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Serena Scarpelli,1 Valentina Alfonsi,1 Milena Camaioni,1 Maurizio Gorgoni,1,2 Antonio Albano,3 Alessandro Musetti,4 Maria Catena Quattropani,5,6 Giuseppe Plazzi,7,8 Luigi De Gennaro,1,2 Christian Franceschini3 1Department of Psychology, University of Rome Sapienza, Rome, Italy; 2Body and Action Lab, IRCCS Fondazione Santa Lucia, Rome, Italy; 3Department of Medicine and Surgery, Faculty of Medicine and Surgery, University of Parma, Parma, Italy; 4Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Italy; 5Department of Educational Sciences, University of Catania, Catania, Italy; 6Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy; 7Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; 8IRCCS Institute of Neurological Sciences, Bologna, ItalyCorrespondence: Serena Scarpelli, Department of Psychology, University of Rome Sapienza, Via dei Marsi 78, Rome, 00185, Italy, Tel +39 06 49917508, Email serena.scarpelli@uniroma1.itPurpose: COVID-19 pandemic waves have strongly influenced individuals’ behaviors and mental health. Here, we analyzed longitudinal data collected in the Spring 2020 and 2021 from a large Italian sample with the aim of assessing changes in dream features between the first and third wave. Specifically, we evaluated the modifications of pandemic dream activity as a function of the general distress variations over time. Also, we detected the best explanatory variables of nightmare frequency and distress.Materials and Methods: Participants previously involved in the web survey during the first wave of the pandemic were asked to complete a new online survey on sleep and dream features available in Spring 2021 (N=728). Subjects decreasing their level of psychological general distress in the third (T3) vs the first (T1) pandemic wave were defined as “Improved” (N=330). In contrast, participants with an unchanged or increased level of general distress were defined as “Not Improved” (N=398).Results: Statistical comparisons revealed that dream recall frequency, nightmare frequency, lucid dream frequency, and emotional intensity show a reduction in T3 than T1. Moreover, the Improved group is characterized by lower nightmare rate and nightmare distress than Not Improved people. Our findings confirmed that beyond the trait-like variables (ie, age, sex), specific sleep-related measures are related to nightmare features. In particular, poor sleep hygiene was one of the best determinants of nightmare distress among Not Improved subjects.Conclusion: Our findings revealed that people experienced an adaptation to the pandemic during the third wave. We also strengthen the notion that nightmares and their variations over time are strongly related to human well-being, suggesting that specific trait-like and sleep-related factors could modulate the relationship between mental health and nightmare features.Keywords: nightmare, distress, sleep, pandemic, third wave, clinical psychology

Patients with schizophrenia spectrum disorders have a higher prevalence and frequency of smoking rates when compared to the rest of the population; to this, it must be added that they develop a greater dependence and have some worse health consequences than the general population. This is qualitative research on the perception of smoking in healthcare professionals assigned to psycho-rehabilitation programs for patients with schizophrenia spectrum disorders. The point of view of health personnel (Psychologists, Psychiatrists, Pedagogists, and Nurses) about cigarette smoking in these patients was analyzed, focusing on their implications in disturbance and comparing them with e-cigarettes too. The methodology used to collect the data was a semi-structured interview with five questions. The research path was carried out in two assisted therapeutic communities that are clinics for the rehabilitation of serious mental illness in the period between November and July 2022. The results showed that the opinion of health professionals on smoking is very negative. Research has also shown that nearly all patients are smokers; however, their high grade of addiction is caused by periods of high stress due to various factors that lead patients to consume a greater number of cigarettes. Almost all respondents have a positive opinion of the e-cigarette, which was defined as an excellent substitute for traditional cigarettes.

The assessment of health-related quality of life (QoL) in chronic conditions is considered as relevant, especially in patients with hypothyroidism where a high comorbidity with depressive and anxiety issues is reported. The present cross-sectional pilot study aims at: i) examining the correlation of thyroid-specific and generic measures of QoL in patients with Hashimoto’s Thyroiditis (HT); ii) investigating the associations of generic and thyroid-specific measures of QoL with depression and anxiety in patients with HT; iii) comparing generic and thyroid-specific measures of QoL in patients with HT versus controls. Twenty-one patients with serologically and/or ultrasonographically verified HT and sixteen controls with non-toxic goiter or post-surgical hypothyroidism were recruited for this study. Generic and disease-specific QoL were assessed by Health Survey Short Form-36 (SF-36) and Thyroid Patient Reported Outcome (ThyPRO) questionnaires, respectively, whereas depression and anxiety were measured through Beck Depression Inventory-second edition (BDI-II) and Hamilton Anxiety Rating Scale (HAM-A) questionnaires, respectively. Findings showed that ThyPRO and SF-36 scores were associated with each other only regarding the mental health domain, and that such QoL measures were consistently associated with depression levels but not with anxiety. Besides, no statistically significant difference was found between patients with HT and controls with regard to generic and thyroid-specific QoL. The present study suggests that generic and disease-specific measures of QoL can sufficiently assess the mental functioning domain and capture depressive symptoms, but only thyroid-specific measures (such as ThyPRO) can provide an accurate examination of physical aspects of QoL and the overall disease impact in patients’ lives. Besides, some methodological limitations should be taken into account in both using generic and disease-specific instruments with regard to their tendency to underestimate possible anxiety problems., Mediterranean Journal of Clinical Psychology, Vol 9, No 2 (2021)

Introduction. Increasing interest exists concerning the physical and mental wellbeing of patients with hyperthyroidism. Aim. This review aims at gathering the most updated literature on the quality of life (QoL) in patients with hyperthyroidism. Method: We searched PubMed from inception to May 20, 2020 for English language studies using the following entries: “hyperthyroidism AND quality of life”, “Graves’ disease AND quality of life”, “diffuse toxic goiter AND quality of life”, “toxic nodular goiter AND quality of life”, “subclinical hyperthyroidism AND quality of life”. Thirty-nine papers were finally reviewed. Results: Patients with hyperthyroidism have worse QoL than euthyroid subjects, especially if they have Graves’ disease and Graves’ orbitopathy. Treatment of hyperthyroidism with restoration of euthyroidism may not fully restore QoL even after many years, indicating that such patients have difficulties adapting to and coping with their illness, thus experiencing marked and longstanding limitations in physical, mental and psychosocial functioning. Conclusion. As differences exist on long-term outcomes between therapeutic options for hyperthyroidism, it is logical to hypothesize related differences in long-term changes in QoL. Future clinical and psychological studies could monitor QoL and its related domains across different stages of disease and deepen patients’ trajectories of illness experience and the use of coping strategies to face their condition., Mediterranean Journal of Clinical Psychology, Vol 8, No 2 (2020)

Background: past studies have investigated the relationship between mourning and the quality of life in caregivers who care for terminally ill patients. Recently, complicated pain has been recognized as a risk factor for mental and physical health and severe suffering can interfere with individual functioning and social relationships. Every day, home-based palliative care workers confront health professionals who may develop complicated pain after the patient's death. Methods: the aim is to identify family members who take care of a high risk of complicated pain and to do this the SISIFO Consortium has developed a psychological intervention program to prevent complicated pain in family caregivers of terminally ill patients. Results: the common features of the psychological intervention and the future directions of the research were discussed. Conclusions: the purpose of this document is to illustrate the detailed procedure of the palliative home care service. Furthermore, the results of the psychological intervention program adopted by the service were briefly summarized., Journal of Clinical & Developmental Psychology, Vol 2, No 1 (2020)

Backgrounds: Psychological factors may affect patients’ ability to cope with chronic illness, which occur with a high incidence as they represent age related disorder. Anxiety, depression and alexithymia could specifically interfere with compliance and adherence leading to predictable consequences and predicting morbidity and mortality independently of several confounders. The present work aims at investigating the relationship between alexithymia and affective dimension such as anxiety and depression levels, and health related quality of life in T2DM patients. Particularly, alexithymia was analyzed in its three main facets and time since diagnosis was considered with also metabolic control. Methods: Forty seven patients with T2DM were consecutively enrolled and assessed with a gold standard interview and with a psycho-diagnostic evaluation. Clinical psychological exploration consisted of HAM-A, BECK-II, SF-36 and TAS-20 administration. Statistical analysis was performed using IBM SPSS statistical version 25. Data were analyzed anonymously. Results: 47 participants showed moderate depressive symptoms as confirmed by the mean BDI-II and HAMA-A score (15.14 ± 8.95 and 24.31 ± 6.95, respectively), suggesting a high prevalence of anxiety in the enrolled subjects. It was observed a lower perceived QoL as resulted by the MCS and PCS mean values (37.68 ± 9.41 and 39.31 ± 12.29, respectively) and TAS-20 highlighted considerable mean values of 60.53 ± 7.93 in the recruited participants with a prevalence in EOT values (27.51± 4.27), in comparison with mean DID and DDF values (17.26 ± 5.52 and 15.48 ± 3.84, respectively). Conclusions: Our study may suggest a predictive role of alexithymia in patients with T2DM. Moreover, lower PCS and MCS, revealing worst perceived QoL were associated to both higher anxiety and disease duration., Mediterranean Journal of Clinical Psychology, Vol 7, No 3 (2019)

The aim of palliative care is to improve the quality of life of patients and their families facing the problem associated with life-threatening illness. Therefore, home care workers have daily confront with death and suffering of their patients and families. Hence, palliative home care may generate highly negative and stressful emotions for healthcare professionals, known as burnout syndrome. Research in the field of helping professions highlights the associations between dysfunctional coping strategies and burnout syndrome, but, at present, few studies explore the risk of burnout on home care workers. At the same time, there is a growing evidence for the metacognitions as the basis for the development and maintenance of emotional disorders. Aim of the present research is to examine the risk of burnout in palliative home care workers and its relationships with coping strategies and metacognitions. A sample of 62 healthcare workers of palliative care completed a demographic questionnaire, the MBI, the CISS and the MCQ-30. The results have shown that there was an average risk of Depersonalization subscale. Furthermore, results of correlational analysis have shown some significant correlations between MBI and other constructs. Finally, the results of regression analyses have shown that negative beliefs and cognitive distrust accounted for up to 21% of variance of risk burnout. If confirmed by future research, results of this study would have implications in clinical practice. Started from the relationship between burnout, coping strategies and metacognitions, psychological interventions based on metacognitive approach could have positive effects on palliative home care workers.

In the occidental world, feeding is not only a physiological need but it may become a compulsive behavior. In fact, the tendency to instant gratification may represent a way to escape from unpleasant moods and may lead to addictive behaviors. In this process, Metacognitions, defined as internal cognitive factors that control, monitor and evaluate thinking processes, have a central role. The aim of our study was to investigate the relationship between eating behavior, psychological needs and metacognitive processes. We evaluated 44 adults using the following instruments: Eating Disorders Inventory III (EDI-III), Metacognition Questionnaire 30 (MCQ-30) and Frontal Lobe Score. Data analysis was performed using SPSS for Windows applying correlational analysis (Spearman’s Rho). We found that negative beliefs about worry concerning uncontrollability and danger were positive correlated with general psychological maladjustment composite (0.61 p, Mediterranean Journal of Clinical Psychology, Vol 4, No 3 (2016)

Executive Functions are goal-directed neurocognitive processes that allow the management of cognition and behavior. Executive Functions are essential to allow people to set goals, self-monitor, inhibit inappropriate responses, and generally engage in well-planned, flexible, future-oriented behavior. Metacognitive processes, in close alliance with executive functions, are viewed as integral components of awareness and emotional regulation. The influence of metacognition on planning, monitoring and mental flexibility has not been investigated. The aim of this pilot study was to examine the relationship between metacognition and executive functions in Amyotrophic Lateral Sclerosis patient's caregivers. Twenty-two caregivers were evaluated using the following instruments: Metacognition Questionnaire-30 and Wisconsin Card Sorting Test. Data analysis was performed using SPSS for Windows applying correlational analysis (Spearman’s Rho). We founded that total score of metacognition is positive correlated with number of perseverative errors made in Wisconsin (0.75 p, Mediterranean Journal of Clinical Psychology, Vol 3, No 3 (2015)