The ACTyourCHANGE in Teens Study Protocol: An Acceptance and Commitment Therapy-Based Intervention for Adolescents with Obesity: A Randomized Controlled Trial

This Randomized Controlled Trial [(RCT) aims to evaluate the effectiveness of a brief Acceptance and Commitment Therapy (ACT)-based intervention combined with treatment as usual (TAU) compared to TAU only in improving psychological conditions in a sample of adolescents with obesity (body mass index, BMI > 97th percentile for age and sex) within the context of a wider multidisciplinary rehabilitation program for weight loss. Fifty consecutive adolescents (12-17 years) of both genders with obesity will be recruited among the patients hospitalized in a clinical center for obesity rehabilitation and randomly allocated into two experimental conditions: ACT + TAU vs. TAU only. Both groups will attend a three-week in-hospital multidisciplinary rehabilitation program for weight loss. The ACT + TAU condition comprises a psychological intervention based on ACT combined with a standard psychological assessment and support to the hospitalization. The TAU comprises the standard psychological assessment and support to the hospitalization. At pre- to post-psychological intervention, participants will complete the Avoidance and Fusion Questionnaire for Youth, the Psychological Well-Being Scale, the Depression Anxiety Stress Scale, the Difficulties in Emotion Regulation Scale, and the Emotional Eating subscale of the Dutch Eating Behavior Questionnaire to assess psychological well-being as the primary outcome and experiential avoidance, psychological distress, emotional dysregulation, and emotional eating as secondary outcomes. Repeated-measures ANOVAs (2 x 2) will be conducted. The study will assess the effectiveness of a brief ACT-based intervention for adolescents with obesity in improving their psychological conditions by targeting specific core processes of the ACT framework (openness, awareness, and engagement). Future directions of the study will assess whether these psychological processes will contribute to addressing long-term weight loss

The ACTyourCHANGE study protocol: promoting a healthy lifestyle in patients with obesity with Acceptance and Commitment Therapy-a randomized controlled trial

BackgroundAs treatment of choice in promoting psychological flexibility, Acceptance and Commitment Therapy (ACT) was found to be effective in several conditions, and among different populations, including weight management in individuals with obesity. However, the mechanism of action of psychological flexibility is less known. The aim of the present study is, within the context of a brief ACT intervention for behavioral change and behavioral maintenance of a healthy lifestyle in a sample of inpatients with obesity, to explore the effect of each subcomponent of the psychological flexibility model on treatment processes and outcomes.MethodsA randomized controlled trial will be conducted. Ninety Italian adult inpatients with obesity attending a rehabilitation program for weight loss will be randomly allocated into three experimental conditions targeting respectively each subcomponent of the psychological flexibility model: group Engage focused on values-oriented behaviors, group Openness focused on acceptance and cognitive defusion, and group Awareness focused on being present and aware of thoughts, feelings, and behaviors at every moment. Weight, BMI (kg/m(2)), the Psychological General Well-Being Inventory (PGWBI), the Outcome Questionnaire-45.2 (OQ-45.2), the Depression Anxiety and Stress Scale (DASS-21), the Difficulties in Emotion Regulation Scale (DERS), the Dutch Eating Behaviors Questionnaire (DEBQ), the Brief Values Inventory (BVI), the Committed Action Questionnaire (CAQ), the Italian-Cognitive Fusion Questionnaire (I-CFQ), the Five Facet Mindfulness Questionnaire (FFMQ), and the Acceptance and Action Questionnaire (AAQ-II) will be assessed at the beginning (time 0), at the end of psychological intervention (time 1), and after 3 (time 2) and 6months (time 3) and 9months (time 4) from discharge. During the following month after discharge, outpatients will be monitored in their adherence to a healthy lifestyle, using a wearable device.To assess the effectiveness of the intervention, mixed between-within 3 (conditions) x4 (times) repeated measure ANOVAs will be conducted to examine changes from time 0 to time 1, 2, 3, and 4 in means of weight, BMI, and means of scores PGWBI, OQ-45.2, DASS, DERS, DEBQ, AAQ-II, BVI, CAQ, I-CFQ, and FFMQ, between three groups.DiscussionThis study will contribute to clarify the mechanism of action of each subcomponent of the psychological flexibility model and understand its impact on the promotion of a healthy lifestyle.Trial registrationClinicalTrials.govNCT04474509. Registered on July 4, 202

Correction to: Evaluation of the reliability and validity of the Italian version of the schema mode inventory for eating disorders-short form for adults with dysfunctional eating behaviors

The article Evaluation of the reliability and validity of the Italian version

Drunkorexia: Empirical investigation and analysis of the characteristics of the phenomenon in an Italian sample of adolescents and young adults

Introduction: the term drunkorexia refers to the act of self-imposed utilization of extreme weight control methods to compensate for alcohol consumption typically observed among university students. Despite its diffusion, there is a lack of research investigating the presence of this new alarming trend in Italy. Aim: this study estimates the frequency of drunkorexia behaviours in a sample of Italian youth aged 14-24, explores the motivations for alcohol consumption among those presenting drunkorexia-type behaviours, and examines the relationship between drunkorexia and disordered eating. Methods: drunkorexia behaviors, eating habits and motives for alcohol use were investigated in 403 subjects (F=301, M=102) aged 14-24 through self-report questionnaires. A series of analyses, including descriptive statistics, univariate analysis of the variance and multiple regressions were run. Results: 62.5% of the sample showed drunkorexia-type behaviours. Drunkorexia was related to disordered eating, especially among females older than eighteen. Discussion and Conclusions: this the first study investigating the incidence of drunkorexia behaviors in a sample of youth living in Northern Italy. Evidence-based interventions for eating disorders and drinking problems should inspire the development of ad hoc preventive and treatment actions for drunkorexia.

Drunkorexia: Empirical investigation and analysis of the characteristics of the phenomenon in an Italian sample of adolescents and young adults

The term drunkorexia refers to the act of self-imposed utilization of extreme weight control methods to compensate for alcohol consumption typically observed among university students. Despite its diffusion, there is a lack of research investigating the presence of this new alarming trend in Italy. Aim: this study estimates the frequency of drunkorexia behaviours in a sample of Italian youth aged 14-24, explores the motivations for alcohol consumption among those presenting drunkorexiatype behaviours, and examines the relationship between drunkorexia and disordered eating. Methods: drunkorexia behaviors, eating habits and motives for alcohol use were investigated in 403 subjects (F=301, M=102) aged 14-24 through self-report questionnaires. A series of analyses, including descriptive statistics, univariate analysis of the variance and multiple regressions were run. Results: 62.5% of the sample showed drunkorexia-type behaviours. Drunkorexia was related to disordered eating, especially among females older than eighteen. Discussion and Conclusions: this the first study investigating the incidence of drunkorexia behaviors in a sample of youth living in Northern Italy. Evidence-based interventions for eating disorders and drinking problems should inspire the development of ad hoc preventive and treatment actions for drunkorexia

Evaluation of the reliability and validity of the Italian version of the schema mode inventory for eating disorders: short form for adult with dysfunctional eating behavior

Purpose: To examine the psychometric properties and the factorial structure of the Italian version of the schema mode inventory for eating disorders\u2014short form (SMI-ED-SF) for adults with dysfunctional eating patterns. Methods: 649 participants (72.1% females) completed the 64-item Italian version of the SMI-ED-SF and the eating disorder examination questionnaire (EDE-Q) for measuring eating disorder symptoms. Psychometric testing included confirmatory factor analysis (CFA) and internal consistency. Multivariate analysis of covariance (MANCOVA) was also run to test statistical differences between the EDE-Q subscales on the SMI-ED-SF modes, while controlling for possible confounding variables. Results: Factorial analysis confirmed the 16-factors structure for the SMI-ED-SF [S\u2013B\u3c7 2 (1832) = 3324.799; p <.001; RMSEA = 0.045; 90% CI 0.043\u20130.048; CFI = 0.880; SRMR = 0.066; \u3c7 2/df = 1.81; < 3]. Internal consistency was acceptable in all scales, with Cronbach\u2019s Alpha coefficients ranging from 0.635 to 0.873. Conclusions: The SMI-ED-SF represents a reliable and valid alternative to the long-form SMI-ED for assessment and conceptualization of schema modes in Italian adults with disordered eating habits. Its use is recommended for clinical and research purposes. Level of evidence: Level V, descriptive study

The Impact of Social Isolation during the COVID-19 Pandemic on Physical and Mental Health: The Lived Experience of Adolescents with Obesity and Their Caregivers

Adolescence is a complex developmental phase, made more complex by obesity andthe social isolation imposed by the COVID-19 pandemic. The literature related to the impact ofsocial isolation on obesity self-management in adolescents is scant and inconsistent. This paperdescribes the phenomenon from the perspectives of a sample of adolescents with obesity enrolled inan inpatients\u2019 multidisciplinary rehabilitation program for weight-loss and their caregivers, and itsimpact on different life domains. Individual semi-structured ad hoc interviews were conducted with10 adolescent-caregiver dyads, and narratives were qualitatively investigated using an interpretativephenomenology approach to data. Twenty participants took part in the study. The major themesthat emerged from this study fall into five basic categories: (1) COVID-19 as an opportunity toreconsider what makes a good life; (2) Persistence in life; (3) Empowering relationship; (4) Dailyroutine in quarantine; (5) Lives on hold. Understandings drawn from this study may assist healthcare professionals in providing holistic support, and guidance to adolescents with weight-relatedissues and their caregivers who experience social isolation during the COVID-19 pandemi

The ACTyourCHANGE study protocol: promoting a healthy lifestyle in patients with obesity with Acceptance and Commitment Therapy-a randomized controlled trial

BACKGROUND: As treatment of choice in promoting psychological flexibility, Acceptance and Commitment Therapy (ACT) was found to be effective in several conditions, and among different populations, including weight management in individuals with obesity. However, the mechanism of action of psychological flexibility is less known. The aim of the present study is, within the context of a brief ACT intervention for behavioral change and behavioral maintenance of a healthy lifestyle in a sample of inpatients with obesity, to explore the effect of each subcomponent of the psychological flexibility model on treatment processes and outcomes.METHODS: A randomized controlled trial will be conducted. Ninety Italian adult inpatients with obesity attending a rehabilitation program for weight loss will be randomly allocated into three experimental conditions targeting respectively each subcomponent of the psychological flexibility model: group Engage focused on values-oriented behaviors, group Openness focused on acceptance and cognitive defusion, and group Awareness focused on being present and aware of thoughts, feelings, and behaviors at every moment. Weight, BMI (kg/m2), the Psychological General Well-Being Inventory (PGWBI), the Outcome Questionnaire-45.2 (OQ-45.2), the Depression Anxiety and Stress Scale (DASS-21), the Difficulties in Emotion Regulation Scale (DERS), the Dutch Eating Behaviors Questionnaire (DEBQ), the Brief Values Inventory (BVI), the Committed Action Questionnaire (CAQ), the Italian-Cognitive Fusion Questionnaire (I-CFQ), the Five Facet Mindfulness Questionnaire (FFMQ), and the Acceptance and Action Questionnaire (AAQ-II) will be assessed at the beginning (time 0), at the end of psychological intervention (time 1), and after 3 (time 2) and 6months (time 3) and 9months (time 4) from discharge. During the following month after discharge, outpatients will be monitored in their adherence to a healthy lifestyle, using a wearable device. To assess the effectiveness of the intervention, mixed between-within 3 (conditions) *4 (times) repeated measure ANOVAs will be conducted to examine changes from time 0 to time 1, 2, 3, and 4 in means of weight, BMI, and means of scores PGWBI, OQ-45.2, DASS, DERS, DEBQ, AAQ-II, BVI, CAQ, I-CFQ, and FFMQ, between three groups.DISCUSSION: This study will contribute to clarify the mechanism of action of each subcomponent of the psychological flexibility model and understand its impact on the promotion of a healthy lifestyle.TRIAL REGISTRATION: ClinicalTrials.gov NCT04474509 . Registered on July 4, 2020