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The goal of this study was to test the efficacy of training community-based psychotherapists who were part of a practice research network to be more attuned to their patients' experiences of the therapeutic relationship. We were particularly interested in the effect of therapist training on the congruence of alliance ratings with their patients. Forty psychotherapists who treated 117 patients were randomly assigned to receive either no training or training, whose learning objectives were to help therapists to develop and maintain a therapeutic alliance. The training included workshops and ongoing consultations to help the clinician to strengthen the therapeutic relationship with the use of mentalizing, attachment theory, countertransference management, and metacommunication. Therapeutic alliance and well-being outcomes were measured at each of six consecutive early psychotherapy sessions. We used the truth and bias model and response surface analysis within a multilevel modeling context to test hypotheses. There was a significantly faster rate of alliance growth in the training versus the no training condition when the alliance was rated by therapists, but not when rated by patients. Trained therapists experienced greater temporal congruence in alliance ratings with their patients compared to untrained therapists. Patient well-being outcomes improved in a session when trained therapists and their patients agreed in their positive alliance ratings in a previous session. This association not significant among untrained therapists. Training therapists in key interpersonally focused skills may lead them to be better attuned to their patients' experiences of the therapeutic relationship. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The aim of this study was to examine workers’ psychological distress during the COVID-19 pandemic as a function of their individual coping, dyadic coping, and work-family conflict. We also tested the moderating role of gender and culture in these associations. To achieve this aim, we run HLM analyses on data from 1521 workers cohabiting with a partner, coming from six countries (Italy, Spain, Malta, Cyprus, Greece, and Russia) characterized by various degrees of country-level individualism/collectivism. Across all six countries, findings highlighted that work-family conflict as well as the individual coping strategy social support seeking were associated with higher psychological distress for workers, while the individual coping strategy positive attitude and common dyadic coping were found to be protective against workers’ psychological distress. This latter association, moreover, was stronger in more individualistic countries.

ObjectiveThis study aims to longitudinally investigate the effects of individual's factors on subsequent burn-out/psychological distress in a sample of mental health practitioners, testing if higher attachment anxiety and avoidance and lower reflective functioning (i.e., certainty and uncertainty of mental states) and well-being at baseline may lead to a greater psychological distress and burn-out 1 year later. MethodsThe sample consisted of 40 experienced psychotherapists (females: 72.5%; mean age: 47.40 +/- 9.48 years) who completed a battery of questionnaires at baseline and 1 year later. Statistical analyses were conducted with Bayesian multiple linear regressions. ResultsGreater attachment anxiety and certainty about mental states and lower individual's well-being at baseline predicted greater burn-out 1 year later. Similarly, greater attachment anxiety and lower individual's well-being at baseline predicted psychological distress at 1 year follow-up. Of note, uncertainty of mental states and avoidant attachment were not associated with outcomes. ConclusionThese findings suggest that the levels of burn-out and psychological distress among psychotherapists may be alleviated with interventions targeting attachment insecurity, specific aspects of reflective functioning (i.e., certainty about mental states) and well-being.

Background: The present study aimed at (1) providing further validity and reliability evidence for the Italian version of the cognitive section of the ALS Cognitive Behavioral Screen (ALS-CBS™) and (2) testing its diagnostics within an Italian ALS cohort, as well as at (3) exploring its capability to discriminate patients from healthy controls (HCs). Methods: N = 293 non-demented ALS patients were administered the cognitive sections of the ALS-CBS™ and Edinburgh Cognitive and Behavioural ALS Screen (ECAS). N = 96 HCs demographically matched with N = 96 patients were also administered the cognitive section of the ALS-CBS™. In patients, factorial and construct validity, internal reliability, and diagnostics against a defective score on the cognitive section of the ECAS were tested. Case–control discrimination was assessed via a logistic regression. Results: ALS-CBS™ cognitive subscales were underpinned by a simple, unidimensional structure, internally reliable (McDonald’s ω = 0.74), and mostly related with ECAS executive and fluency scores (rs = 0.54–0.71). Both raw and age- and education-adjusted scores on the cognitive section of the ALS-CBS™ accurately detected ECAS-defined cognitive impairment (AUC = 0.80 and.88, respectively), yielding optimal error-based, information-based and unitary diagnostics. A cut-off of < 15.374 was identified on adjusted scores. The test was able to discriminate patients from HCs (p < 0.001). Discussion: The cognitive section of the Italian ALS-CBS™ is a valid, reliable, and diagnostically sound ALS-specific screener for detecting frontotemporal, executive-/attentive-based cognitive inefficiency in non-demented ALS patients, being also able to discriminate them from normotypical individuals.

Introduction: A stroke survivor’s Quality of life (QOL) could be associated with the caregiver’s anxiety, depression and burden. The identification of specific trajectories in stroke survivors and their associations with caregivers’ outcomes, would be helpful for developing more tailored interventions for survivors and caregivers within the first year after the stroke onset. The aims of this study were to: identify the distinct trajectories of the stroke specific QOLs of stroke survivors discharged from rehabilitation hospitals; examine the associations between the stroke survivors’ QOL trajectories and the caregivers’ anxiety, depression and burden over time; and identify the predictors of the survivors’ QOL trajectories. Methods: This is a longitudinal, multicentre prospective study. Were recruited 415 stroke survivors and their caregivers, after the patients’ discharge from one of 20 rehabilitation hospitals located in central and southern Italy and were followed up every 3 months for 1 year. Results: Stroke survivors had similar trajectories in the physical dimensions of QOL, unlike psychological dimensions, where emerge two distinct trajectories of change in the QOL stroke survivor. The first trajectory (86%) included those who started with greater levels of QOL and improved slightly to markedly in all psychological domains, with this improvement decelerating over time. The second trajectory (14%) comprised those who started with lower overall levels of psychological QOL and experienced a linear worsening in Memory and Communication and no changes in Emotion and Participation. The impact of the distinct stroke survivors’ QOL trajectories on caregiver variables, such as burden, anxiety, and depression were examined. Caregivers experienced linear decreases in anxiety ( p < .001)during the first year post-stroke, while burden ( p = .086)and depression ( p = .057)did not significantly change over time. Conclusion: Preventing the risk factors of a stroke survivor from causing a deterioration in QOL is a fundamental role in public health. Adopting precautionary strategies, for those who present certain risk factors for survivors’ discharged from rehabilitation hospitals, could lead to an improvement in the burden and depression of the caregiver.

Cognitive dysfunction has been observed following recovery from COVID-19. To the best of our knowledge, however, no study has assessed the progression of cognitive impairment after 1 year. The aim was to assess cognitive functioning at 1 year from hospital discharge, and eventual associations with specific clinical variables.Seventy-six patients (aged 22-74 years) who had been hospitalized for COVID-19 were recruited. Patients received neuropsychological assessments at 5 (n = 76) and 12 months (n = 53) from hospital discharge.Over half (63.2%) of the patients had deficits in at least one test at 5 months. Compared to the assessment at 5 months, verbal memory, attention and processing speed improved significantly after 1 year (all p 0.05), whereas visuospatial memory did not (all p 0.500). The most affected domains after 1 year were processing speed (28.3%) and long-term visuospatial (18.1%) and verbal (15.1%) memory. Lower PaOOur study expands the results from previous studies showing that cognitive impairment can still be observed after 1 year. Patients with severe COVID-19 should receive periodic cognitive follow-up evaluations, as cognitive deficits in recovered patients could have social and occupational implications.

Literature about the impact of infertility and endometriosis on Quality of Life (QoL) is scarce and needs further investigation. Our aim was to deeply investigate the QoL of women with diagnoses of both endometriosis and infertility with failed Assisted Reproductive Treatments (ART). We conducted a concurrent mixed-method study composed of both quantitative and qualitative surveys. The quantitative survey included 22 women who completed the FertiQoL. The qualitative survey included 15 of them who provided written answers to open-ended questions aimed at deeply exploring their QoL. Data were initially analyzed separately and then combined in a meta-matrix. From the quantitative survey emerged that women at higher risk for low QoL were those who have experienced previous spontaneous miscarriages and that the domains of the FertiQoL related to fertility treatment (i.e. increased pain severity, disturbed daily life routine, and dissatisfaction with services) were the most critical. From the Interpretative Phenomenological Analysis (IPA) of qualitative survey, narrations about the physical, relational, social, emotional-cognitive, and behavioural impact of the diseases emerged. Mixed findings showed that the QoL of this population was scarce and that different levels (the inner world, the behaviours, the relational context, and the environmental context) are strictly connected and interact between them in influencing QoL. Multi-level preventive or supportive programs (with specific attention to pain experience, coping strategies, quality of services and governmental support) are required for this population.

The social isolation and the subsequent, increased use of Social Networking Sites due to the COVID-19 pandemic have had an impact on subjective well-being around the world. The present longitudinal study examined whether changes in psychological distress and well-being during the Italian second wave of the pandemic differ among people with different levels of Problematic Facebook Use (PFU). A total of 493 participants (Mage = 24.55±7.25; 80.3% females) completed measures of passive use of Facebook, social comparison orientation on Facebook, fear of missing out, psychological distress (depressive symptoms and fear of COVID-19 pandemic) and well-being across three waves. Latent class analysis (LCA) categorized participants into three groups with different PFU levels: Healthy users, Moderate PFU users, and High PFU users. Hierarchical Linear Modeling showed that the between-person level (class membership) accounted for most of the variability in psychological distress and well-being. No significant changes were found in psychological distress and well-being over time, but the High PFU users showed greater levels of psychological distress and lower levels of well-being at each time point. The findings of this study suggest that the relationship between PFU, psychological distress and well-being may reflect trait-like time-invariant differences between individuals rather than state-like changes.

Sixty women with a diagnosis of endometriosis (30 with low pain severity - LP; 30 with high pain severity - HP) were evaluated at study entry (T0) and after three months (T1). At T0 they were compared for different psychological dimensions to sixty-two age-paired healthy women (CG). HP group had significantly higher scores on depressive symptomatology, sexual distress, and catastrophizing than CG, and higher scores on worry traits than LP. Metacognitive beliefs predicted sexual distress at T1, over and above pain severity. Pain affects different domains of mental health in this population. Coping strategies, metacognitive beliefs, and worry traits may modulate pain experience and psychological distress.

We developed a new Italian short version of the Geriatric Anxiety Scale (GAS-12) and evaluated its psychometric properties. The GAS-12 specifically screens for anxiety symptoms in the Italian older adult population by identifying items that best discriminate anxiety in this population.In Study 1, we administered the full-length Italian translation of the GAS to 517 older adults and used item response theory to identify the most discriminating items and to develop the short form used in Study 2. In Study 2, we evaluated the functioning of the new short form of the questionnaire in a new sample of 427 older adults using Confirmatory factor analysis.Analyses indicated 12 items that discriminated well between anxious and non-anxious participants and distributed along the latent continuum of each trait. The GAS-12 fits a three-factor structure. There was also evidence for convergent and divergent validity.The Italian GAS-12 appears to be a useful instrument for the quantitative screening of anxiety in Italian older adults.Anxiety imposes significant impairment thus making imperative the screening and assessment of anxiety symptoms. The GAS-12 is particularly indicated with limited time and many scales in a clinical assessment or research protocols.

Previous research provides support for the role of psychosocial variables in the progression of hypertension. However, few studies have rigorously tested the longitudinal interplay between blood pressure and depressive symptoms, quality of life, and well-being. Fewer still disaggregate the effects of changes of these psychological variables within patients over time from the effects of differences between patients on essential hypertension.A total of 185 patients with hypertension and metabolic syndrome (130 males, 70.3%; mean age 54 ± 10.93 years) volunteered for this multicentre study. We analyzed the longitudinal associations between office or daytime ambulatory blood pressure with depressive symptoms, well-being, and quality of life, measured at the same three time points (baseline and 36- and 48-week follow-up), through multilevel models and controlling for several sociodemographic and clinical factors.Within-person increases in depressive symptoms were significant, positive time-varying covariates of both office and daytime blood pressure, even after controlling for several potential confounders (e.g., age, sex, changes over time in risk factors for metabolic syndrome). Within-person increases in well-being and mental health components of quality of life had similar negative associations with the level of blood pressure over time. Between-person differences in these variables tended not to predict blood pressure.Our findings provide a deeper insight on the relationship between variability of psychological variables within individuals and their levels of blood pressure. The findings support the need for health services to implement evidence-based psychological interventions that can foster a better management of the hypertensive disease. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Objective: The therapeutic alliance has been studied in group interventions, but its relationship to patient outcome is still controversial. This study systematically reviewed the association of both the member-leader and member-group alliance with patient outcomes, and assessed the effects of several theoretically informed moderators. Method: A three-level meta-analysis was conducted on 57 studies to disentangle within- and between-study variability in the alliance-outcome association. Results: The overall effect size of the unconditional model was r = -.259 (95% CI: -.302, -.214; p < .001), whereas the correlation between alliance and outcome based on the three-level meta-analytic model was r = -.215 (95% CI: -.252, -.178; p < .001) indicating a medium effect. Meta-regressions of moderators showed that the alliance-outcome correlation was higher when patients reported on their alliance with the group/other members compared with when they rated the alliance with the leader. Outcome type, rating perspective, theoretical orientation, treatment length, and year of publication were significant moderators of the relationship between alliance and outcome. Conclusions: The current meta-analysis highlighted that the therapeutic alliance, especially with other group members, is a significant predictor of outcomes in group therapies even after controlling for several moderators and adopting more conservative statistical modeling.What is the public health significance of this article? Prior research has established that member-leader alliance is a predictor of outcome in group psychotherapy with a small effect. This meta-analysis provides a comprehensive analysis of the complex role of the alliance in group therapy, suggesting that the alliance with other group members or the group as a whole has a significantly larger association with outcome. This study provides support for the importance of the group context on the alliance-outcome relationship.

The impact of trait perfectionism on coping and affective response has been well-documented in laboratory performances, and yet little is known about the role played by perfectionistic self-presentation in performances beyond the effects of trait perfectionism.We aimed to address this knowledge gap by examining the relationships between perfectionistic self-presentation, maladaptive emotion-focused coping, and affective response to laboratory problem-solving tasks.A group of 130 undergraduates attempted challenging, time-limited arithmetic and anagram tasks. Upon task completion, participants' scores were announced along with their mistakes. Additionally, participants completed measures assessing their positive and negative affect before and after lab performance, as well as coping strategies utilized during performance.Participants with elevated perfectionistic self-presentation experienced greater levels of negative affect and maladaptive emotion-focused coping. Moreover,Our findings highlight the unique contribution of perfectionistic self-presentation beyond trait perfectionism in performance settings and suggest a need for future research.

Shame is an intense, difficult to regulate, self-conscious emotion that predicts aspects of poor psychological functioning and is also strongly related to early relationships. Attachment insecurities, which constitute non-specific risk factors for psychological maladjustment, have been associated with an individual’s tendency to experience shame. In this study, we sought to examine the serial mediating roles of dispositional shame and shame-coping styles (i.e., attack other, attack self, withdrawal and avoidance) in the association between anxious and avoidant attachment, and psychological distress. Using a cross-sectional design, self-reported data were collected. The study sample included 978 respondents (57% female) with a mean age of 32.17 ± 13.48 years. The results of the path analysis indicated that both attachment dimensions were sequentially associated with dispositional shame and then with the attack self shame-coping style, which was, in turn, positively related to psychological distress. Further, attachment insecurities were sequentially associated with dispositional shame and then with the avoidance shame-coping style, which was, in turn, negatively related to psychological distress. The model was gender invariant, suggesting that the serial mediation worked in a similar way for men and women. The practical implications of these findings are discussed.

Parental perfectionism (e.g., perfectionistic concerns) has been strongly implicated in adolescent psychological maladjustment such as depression and anxiety. However, little is known about the links between parental perfectionistic self-presentation (i.e., the interpersonal expressions of perfectionism) and adolescent psychological outcomes. According to the Perfectionism Social Disconnection Model (Hewitt et al., 2017), people with elevated perfectionistic self-presentation engage in social behaviors characterized by a lack of emotional sensitivity or responsiveness, which then increases one’s risk of social disconnection and psychological maladjustment. This theory has seldom been tested in the context of parent-adolescent and family relationships. Therefore, this cross-sectional study aimed to explore the mediational role of familial affective responsiveness in the associations between parental perfectionistic self-presentation and adolescent psychological outcomes. Participants were 58 dyads of clinically depressed adolescents (Mage = 15.52; 74.5% female) and their primary caregivers (Mage = 46.08; 51 mothers). Path analysis indicated that the overall model fit the data well. Congruent with the Perfectionism Social Disconnection Model, analyses showed that adolescent but not parent-reported family dysfunction in affective responsiveness mediated the relations between parental perfectionistic self-presentation and adolescent depressive symptoms, suicidal ideation, and alcohol-related problems, even after controlling for parental depression. Taken together, our findings provide new information for the role of parental perfectionistic self-presentation in adolescent psychological maladjustment and highlight parental perfectionistic self-presentation as a potential target for therapeutic intervention in adolescent depression.

This study aimed to develop the Therapist Self-Efficacy Scale (T-SES), and test its validity in a sample of Italian mental health therapists, to assess their professional self-efficacy concerning their practice of eTherapy in a synchronous video-based setting.A sample of 322 Italian mental health professionals (37.6% psychologists, 62.4% psychotherapists; MThe T-SES showed a clear, one-factor structure with good psychometric properties. Significant associations were found with insight orientation, general self-efficacy, self-esteem, and personality traits of openness, conscientiousness, and agreeableness. The results showed no differences between psychologists and psychotherapists, or differences based on years of experience.The T-SES is an agile and versatile self-report measure for mental health professionals to assess their self-efficacy concerning their therapeutic activity, which can provide information for tailoring training for eTherapy.

Aim Healthy lifestyle behaviors and a good adherence to pharmacological treatments are important predictors of lower recurrence rates and better overall outcomes among patients with an established acute coronary syndrome (ACS). The present study sought to investigate the longitudinal trajectories of these behaviors years after the onset of an ACS. Subject and methods We recruited a sample of 275 newly diagnosed consecutive patients at their first ACS event (mean age: 57.1 ± 7.87 years; 84% males) admitted to a cardiac rehabilitation program from three large public hospitals in Northern Italy. Patients completed a battery of sociodemographic questionnaires, which evaluated healthy lifestyles (smoking status, alcohol intake, diet, and physical activity) and adherence to pharmacological treatments, at five time-points (pre-event, 6-, 12-, 24-, and 36-month follow-ups). Longitudinal trajectories were examined through hierarchical (generalized) linear models, controlling for several demographic and clinical variables. Results We found significant changes in all healthy lifestyles from pre-event to the 6-month follow-up, suggesting the adoption of healthier behaviors soon after the cardiac event. However, from the 6-month up to the 3-year follow-up, patients experienced small but significant declines in their self-reported levels of healthy dietary behaviors and physical activity. Further, we found that the odds of being at medium risk of non-adherence to the pharmacological treatments significantly increased over the course of 3 years. Conclusion Given the negative long-term trajectories in specific lifestyles and adherence to pharmacological treatments, cardiac rehabilitation programs are suggested to provide repeated psychological interventions aimed at fostering patients’ capabilities to self-regulate their habitual behaviors.

Excessive use of technology has become a worldwide problem due to its high prevalence, fast growth rate, and undesirable consequences. However, little is known about underlying psychological mechanisms that maintain excessive use of technology. We investigated the mediating role of self-esteem, novelty seeking, and persistence on the relationship between attachment dimensions and technology addiction among young adults. Data were collected from 727 young adults (females, N = 478; 66.3 percent), aged 23.44 ± 3.02 years. Participants completed self-report measures of secure and insecure attachment dimensions, personality, and temperament characteristics (i.e., self-esteem, novelty seeking, and persistence), technology addiction and frequency of technology use (i.e., own technology use, perceived use by peers and parents). The mediation model was tested through a path analysis. The effects of attachment insecurity on technology addiction were partially mediated by the levels of persistence and self-esteem, whereas the effects of attachment security on technology addiction were fully mediated. The effects remained robust even after controlling for the frequency of technology use. The model was gender and age invariant, suggesting that the mediation worked in a similar way for both men and women and across ages. Findings suggest that attachment dimensions exert not only a direct but also an indirect effect on technology addiction through self-esteem and persistence. Such findings may help to develop psychosocial interventions that are sensitive to young adults' attachment, personality, and temperament characteristics.

Abstract. The aim of the study was to explore the effects of situational stress and anxiety in a group of healthy elderly, both in terms of psychophysiological correlates and cognitive performance. Eighteen participants ( Mage = 70 ± 6.3; range 60–85) were assessed for anxiety and were instructed to perform a computerized math task, under both a stressful and a control condition, while near-infrared spectroscopy (NIRS) signal and electrocardiography (ECG) were recorded. NIRS results evidenced an increased activation of right PFC during the entire procedure, even if effect sizes between left and right channels were larger during the experimental condition. The amount of right activation during the stressful condition was positively correlated with anxiety. Response times (RTs) were slower in more anxious than in less anxious individuals, both during the control and stressful conditions. Accuracy was lower in more anxious than in less anxious individuals, only during the stressful condition. Moreover, heart rate (HR) was not modulated by situational stress, nor by anxiety. Overall, the present study suggests that in healthy elderly, anxiety level has a significant impact on cerebral responses, and both on the amount of cognitive resources and the quality of performance in stressful situations.

Introduction: Research on the trajectory of survivors’ quality of life over time has generally focused on the first six months post-stroke, and results are inconsistent. Indeed, while some studies found an improvement of the stroke survivors’ quality of life from one to six months post-stroke, other studies showed an improvement during inpatient rehabilitation but a worsening at six months after discharge. Aim: To investigate the longitudinal growth trajectories of disease-specific quality of life dimensions and their predictors over one year. Methods: A multicentric longitudinal design were used for this study. Four hundred and fifteen stroke survivors (mean age 70.6 + 12.2 years; 81% ischemic stroke) were recruited after discharge from rehabilitation hospitals and were followed up every three months for one year. Changes in stroke impact scale dimension scores were evaluated using hierarchical linear models and linear, logarithmic, quadratic, and cubic time slope. Results: We observed a significant linear and quadratic increase in most stroke impact scale dimensions from the baseline to 12-month follow-up. The communication dimension was stable over time, while the memory dimension increased only linearly. Higher physical dimensions scores were predicted by lower age, hypercholesterolemia, and better physical functioning at baseline, while higher communication was predicted by lower age, better physical functioning, and a diagnosis of peripheral vascular disease. Better memory was predicted by lower age, married status, better physical functioning, and left-hemisphere stroke. Better participation was predicted by lower age and better physical functioning. No predictors were observed for emotion. Conclusions: Disease-specific quality of life significant increase from the baseline to 12-month follow-up, especially in physical dimensions. Lower age, hypercholesterolemia, better physical functioning and diagnosis of peripheral vascular disease seem to be predictors or better quality of life. Through the analyses of predictors, we identified stroke survivors who are more at risk and who need more tailored interventions to improve quality of life.

Considering the mechanisms capable of causing brain alterations in COVID-19, we aimed to study the occurrence of cognitive abnormalities in the months following hospital discharge. We recruited 38 (aged 22–74 years, 27 males) patients hospitalized for complications of SARS-CoV-2 infection in nonintensive COVID units. Participants underwent neuropsychological testing about 5 months after hospital discharge. Of all patients, 42.1% had processing speed deficits, while 26.3% showed delayed verbal recall deficits. Twenty-one percent presented with deficits in both processing speed and verbal memory. Bivariate analysis revealed a positive correlation between the lowest arterial oxygen partial pressure (PaO2) to fractional inspired oxygen (FiO2) (P/F) ratio during hospitalization and verbal memory consolidation performance (SRT-LTS score, r = 0.404, p = 0.027), as well as a positive correlation between SpO2 levels upon hospital arrival and delayed verbal recall performance (SRT-D score, rs = 0.373, p = 0.042). Acute respiratory distress syndrome (ARDS) during hospitalization was associated with worse verbal memory performance (ARDS vs. no ARDS: SRT-LTS mean score = 30.63 ± 13.33 vs. 44.50 ± 13.16, p = 0.007, SRT-D mean score = 5.95 ± 2.56 vs. 8.10 ± 2.62, p = 0.029). Cognitive abnormalities can frequently be found in COVID-19 patients 5 months after hospital discharge. Increased fatigability, deficits of concentration and memory, and overall decreased cognitive speed months after hospital discharge can interfere with work and daily activities.

Cardiovascular disease is one of the most common causes of hospitalization and is associated with high morbidity and mortality rates. Among the most important modifiable and well-known risk factors are an unhealthy diet and sedentary lifestyle. Nevertheless, adherence to healthy lifestyle regimes is poor. The present study examined longitudinal trajectories (pre-event, 6-, 12-, 24-, 36-, and 60-month follow-ups) of protein intake (fish, legumes, red/processed meat) and physical activity in 275 newly-diagnosed patients with acute coronary syndrome. Hierarchical Generalized Linear Models were performed, controlling for demographic and clinical variables, the season in which each assessment was made, and the presence of anxiety and depressive symptoms. Significant changes in protein intake and physical activity were found from pre-event to the six-month follow-up, suggesting the adoption of healthier behaviors. However, soon after the six-month follow-up, patients experienced significant declines in their healthy behaviors. Both physical activity and red/processed meat intake were modulated by the season in which the assessments took place and by anxiety symptoms over time. The negative long-term trajectory of healthy behaviors suggests that tailored interventions are needed that sustain patients’ capabilities to self-regulate their behaviors over time and consider patient preference in function of season.

COVID-19 outbreak imposes the adoption of extraordinary contain- ment measures, including the strict necessity to limit interpersonal contact. Face-to-face psychotherapy collides with this requirement and, above all, it might endanger both therapists and patients’ safety. Telepsychotherapy might come to the aid, ensuring thera- peutic continuity and the possibility to reach people who might benefit of extra psychological support. Infectious outbreaks have been indeed associated with major psychopathological outcomes. The aim of the present work is to review the most recent experi- mental evidence about telepsychotherapy, focusing on its effec- tiveness, possible determinants of efficacy and therapists/patients’ attitudes, to rapidly inform psychotherapists. Out of the 857 records found, 18 studies have been included in the review. Our results show that, despite therapists and public’s skepticism, telepsy- chotherapy is a trustworthy alternative to be adopted, which can be used efficaciously to treat common mental-health disorders such as anxiety, depression and post-traumatic distress. As well as in the traditional setting, a higher number of sessions and the proper management of patients’ expectations seem to be asso- ciated with better outcomes. On the contrary, low familiarity with web-based means of communication and technical issues might reduce specifically the effectiveness of telepsychotherapy.

Understanding the determinants of risk perception for COVID‐19 might help to promote self‐preventive behaviours. This scoping review aimed to map the extent, variety and characteristics of the evidence on the possible determinants of risk perception for COVID‐like diseases. PubMed, Scopus and Web of Science were searched for original, peer‐reviewed English‐written articles published up to March 2020 and investigating risk perception determinants for respiratory infectious diseases in adults. Titles and abstracts were screened, and full texts were analysed by the first author; when unsure, eligibility was discussed with the last author. Data were collected according to an extraction sheet developed by the first and last authors. The cross‐sectional evidence covers a variety of diseases, countries and timings of testing. Mostly, questionnaires recorded socio‐demographics, media exposure, trust in institutions, disease proximity and knowledge; psychological variables, including personality traits, distress and self‐efficacy, were less investigated. A miscellaneous operationalization of risk perception emerged, including the likelihood of getting sick, perceived dangerousness, concerns or a combination of them. A comprehensive understanding of the substantial amount of evidence may be challenging due to methodological heterogeneity. Referring to uniform theoretical frameworks is recommended; also, longitudinal research may be implemented to probe causal relationships.

Background The ability to simulate alternatives to factual events is called counterfactual thinking (CFT) and it is involved both in emotional and behavioral regulation. CFT deficits have been reported in psychiatric and neurological conditions, possibly contributing to patients’ difficulties in modulating behaviors and affections. Thus, acknowledging the presence and possible consequences of CFT impairments might be essential for optimal clinical management. Objectives This scoping review aims to summarize the previous evidence about CFT in psychiatric and neurological diseases to determine the extent of the previous research and what has been discovered so far, the variety of clinical conditions considered, the methodologies adopted, and the relevant issues to be addressed by future investigations. Methods PsycInfo, PubMed, Scopus, and Web of Science were searched to identify articles published up to January 2020, written in English and focused on CFT in adults affected by psychiatric or neurological conditions. Results Twenty-nine studies have been included; most of them focused on psychiatric conditions, a minority considered neurological diseases. The generation of counterfactual thoughts related to a negative real-life or a fictional event and the counterfactual inference test were the most popular tasks adopted. CFT impairments were reported in both psychiatric and neurological conditions, likely associated with a fronto-executive dysfunction. Conclusions Future research might further explore CFT in those psychiatric and neurological conditions in which CFT difficulties have been preliminary reported. Furthermore, it would be recommendable to extend this investigation to all the clinical conditions possibly at risk of fronto-executive dysfunction. In the end, we speculate that since CFT plays a role in driving everyday behaviors, it might be crucial also when medical decisions are involved; thus, future research might extend the investigation of CFT especially to those populations that implicate complex clinical management.

BACKGROUND While the general uptake of e-mental health interventions remained low over the past years, physical distancing and quarantine measures relating to the COVID-19 pandemic created a need and demand for online consultations and telepsychology in only a matter of weeks. OBJECTIVE This study investigates the uptake of online consultations provided by mental health professionals during the first wave of the COVID-19 pandemic, with a specific focus on professionals’ motivations, perceived barriers, and concerns regarding online consultations. METHODS An online survey on the use of online consultations was set up in March 2020. The Unified Theory of Acceptance and Use of Technology (UTAUT) guided the deductive qualitative analysis of the results. RESULTS In total, 2,082 mental health professionals from Austria, Belgium, Cyprus, France, Germany, Italy, Lebanon, Lithuania, the Netherlands, Norway, Portugal, Spain, and Sweden were included. The results showed a high uptake of online consultations during the COVID-19 pandemic but limited previous training on this topic undergone by mental health professionals. Most professionals had positive experiences with online consultations, but questions about the performance of online consultations in a mental health context and practical considerations appear to be major barriers that hinder implementation. CONCLUSIONS This study provides an overview of the mental health professionals’ actual needs and concerns regarding the use of online consultations in order to highlight areas of possible intervention and allow the implementation of necessary governmental, educational, and instrumental support so that online consultation can become a feasible and long-term option in mental healthcare.

Background:The understanding of factors that shape risk perception is crucial to modulate the perceived threat and, in turn, to promote optimal engagement in preventive actions.Methods:An on-line, cross-sectional, survey was conducted in Italy between May and July 2020 to investigate risk perception for COVID-19 and the adoption of preventive measures. A total of 964 volunteers participated in the study. Possible predictors of risk perception were identified through a hierarchical multiple linear regression analysis, including sociodemographic, epidemiological and, most of all, psychological factors. A path analysis was adopted to probe the possible mediating role of risk perception on the relationship between the independent variables considered and the adoption of preventive measures.Results:Focusing on the psychological predictors of risk perception, high levels of anxiety, an anxious attachment, and an external locus of control predicted higher perceived risk. Conversely, high levels of openness personality and of avoidant attachment predicted a lower perception of risk. In turn, the higher was the perceived risk the higher was the adoption of precautionary measures. Furthermore, psychological factors influenced the adoption of preventive behaviors both directly and indirectly through their effect on risk perception.Conclusions:Our findings might be taken into high consideration by stakeholders, who are responsible for promoting a truthful perception of risk and proper compliance with precautionary measures.

To investigate the longitudinal growth trajectories of disease-specific quality of life (QoL) dimensions and their associations over 1 year.A longitudinal design. Data were collected between February 2015-May 2017.Four hundred and fifteen stroke survivors (mean age 70.6 years; 81% ischaemic stroke) were recruited after discharge from rehabilitation hospitals and were followed up every 3 months for 1 year. Changes in Stroke Impact Scale (SIS) dimension scores were evaluated using hierarchical linear models (HLMs) and linear, logarithmic, quadratic, and cubic time slope.We observed a significant linear and quadratic increase in most SIS dimensions from the baseline to 12-month follow-up, especially in physical dimensions. The communication dimension was stable over time, while the memory dimension increased only linearly. Higher physical dimension scores were significantly associated with lower age, hypercholesterolaemia, and better physical functioning at baseline, while higher communication was associated with lower age, better physical functioning, and a diagnosis of peripheral vascular disease. Better memory was associated with lower age, married status, better physical functioning, and left-hemisphere stroke. Better participation was associated with lower age and better physical functioning. No significant associations were observed for emotion.This study provides important information about the trajectories of stroke survivors' specific QoL and their associated variables.Stroke has a great impact on stroke survivors' QoL. Disease-specific QoL significantly increases from the baseline to 12-month follow-up, especially in physical dimensions. Lower age, hypercholesterolaemia, better physical functioning, and diagnosis of peripheral vascular disease seem to be associated with better QoL. Through the analyses of associated variables, we identified stroke survivors who are more at risk and who need more tailored interventions to improve their physical, psychological, emotional, and social dimensions.目的: 研究疾病特异性生活质量 (QoL) 各维度在1年内的纵向增长轨迹及其关联性。 设计: 一项纵向设计。在2015年2月至2017年5月之间收集数据。 方法: 招募了415名从康复医院出院的脑卒中幸存者 (平均年龄70.6岁; 81%为缺血性脑卒中) , 在1年内每隔3个月进行一次随访。使用多层线性模型 (HLMs) 和线性、对数、二次方和三次方时间斜率评估脑卒中影响量表 (SIS) 维度评分的变化。 结果: 据观察, 从基线检查到12个月的随访, 大多数脑卒中影响量表维度都呈显著的线性二次方增加趋势, 尤其是身体维度。沟通维度随着时间的推移保持稳定, 而记忆维度仅呈线性增加趋势。较高的身体维度评分与基线时较低的年龄、高胆固醇血症和较好的身体机能显著相关, 而较高的沟通维度评分与较低的年龄、较好的身体机能和周围血管疾病的诊断相关。较高的记忆维度评分与较低的年龄、已婚状态、较好的身体机能和左侧半脑中风相关。较高的参与维度评分与较低的年龄和较好的身体机能有关。情绪方面没有观察到显著的关联。 结论: 本研究提供了有关脑卒中幸存者的特定生活质量及其相关变量的重要轨迹信息。 影响: 脑卒中对脑卒中幸存者的生活质量影响很大。从基线检查到12个月的随访, 疾病特异性生活质量显著提高, 尤其是身体方面。较低的年龄、高胆固醇血症、较好的身体机能和周围血管疾病的诊断似乎与较高的生活质量相关。通过对相关变量的分析, 我们发现脑卒中幸存者的风险更高, 需要对脑卒中幸存者采取更具针对性的干预措施, 以改善脑卒中幸存者的生理、心理、情感和社会维度。.

Introduction: The study aims at investigating psychometric properties of the Edinburgh cognitive and behavioural ALS screen (ECAS) in Parkinson’s (PD) and Huntington’s (HD) diseases. The sensitivity and specificity of the ECAS in highlighting HD and PD cognitive-behavioural features and in differentiating between these two populations and from healthy controls (HC) were evaluated. Moreover, correlations between the ECAS and traditional cognitive measures, together with core clinical features, were analysed. Methods: Seventy-three PD patients, 38 HD patients, and 49 education-matched healthy participants were enrolled. Participants were administered the ECAS, together with other cognitive screening tools and psychological questionnaires. Patients’ behavioural assessment was also carried out with carers. Results: The ECAS distinguished between HD patients and HC and between the two clinical syndromes with high sensitivity and specificity. Even if the diagnostic accuracy of the ECAS in distinguishing between PD and HC was low, the PD cognitive phenotype was very well described by the ECAS performances. Convergent validity of the ECAS against other traditional cognitive screening was observed, as well as correlations with psychological aspects and typical clinical features, especially for the HD group. Conclusions: The ECAS represents a rapid and feasible tool, useful also in other neurodegenerative disorders affecting verbal-motor abilities than the amyotrophic lateral sclerosis such as PD and HD. Clinical applications in these neurodegenerative conditions require further investigations and, probably, some adaptations of the original test.