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INTRODUZIONE: La letteratura scientifica ha mostrato che nell’infanzia e nell’adolescenza il disagio psicologico si manifesta prevalentemente sotto forma di sintomatologia ansiosa e particolarmente marcati risultano essere i fenomeni di somatizzazione. Negli ultimi anni nelle scuole è aumentato l’interesse nei confronti di interventi preventivi volti ad incrementare il livelli di benessere psicologico e a ridurre quelli di disagio psichico. L’ obiettivo di questo studio è applicare e comparare gli effetti di due interventi scolastici, uno specificatamente indirizzato a promuovere il benessere psicologico (Well-Being Therapy-WBT) e l’altro finalizzato a ridurre i livelli di ansia. METODO: 165 studenti (70F, 95M; età media = 11.41±0.56), frequentanti 8 diverse scuole medie localizzate nel nord Italia, hanno aderito volontariamente al progetto. Le classi sono state randomizzate alle seguenti condizioni sperimentali: a) un protocollo di promozione del benessere psicologico (WBT); b) un protocollo di gestione dell' ansia (AM). Entrambi gli interventi consistevano di sei incontri di due ore a cadenza settimanale. Gli studenti sono stati valutati durante la prima e l’ultima sessione degli interventi e sei mesi dopo la loro conclusione usando: 1) le Psychological Well-Being Scales (PWB), il Symptom Questionnaire (SQ) e la Revised Children’s Manifest Anxiety Scale (R-CMAS). Per valutare i cambiamenti nelle varie sottoscale dei questionari usati all’interno dei due gruppi sperimentali è stata utilizzata un’analisi della varianza per misure ripetute within group. Per comparare gli effetti dei due interventi è stata condotta un’analisi della varianza, usando i punteggi iniziali come covariate. RISULTATI: L’analisi della varianza per misure ripetute all’interno del gruppo WBT ha messo in evidenza un significativo aumento dell’Autonomia (PWB) e una riduzione dell’ansia fisiologica tra il retest e il follow-up. L’analisi della varianza per misure ripetute all’interno del gruppo AM ha invece evidenziato una riduzione dell’Ansia (SQ) tra il test e il retest. Inoltre il punteggio nella scala della Preoccupazione (R-CMAS) è diminuito al retest e ulteriormente al follow-up. L’analisi della covarianza ha messo in evidenza che il protocollo di gestione dell’ansia è più efficace nel ridurre l’Ansia (SQ), mentre il protocollo di WBT ha un effetto significativamente maggiore nell’aumentare la Buona Disposizione verso gli altri (SQ). CONCLUSIONI: L’intervento diretto alla gestione dell' ansia e delle emozioni negative si è rivelato efficace per ridurre i livelli di malessere psicologico negli adolescenti, soprattutto per quanto riguarda i sintomi di somatizzazione e ansia fisiologica. L’intervento finalizzato alla promozione del funzionamento ottimale si è rivelato efficace nell‘aumentare i livelli di benessere, apportando un miglioramento nei rapporti interpersonali dei ragazzi. Ulteriori studi sono necessari per valutare l’efficacia di un’integrazione dei due protocolli.

La correlazione fra i disturbi cardiovascolari e il disagio psicologico è supportata da numerose evidenze scientifiche. Tuttavia, non sono mai stati chiaramente enumerati i criteri per la convalidazione scientifica delle entità che attualmente sono classificate nella nosografia psichiatrica corrente (DSM-IV) sotto la categoria “Fattori psicologici che influenzano la condizione medica” . E’ inoltre complicato misurare questo tipo di disagio psicologico ed è necessario il supporto del giudizio clinico. Negli ultimi anni la ricerca in psicosomatica ha posto un’ attenzione sempre maggiore a questi problemi di ordine clinico e metologico. Le variabili psicologiche messe in luce dalla ricerca in psicosomatica sono state tradotte in strumenti operativi, come ad esempio i Criteri Diagnostici per la Ricerca in Psicosomatica (DCPR). Attraverso l'uso di questo strumento diagnostico, l’umore irritabile, la demoralizzazione e il comportamento di tipo A sono stati frequentemente riscontrati nei pazienti in setting cardiologici. L’utilizzo congiunto dei criteri contenuti nel DSM-IV e di quelli presenti nei DCPR permette quindi di identificare quei fattori psicologici che sembrano poter influenzare la condizione cardiaca. Rimane comunque la necessità di sviluppare questa linea di ricerca per capire se il trattamento congiunto della condizione clinica e di quella psicologica subsindromica possa migliorare la qualità della vita dei pazienti cardiopatici e ridurne il rischio di morbilità e mortalità.

Background: The aim of our study was to evaluate how sociodemographic factors, psychosocial adaptation to pregnancy and well-being levels are associated with the onset of preterm uterine contractions allowing symptomatic preterm labor. Methods: In a prospective case-control design, 51 consecutive women admitted for threatened preterm labor were enrolled. The patients received standard care. The day before discharge, once contractions had been stopped, the patients were administered 2 questionnaires: the Prenatal Self-Evaluation Questionnaire of Lederman and the Psychological Well-Being Scales. Controls were enrolled among asymptomatic, healthy women attending routine prenatal care. They were matched for parity and gestational age. Results: Gestational age at inclusion ranged from 25 to 34 weeks. Fourteen cases and 4 controls delivered preterm. Cases were less educated than controls, showed a lower acceptance of pregnancy and worse relationship with others, namely with the husband, compared to controls. They also displayed a reduced environmental mastery. Conclusion: Having a low education, poor relationship with others, including the husband, and impaired coping skills appeared to be independent risk factors for the development of symptomatic preterm labor in urbanized women.

There is insufficient research on rating psychological well-being and distress in clinical populations. The aim of this study was to evaluate the differential characteristics of instruments assessing well-being and distress in 20 remitted patients with affective (mood and anxiety) disorders and 20 healthy control subjects matched for sociodemographical variables. Remitted patients displayed significantly higher levels of psychological distress - as measured by Paykel's Clinical Interview for Depression (CID), Van Pragg's Scale for Personality Disturbances and Kellner's Symptom Questionnaire (SQ) - and significantly less well-being - as measured by Ryff's Scales of Psychological Well-Being (PWB) and the SQ - than control subjects. The correlations between scales of psychological distress and well-being were found to be complex in both patients and controls. Psychotherapeutic treatment of residual symptomatology in patients disclosed a differential sensitivity of the scales to change. The results thus suggest that well-being cannot be equated to lack of distress (as implicitly endorsed by current psychiatric paradigms), and the need for a multidimensional assessment in stress medicine

In the last decade there has been increasing interest in the potential of early preventive interventions capable of promoting psychological well being in order to reduce the risk of childhood psychological distress. This study analyzes the differential effects of strategies for promotion of psychological well-being (Well-Being Therapy, WBT) and removal of distress (Anxiety Management, AM) in a non clinical school setting.Our sample consisted of eight classes (N=162 students) attending middle schools in Northern Italy which were randomly assigned to a protocol derived from WBT (4 classes) and to an anxiety-management protocol (AM) (4 classes). Immediately before and after both school interventions students were assessed using the Psychological Well-Being Scales (PWB), Kellner's Symptom Questionnaire (SQ) and the Revised Children's Manifest Anxiety Scale (R-CMAS). A six month follow-up was performed in the following school year, and students were re-assessed with the same psychometric instruments.Our results lend support to the possibility to change attitudes to psychological well-being and distress with brief interventions in school (both well-being improving and distress removing).Further investigations should determine whether the combined and sequential integration of well-being and symptom oriented strategies may yield more complete and lasting effects that each strategy alone.

Background Somatization is a widespread clinical phenomenon that cuts across diagnostic categories, both psychiatric and medical. Objective This study investigates whether somatization can be assessed with a comprehensive diagnostic system, the Diagnostic Criteria for Psychosomatic Research (DCPR) in gastroenterology and cardiology (myocardial infarction) patients. Method Authors assessed a group of 343 outpatients, 190 gastroenterology and 153 cardiology outpatients, with functional gastrointestinal disorders and recent first myocardial infarction. Results A total of 146 patients were diagnosed by the DCPR Somatization cluster and 106 by the DCPR Abnormal Illness Behavior cluster; 27 patients who met DSM–IV criteria for somatoform disorders were not classified with any DCPR somatization syndromes, whereas 120 with DCPR Somatization cluster did not satisfy the criteria for DSM–IV somatoform disorders. Conclusion Findings suggest that the DCPR is able to identify clinical and subthreshold psychosomatic syndromes and that it can used jointly with the DSM–IV.

Objective The aim of this study was to assess the presence of demoralization and major depression in the setting of medical disease. Method 807 consecutive outpatients recruited from different medical settings (gastroenterology, cardiology, endocrinology, and oncology) were assessed according to DSM-IV criteria and Diagnostic Criteria for Psychosomatic Research, using semistructured research interviews. Results Demoralization was identified in 245 patients (30.4%), while major depression was present in 135 patients (16.7%). Even though there was a considerable overlap between the 2 diagnoses, 59 patients (43.7%) with major depression were not classified as demoralized, and 169 patients (69.0%) with demoralization did not satisfy the criteria for major depression. Conclusions The findings suggest a high prevalence of demoralization in the medically ill and the feasibility of a differentiation between demoralization and depression. Further research may determine whether demoralization, alone or in association with major depression, entails prognostic and clinical implications.

Objective To use the Diagnostic Criteria for Psychosomatic Research (DCPR) for characterizing alexithymia in a large and heterogeneous medical population, in conjunction with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and other DCPR criteria. Method Of 1305 patients recruited from 4 medical centers in the Italian Health System, 1190 agreed to participate. They all underwent an assessment with DSM-IV and DCPR structured interviews. A total of 188 patients (15.8%) were defined as alexithymic by using the DCPR criteria. Data were submitted to cluster analysis. Results Five clusters of patients with alexithymia were identified: (1) alexithymia with no psychiatric comorbidity (29.3% of cases); (2) depressed somatization with alexithymic features (23.4%); (3) alexithymic illness behavior (17.6%); (4) alexithymic somatization (17%) and (5) alexithymic anxiety (12.8%). Conclusions The results indicate that DCPR alexithymia is associated with a comorbid mood or anxiety disorder in about one third of cases; it is related to various forms of somatization and abnormal illness behavior in another third and may occur without psychiatric comorbidity in another subgroup. Identification of alexithymic features may entail major prognostic and therapeutic differences among medical patients who otherwise seem to be deceptively similar since they share the same psychiatric and/or medical diagnosis.

AIM: The aim of the present study was to validate the Italian version and to assess the clinimetric properties of Ahearn and Carroll's Visual Analogue Scales for Bipolarity (MVAS-BP), a self-rating questionnaire measuring affective state. METHOD: MVAS-BP consist of 26 items: 1 item assesses overall mood, 2 items anger and 23 items are based on the Carroll model of bipolar disorder (Consummatory Reward, Incentive Reward, Central Pain, Psychomotor Regulation). MVAS-BP have been translated into Italian and administered with Kellner's Symptom Questionnaire (SQ), Ryff's Psychological Well-Being Scales (PWB), and Cloninger's Tridimensional Personality Questionnaire (TPQ) to a normative sample of 450 people. The assessment was repeated after one month. Test-retest reliability, means scores, differences according to sociodemographic variables and correlations among the scales of MVAS-BP, SQ, PWB and TPQ were performed in order to assess clinimetric properties. RESULTS: Test-retest coefficients were highly significant. Significant sex differences were found in the scales of consummatory reward, central pain, psychomotor regulation and anger. MVAS-BP scales were significantly related with symptom and well-being scales, but with very low correlation coefficients, and only with one personality dimension, TPQ Harm Avoidance. DISCUSSION: MVAS-BP has been found to possess clinimetric properties and to record specific and different information from those investigated by other questionnaires.

This book brings together the latest research on positive psychology from an international cast of researchers and particularly from the growing body of European researchers. The chapters describe research and practice from diverse fields of positive psychology, covering topics such as happiness and well-being, motivation and goals, personality, academic performance and coping, measurement and interventions. The book emphasizes a cultural approach to the human pursuit of well-being. It is unique in that it presents research from a range of cultures, such as Russia, Croatia, and Egypt, in addition to ten different Western cultures. This approach helps broaden our understanding of those aspects of human experience that make life worth living in diverse cultural conditions. The book includes well-known and new authors from the field and contains selected papers that were presented at the 4th European Conference of Positive Psychology held in 2008 in Croatia.

The aim of the present study was to examine the differential effects of strategies for promotion of psychological well-being (Well-Being Therapy, WBT) and removal of distress (Anxiety Management, AM) in a non-clinical school setting.162 students attending middle schools in Northern Italy were randomly assigned to: (a) a protocol derived from WBT; (b) an anxiety-management protocol (AM). The students were assessed immediately before and after the interventions, and after 6 months using: Psychological Well-Being Scales (PWB), Symptom Questionnaire (SQ) and the Revised Children's Manifest Anxiety Scale (RCMAS). In school children, well-being and symptom focused interventions produced slightly different effects on psychological dimensions. WBT, by facilitating progression toward positive and optimal functioning, may integrate symptom-centered strategies.

The objective of this study was to test the efficacy of a new school program for the promotion of psychological well-being (PWB) and optimal human functioning in adolescence. A specific strategy for enhancing PWB, well-being therapy (WBT), has been developed, and controlled investigations have documented its efficacy in adult clinical populations. In this study, a school-based intervention derived from WBT and adapted for an adolescent population has been compared to an attention-placebo intervention in a high school setting. Nine classes (227 students) of one high school volunteered to participate and were randomly assigned to WBT intervention group (five classes, 129 students) and attention-placebo group (four classes, 98 students). Both school-based interventions consisted of six, 2-h sessions. Assessment was performed at preintervention and postintervention, and after 6 months using symptom questionnaire (SQ), PWB scales, and revised children’s manifest anxiety scale (RCMAS). A significant effect of WBT in improving the personal growth scores and the total PWB score at retest were observed. WBT school-based intervention resulted also in a significant improvement in: SQ physical well-being and in RCMAS physiological anxiety at retest, SQ anxiety at follow-up and SQ somatization both at retest and at follow-up. All these symptom dimensions display an opposite pattern in the attention-placebo group, i.e., they tend to get worse at follow-up. A school intervention based on promoting positive emotions and well-being was effective not only in increasing PWB among adolescents, but also in decreasing distress, in particular somatization. Future research with larger samples and longer follow-up are necessary to confirm the efficacy of school WBT.

Summary Objective To verify whether patients with pituitary disorders in remission and on appropriate treatment display significant differences in psychological distress compared to healthy controls and other patients treated for nonpituitary endocrine disorders. Design A single-centred, controlled study. Patients Eighty-six outpatients cured or in remission for at least 9 months following appropriate treatment by surgery, irradiation and/or pharmacological interventions for pituitary disease were compared with 86 healthy subjects. A sample comprising 60 outpatients cured or in remission from nonpituitary endocrine disorders was also compared. Measurements (1) A modified version of the Structural Clinical Interview for DSM-IV; (2) a shortened version of the structured interview for the Diagnostic Criteria for Psychosomatic Research (DCPR); (3) the Psychosocial Index (PSI); and (4) the Medical Outcomes Study (MOS) short form General Health Survey (SF-20) were employed. Results Patients with pituitary disease displayed a higher prevalence of psychiatric disease (P

Background Adjustment disorders have been found to be the most frequent psychiatric diagnosis in the medically ill. Problems have been raised, however, as to their clinical value. The aim of the study was to characterize the psychosomatic features of adjustment disorders. Methods One hundred patients with medical illness and a diagnosis of adjustment disorder according to DSM-IV criteria were interviewed according to the Diagnostic Criteria for Psychosomatic Research (DCPR) system, consisting of 12 clusters. Results A considerable overlap was shown between adjustment disorders and DCPR clusters related to abnormal illness behavior (health anxiety, tanatophobia, nosophobia and illness denial) (54%), somatization (functional somatic symptoms secondary to a psychiatric disorder, persistent somatization, conversion symptoms and anniversary reaction) (37%) and demoralization (33%). Only 13 of the patients with adjustment disorders did not present any DCPR syndromes. Limitations The study is cross-sectional and does not allow to determine the prognostic features of DCPR categorization. Conclusion The clinical information which derives from the concomitant application of the DCPR might improve and make more specific the treatment of patients with adjustment disorders.