Factor Structure and Criterion Validity of an Enlarged Version of the Parental Bonding Instrument

Factorial structure and criterion validity of an enlarged version of the Parental Bonding Instrument (PBI-E) were evaluated in a community sample of young adults. This enlarged version was obtained by adding parental favouritism (FAV) and put-down/shaming (PUT_D) to the original care and overprotection (OV) scales as recalled by the offspring. Factor analysis suggested a five factor model as the best solution, identifying CARE, FAV and PUT_D and splitting the overprotection items into two factors, denial of psychological autonomy (DPA) and discouragement of behavioural freedom, (DBF) with Cronbach's alphas ranging from .77 to .92. These five scales were correlated with depression and anxiety of the offspring, measured by BDI and STAI. Both of them correlated negatively with care and positively with the other parental scales, as expected by Parker's theory on the role of affectionless control for the psychopathological vulnerability of the children. A series of hierarchical regression analyses, including CARE, DPA and DBF at the first step and FAV and PUT_D at the second step, showed that the latter enhanced the predictive power of the instrument. Overall these findings: (1) suggest a five factor structure for the PBI-E and (2) confirm the criterion validity of the PBI scales in respect to children's depression and anxiety, providing also compelling evidence for the incremental validity of Gilbert's scales

LTPc: attendibilità di un metodo di osservazione diretta delle relazioni familiari

La capacità di valutare la funzionalità delle relazioni familiari è divenuta indispensabile per gli psicologi e gli psicopatologi impegnati nella ricerca e nella clinica in età evolutiva e di conseguenza si assiste ad un progressivo interesse per il metodo dell’osservazione diretta. Obiettivo di questo contributo è presentare una procedura standardizzata di osservazione diretta del funzionamento familiare, Lausanne Trilogue Play clinico (LTPc), con particolare attenzione ad alcune delle sue principali caratteristiche psicometriche (attendibilità). Attraverso il LTPc è stato osservato un campione di 81 famiglie cliniche. I primi risultati denotano una buona attendibilità dello strumento, sia nel senso che consente il raggiungimento di un li-vello di accordo soddisfacente tra i giudici, sia nel senso che mostra un positivo livello di coerenza tra le sue componenti. Parole chiave: Coordinazione triangolare, Alleanza familiare, Metodi di osservazione della famiglia, Intersoggettività nella famiglia

Inverse association of circulating SIRT1 and adiposity. A study on underweight, normal weight, and obese patients

Context: Sirtuins (SIRTs) are NAD+-dependent deacetylases, cellular sensors to detect energy availability, and modulate metabolic processes. SIRT1, the most studied family member, influences a number of tissues including adipose tissue. Expression and activity of SIRT1 reduce with weight gain and increase in conditions of starvation. Objective: To focus on SIRT1 plasma concentrations in different conditions of adiposity and to correlate SIRT1 with fat content and distribution, energy homeostasis and inflammation in under-weight, normal-weight, and obese individuals. Materials and Methods: 21 patients with anorexia nervosa, 26 normal-weight and 75 patients with obesity were evaluated. Body fat composition by dual-energy X-ray absorptiometry, ultrasound liver adiposity, echocardiographic epicardial fat thickness (EFT), inflammatory (ESR, CRP, and fibrinogen), and metabolic (FPG, insulin, LDL- and HDL-cholesterol, triglycerides) parameters, calculated basal metabolic rate (BMR) and plasma SIRT1 (ELISA) were measured. Results: SIRT1 was significantly higher in anorexic patients compared to normal-weight and obese patients (3.27 ± 2.98, 2.27 ± 1.13, and 1.36 ± 1.31 ng/ml, respectively). Linear regression models for each predictor variable adjusted for age and sex showed that SIRT1 concentration was inversely and significantly correlated with EFT, fat mass %, liver fat content, BMR, weight, BMI, WC, LDL-cholesterol, insulin, ESR. Stepwise multiple regression analysis revealed that age and EFT were the best independent correlates of SIRT1 (β = -0.026 ± 0.011, p = 0.025, and β = -0.516 ± 0.083, p < 0.001, respectively). Conclusions: Plasma SIRT1 shows a continuous pattern that inversely follows the whole spectrum of adiposity. SIRT1 significantly associates with EFT, a strong index of visceral fat phenotype, better than other indexes of adiposity studied here

Evolving trends in the management of acute appendicitis during COVID-19 waves. The ACIE appy II study

Background: In 2020, ACIE Appy study showed that COVID-19 pandemic heavily affected the management of patients with acute appendicitis (AA) worldwide, with an increased rate of non-operative management (NOM) strategies and a trend toward open surgery due to concern of virus transmission by laparoscopy and controversial recommendations on this issue. The aim of this study was to survey again the same group of surgeons to assess if any difference in management attitudes of AA had occurred in the later stages of the outbreak. Methods: From August 15 to September 30, 2021, an online questionnaire was sent to all 709 participants of the ACIE Appy study. The questionnaire included questions on personal protective equipment (PPE), local policies and screening for SARS-CoV-2 infection, NOM, surgical approach and disease presentations in 2021. The results were compared with the results from the previous study. Results: A total of 476 answers were collected (response rate 67.1%). Screening policies were significatively improved with most patients screened regardless of symptoms (89.5% vs. 37.4%) with PCR and antigenic test as the preferred test (74.1% vs. 26.3%). More patients tested positive before surgery and commercial systems were the preferred ones to filter smoke plumes during laparoscopy. Laparoscopic appendicectomy was the first option in the treatment of AA, with a declined use of NOM. Conclusion: Management of AA has improved in the last waves of pandemic. Increased evidence regarding SARS-COV-2 infection along with a timely healthcare systems response has been translated into tailored attitudes and a better care for patients with AA worldwide

Validity of Criteria-Based Content Analysis (CBCA) at trial in free-narrative interviews

Objective: The reliability of child witness testimony in sexual abuse cases is often controversial, and few tools are available. Criteria-Based Content Analysis (CBCA) is a widely used instrument for evaluating psychological credibility in cases of suspected child sexual abuse. Only few studies have evaluated CBCA scores in children suspected of being sexually abused. We designed this study to investigate the reliability of CBCA in discriminating allegations of child sexual abuse during court hearings, by comparing CBCA results with the court's final, unappealable sentence. We then investigated whether CBCA scores correlated with age, and whether some criteria were better than others in distinguishing cases of confirmed and unconfirmed abuse. Methods: From a pool of 487 child sexual abuse cases, confirmed and unconfirmed cases were selected using various criteria including child IQ ≥ 70, agreement between the final trial outcome and the opinion of 3 experts, presence of at least 1 independent validating informative component in cases of confirmed abuse, and absence of suggestive questions during the child's testimonies. This screening yielded a study sample of 60 confirmed and 49 unconfirmed cases. The 14 item version of CBCA was applied to child witness testimony by 2 expert raters. Results: Of the 14 criteria tested, 12 achieved satisfactory inter-rater agreement (Maxwell's Random Error). Analyses of covariance, with case group (confirmed vs. unconfirmed) and gender as independent variables and age as a covariate, showed no main effect of gender. Analyses of the interaction showed that the simple effects of abuse were significant in both sex. Nine CBCA criteria were satisfied more often among confirmed than unconfirmed cases; seven criteria increased with age. Conclusion: CBCA scores distinguish between confirmed and unconfirmed cases. The criteria that distinguish best between the 2 groups are Quantity of Details, Interactions, and Subjective Experience. CBCA scores correlate positively with age, and independently from abuse; all the criteria test except 2 (Unusual Details and Misunderstood Details) increase with age. The agreement rate could be increased by merging criteria Unusual and Superfluous details that achieve a low inter-rater agreement when investigated separately. Practice implication: Given its ability to distinguish between confirmed and unconfirmed cases of suspected child abuse, the CBCA could be a useful tool for expert opinion. Because our strict selection criteria make it difficult to generalize our results, further studies should investigate whether the CBCA is equally useful in the cases we excluded from our study (for example mental retardation). © 2011 Elsevier Ltd