Screening for Distress in Oncological Patients: The Revised Version of the Psychological Distress Inventory (PDI-R)

Continuous Norming Approaches: A Systematic Review and Real Data Example

Norming of psychological tests is decisive for test score interpretation. However, conventional norming based on subgroups results either in biases or require very large samples to gather precise norms. Continuous norming methods, namely inferential, semi-parametric, and (simplified) parametric norming, propose to solve those issues. This article provides a systematic review of continuous norming. The review includes 121 publications with overall 189 studies. The main findings indicate that most studies used simplified parametric norming, not all studies considered essential distributional assumptions, and the evidence comparing different norming methods is inconclusive. In a real data example, using the standardization sample of the Need for Cognition-KIDS scale, we compared the precision of conventional, semi-parametric, and parametric norms. A hierarchy in terms of precision emerged with conventional norms being least precise, followed by semi-parametric norms, and parametric norms being most precise. We discuss these findings by comparing our findings and methods to previous studies.

The Shield of Self-Esteem: Buffering against the Impact of Traumatic Experiences, Fear, Anxiety, and Depression

BACKGROUND

Adverse life occurrences (e.g., severe accidents, violence/abuse, organic disorders such as COVID-19) can elicit traumatic responses that heighten fear, anxiety, and depression. However, scientific research has shown that certain variables, such as self-esteem, based on theories like terror management theory (TMT) and the anxiety-buffering hypothesis (ABH), can mitigate the negative effects of trauma. This study aimed to test the ABH by assessing the buffering role of self-esteem in the relationships among the impact of traumatic experiences, fear, anxiety, and depression.

METHOD

An observational research design was used. This study involved 321 participants who experienced COVID-19 as a traumatic experience. A sequential multiple-mediation model with observed variables (path analysis) was used to test the impact of the traumatic experience on fear, anxiety, and depression, examining the protective role of self-esteem.

RESULTS

A path analysis revealed that fear and anxiety mediated the relationship between the impact of the traumatic experience of COVID-19 and depression. Additionally, in line with the ABH, self-esteem was found to mediate the relationship between the predictors and their adverse psychological consequences. This suggests that self-esteem played a buffering role, mitigating the negative impact of traumatic experiences on mental health outcomes.

CONCLUSIONS

These findings underscore the central mediating role of self-esteem, as well as fear and anxiety, in the pathway from trauma-related factors to depression. These insights advocate for evidence-based interventions aimed at alleviating the psychological suffering associated with traumatic experiences, fostering adaptation, and supporting psychological health.

The impact of trauma core dimensions on anxiety and depression: a latent regression model through the Post-Traumatic Symptom Questionnaire (PTSQ)

Adverse life events (e.g., severe accidents, violence/abuse, organic disorders) can elicit traumatic responses characterized by intrusive thoughts, hyperarousal, and avoidance-highlighting the need for sound assessment tools. Also, these traumatic components could heighten anxiety and depression symptoms. This study aims included to: (1) assessing the psychometric properties of the Post-Traumatic Symptom Questionnaire (PTSQ) and delineating clinical cut-offs; (2) investigating how distinct trauma components contribute to anxiety and depression symptoms. Involving 761 participants who experienced a traumatic event, Part I tested the PTSQ psychometric properties, defining clinical cut-offs. Part II tested the impact of traumatic components on anxiety and depression symptoms, using a multiple multivariate latent regression model. PTSQ exhibited exemplary fit indices and robust psychometric properties. Clinically relevant cut-offs were identified. The differential contributions of intrusion, avoidance, and hyperarousal to anxiety and depression symptoms were evaluated, elucidating the strength and nature of these relationships. This study reaffirms the PTSQ as a psychometrically sound and reliable instrument. It underscores the effects of intrusion, avoidance, and hyperarousal on anxiety and depression symptoms in individuals with traumatic experiences. These insights advocate for evidence-based interventions aimed at alleviating the psychological suffering associated with trauma components, fostering adaptation and supporting psychological health.

Unveiling the Role of Emotion Regulation in the Relationship between Intimate Partner Violence Increases and Post-Traumatic Stress Disorder: A Mediation Analysis

(1) Background: Experiencing intimate partner violence (IPV) can greatly impact victims' physical and mental health, often leading to post-traumatic stress disorder (PTSD). Emotion regulation has been identified in the literature as a factor that contributes to the manifestation of PTSD. Consequently, this study aims to investigate the relationship among the increase in IPV victimization (i.e., physical, psychological, sexual, and economic violence), emotion dysregulation, and PTSD symptoms. It has been hypothesized that emotion dysregulation may mediate the increase in IPV occurrence and PTSD symptoms. (2) Methods: 284 women (Mage = 40.92) exposed to IPV were recruited in Italy. IPV experience was screened using the Revised Conflict Tactic Scale questionnaire. A mediational analysis was performed using Rstudio. (3) Results: The findings corroborated the mediating role of emotion dysregulation: the relationship between the increase in IPV and PTSD symptoms appears to be mediated by emotion dysregulation. (4) Conclusions: These findings bolster the existing literature regarding the association between emotion dysregulation and PTSD, underscoring the important role of emotion dysregulation in trauma symptoms. This highlights the significance of prioritizing the treatment of emotion dysregulation as a focal point for intervention and support for those who have experienced IPV.

Emotional Regulation, Coping, and Resilience in Informal Caregivers: A Network Analysis Approach

Public health emergencies such as the COVID-19 pandemic can further strain the mental health of informal caregivers who provide unpaid assistance to family members or friends who need support due to illness, disability, or aging. However, there is a lack of research exploring the resources and adaptive strategies that promote resilience in informal caregivers. This cross-sectional study used psychometric network analysis to model the interplay between coping strategies, emotion regulation, trait resilience, and anxiety and depression symptoms in 351 Italian informal caregivers. The results showed that coping through a positive attitude, emotional reappraisal, and trait resilience were the most central and interconnected nodes in the network. These adaptive strategies buffered against the negative impact of anxiety and depression symptoms, providing valuable insights into the mechanisms underlying resilience and well-being in informal caregivers. Clinically, it is crucial to assess and foster these resilience-promoting factors (positive attitude coping, cognitive reappraisal, and trait resilience) to help mitigate the mental health challenges faced by informal caregivers, especially in the context of public health crises such as the COVID-19 pandemic.

Cognitive restraint, uncontrolled eating, and emotional eating. The Italian version of the Three Factor Eating Questionnaire-Revised 18 (TFEQ-R-18): a three-step validation study

BACKGROUND

The Three Factor Eating Questionnaire-Revised 18 (TFEQ-R-18) is an extensively used questionnaire to measure three transdiagnostic features of eating behavior: cognitive restraint, uncontrolled eating, and emotional eating.

OBJECTIVE

This research aims to investigate the psychometric properties of the Italian version of the TFEQ-R-18 in three large community samples.

METHOD

Cross-sectional research designs were employed. In Study 1 (N = 537), an exploratory graph analysis (EGA) was used to examine item clustering within the TFEQ-R-18. In Study 2 (N = 645), a confirmatory factor analysis (CFA) was conducted to test its structural validity. In Study 3 (N = 346), a MANOVA was employed assessing mean differences across eating disorders (e.g., anorexia nervosa, bulimia nervosa, binge eating disorder).

RESULTS

In Study 1, the EGA accurately identified the three original dimensions of the TFEQ-R-18. Study 2 showed that the Italian TFEQ-R-18 has good fit indexes (CFI = 0.989, RMSEA = 0.064; 90% CI [0.058, 0.070], SRMR = 0.062), and possesses robust psychometric properties. Study 3 reveals distinct, statistically significant differences among eating disorders.

CONCLUSION

The TFEQ-R-18 proves to be a concise and precise tool for measuring transdiagnostic eating behaviors. Its applicability in the Italian context, supported by robust psychometric properties, suggests its utility for both research and clinical purposes. The findings affirm its potential to inform interventions aimed at enhancing psychological health.

LEVEL OF EVIDENCE

Level V, descriptive study.

Development and Validation of the Teacher Career-Related Support Self-Efficacy (TCSSE) Questionnaire

Background: Career-related teacher support self-efficacy refers to the teacher’s confidence in his/her own ability to support students’ career choices. To our knowledge, there are neither studies that focus on this topic nor instruments to measure it. Therefore, the current study aimed at developing and validating an instrument to assess teacher career-related support self-efficacy (TCSSE). Methods: In a multi-step process, items were developed and three studies that involved Italian in-service teachers were conducted. In Study 1 (n = 232), the TCSSE was developed and exploratory factor analysis on the 51 initial items was performed. In Study 2 (n = 294), six factors—Get Ready, Empower Self, Get Curious, Empower Skills, Emotional Support and Instrumental Support (α = 0.885)—across 36 items were tested through confirmatory factor analysis (CFA). In Study 3 (n = 100), the reliability of TCSSE was tested. Results: The EFA performed in Study 1 suggested a six-factor solution with 36 items. The results of Study 2 confirmed the six-factor structure (χ2 (579) = 1387.965, p < 0.001, CFI = 0.964, TLI = 0.961, RMSEA = 0.069), the internal consistency (α = 0.863 for Get Ready, α = 0.857 for Empower Self; α = 0.864 for Get Curious; α = 0.909 for Empower Skills; α = 0.881 for Emotional Support; α = 0.885 for Instrumental Support) and validity of the TCSSE. Finally, in Study 3, the reliability of TCSSE was also confirmed. Conclusion: The TCSSE questionnaire can provide researchers and practitioners with a new and reliable measure to assess teacher career-related support self-efficacy. Suggestions for future studies and practice are also provided.

The Rising of the Shield hero. Development of the Post-Traumatic Symptom Questionnaire (PTSQ) and Assessment of the Protective Effect of self-esteem from trauma-related Anxiety and Depression

Background

Adverse life events such as life-threatening accidents, domestic and/or sexual violence, organic diseases (i.e., cancer), or COVID-19 can have a strong traumatic impact - generating reactions as intrusive thoughts, hyperarousal, and avoidance. Indeed, the traumatic impact of COVID-19 seems to lead individuals to experience anxiety and depression. However, the Anxiety-Buffer Hypothesis suggests that self-esteem could be considered a shield (buffer) against traumatic experiences and their outcomes (i.e., anxiety and depression). The present study has two objectives. First, to develop a measure of the impact of the traumatic event considering the aforementioned reactions. Second, to test the process - triggered by COVID19-related traumatic experience - in which self-esteem buffers the path that leads to anxiety and depression.

Method

In Study 1 (N = 353), the Post-Traumatic Symptom Questionnaire (PTSQ) was developed and a deep investigation of its psychometric properties was conducted. In Study 2 (N = 445), a structural equation model with latent variables was performed to assess the buffering effect of self-esteem.

Results

The PTSQ has excellent fit indices and psychometric properties. According to the ABH, results confirm the buffering effect of self-esteem in the relationships between traumatic symptoms and both anxiety and depression.

Conclusion

On the one hand, the PTSQ is a solid and reliable instrument. On the other hand, that self-esteem is a protective factor against anxiety and depression related to a traumatic experience - such as COVID-19. Targeted psychological interventions should be implemented to minimize the psychological burden of the illness while promoting adaptation and positive aspects of oneself.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40653-022-00503-z.

Understanding stigma toward schizophrenia

Schizophrenia is arguably one of the most stigmatized psychiatric disorders, with patients frequently seeing the burden of stigmatization as a "second illness." Thus, the purpose of this study was to investigate the relationships among the main aspects of the stigma toward schizophrenia. This study used a vignette methodology with 2053 individuals from the general population in Italy. The main aspects of stigma - causal beliefs, recommended treatments, social distance, perception of dangerousness, and avoidance - were investigated through participants' responses, and a latent variable structural equation model (SEM) approach was used to test the relationships among them. Perceived dangerousness predicts the desire for social distancing from an individual with schizophrenia, which predicts the desire for avoidance. In addition, biogenetic causal beliefs of schizophrenia and position on the appropriate medical treatment predict the perception of dangerousness and thus a greater desire for social distance. This study contributes to the literature on the stigmatization of mental health by improving our understanding of the phenomenon. Highlighting the relationships between aspects of stigma allows for a discussion of the implications for anti-stigma interventions.

Assessment of perceived support in the context of emergency: Development and validation of the psycho-social support scale

In research and clinical contexts, it is important to briefly evaluate perceived Psychological and Social Support (PSS) to plan psychological interventions and allocate efforts and resources. However, an appropriate brief assessment tool for PSS was lacking. This study aimed at developing a brief and accurate scale to specifically measure PSS in clinical and emergency contexts, with specific, relevant, targeted, and irredundant items. Experienced clinicians developed the perceived Psycho-Social Support Scale (PSSS) and administered it to a clinical sample (N = 112) seeking psychological help during the COVID-19 emergency. A Confirmatory Factor Analysis examined the PSSS internal structure, and a Multiple Indicator and Multiple Causes model investigated its association with the number of sessions and emotional symptoms. The PSSS showed good psychometric properties and the Confirmatory Factor Analysis provided acceptable fit indexes for a unidimensional structure. The Multiple Indicators and Multiple Causes revealed that more sessions and emotional symptoms were associated with lower PSSS scores. The PSSS is a reliable brief tool to measure PS and could be useful to individualize treatments (i.e., number of sessions) to efficiently allocate efforts and resources in clinical contexts and emergencies (e.g., earthquake, COVID-19 pandemic).

Supplementary Information

The online version contains supplementary material available at 10.1007/s12144-022-03344-z.