Psychometric properties of an Italian version of the Barratt Impulsiveness Scale-11 (BIS-11) in nonclinical subjects

Cognitive disturbances basic symptoms in help-seeking patients with borderline personality disorder: Characteristics and association with schizotypy

AIM

Although the presence of psychotic symptoms has been widely recognized in Borderline Personality Disorder (BPD), no study previously investigated cognitive Basic Symptoms (BS) and their clinical implications in patients with BPD.

METHODS

This cross-sectional study specifically examined the prevalence of COGDIS (cognitive disturbances) BS criteria in 93 help-seeking outpatients with BPD by using the Schizophrenia Proneness Instrument-Adult Version (SPI-A). We then explored associations of COGDIS with personality traits, functioning and core psychopathological features of BPD.

RESULTS

The prevalence rates of COGDIS criterion were 62.4%. BPD patients meeting COGDIS criteria reported higher levels of schizotypal personality traits, dissociative experiences and work/social functional impairment compared to individuals without COGDIS criteria. Furthermore, the number of cognitive BSs showed a positive correlation with severity levels of schizotypy.

CONCLUSIONS

Cognitive BS are common in BPD. Cognitive disturbances are associated with schizotypal personality traits and specific clinical features. The presence of cognitive BSs may identify a more severe subgroup of patients with BPD, potentially vulnerable to psychotic symptoms and reliably identifiable through assessment of schizotypal traits.

Betting on Your Feelings: The Interplay between Emotion and Cognition in Gambling Affective Task

Background: Gambling Disorder (GD) is a bio-psycho-social disorder resulting from the interaction of clinical, cognitive, and affective factors. Impulsivity is a crucial factor in addiction studies, as it is closely linked to cognitive distortions in GD by encompassing impulsive choices, motor responses, decision-making, and cognitive biases. Also, emotions, mood, temperament, and affective state are crucial in developing and maintaining GD. Gambling can be used as a maladaptive coping strategy to avoid or escape problems and distress. Methods: The aim of the present study is to explore differences in personality traits and emotion regulation of people suffering from GD, substance-dependent gamblers (SDGs), and healthy controls (HCs). Additionally, the study proposes a new experimental task: the "Gambling Affective Task" (GAT) to investigate the influence of affective priming on risk-taking behaviors. Results: Our findings indicate that participants placed lower bets following positive priming. Additionally, SDGs wagered significantly higher amounts than HCs, regardless of priming type. In general, participants exhibited longer response times after positive priming trials, compared to negative and neutral priming trials. These findings suggest that experiencing positive emotions can act as a protective factor by delaying and lengthening gambling behaviors. By comparing gamblers with and without substance comorbidity, we can gain insight into the exclusive factors of GD and improve our understanding of this disorder. Conclusions: By elucidating the impact of emotional states on risk-taking, the research also provides new insights into the prevention and treatment of GD.

Exploring the Relationship of Anxiety and Depressive Symptoms and Impulsiveness with the Quality of Life of Older Patients with Cardiovascular Disease: A Cross-Sectional Study

BACKGROUND

This study aimed to evaluate the relationship of selected clinical (i.e., body mass index, BMI) and psychological factors (i.e., anxiety, depression, and impulsiveness) with the quality of life (QoL) of elderly patients with cardiovascular disease (CVD) in a single clinical center in Italy.

METHODS

A total of 238 patients of older age (≥65 years) with CVD who voluntarily attended a single clinical center for weight loss and cardiac rehabilitation were sequentially recruited and tested upon admission to the hospital based on pre-established inclusion criteria.

RESULTS

The findings indicated that anxiety and depressive symptoms were moderately associated with lower QoL. Additionally, there were noteworthy but minor negative connections between impulsivity and QoL. Furthermore, BMI was inversely associated with the perceived QoL of the participants, and when incorporated into the regression analysis, BMI alone significantly accounted for 11.8% of the variability in QoL. This percentage increased to 18.4% with the inclusion of impulsiveness in the model and further to 34.3% with the addition of anxiety and depressive symptoms. However, after introducing anxiety and depression, the association between impulsivity and QoL ceased to be statistically significant.

CONCLUSIONS

Integrating the routine assessment and treatment of psychological factors into the care of older patients with CVD is important for optimizing their overall health outcomes and improving their QoL.

Are eco-sustainable dietary patterns associated with impulsiveness? An insight from Italy

Impulsivity is known to influence food choices. We explored possible differences in its expression between individuals with or without an eco-sustainable diet and its relationship with cognitions and behaviours about eco-sustainable foods. Participants were categorised as having or not having an eco-sustainable diet. Impulsivity traits and cognitions and behaviours about sustainable food products were measured. Among the 332 participants, 92.78% showed an eco-sustainable diet, whereas only 7.22% had an eco-sustainable diet. No difference between groups emerged about impulsive traits, whereas significant differences emerged in cognitions and behaviours about sustainable foods, with the only exceptions of subjective norms and past behaviour. Impulsive traits were linked to cognitions and behaviours differently within groups. Impulsivity traits may be related to actions towards eco-sustainable foods, with the perception of their availability playing a crucial role. Increasing contextual opportunities may be fundamental for having eco-sustainable consumers.

Validation of the Italian version of the Parkinson's Disease- Cognitive Functional Rating Scale

A key distinguishing factor between mild cognitive impairment (MCI) and dementia in Parkinson's disease (PD) lies in the notable decrease in functioning due to cognitive impairment. The Parkinson's Disease-Cognitive Functional Rating Scale (PD-CRFS) was developed to assess functional limitations caused by cognitive impairment, while reducing the influence of motor impairment. The aim of this multicenter study was to (i) validate the Italian version of the PD-CFRS in PD, (ii) determine optimal cut-off scores for detecting MCI and dementia in PD, (iii) compare its performances with the most established functional assessment tool (IADL). Six hundred and sixty nine PD participants were recruited from 4 Italian Movement Disorders centers (Venice, Milan, Gravedona, and Salerno). They underwent Level-II cognitive evaluation, which resulted in 282 PD-NC, 310 PD-MCI, and 77 PDD. The PD-CFRS's psychometric and clinimetric properties, applicability, and responsiveness were analyzed. The PD-CFRS showed high acceptability. Floor and ceiling effects were acceptable. It also displayed strong internal consistency (Cronbach's α = 0.738), and test-retest reliability (ICC = .854). The PD-CFRS demonstrated higher coefficient of variation to detect dysfunction in PD-MCI patients in comparison to the IADL scale (PD-CFRS 96% vs IADL 22.5%). Convergent validity with the IADL was r = - 0.638 and - 0.527 in males and females, respectively. PD-CFRS total score negatively correlated with global cognition (MoCA corrected score r = - 0.61; p < 0.001). A cut-off score > 6.5 identified PDD with a sensitivity of 90% and specificity of 88% (AUC = .959). A cut-off value of > 1 detected PD-MCI with a sensitivity of 68% and specificity of 69% (AUC = .695). The Italian version of the PD-CFRS demonstrated to be an easy, valid and reliable tool that properly captures functional impairment due to cognitive decline in PD. It also proved to be particularly effective in the advanced stages of PD, and would be a useful support for the diagnosis of PD-MCI and PDD.

Gender differences in the effects of emotion induction on intertemporal decision-making

'Good things come to those who wait' is a popular saying, which goes along with numerous daily life decisions requiring trade-offs between immediate-small and later-larger rewards; however, some individuals have a tendency to prefer sooner rewards while discounting the value of delayed rewards, known as delay discounting. The extant literature indicates that emotions and gender can modulate intertemporal choices, but their interplay remains hitherto poorly investigated. Here, 308 participants were randomized to different conditions, inducing distinct emotions-fear, joy, a neutral state-through standardized movie clips, and then completed a computerized delay discounting task for hypothetical money rewards. Following the induction of fear, women discount the future steeper than men, thus preferring immediate-smaller rewards rather than larger-delayed ones. Also, women were more prone to choose immediate rewards when in a fearful condition than when in a positive state of joy/happiness. By contrast, men were unaffected by their emotional state when deciding on monetary rewards. Our findings provide evidence that fear can trigger different intertemporal choices according to gender, possibly reflecting the adoption of different evolutionary strategies.

Gambling and virtual reality: unraveling the illusion of near-misses effect

Introduction

Studying gambling behavior is a crucial element in reducing the impact of problem gambling. Nevertheless, most current research is carried out in controlled laboratory settings rather than real-life situations, which raises concerns about how applicable the findings are in the broader context. Virtual reality (VR) has proven to be a valuable tool and has been utilized in various experimental scenarios. A limited number of studies have employed VR to investigate gambling behaviors, and few have explored them in an older adolescent context.

Methods

This study examined the behavioral and physiological effects of gambling behavior, including problem gambling, gaming addiction, and risk-taking decision-making in a sample of 36 high-school students aged between 18 to 20 years using an ad-hoc constructed VR scenario designed to simulate a slot-machine platform.

Results

The behavioral results highlighted that participants reporting more problem gambling were sensitive to near-misses: i.e., they bet more after near-misses than after losses. This result may reflect the false belief that gamblers, after near-misses, are closer to winning. Physiological data showed that participants exhibited heart rate deceleration during the anticipation of the outcome, which has been suggested to represent a marker of feedback anticipation processing and hyposensitivity to losses.

Discussion

Overall, this study provides evidence for a new VR tool to assess gambling behaviors and new insights into gambling-related behavioral and physiological factors. Implications for the treatment of problem gambling are discussed.

The effects of virtual reality environmental enrichments on craving to food in healthy volunteers

RATIONALE

Environmental enrichment (EE) is a non-pharmacological approach that has been shown to be effective in reducing food-taking in rats. Studies in human volunteers are still in their infancy, given the difficulty to translate the complexity of EE in clinical practice. Virtual reality (VR) is a promising methodological approach, but no study has yet applied it to model and test EE in humans.

OBJECTIVES

The present study is the first to assess the effects of virtual EE on craving for palatable food.

METHODS

Eighty-one healthy volunteers (43 women) were divided into three groups: (i) exposure to a virtual EE (VR-EE), (ii) exposure to a virtual neutral environment (VR-NoEE), and (iii) without exposure to VR (No VR). Craving for palatable food at basal level and evoked by neutral and palatable food images was assessed before and after the VR simulation. Behavior during VR exposure and subjective measures related to the experience were also collected.

RESULTS

VR-EE group showed a significantly greater decrease in pre-post craving difference compared to No VR for all assessments and at basal level compared to VR-NoEE. Interestingly, an inverse correlation between craving and deambulation in the VR simulation emerged in VR-EE group only.

CONCLUSIONS

The study highlighted the feasibility of exposing human subjects to an EE as a virtual simulation. Virtual EE induced effects on basal craving for food that suggest the potential for further improvements of the protocol to extend its efficacy to palatable food cues.

Chrono-Nutritional Patterns, Medical Comorbidities, and Psychological Status in Patients with Severe Obesity

Chrono-nutrition studies dietary habits and their role in the onset of metabolic diseases. The aim of this study is to describe chrono-nutritional patterns based on the analysis of the eating habits of patients with severe obesity during the 24-h cycle and investigate a possible relationship between these profiles, the comorbidities, and the psychological status. From the overall evaluation of the chrono-nutritional profiles of 173 patients with severe obesity, four predominant eating patterns were obtained with a refined statistical model. A regression analysis was performed to determine the relationship between chrono-nutritional patterns, medical comorbidities, and psychological status. Profile 1 was the most frequent (46.2%) and characterised by the regular presence of the three main meals. The distribution of the chrono-nutritional profiles did not vary with BMI. Chrono-nutritional profiles affected predominantly psychological variables, with lower performances among chrono-nutritional profiles 3 (to eat during all the 24-h, with nibbling and snacking also during the night) and 4 (like the fourth but without night-eating). This finding could be useful in the assessment and treatment of patients with obesity, allowing the identification of patients with a higher probability of suffering from a psychopathological condition simply by knowing the patients' dietary profiles.

The relationship between perseverative thinking, proactive control, and inhibition in psychological distress: a study in a women's cohort

Cognitive control is a core feature of several mental disorders. A recent account poses that health problems may derive from proactive forms of cognitive control that maintain stress representation over time. The working hypothesis of the present study is that psychological distress is caused by the tendency to select a particular maladaptive self-regulation strategy over time, namely perseverative thinking, rather than by transient stimulus-response patterns. To test this hypothesis, we asked 84 women to carry out a battery of standardized questionnaires regarding their tendency to undertake perseverative thinking and their level of psychological distress, followed by cognitive tasks measuring the tendency to use proactive versus reactive control modality and disinhibition. Through a series of mediation analyses, we demonstrate that the tendency to use proactive control correlates with psychological distress and that this relation is mediated by perseverative thinking. Moreover, we show that the relation between low inhibitory control and psychological stress is more strongly mediated by perseverative thinking than impulsiveness, a classical construct that focuses on more transient reactions to stimuli. The present results underline the importance of considering psychological distress as the consequence of a maladaptive way of applying control over time, rather than the result of a general deficit in cognitive control abilities.

Who really hoards? Hoarding symptoms in adults with attention-deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD) and healthy controls

Although hoarding disorder (HD) is included in the DSM-5 in the obsessive-compulsive and related disorders chapter, in the last few years, HD has been consistently associated with attention-deficit hyperactivity disorder (ADHD). Some studies on HD patients show higher comorbidity with ADHD than with OCD and some studies on ADHD patients found significant higher rates of HD symptoms compared to the general population. However, the aim of the present study was to be the first direct comparison of the prevalence of HD and HD symptoms across adults with a primary diagnosis of ADHD, OCD and a sample of matched healthy controls (HCs).

METHODS

57 adult patients with a primary diagnosis of ADHD and 50 adult patients with a primary diagnosis of OCD were enrolled and matched with 50 HCs. The presence of hoarding disorder and symptoms were assessed though the Saving Inventory Revised (SI-R).

RESULTS

ADHD patients showed significantly higher prevalence of HD comorbidity (32.1%) with respect to both OCD patients (8%) and HCs (4%). The prevalence of HD symptoms was also significantly higher in ADHD patients than in both OCD and HCs. Although OCD patients showed a higher prevalence of HD and HD symptoms with respect to HCs, these differences did not reach statistical significance.

CONCLUSION

HD is significantly more comorbid in ADHD patients than in OCD and HCs. A better understanding and definition of the boundaries between HD and the OCD and ADHD spectrum could lead to the development of a more precise treatment approach for hoarding disorder.

Chronotype is associated with affective temperaments, clinical severity and worse treatment outcomes in bipolar disorders: results from a two-center, cross-sectional study

OBJECTIVE

The present study was aimed at investigating the clinical correlates of evening chronotype in a population of subjects suffering from bipolar disorders (BD).

METHODS

We assessed chronotype using the Morningness-Eveningness Questionnaire. We administered the brief Temperament Evaluation of Memphis, Pisa, and San Diego, the Barratt Impulsiveness Scale, and the Alda Scale to evaluate affective temperaments, impulsiveness, and response to mood stabilisers. We performed bivariate analyses and ran a logistic regression model to analyse clinical variables associated with evening chronotype.

RESULTS

In our sample (n = 178), subjects with an evening chronotype (n = 56, 31.5%) more often suffered from BD type I and reported higher prevalence of seasonality, antidepressant-induced mood switches, psychotic, aggressive, mixed, and anxiety features, and substance use disorders. The number of lifetime suicide attempts and mood episodes was higher in this subgroup. Depressive, cyclothymic, irritable, and anxious temperament scores were higher among evening-chronotype subjects, who also displayed greater levels of impulsiveness and worse treatment response. At the logistic regression, evening chronotype was associated with depressive and irritable temperaments.

CONCLUSIONS

Subjects with evening chronotype display higher clinical severity and worse BD course. Clinicians should evaluate the presence of evening chronotype in BD subjects, especially in those with irritable or depressive temperament.Key pointsEvening chronotype is a frequent clinical feature in subjects suffering from bipolar disorders (BD);Affective temperaments, particularly depressive and irritable, are associated with evening chronotype in BD;Evening chronotype underpins higher severity of the clinical picture in BD, as well as a worse response to mood stabiliser treatment;Circadian preferences should be systematically assessed in subjects suffering from BD, with particular attention to evening preference.

Transcranial direct current stimulation (tDCS) over the orbitofrontal cortex reduces delay discounting

Delay discounting (DD) is a quantifiable psychological phenomenon that regulates decision-making. Nevertheless, the neural substrates of DD and its relationship with other cognitive domains are not well understood. The orbitofrontal cortex (OFC) is a potential candidate for supporting the expression of DD, but due to its wide involvement in several psychological functions and neural networks, its central role remains elusive. In this study, healthy subjects underwent transcranial direct current stimulation (tDCS) while performing an intertemporal choice task for the quantification of DD and a working memory task. To selectively engage the OFC, two electrode configurations have been tested, namely, anodal Fp1-cathodal Fp2 and cathodal Fp1-anodal Fp2. Our results show that stimulation of the OFC reduces DD, independently from electrode configuration. In addition, no relationship was found between DD measures and either working memory performance or baseline impulsivity assessed through established tests. Our work will direct future investigations aimed at unveiling the specific neural mechanisms underlying the involvement of the OFC in DD, and at testing the efficacy of OFC tDCS in reducing DD in psychological conditions where this phenomenon has been strongly implicated, such as addiction and eating disorders.

Executive Attentional Dyscontrol as a Core Cognitive and Behavioral Feature of Individuals with Obesity and Cardiovascular Disease: A Cross-Sectional Investigation

Executive attention as a frontal domain ability that is effective in potentially blocking distracting information, reconciling conflicts among simultaneous attentional demands, and regulating impulsive behavior may be impaired in individuals with obesity and cardiovascular disease (CVD). This study aimed (i) to explore the presence of selected cognitive (global cognitive impairment, sensitivity to interference, and attention) and psychological (quality of life, depression, anxiety, and impulsivity) dimensions and (ii) to examine the interactive relationship between attentional dyscontrol-both as a psychological and as a cognitive measure-and the above-mentioned variables in a sample of patients with CVD attending a cardiac rehabilitation program across different body mass index (BMI) levels. Clinical information of 104 patients with CVD was retrospectively collected. Participants were classified into three groups according to their BMI as follows: normal weight (NW = 30), overweight (OW = 19), and obese (OB = 55). Individuals with CVD and a higher BMI showed problems in controlling executive attention-through both neuropsychological and behavioral measures. Specifically, OB patients demonstrated reduced sensitivity to cognitive interference, lower capabilities in divided attention during visual-tracking tasks, and greater impulsivity compared to NW patients. This behavioral characteristic was also found to be correlated with higher levels of anxiety and depression and a lower quality of life. Implications for cognitive rehabilitation were discussed to offer directions for better management of patients with CVD and obesity.

I feel addicted to watching TV series: association between binge-watching and mental health

Background

Binge-watching (BW) is the consecutive viewing of three or more episodes of the same series in one sitting. Although some negative effects on mental health were evidenced, the continuum of BW from leisure activity to problematic behavior is still unclear. This study aimed to analyze mental health (depression, trait anxiety, social anxiety, impulsivity, alexithymia) of people involved in different expressions of BW.

Methods

A cross-sectional survey collected data from 482 respondents. According to a validated BW questionnaire, participants were divided into Problematic BW, Moderate BW, Non-BW, and No-viewer, and differences between groups were tested on psychological dimensions assessed via standardized questionnaires evaluating: trait and social anxiety, depression, impulsivity, and emotional dysregulation.

Results

An association between problematic BW and worse mental health conditions was evidenced, and a positive effect of non-problematic BW was supported. A negative linear trend from the BW as a leisure activity to problematic BW was marked, indicating how a possible maladaptive behavior orientation of BW in specific mental health conditions could be figured out as a behavioral addiction.

Interval timing relative to response inhibition in the differential reinforcement of low-rate responding in normally developing young adults

With recent proposal suggesting the multifaceted nature of impulsivity, researchers have been intrigued by the question of whether the impulsive behaviour measured in the traditionally psychological paradigms is unitary. One such paradigm, the differential reinforcement of low-rate responding (DRL), has been used to assess response inhibition, but its underlying mechanism has still been debated. In present research, we examined and differentiated the effects of both response inhibition and interval timing on a multisession DRL-10 s (DRL-10 s) in a large sample of normally developing young adults, as well as with three other measures including the stop-signal reaction task (SSRT), time production task-10 s (TPT-10 s), and the Barrett impulsivity scale-11 (BIS-11). The results showed that behavioural changes existed in DRL. As the task sessions progressed, there was an increase in both reinforcement probability and peak time, but a decrease in burst responses. Most importantly, both principal component analysis and generalized multilevel modeling yielded consistent results that as the task progressed, there was an increasing involvement of the TPT in the late sessions of DRL. However, none of the effect of SSRT was found. In sum, the differential degrees of involvement of the timing process, relative to response inhibition, were observed in DRL.

Sex difference in driving speed management: The mediation effect of impulse control

Previous studies have shown that male drivers drive faster than female drivers, but there is no agreement on whether impulsivity could induce this sex difference, nor is there a cross-sectional comparison of the effects of different road environments. The purpose of this study was to verify whether impulsivity and impulse control could explain the sex differences in driving speed. A driving simulator study (study 1, N = 41) was performed to investigate whether there were sex differences in driving speeds in two road sections of different complexity, and a questionnaire survey (study 2, N = 163) was conducted to investigate the relationship between sex, impulsivity, impulse control and driving behavior of the participants. The results showed that male drivers drove faster on simple roads, but this difference did not show on complex roads. There were no sex differences in impulsivity traits, but male participants had significant lower levels of impulse control. The results also reveal a partial mediating role of impulse control in the relationship between sex and driving speed. These results suggest that impulse control can predict dangerous driving behaviors and is an important factor in explaining sex differences in driving speed.

Virtual agents and risk-taking behavior in adolescence: the twofold nature of nudging

Peer pressure can influence risk-taking behavior and it is particularly felt during adolescence. With artificial intelligence (AI) increasingly present in a range of everyday human contexts, including virtual environments, it is important to examine whether AI can have an impact on human's decision making processes and behavior. By using the balloon analogue risk task (BART) evaluating propensity to take risk, in this study 113 adolescents' risk-taking behavior was measured when playing alone and in the presence of either a robot avatar or human avatar. In the avatar conditions, participants performed the BART while the avatars either (1) verbally incited risk-taking or (2) discouraged risk-taking (experimental tasks). Risk-taking behavior in the BART was assessed in terms of total number of pumps, gain and explosions. Tendency to impulsivity was also evaluated, as well as the effects of age and gender on risky behavior. The main finding showed a significant effect of both avatars on risk-taking tendency, with riskier behavior during incitement than discouragement conditions, the latter being also substantially different from the playing-alone condition. The results of this study open up new questions in a very sensitive and timely topic and offer various insights into the effect of nudging on adolescents' behavior in virtual contexts.

The Metacognitions about Binge Eating Questionnaire: Investigation of the association between specific metacognitions and Binge Eating Disorder

Literature suggested that metacognitions are involved in eating problems and may be relevant to the understanding of Binge Eating Disorder (BED). The goal of the current studies was to develop the first self-report instrument on metacognitions about binge eating. In Study 1, a community sample completed the Metacognitions about Binge Eating Questionnaire (MBEQ); an Exploratory Factor Analysis (EFA) was performed. In study 2, a community sample completed the MBEQ and measures assessing severity of binge eating, irrational food beliefs, anxiety, depression, impulsiveness. A Confirmatory Factor Analysis (CFA) was performed. Concurrent and incremental validity were assessed. In study 3, a clinical sample of participants with a diagnosis of BED completed the MBEQ and other measures. Bivariate correlational analysis and hierarchical linear regression were performed. Participants from the general population and participants with a diagnosis of BED were compared. EFA and CFA supported a two-factor solution consisting of positive and negative metacognitions about binge eating. Concurrent and incremental validity were acceptable. The metacognitions factors correlated positively with anxiety, depression, irrational food beliefs, impulsiveness in the community sample, and anxiety, irrational food beliefs, impulsiveness in clinical sample. The metacognitions factors contributed to the prediction of BEDs symptoms, in community and clinical samples, over and above age, gender, impulsiveness, anxiety, depression, irrational food beliefs. The MBEQ possesses good psychometric properties and appears a reliable and valid measure of positive and negative metacognitions about binge eating. Metacognitions about binge eating could be a therapeutic target to reduce the severity of binge eating episodes.

Impairment of arbitration between model-based and model-free reinforcement learning in obsessive-compulsive disorder

Introduction

Obsessive-compulsive disorder (OCD) is characterized by an imbalance between goal-directed and habitual learning systems in behavioral control, but it is unclear whether these impairments are due to a single system abnormality of the goal-directed system or due to an impairment in a separate arbitration mechanism that selects which system controls behavior at each point in time.

Methods

A total of 30 OCD patients and 120 healthy controls performed a 2-choice, 3-stage Markov decision-making paradigm. Reinforcement learning models were used to estimate goal-directed learning (as model-based reinforcement learning) and habitual learning (as model-free reinforcement learning). In general, 29 high Obsessive-Compulsive Inventory-Revised (OCI-R) score controls, 31 low OCI-R score controls, and all 30 OCD patients were selected for the analysis.

Results

Obsessive-compulsive disorder (OCD) patients showed less appropriate strategy choices than controls regardless of whether the OCI-R scores in the control subjects were high (p = 0.012) or low (p < 0.001), specifically showing a greater model-free strategy use in task conditions where the model-based strategy was optimal. Furthermore, OCD patients (p = 0.001) and control subjects with high OCI-R scores (H-OCI-R; p = 0.009) both showed greater system switching rather than consistent strategy use in task conditions where model-free use was optimal.

Conclusion

These findings indicated an impaired arbitration mechanism for flexible adaptation to environmental demands in both OCD patients and healthy individuals reporting high OCI-R scores.

The Role of Alexithymia and Impulsivity in Male Victims and Perpetrators of Intimate Partner Violence

(1) Background: Alexithymia and impulsivity appear to represent risk factors for violence perpetration, while mixed results are present with respect to victimization experience. In light of this, the purpose of this study was to compare the roles of both alexithymia and impulsivity among three different samples of men: men who experienced partner victimization (IPVV); male intimate partner violence perpetrators (IPVP); and men from the general population (CG). (2) Methods: Participants were recruited from specialized centers in Italy. A profile analysis was conducted. (3) Results: The results showed that IPVV presented alexithymia and impulsivity comparable to the CG. Furthermore, differences were found between victims and perpetrators in terms of impulsivity and alexithymia. The IPVP group had higher levels of both impulsivity and alexithymia in comparison to IPVV. Moreover, the perpetrators exhibited significantly higher levels of alexithymia compared to the CG. However, despite the medium Cohen's d (d = 0.441) resulting from the analyses, IPVP's level of impulsivity was not statistically different from the CG. (4) Conclusion: Alexithymia and impulsivity appear to play a key role in violent behaviors and should be the focus of psychological interventions with perpetrators.

Impaired Metacognitive Differentiation, High Difficulty in Controlling Impulses and Non-acceptance of Emotions are Associated With the Severity of Gambling Disorder

The role of metacognition in gambling disorder (GD) is underexplored. To date, only two studies have investigated the role of metacognitive functioning, but among the adolescent population. The first aim of the current research was to assess and compare adult male gamblers with healthy controls (HCs) in relation to metacognition, impulsivity and emotional dysregulation. The second aim was to identify the variables among metacognition, impulsivity and emotional dysregulation associated with the severity of GD by means of linear regression.A total of 116 adult males (58 with GD and 58 HCs) completed self-report questionnaires on gambling severity, metacognition, emotional dysregulation and impulsivity. A linear regression analysis was run to assess the variables associated with gambling severity.Patients with GD exhibited more impaired scores than HCs in all the psychopathological dimensions investigated. More interestingly, gambling severity was significantly associated with metacognitive differentiation/decentration, difficulty in controlling impulses and non-acceptance of negative emotions.According to our results, the severity of gambling is associated with impaired metacognitive differentiation, high difficulty in controlling impulses and non-acceptance of negative emotions, and these findings can lead to new treatment implications. Interventions focused on metacognition and emotion regulation could help patients with GD to avoid maladaptive strategies such as behavioural addictions and, more specifically, to manage their own emotions. This type of treatment could help gamblers to become more aware of their internal state and learn strategies for adaptively managing emotions through functional metacognitive differentiation.

Investigating Functioning Profile of Adolescents with Anorexia before and during the COVID-19 Pandemic: A Cross-Sectional Study on Mentalizing, Alexithymia, and Impulsiveness

Anorexia nervosa (AN) usually emerges in adolescence when important changes occur in cognitive, emotional, and social processes. Mentalizing, alexithymia, and impulsiveness represent key dimensions for the understanding and interpretation of psychological difficulties in AN. The outbreak of the COVID-19 pandemic has impacted adolescents with AN, showing a worsening of the disease. The main aims of the present paper are (1) to compare adolescents with AN before and during the COVID-19 pandemic and (2) to explore the relationship between mentalizing, alexithymia, impulsiveness, and psychological difficulties related to eating disorders in adolescents with AN during the COVID-19 pandemic. One hundred and ninety-six AN female adolescents (N = 94 before COVID-19; N = 102 during COVID-19) participated in this study. The results show that adolescents with AN during the COVID-19 pandemic had a more impaired functioning profile than the before COVID-19 group. Mentalizing, alexithymia, and impulsiveness had a predictive role on psychological difficulties related to eating disorders in adolescents with AN during the COVID-19 pandemic. In conclusion, our data reveal that the COVID-19 pandemic has likely represented a stress condition that affects mental health; worsening the severity of adolescents with AN clinical condition. Lastly, predictive patterns suggest the existence of a link between difficulties in the ability to face the problems of the present time using effective strategies and the severity of psychological symptoms.

Impulsivity and alexithymia predict early versus subsequent relapse in patients with alcohol use disorder: A 1-year longitudinal study

INTRODUCTION

Longitudinal psychopathological predictors of relapse in alcohol use disorder are unclear.

METHODS

Relapses, sociodemographic and psychopathological risk factors were assessed in 171 alcohol use disorder outpatients within a 1-year follow up. Impulsivity and alexithymia were evaluated using the Barratt Impulsiveness Scale and the Toronto Alexithymia Scale, respectively.

RESULTS

At endpoint, 39% of patients maintained abstinence, 30.9% relapsed at ≤1 month from detoxification (early), 30.1% at >1 month (subsequent). Baseline Barratt Impulsiveness Scale score was predictive of early versus subsequent relapse (odds ratio 1.12, p = 0.005) and versus abstinence (odds ratio 1.17, p < 0.001). Toronto Alexithymia Scale score was a risk factor for subsequent versus early relapse (odds ratio 1.13, p = 0.003) and versus abstinence (odds ratio 1.21, p < 0.001).

DISCUSSION AND CONCLUSIONS

Impulsivity predicted relapse within the first 4-weeks; alexithymia showed delayed effects. Time-varying effects of specific relapse factors emphasise the need for preliminary careful assessment and personalised interventions to promote long-term abstinence.

Protective Role of Self-Regulatory Efficacy: A Moderated Mediation Model on the Influence of Impulsivity on Cyberbullying through Moral Disengagement

During online interactions, adolescents are often exposed to deviant opportunities. In this context, the capacity to regulate one's behavior is essential to prevent cyberbullying. Among adolescents, this online aggressive behavior is a growing phenomenon, and its deleterious effects on teenagers' mental health are well known. The present work argues the importance of self-regulatory capabilities under deviant peer pressure in preventing cyberbullying. In particular, focusing on two relevant risk factors, i.e., impulsivity and moral disengagement, we examine (1) the mediation role of moral disengagement in the process leading to cyberbullying from impulsivity; (2) the buffering effect of the perceived self-regulatory capability to resist deviant peer pressure in mitigating the effect of these impulsive and social-cognitive dimensions on cyberbullying. Moderated mediation analysis was performed on a sample of 856 adolescents; the results confirm that the perceived self-regulatory capability to resist peer pressure effectively mitigates the indirect effect of impulsivity through moral disengagement on cyberbullying. The practical implications of designing interventions to make adolescents more aware and self-regulated in their online social lives to counter cyberbullying are discussed.

Executive functioning and divergent thinking predict creative problem-solving in young adults and elderlies

The role of executive functioning in creative thinking is under debate. Some authors suggested that increased inhibitory control, a component of executive functioning, is detrimental to creative solutions, whereas others argued that executive functions are central to creative problem-solving, thus questioning Guilford's classical distinction between divergent and convergent thinking. Executive functions decline with age. In this study, we investigated the contributions of executive functioning and its age-related decline and divergent thinking to creative problem-solving. To this aim, we divided our sample of sixty healthy adults into two age groups of young adults (20-26 years) and elderly (60-70 years) and we assessed their creative problem-solving abilities (using the compound remote associate problems) as well as other potential cognitive predictors of creative problem-solving (i.e., impulsivity, divergent thinking, verbal working memory, and decision-making style). A linear regression model revealed that the ability to solve problems creatively is negatively predicted by older age and impulsivity, while positively predicted by divergent thinking and verbal working memory. These findings reveal a combined contribution of executive functions and divergent thinking to creative problem-solving, suggesting that both convergent and divergent processes should be considered in interventions to contrast age-related decline.

Brain functional connectivity differences between responders and non-responders to sleeve gastrectomy

PURPOSE

To compare resting-state functional connectivity (RSFC) of obese patients responders or non-responders to sleeve gastrectomy (SG) with a group of obese patients with no past medical history of metabolic or bariatric surgery.

METHODS

MR images were acquired at 1.5 Tesla. Resting-state fMRI data were analyzed with statistical significance threshold set at p < 0.05, family-wise error (FWE) corrected.

RESULTS

Sixty-two subjects were enrolled: 20 controls (age range 25-64; 14 females), 24 responders (excess weight loss > 50%; age range 23-68; 17 females), and 18 non-responders to sleeve gastrectomy (SG) (excess weight loss < 50%; age range 23-67; 13 females). About within-network RSFC, responders showed significantly lower RSFC with respect to both controls and non-responders in the default mode and frontoparietal networks, positively correlating with psychological scores. Non-responders showed significantly higher (p < 0.05, family-wise error (few) corrected) RSFC in regions of the lateral visual network as compared to controls. Regarding between-network RSFC, responders showed significantly higher anti-correlation between executive control and salience networks (p < 0.05, FWE corrected) with respect to both controls and non-responders. Significant positive correlation (Spearman rho = 0.48, p = 0.0012) was found between % of excess weight loss and executive control-salience network RSFC.

CONCLUSION

There are differences in brain functional connectivity in either responders or non-responders patients to SG. The present results offer new insights into the neural correlates of outcome in patients who undergo SG and expand knowledge about neural mechanisms which may be related to surgical response.

What influences psychological functioning in patients with mood disorders? The role of clinical, sociodemographic, and temperamental characteristics in a naturalistic study

BACKGROUND

The present study aims to assess clinical and psychological correlates of psychological functioning in patients with mood disorders, in a naturalistic setting. In particular, we aimed to describe which sociodemographic, clinical, and temperamental dispositions are more frequently associated with poor psychological functioning, and to describe the association between cognitive and psychological functioning in euthymic patients with major depression and bipolar disorder.

METHODS

Inclusion criteria were as follows: (1) diagnosis of major depression, or bipolar disorder type I or II; (2) age between 18 and 65 years; and (3) being in a stable phase of the disorder. Patients' psychiatric symptoms, quality of life, affective temperaments, and impulsivity were investigated with validated assessment instruments.

RESULTS

166 patients have been recruited, mainly female (55.4%), whose mean age was 47.1 ± 14.2 years. 42.6% of individuals reported a diagnosis of major depression. According to regression analyses, poor cognitive performance (p < 0.05), reduced perceived quality of life (p < .0001), lifetime suicide attempts (p < 0.01), and increased trait-related impulsivity (p <0 .001) strongly correlated with poor psychological functioning. Moreover, cyclothymic and irritable dispositions were also associated with poor social functioning (p < 0.01), whereas hyperthymic affective disposition was associated to a better psychological performance (p < 0.01).

CONCLUSIONS

Our results support the evidence that patients with mood disorders should be assessed for psychological functioning and affective dispositions, to identify patients at higher risk to develop worse long-term outcomes and to develop targeted interventions.

The Role of Emotional Dysregulation, Impulsivity Traits and Aggressive Behaviors in Adolescents Who Sustain Multiple Motor-Vehicle Crashes

Adolescents tend to experience multiple motor-vehicle crashes (MVCs). Recent literature has thoroughly explored the psychological consequences following an MVC, but prior psychological functioning, the ability to regulate one's emotions and tendencies to impulsivity and aggressive behaviors have been far less explored. This study aims to explore the emotional-behavioral functioning, measured with the Youth Self-Report (YSR); emotional dysregulation, measured with the Difficulties in Emotional Regulation Scale (DERS); impulsivity traits, measured with the Barratt Impulsiveness Scale (BIS-11); and the capacity to be mindful, measured with the Mindful Attention Awareness Scale (MAAS), in adolescents that have experienced one or more MVCs in a year. N = 295 adolescents who visited an emergency department for MVCs were divided in two groups based on the number of MVCs they had sustained over the course of a year. The adolescents in Group 1 sustained more than three MVCs, and adolescents in Group 2 sustained only one. Participants were assessed through self-report questionnaires. Adolescents showed difficulties in emotional regulation, impulsivity traits, aggressive behaviors and a low capacity to be mindful. These results may be useful in the creation of intervention and prevention programs focused on emotional awareness targets for adolescents.

The modulation of sustainability knowledge and impulsivity traits on the consumption of foods of animal and plant origin in Italy and Turkey

Given the environmental challenge we face globally, a transition to sustainable diets seems essential. However, the cognitive aspects underlying sustainable food consumption have received little attention to date. The aims of this cross-cultural study were: (1) to explore how impulsivity traits and individuals' knowledge of food environmental impact influence their frequency of consumption of animal- and plant-based foods; (2) to understand the modulation of individual characteristics (i.e. generation, sex, BMI, and sustainability knowledge). An online survey investigating impulsivity traits, sustainability knowledge and ratings of diverse food items was designed and administered to respondents from Italy (N = 992) and Turkey (N = 896). Results showed that Turkish respondents were higher in impulsivity and animal products consumption. Italians, instead, had greater sustainability knowledge and consumed more plant-based foods. Females in both groups reported greater knowledge of sustainability, consistent with previous findings. In terms of generations, the lowest consumption of animal products was reported by Turkish Generation Z and Italian Millennials. In conclusion, this study shed light on the interaction of psychological factors and individual characteristics with the perceived environmental impact of foods. Moreover, the adopted cross-cultural approach allowed to identify several differences in participants' responses ascribable to their different nationalities and gastronomic cultures.

Trait-Related Impulsivity, Affective Temperaments and Mood Disorders: Results from a Real-World Multicentric Study

Trait-related impulsiveness is highly prevalent in patients with mood disorders, being associated with negative outcomes. The predictive role of affective temperaments on trait-related impulsivity is still understudied. The aim of the present study is to investigate the relationship between impulsivity and affective temperaments in a sample of euthymic patients with mood disorders. This is a real-world multicentric observational study, carried out at the outpatient units of seven university sites in Italy. All patients filled in the short version of Munster Temperament Evaluation of the Memphis, Pisa, Paris and San Diego and the Barratt Impulsiveness Scale. The study sample included 653 participants, mainly female (58.2%), with a mean age of 46.9 (±14.1). Regression analyses showed that higher levels of trait-related impulsivity were associated to suicide attempts (p < 0.000), the presence of psychotic symptoms during acute phases (p < 0.05), a seasonal pattern (p < 0.05), a lower age at onset of the disorder (p < 0.05), cyclothymic (p < 0.01) and irritable temperaments (p < 0.01). The results of our study highlight the importance to screen patients with mood disorders for impulsivity and affective temperaments in order to identify patients who are more likely to present a worse outcome and to develop personalized and integrated early pharmacological and psychosocial treatment plans. Novelties of the present paper include the recruitment of patients in a stable phase, which reduced possible bias in patients’ self-reports, and the multicentric nature of the study, resulting in the recruitment of a large sample of patients with mood disorders, geographically distributed across Italy, thus improving the generalizability of study results.

Childhood emotional abuse and motor impulsiveness among male violent inmates with antisocial personality disorder

This study aimed to explore the relationship among childhood maltreatment, impulsiveness and antisocial personality through a questionnaire survey of violent male inmates. We found that the scores of inmates with Antisocial Personality Disorder (ASPD) in Childhood Trauma Questionnaire-28 item Short Form (CTQ-SF) and Barratt Impulsive Scale-11 (BIS-11) were higher than those in the Non-Antisocial personality group, and there was a significant correlation between the scores of CTQ-SF and BIS-11. We found that the interaction between impulsivity and childhood abuse predicts ASPD levels. Moreover, motor and non-planning impulsiveness played important roles in the observed differences in antisocial personality scores among the inmates who had experienced childhood maltreatment; motor impulsiveness was mainly related to emotional abuse, physical abuse, and sexual abuse, while non-planning impulsiveness was mainly related to emotional neglect and physical neglect. These findings suggest that identifying and providing timely intervention for inmates with high impulsiveness who experienced maltreatment in childhood may also contribute to the prevention of violent behavior and to better prison management.

A Pre-Adolescent and Adolescent Clinical Sample Study about Suicidal Ideation, Suicide Attempt, and Self-Harming

Suicide is the second cause of death among adolescents, and nonsuicidal self-injury (NSSI) is one of the main risk factors for suicidal behavior. However, the possible variables specifically associated with suicidal ideation and suicide attempt, as well as the psychopathological characteristics linked to the concomitant presence of suicidal ideation/attempt and NSSI are still under-investigated in youth. The current study aimed to address these issues in a sample of 174 young Italian inpatients (M_age = 14.3 years ± 1.93, 78.2% girls). Sociodemographic and clinical variables were assessed through psycho-diagnostic interviews and ad hoc questionnaires. A binomial logistic regression was performed to identify the predictors of suicidal ideation and suicide attempt. Then, Kruskal-Wallis tests were run to analyze the psychopathological differences between patients with suicidal ideation and suicide attempt considering the coexistence of NSSI. The results highlighted that previous access to child mental health services and general psychopathological problems significantly predicted suicidal ideation, while previous hospitalizations, borderline personality functioning, and affective disorders significantly predicted suicide attempt. In general, inpatients with also NSSI reported higher levels of internalizing, somatic and total problems, impulsiveness, alexithymia, and emotional dysregulation. The clinical implications of our findings in terms of primary and secondary preventive programs are discussed.

Decoding Emotion in Drug Abusers: Evidence for Face and Body Emotion Recognition and for Disgust Emotion

Background: Different drugs damage the frontal cortices, particularly the prefrontal areas involved in both emotional and cognitive functions, with a consequence of decoding emotion deficits for people with substance abuse. The present study aimed to explore the cognitive impairments in drug abusers through facial, body and disgust emotion recognition, expanding the investigation of emotions processing, measuring accuracy and response velocity. Methods: We enrolled 13 addicted to cocaine and 12 alcohol patients attending treatment services in Italy, comparing them with 33 matched controls. Facial emotion and body posture recognition tasks, a disgust rating task and the Barrat Impulsivity Scale were included in the experimental assessment. Results: We found that emotional processes are differently influenced by cocaine and alcohol, suggesting that these substances impact diverse cerebral systems. Conclusions: Drug abusers seem to be less accurate on elaboration of facial, body and disgust emotions. Considering that the participants were not cognitively impaired, our data support the hypothesis that emotional impairments emerge independently from the damage of cognitive functions.

Behavioral Addictions Questionnaire (BAQ): Validation of a New Tool for the Screening of Multiple Addictive Behaviors in the Italian Population

This study deals with the uncertainty in defining behavioral addictions (BAs). BAs are characterized by specific compulsive behaviors, regardless of potential negative consequences. However, to differentiate a behavior from a leisure activity to an addictive one is still an object of debate in the literature. Accordingly, this study aimed to assess the psychometric properties of the Behavioral Addictions Questionnaire (BAQ) as a possible screening tool for multiple BAs (i.e., shopping, food addiction, gambling, sex, work, exercise, Internet, videogames, and smartphone). BAQ aims to give a dimensional and quantitative assessment of addictive behaviors in a continuum, including both the adaptive and maladaptive features of the behaviors. Five hundred and seventy-six healthy adults (age range: 18–88) participated in the study, completing a survey including the BAQ questionnaire. Considering both exploratory and confirmatory factor analyses, statistical examination suggested good psychometric properties, with adequate validity in all its subscales (i.e., the goodness of fit). Moreover, also higher reliability was confirmed for each dimension detected (i.e., all alpha over 0.65). The BAQ represents a comprehensive screening instrument that benefits from appropriate validity and reliability for assessing BAs. Therefore, it can be used in clinical fields and research. Moreover, the feature of BAs on a continuum, and the severity index adopted by the study, can help from a preventive perspective. However, further validation of the BAQ is needed in other countries and contexts.

Which mixed depression model? A comparison between DSM-5-defined mixed features and Koukopoulos' criteria

BACKGROUND

The criteria of the Diagnostic and Statistical Manual of Mental Disorders 5th edition "with mixed features specifier" (DSM-5 MFS) are considered controversial since they include only typical manic symptoms. By contrast, Koukopoulos developed an alternative model of mixed depression (MxD) focusing primarily on the excitatory component.

OBJECTIVE

To compare DSM-5 MFS and Koukopoulos' MxD (KMxD) in terms of prevalence, associated clinical variables, and discriminative capacity for bipolar depression in patients with major depressive episode (MDE).

METHODS

A total of 300 patients with MDE-155 with major depressive disorder and 145 with bipolar disorder (BD)-were recruited. The discriminative capacity of DSM-5 MFS and KMxD criteria for BD was estimated using the area under the curves of receiver operating characteristic (ROC_AUC). The clinical variables associated with these two diagnostic constructs were assessed by performing a logistic regression.

RESULTS

A total of 44 and 165 patients met the DSM-5 MFS and KMxD criteria, respectively. The ROC_AUCs and their confidence intervals for BD according to DSM-5 MFS and KMxD were 77.0% (72.0%-82.1%) and 71.9% (66.2%-77.7%), respectively. The optimal thresholds (combining sensitivity and specificity measures) for BD diagnosis were ≥1 (77%/68%) for DSM-5 MFS and ≥3 symptoms (78%/66%) for KMxD. However, considering the DSM-5 MFS cut-off (≥3 symptoms), the specificity (97%) increased at the expense of sensitivity (26%).

CONCLUSIONS

KMxD and DSM-5-MFS showed an overlapping discriminative capacity for bipolar depression. The current diagnostic threshold of DSM-5 MFS did not prove to be very inclusive, if compared with the greater diagnostic sensitivity of KMxD, which also yielded better association with clinical variables related to mixedness.

The role of associative learning in healthy and sustainable food evaluations: An event-related potential study

Individuals in industrialized societies frequently include processed foods in their diet. However, overconsumption of heavily processed foods leads to imbalanced calorie intakes as well as negative health consequences and environmental impacts. In the present study, normal-weight healthy individuals were recruited in order to test whether associative learning (Evaluative Conditioning, EC) could strengthen the association between food-types (minimally processed and heavily processed foods) and concepts (e.g., healthiness), and whether these changes would be reflected at the implicit associations, at the explicit ratings and in behavioral choices. A Semantic Congruency task (SC) during electroencephalography recordings was used to examine the neural signature of newly acquired associations between foods and concepts. The accuracy after EC towards minimally processed food (MP-food) in the SC task significantly increased, indicating strengthened associations between MP-food and the concept of healthiness through EC. At the neural level, a more negative amplitude of the N400 waveform, which reflects semantic incongruency, was shown in response to MP-foods paired with the concept of unhealthiness in proximity of the dorsal lateral prefrontal cortex (DLPFC). This implied the possible role of the left DLPFC in changing food representations by integrating stimuli's features with existing food-relevant information. Finally, the N400 effect was modulated by individuals' attentional impulsivity as well as restrained eating behavior.

Apathy and impulsiveness in Parkinson disease: Two faces of the same coin?

Apathy and impulsiveness are 2 common non-motor symptoms in Parkinson disease that could occur in different periods or simultaneously. Apathy and impulsiveness could be interpreted as opposite extremes of a spectrum of motivated behavior dependent on dopaminergic dysfunction, in which, impulsivity, is a result of a hyperdopaminergic state, whereas apathy is viewed as a hypodopaminergic. The study aimed to investigate the presence of impulsiveness and other neuropsychiatric symptoms in Parkinson disease patients with apathy symptoms. Eighty-one patients with Parkinson disease were enrolled in this retrospective study. All subjects were evaluated by the Italian version of the Dimensional Apathy Scale and the Barratt Impulsiveness Scale-version 11, to assess, respectively, apathy and impulsiveness; they were divided into 2 groups (apathy and no apathy). All patients were administered also with questionnaires assessing depressive and anxious symptoms. Statistical analyses showed relevant results. In no-apathy group, education was a significant predictor on impulsiveness (attentional and motor) and apathy (executive and emotional); depression was a significant predictor on planning impulsivity and apathy. This study aimed to consider the importance of apathy and impulsivity in Parkinson disease. Although these are considered as opposite extremes of a spectrum of motivated behavior dependent on dopaminergic dysfunction, these can also occur separately. Moreover, several variables could represent important predictors of apathy and impulsiveness, such as depression. Future investigations should deepen the role of other demographics and psychological variables.

Obesity and Psychological Factors Associated with Weight Loss after Bariatric Surgery: A Longitudinal Study

Bariatric surgery is indicated for treatment of severely obese people and can lead to significant weight loss as well as reduction of comorbidities associated with obesity. The present study aims to investigate the relationship between different psychological factors (e.g., tendency to binge eating, impulsivity, alexithymia), adherence to the nutritional plan, and weight loss after bariatric surgery. Forty-five candidates for bariatric surgery accessing a center for the care of obesity were assessed at T0 (pre-surgery) and T1 (6 months post-surgery) through anthropometric and psychometric measures. Simple linear correlations and linear regressions were conducted to evaluate the relationship between the psychological variables, adherence to nutritional plan, and weight loss 6 months after bariatric surgery. Non-planning impulsivity was the principal factor that succeeded in explaining adherence to the diet plan among all the variables considered. Adherence to the nutritional plan and non-planning impulsivity were considered reliable short-term predictors of weight loss after bariatric surgery. This evidence explains the usefulness of promoting research on psychological predictors of outcome in bariatric surgery. Mid- and long-term weight maintenance and quality of life need to be investigated through further follow-up.

Assessment of online compulsive buying: Psychometric properties of the Italian compulsive online shopping scale (COSS)

The rapid diffusion of the Internet has made doing things online in addition to in person possible. This has also lead to the emergence of new potential behavioural addictions related to the digital world, such as online shopping addiction. Given the peculiar features of cyberspace, the development of specific instruments for asseessing online shopping addiction appears to be of great importance to promote a better understanding of the phenomenon and effective clinical interventions. On this basis, this research aims to translate and validate the Compulsive Online Shopping Scale (COSS) for the Italian context. A sample of 397 Italian participants (M_age = 32.54 years, SD = 11.16) completed an online survey consisting of the Italian COSS, Edwards Compulsive Buying Scale, Internet Addiction Test, Yale‑Brown Obsessive Compulsive Scale‑ Second Edition, and Barratt Impulsiveness Scale-11. The Confirmatory Factor Analysis (CFA) showed the adequacy of the model fit to the data for a correlational solution with the same 7 factors of the original version: Salience¸ Mood modification¸ Conflict¸ Tolerance¸ Relapse¸ Withdrawal¸ and Problems. Furthermore, good indications of internal consistency, convergent and discriminant validity emerged from the results. Therefore, the Italian COSS seems to be a valid and reliable self-report scale that can be used to assess the risk of compulsive online shopping among Italian-speaking individuals and may be useful for both research and clinical practice.

Exploration of mood spectrum symptoms during a major depressive episode: The impact of contrapolarity-Results from a transdiagnostic cluster analysis on an Italian sample of unipolar and bipolar patients

Background

Subthreshold hypomania during a major depressive episode challenges the bipolar-unipolar dichotomy. In our study we employed a cross-diagnostic cluster analysis - to identify distinct subgroups within a cohort of depressed patients.

Methods

A k-means cluster analysis— based on the domain scores of the Mood Spectrum Self-Report (MOODS-SR) questionnaire—was performed on a data set of 300 adults with either bipolar or unipolar depression. After identifying groups, between-clusters comparisons were conducted on MOODS-SR domains and factors and on a set of sociodemographic, clinical and psychometric variables.

Results

Three clusters were identified: one with intermediate depressive and poor manic symptomatology (Mild), one with severe depressive and poor manic symptomatology (Moderate), and a third one with severe depressive and intermediate manic symptomatology (Mixed). Across the clusters, bipolar patients were significantly less represented in the Mild one, while the DSM-5 “Mixed features” specifier did not differentiate the groups. When compared to the other patients, those of Mixed cluster exhibited a stronger association with most of the illness-severity, quality of life, and outcomes measures considered. After performing pairwise comparisons significant differences between “Mixed” and “Moderate” clusters were restricted to: current and disease-onset age, psychotic ideation, suicidal attempts, hospitalization numbers, impulsivity levels and comorbidity for Cluster B personality disorder.

Conclusions

In the present study, a clustering approach based on a spectrum exploration of mood symptomatology led to the identification of three transdiagnostic groups of patients. Consistent with our hypothesis, the magnitude of subthreshold (hypo)manic symptoms was related to a greater clinical severity, regardless of the main categorical diagnosis.

Levels and Relationships of Impulsivity and Aggressive Driving in Shaqra, Saudi Arabia

Background: Aggressive driving is prevalent and may be associated with impulsivity. The relationships between these variables among Saudi drivers have received scant attention. In this study, we aimed to examine the level of aggressive driving and its relationships with impulsivity among Saudi drivers in Shaqra. Methods: Overall, 504 Saudi drivers were recruited and assessed in this cross-sectional study using demographic and driving proforma, a self-reporting Barratt impulsiveness scale (BIS), and an Aggressive Driving Behavior Scale (ADBS). Results: BIS and ADBS had mean scores of 37.97 (3.24) and 21.74 (8.51), respectively. In linear regression analysis, the value of the BIS non-planning subscale negatively predicted the value of the ADBS Conflict subscale (beta = -.151, p = .002) and Speeding subscale (beta = -.103, p = .031). In contrast, the value on the score of the BIS Motor subscale statistically significantly and positively predicted the value on the score of the ADBS Speeding subscale (Beta = -.103, p = .032). Conclusion: The result shows a differential link between the component of impulsivity and aggressive driving. The lack of foresight is negatively linked with conflict behavior and high- speed driving, whereas acting without thinking is positively associated with high-speed driving.

Learned self-regulation in top-level managers through neurobiofeedback training improves decision making under stress

Top-level management teams are particularly exposed to stress factors as they frequently have to make important decision under stress. While an existing body of research evidence suggests that stress negatively affects decision-making processes, very little is known about possible strategies to reduce these negative effects. The aim of the current work is to investigate the effect of training self-regulation ability through neurobiofeedback on managers' intertemporal and risky decision making. Twenty-three managers were assigned to the experimental or the control condition. All participants performed, two decisional tasks, before and after a training phase. The tasks were administered through mouse tracker software, in order to measure participants' delay discounting and risk taking propensity on both explicit and implicit choice parameters. During the training phase, the experimental condition received a training protocol based on stress assessment tests via neurobiofeedback signals (i.e., temperature and skin conductance), with the goal of improving self-regulation ability while the control condition was administered a control training. The main result of this study is to have conclusively demonstrated that NBF training increases an individual's ability to self-regulate stress-related psychophysiological phenomena. Consequently, the improved ability to manage one's own reaction to stress enables a reduction in instinctive behavior during a probabilistic choice task.

Validation of a short Italian version of the Barratt Impulsiveness Scale (BIS-15) in non-clinical subjects: psychometric properties and normative data

Introduction

The Barratt Impulsiveness Scale (BIS) is a questionnaire employed to measure impulsivity, which is associated with risky behaviors and mental disorders. We aimed to assess the psychometric properties of the BIS in the Italian general population and provide normative data for clinical use.

Materials and methods

A cross-sectional survey methodology was employed to collect data. Then, 534 participants of different ages and educational levels completed the BIS, PHQ-9, GAD-7, and S-UPPS-P. We designed an ad hoc data-driven outcome checklist to identify which items deserved to be retained. Furthermore, internal consistency, convergent and divergent validity, and factorial structure were evaluated. A regression-based procedure was used to explore the influence of demographic variables on the BIS score and to provide adjusting factors and a sensitive cutoff.

Results

Item analysis suggested removing 15 items. Consequently, we tested the psychometric properties of a shorter version of the BIS (BIS-15). IRT test information functions indicated an almost identical measurement precision of the BIS-15 as compared to the original BIS. The BIS-15 demonstrated reliable internal consistency and good convergent and divergent validity. The PCA revealed a four-factor solution: “pure impulsivity,” “planning and thinking,” “lack of attention and concentration,” and “impulsive buying.” A significant effect of sex and years of education was found. Norms for the adjustment of raw scores were provided (cutoff = 37.39).

Conclusions

The BIS-15 showed almost identical psychometric properties as compared with the original scale, reducing the administration time. Our norms may allow identifying individuals with impulsivity of clinical interest.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10072-022-06047-2.

Test of Reliability and Validity of Impulsiveness Scale Among Married Chinese

Introduction

Aim

Methods

Results

Conclusion

Alter Game: A Study Protocol on a Virtual "Serious Game" for Relapse Prevention in Patients With Gambling Disorder

Cognitive behavioral therapy (CBT) is the most successful protocol in gambling disorder (GD) treatment. However, it presents some weaknesses, especially concerning relapse prevention (RP). RP is one of the most important therapeutic steps, aiming at managing cravings and to avoid future relapse increasing perceived self-efficacy. Encouraging results come from the blending of psychotherapy and virtual reality (VR), containing gambling cues. The goal of Alter Game (approved by the Ethical Commission, Prot. No. 69346) is verifying the efficacy of an innovative psychological treatment for GD based on the integration of traditional CBT therapy and an immersive VR cue exposure therapy using a serious virtual game, which is a game designed for purposes other than entertainment. RP in virtual cue-exposure therapy allows pathological gamblers to manage the urge to gamble and to avoid relapse by becoming aware of which internal and external triggers are related to craving. We hypothesize that the integrated intervention will be more effective than simple CBT with regard to self-efficacy, craving, and gambling-related distortions. Four virtual ecological environments were developed, and a virtual app, Exludo, interfaced with a computerized multiparametric acquisition system for biofeedback, was created. A sample of about 60 patients aged between 18 and 65 with GD referring to the Addiction Medicine Unit of Verona (Rossi Hospital) will be recruited. Patients will be randomly assigned to the CBT group (16 CBT sessions) or the CBT + VR group (8 CBT sessions + 8 VR cue-exposure therapy sessions). The MCMI-III, the BIS-11, and the SOGS will be used to evaluate inclusion and exclusion criteria, while the Gambling Related Cognitions Scale and the Multidimensional Gambling Self-Efficacy Scale will be used to verify changes as a function of the treatment. Craving will be evaluated through VAS, and psychophysiological variables will be assessed through biofeedback. A pre-test/post-test experimental design with a 1-month follow-up will be conducted. This study will examine an innovative psychotherapeutic protocol for GD treatment, and it will help in identifying new virtual tools to increase the efficacy of traditional therapeutic approaches that could also be applied to treat other addictions.