients with obsessive-compulsive disorder (OCD) who do not fully respond to cognitive-behavioural therapy (CBT). Limited data are available on the role of Comorbid Personality Disorders (CPDs) in the outcome of treatment-resistant obsessivecompulsive disorder (OCD), despite the fact that CPDs are considered a predictor of a poorer outcome. This study investigated whether a time-intensive scheduling of treatment could be an effective strategy aimed at attenuating the negative influence of CPDs on outcome in a sample of 49 inpatients with a primary diagnosis of treatment-resistant OCD. Method: 38 inpatients completed the five-week individual treatment consisting of daily and prolonged sessions of exposure with response prevention (ERP) delivered for 2 h in the morning and 2 h in the afternoon. 44% of the sample received a full diagnosis of one or more CPDs. Following a pre-post-test design, outcome measures included the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Beck Depression Inventory-II (BDI-II) and Beck Anxiety Inventory (BAI). Results: Data showed that the treatment was effective and indicated that CPDs were not a significant predictor of treatment failure. Limitations: Future larger studies should evaluate the role of specific clusters of CPDs on the outcome of resistant OCD. Conclusions: These findings suggest that an intensive treatment could be effective for severely ill patients who have not responded to weekly outpatient sessions and could also attenuate the negative impact of CPDs on outcome, evidencing the importance of a tailored therapeutic approach for patients who need a rapid reduction in OCD-related impairment

Terapia cognitivo-comportamentale per giovani ad alto rischio di un primo episodio di psicosi: un trial randomizzato controllato. [Cognitive behavioural therapy for young individuals at ultra-high risk of a first episode of psychosis: A randomised controlled trial]

Scopo. Nell’ultimo ventennio l’interesse di ricercatori e clinici nella prevenzione di disturbi psicotici è cresciuto notevolmente. Gli studi internazionali su strategie a favore di giovani “ad alto rischio di un primo episodio di psicosi” sono ancora in numero ridotto, mentre in Italia risultano del tutto assenti. Oltre a manifestare sintomi psicotici sotto-soglia, questa popolazione di frequente riporta un compromesso funzionamento. La terapia cognitivo-comportamentale (TCC) è la strategia di prima linea, ma si rileva in letteratura l’importanza di studi su ulteriori misure di esito, quali il funzionamento. Il presente studio ha valutato se un protocollo di TCC modulare riducesse il rischio di un primo episodio psicotico in un gruppo di giovani ad alto rischio a post-trattamento e follow-up rispettivamente di 6 e 14 mesi a confronto con trattamento di supporto psicologico di routine ( treatment as usual). Metodi. Cinquantotto partecipanti (età media=25,51, 67,20% maschi) che soddisfacevano criteri per stati mentali a rischio alla Comprehensive Assessment of At-Risk-Mental States sono stati randomizzati a TCC o treatment as usual. Il protocollo di TCC ha incluso 30 sedute settimanali. Risultati. Nel gruppo TCC, il numero di giovani che ha sviluppato un primo episodio psicotico a follow-up è stato inferiore (n=4, 10,30%) a quello del gruppo di controllo (n=8, 27,60%), sebbene tale differenza sia risultata di significatività marginale [Log rank test χ2(1)= 3,66, p=0,05]. I giovani con funzionamento baseline più alto hanno ottenuto maggiori benefici al di là del tipo di percorso. Conclusioni. Anche nel contesto italiano, la TCC sembra efficace e promettente nel prevenire un primo episodio psicotico in giovani con stato mentale a rischio.Aim. In the last two decades, the interest of researchers and clinicians in preventing psychotic disorders has increased considerably. Research on prevention strategies in favour of young people classified as “at ultra-high risk of a first episode of psychosis” is still scarce, and in Italy no study is available. In addition to presenting subthreshold psychotic symptoms, this population of young people often reports poor functioning. Cognitive behavioural therapy (CBT) is the first-line strategy, but in the literature there is the need for research on further outcomes, such as functioning. The present study assessed whether a modular CBT protocol reduced the risk of first psychotic episode in a group of individuals at ultra-high risk of psychosis at 6-month post-treatment and 14-month follow-up compared to routine psychological support (treatment as usual). Methods. Fifty-eight participants (mean age=25.51, 67.20% males) who met criteria for at risk mental state at the Comprehensive Assessment of At-Risk-Mental States were randomized to CBT or treatment as usual. The CBT protocol included 30 weekly sessions. Results. In the CBT group, the number of participants who developed a first psychotic episode at follow-up was lower (n=4, 10.30%) than in the control group (n=8, 27.60%), although this difference was at a borderline significance level [Log rank test χ2 (1)=3.66, p=0.05]. Young individuals with higher baseline functioning achieved greater benefits irrespective of treatment condition. Conclusions. CBT seems an effective and promising strategy also in Italy in preventing a first psychotic episode in young individuals with at-risk mental state. © 2019 Il Pensiero Scientifico Editore s.r.l.. All rights reserved