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IntroductionPositive sexuality, defined as the happiness and fulfillment individuals derive from their sexual experiences, expressions, and behaviors, has been linked to relationship satisfaction and health. However, the intricate associations between positive sexuality and relationship functioning and health indicators have rarely been explored from a network perspective. This approach, by analyzing the interconnections among these factors within a broader system, can offer insights into complex dynamics and identify key variables for targeted interventions.MethodsThe present study applied network analysis to uncover interconnections between positive sexuality, relationship satisfaction, and health indicators, highlight the most relevant variables and explore potential gender-based differences in a sample of 992 partnered individuals (51% women, aged 18–71 years). Networks were estimated via Gaussian Graphical Models, and network comparison test was used to compare men and women.ResultsResults indicated that variables related to positive sexuality were more highly interconnected than the rest of the network. There were small-to-negligible connections between positive sexuality and relationship satisfaction variables, both of which had negligible or no connections with health. The network was globally invariant across gender, though a few connections were gender-specific. The most important variables, regardless of gender, related to pleasurable feelings during sexual intercourse.DiscussionThe findings underscore the importance of enhancing positive sexual experiences within intimate relationships and have implications for research and clinical practice in positive sexuality.

Abstract Background The impact of family and personal cancer history and emotional factors, such as depression and anxiety, on disease representation has received limited attention in studies investigating the development of cancer‐related worry and risk perception within the context of genetic counseling. The current study endeavors to fill this gap by exploring the extent to which depression and anxiety influence cancer worry and risk perception, and the role of health care‐related fear as potential mediator in this relationship. Methods A sample of 178 women who underwent their first genetic counseling for breast/ovarian cancer, 52% of whom had previous cancer diagnoses, completed questionnaires assessing sociodemographic and clinical information, emotional distress in terms of anxiety and depression, cancer‐related worry, risk perception, and health care‐related fears. Results Results of mediation analyses showed that cancer‐related worry and risk perception increased with rising levels of depression and anxiety, with health care‐related fears acting as a mediator in the relationship of depression and anxiety with cancer worry and risk perception. Covariate analysis revealed that previous cancer diagnosis increases cancer‐related worry but not risk perception, while the number of family members affected by cancer increases both outcomes. Conclusion These findings emphasize the need for a holistic approach in genetic counseling and have implications for the clinical practice.

Unhealthy lifestyle behaviors (ULBs) are common in early adolescence and could be worsened by Attention-Deficit/Hyperactivity Disorder (ADHD), as well as by specific psychosocial factors, such as stress and unbalanced (i.e., too high or low scores of) psychological well-being (PWB) dimensions. This multi-center study aimed to evaluate how interactions between ADHD symptoms and psychosocial factors associated with ULBs (i.e., Allostatic Overload and multidimensional Psychological Well-Being), considered as moderators, could affect the adoption of ULBs during adolescence. A total of 440 fourteen-year-old adolescents were recruited from six upper secondary schools in Bologna and Rome (Italy) and completed self-report questionnaires on ULBs, ADHD, and psychosocial factors. Relations between ADHD symptomatology and specific ULBs (i.e., impaired sleep, problematic Internet use) were moderated by variables deemed as “negative” (i.e., Allostatic Overload) or “positive” (i.e., PWB dimensions of Self-Acceptance, Personal Growth, Positive Relations, Purpose in Life, Environmental Mastery): when the “negative” moderator is absent and the levels of the “positive” moderators are higher, ULBs decrease among students with lower ADHD symptomatology but increase among students with more severe ADHD. Based on ADHD severity, interventions should aim at promoting a state of euthymia, which consists in balanced PWB dimensions and reflects the optimal level of well-being to fulfill one’s own potential and self-realization.

The impact of recurrent traumatic experiences during childhood may impede the integration of mentalization abilities and lead to psychopathology. Recently, the Failure to Mentalize Trauma Questionnaire (FMTQ), a comprehensive 29-item self-report scale aimed at identifying deficits in mentalization arising from childhood trauma, was developed. However, the length of the FMTQ may render it impractical for epidemiological studies involving multiple variables and measures. Furthermore, the initial testing revealed inadequate factor reliabilities for the two first-order factors. Therefore, this study aimed to shorten and create a unidimensional version (FMTQ-s) and investigate its psychometric properties, including internal consistency and convergent and concurrent validity, in a non-clinical Italian adult sample. The factor analysis supported a 13-item unidimensional version of the FMTQ with acceptable internal consistency (ordinal alpha = 0.88) and satisfactory convergent and concurrent validity. The FMTQ-s obtained scalar invariance between individuals with and without self-reported childhood traumas. Overall, the FMTQ-s appears to be a feasible and reliable tool for assessing deficits in mentalization resulting from childhood trauma.

Abstract Background Communication of bad news plays a critical role in the physician-patient relationship, and a variety of consensus guidelines have been developed to this purpose, including the SPIKES protocol. However, little is known about physicians’ attitudes towards breaking bad news and to be trained to deliver it. This study aimed to develop and validate a self-report questionnaire to assess physicians’ attitudes towards principles of the SPIKES protocol and training on them. Methods The Breaking Bad News Attitudes Scale (BBNAS) was administered to 484 pediatricians and 79 medical students, recruited at two scientific conferences and two medical schools in Brazil. The questionnaire structural validity, reliability, and associations with other variables were tested. Results The BBNAS showed adequate validity and good reliability, with two factors measuring attitudes towards the SPIKES strategy for braking bad news (α = 0.81) and the possibility to be trained on it (α = 0.77), respectively. Conclusion The novel questionnaire is a psychometrically sound measure that provides information on physicians’ agreement with the SPIKES protocol. The BBNAS can provide useful information for planning training and continuing education programs for clinicians on communication of bad news using the SPIKES as a framework.

Fibromyalgia is a burdensome pain causing patients a very negative emotional state that can worsen their clinical profile, perceived disability, and treatment outcomes. In particular, anger can negatively affect pain and patient adjustment to the disease. Recent studies suggest that metacognitions and anger rumination can negatively affect anger, which in turn can amplify the intensity of pain. This study aims to investigate whether anger rumination and state anger serially mediate the relationship between metacognitions and the intensity of pain. The study included 446 subjects who: declared having received a fibromyalgia diagnosis by a rheumatologist/pain physician; completed measures of metacognitions, anger rumination, state-anger, and pain intensity. The serial mediation analysis was conducted using Hayes' PROCESS macro (Model 6). Negative beliefs about worry and beliefs about the need to control thoughts indirectly influenced the intensity of pain through two significant mediating pathways: state-anger and anger rumination to state-anger. Cognitive self-consciousness affected pain intensity directly (β =.11, p <.05) and indirectly through two significant mediating pathways: state-anger and anger rumination to state-anger. This study highlights the role of serial mediation of anger rumination and state-anger in the relationship between metacognitions and pain intensity in the field of fibromyalgia. Our work introduces new targets for anger management interventions for patients with fibromyalgia. Such interventions could be effectively addressed with a metacognitive approach considering its specific focus on dysfunctional metacognitive beliefs and repetitive negative thinking. [ABSTRACT FROM AUTHOR]

Infertility constitutes an essential source of stress in the individual and couple’s life. The Infertility-Related Stress Scale (IRSS) is of clinical interest for exploring infertility-related stress affecting the intrapersonal and interpersonal domains of infertile individuals’ lives. In the present study, the IRSS was translated into Brazilian–Portuguese, and its factor structure, reliability, and relations to sociodemographic and infertility-related characteristics and depression were examined. A sample of 553 Brazilian infertile individuals (54.2% female, mean aged 36 ± 6 years) completed the Brazilian–Portuguese IRSS (IRSS-BP), and a subsample of 222 participants also completed the BDI-II. A sample of 526 Italian infertile individuals (54.2% female, mean aged 38 ± 6 years) was used to test for the IRSS measurement invariance across Brazil and Italy. Results of exploratory structural equation modeling (ESEM) indicated that a bifactor solution best represented the structure underlying the IRSS-BP. Both the general and the two specific intrapersonal and interpersonal IRSS-BP factors showed satisfactory levels of composite reliability. The bifactor ESEM solution replicated well across countries. As evidence of relations to other variables, female gender, a longer duration of infertility, and higher depression were associated with higher scores in global and domain-specific infertility-related stress. The findings offer initial evidence of validity and reliability of the IRSS-BP, which could be used by fertility clinic staff to rapidly identify patients who need support to deal with the stressful impact of infertility in the intrapersonal and interpersonal life domains, as recommended by international guidelines for routine psychosocial care in infertility settings.

Since the mid-nineties, the European Union and UNESCO have promoted a new form of didactics aimed at developing competences. These "key competences", subsequently identified by the Council and the European Parliament, are considered as fundamental for Europe's response to globalisation. Their close link with a neoliberal perspective of the working world - as can also be deduced from the non-random choice of the term "competence" - is evident. In particular, the competence related to the sense of initiative and entrepreneurship has assumed a strategic role within the "Lifelong Learning Programme" and the "Europe 2020" programme, fostering the spread of a new labour market model no longer based on the prevailing paid employment. Recent Italian legislation on educational institutions, and Law 107/2015 in particular, have acknowledged the European Union guidelines regarding promotion of the key competences, and more specifically of alternating school-work pathways. Although it is too early to make an overall evaluation of the effects these laws have produced, the actions promoted so far do not seem to overcome the existing inequality in Italy's educational and employment opportunities. Furthermore, the objective of promoting competences that can be directly used on the labour market, to the detriment of broader cultural preparation deemed useless for this purpose, risks impoverishing the education of the most disadvantaged, those people who have the fewest chances of acquiring knowledge and critical thinking outside the school context. The transformations taking place in the educational field appear to proclaim the advent of a "Competence Society", the last metamorphosis of an epiphenomenon with its roots in the globalised capitalist system which is leaving social reproduction mechanisms unchanged.

Over twenty years after the publication of La misère du monde (Bourdieu 1993), Pierre Bour-dieu’s work is still highly relevant. The social order that has led to a proliferation of the "small miseries" of the world seems to have prevailed: Pierre Bourdieu’s micro-sociological essay highlighted the symptoms of a disease that has gotten worse in the past few years, and prophetically predicted many of its current con-sequences. This article aims at analysing the consequences on the educational field where practices of "service-sector Taylorism" are emerging alongside the usual mechanisms of social reproduction. These practices are allegedly inspired by meritocracy, but actually aimed at the utilitarian exploitation of human resources. The students’ potential is thus trivialised, dumbed down to a few measurable variables on which teaching and selecting are based, according to a view that treats humans as merely means to an end. Thus, by concealing the social fabric in which individuals are rooted, any failure can be surreptitiously blamed on individual responsibilities. Sociological research has the crucial task of revealing the peculiar logic of this kind of mechanisms, more and more common in several fields, and their ideological implica-tions, typical of neoliberalism: because, as Bourdieu says, "what the social world has done, it can, armed with this knowledge, undo" (Bourdieu 1993d, 629)

Fibromyalgia (FM) diagnosis follows the American College of Rheumatology (ACR) criteria, based on clinical evaluation and written questionnaires without any objective diagnostic tool. The lack of specific biomarkers is a tragic aspect for FM and chronic pain diseases in general. Interestingly, the endogenous opioid system is close to the immune one because of the expression of opioid receptors on lymphocytes membrane. Here we analyzed the role of the Mu opioid receptor on B lymphocytes as a specific biomarker for FM and osteoarthritis (OA) patients. We enrolled three groups of females: FM patients, OA patients (chronic pain control group) and healthy subjects (pain-free negative control group). We collected blood samples to apply immunophenotyping analysis. Written tests were administrated for psychological analysis. Data were statistically analyzed. Final results showed that the percentage of Mu-positive B cells were statistically lower in FM and OA patients than in pain-free subjects. A low expression of Mu-positive B cell was not associated with the psychological characteristics investigated. In conclusion, here we propose the percentage of Mu-positive B cells as a biological marker for an objective diagnosis of chronic pain suffering patients, also contributing to the legitimacy of FM as a truly painful disease.

This study presents the psychometric properties of the Peer Aggressive and Reactive Behaviors Questionnaire (PARB-Q), a self-report questionnaire to measure child overt aggression (PA) and reaction to peer aggression (RPA). Participants were 587 Italian elementary school children, aged 7-10 years (51.5% female). Exploratory and confirmatory factor analyses presented a one-factor solution for the PA scale and a three-factor solution for the RPA scale (reactive aggression, seeking teacher support and internalizing reaction), presenting adequate reliability and goodness-of-fit indexes for both scales. Criterion validity presented satisfactory evidence. The PARB-Q appears to be a psychometrically sound tool to evaluate aggressive behavior and reactions to peer aggression in elementary school children.

Carotid Endarterectomy (CEA) is a surgical treatment validated to prevent cerebral ischemia, embolism and stroke in patients affected by severe stenosis of the carotid artery. A 1999 systematic review of the literature found controversial results about CEA influence on improvement of post-surgical cognitive performance. Moreover, few studies addressed the issue of the positive effects of CEA on quality of life and depression, reporting also controversial findings. The present review was aimed at considering the last 20 years studies focusing on the effects of CEA on the psychological dimensions. The purpose was to clarify the benefits, in terms of psychological well-being, offered by CEA, besides a reduction of the cardiovascular risk, as well as to have indication to lead further research in this area. Results of the 39 studies considered suggest that, although few studies show cognitive deterioration, most of them show stability with a tendency to improve both in cognitive functions and in other psychological areas. Further research is needed to clarify when it would be appropriate the use of CEA, the characteristics of eligible patients, and psychological as well as physical expected outcomes.

Background: Evidence suggests that metabolic syndrome and hostility are independent risk factors for the development of coronary heart disease. Recently, the combined effect of metabolic syndrome and hostility has shown to predict the incidence of myocardial infarction. This study tested whether cynical hostility was associated with the metabolic syndrome in a sample of Italian adults. Methods: 992 subjects participated in the study. Among them, 546 participants were classified as having metabolic syndrome and 446 as controls, not having any of the risk factors that constitute the metabolic syndrome. Cynicism, the cognitive component of hostility, was measured with a self-report questionnaire derived from the Cook–Medley Hostility Scale. Metabolic syndrome was based on having the following risk factors: obesity, hyperinsulinemia, dyslipidemia, and elevated arterial blood pressure. Results: The cross-sectional association of cynical hostility with metabolic syndrome was statistically significant (p

The aim of this study was to investigate changes in cognitive function following carotid endarterectomy (CEA). In 74 asymptomatic CEA patients cognitive function, depression, laterality and severity of stenosis, cerebral Computer Tomography results, and ischemic heart diseases were measured preoperatively. The sample included 31 patients with dementia and 43 patients without any symptom of dementia. Cognitive function was measured again at 3 months postoperatively using a brief standardised test. After controlling for cognitive function and depression at baseline, cognitive function improved significantly at 3 months after CEA in both patients with and without dementia. CEA may offer more than reduced stroke risk to patients, independent of cognitive function.

Health-related quality of life was examined in 49 patients with hepatitis C virus with no psychiatric history who received interferon (IFN)-α treatment. Quality of life was assessed at baseline, at 3-time points during IFN-α therapy and at 1-6 month follow-up, using SF-36. Hepatitis C virus patients showed poorer physical functioning and better social and mental functioning than a normal population. Significant decreases from baseline SF-36 scores were observed at an early phase of treatment. Six patients developed major depression during IFN-α treatment. At baseline, they had reported more bodily pain than patients who did not develop depression during treatment. Planned contrasts revealed that worsening in some dimensions of quality of life at 2 months was greater in depressed than in non-depressed patients. Results suggest that depressive symptoms should be accurately monitored during IFN-α therapy even in patients with no psychiatric history, especially if they present with bodily pain.

This narrative review sought to explore the main critical issues in the assessment of depression in chronic pain and to identify self-report tools that can be reliably used for measuring it. Narrative review of the literature. Articles were obtained through a search of three databases and a hand search of the references of full-text papers. Key results within the retrieved articles were summarized and integrated to address the review objectives. Criterion contamination, different ways to define and evaluate pain and depression across studies, variability in chronic pain samples and settings, pitfalls of diagnostic systems and self-reports, and reluctance to address (or difficulty of recognizing) depression in patients and healthcare providers emerged as main critical issues. The Beck Depression Inventory seems to be the more accurate tool to evaluate depression in chronic pain patients, while other instruments such as the Patient Health Questionnaire could be recommended for a rapid screening. Assessment of depression comorbidity in chronic pain represents a challenge in both research and clinical practice; the choice and use of tests, as well as the score interpretation, require clinical reasoning. Nurses play an important role in screening for depression. Cognitive contents of depression should be carefully evaluated since somatic symptoms may be confusing in the chronic pain context. Some self-reports may be useful for rapid screening. It is also advisable to consider other relevant patient information in evaluating depression. [ABSTRACT FROM AUTHOR]

Abstract Background The topic of sexual obsessions as a psychiatric symptom has not been well investigated. The aim of this study was twofold: 1) to explore the presence of sexual obsessions in patients with mood disorders (n=156), panic disorder (n=54) and schizophrenia (n=79), with respect to non-psychiatric subjects (n=100); 2) to investigate the relationship between sexual obsessions and suicidal behaviors, taking into account socio-demographic variables ad mental disorders. Methods 289 psychiatric patients with mood disorders, panic disorder or schizophrenia, were recruited at the Italian University departments of psychiatry along with 100 non-psychiatric subjects, who presented for a routine eye exam at the ophthalmology department of the same Universities. The assessments included: the Structured Clinical Interview for DSM-IV-TR, the Brief Psychiatric Rating Scale (BPRS), the Obsessive-Compulsive Spectrum Self-Report (OBS-SR), for sexual obsession, and the Mood Spectrum-Self Report lifetime version (MOODS-SR). Suicidality was assessed by means of 6 items of the MOODS-SR. Results Sexual obsessions were more frequent in schizophrenia (54.4%), followed by mood disorders (35.9%). Among schizophrenia patients, males reported more sexual obsessions than females (P Conclusions Special attention should be given to investigate and establish effective strategies of treatment for sexual obsessions, especially those with comorbid mood disorders or schizophrenia.

Abstract Background High grade gliomas are one of the most difficult cancers to treat and despite surgery, radiotherapy and temozolomide-based chemotherapy, the prognosis of glioma patients is poor. Resistance to temozolomide is the major barrier to effective therapy. Alternative therapeutic approaches have been shown to be ineffective for the treatment of genetically unselected glioma patients. Thus, novel therapies are needed. Mitochondria-directed chemotherapy is an emerging tool to combat cancer, and inner mitochondrial permeability transition (MPT) represents a target for the development of cytotoxic drugs. A number of agents are able to induce MPT and some of them target MPT-pore (MPTP) components that are selectively up-regulated in cancer, making these agents putative cancer cell-specific drugs. Objective The aim of this paper is to report a comprehensive analysis of the effects produced by selected MPT-inducing drugs (Betulinic Acid, Lonidamine, CD437) in a temozolomide-resistant glioblastoma cell line (ADF cells). Methods EGFRvIII expression has been assayed by RT-PCR. EGFR amplification and PTEN deletion have been assayed by differential-PCR. Drugs effect on cell viability has been tested by crystal violet assay. MPT has been tested by JC1 staining. Drug cytostatic effect has been tested by mitotic index analysis. Drug cytotoxic effect has been tested by calcein AM staining. Apoptosis has been assayed by Hoechst incorporation and Annexine V binding assay. Authophagy has been tested by acridine orange staining. Results We performed a molecular and genetic characterization of ADF cells and demonstrated that this line does not express the EGFRvIII and does not show EGFR amplification. ADF cells do not show PTEN mutation but differential PCR data indicate a hemizygous deletion of PTEN gene. We analyzed the response of ADF cells to Betulinic Acid, Lonidamine, and CD437. Our data demonstrate that MPT-inducing agents produce concentration-dependent cytostatic and cytotoxic effects in parallel with MPT induction triggered through MPTP. CD437, Lonidamine and Betulinic acid trigger apoptosis as principal death modality. Conclusion The obtained data suggest that these pharmacological agents could be selected as adjuvant drugs for the treatment of high grade astrocytomas that resist conventional therapies or that do not show any peculiar genetic alteration that can be targeted by specific drugs.