Donatella Rita Petretto

The “Reading the Mind in the Eyes” test: Systematic review of psychometric properties and a validation study in Italy

Introduction. The “Reading the Mind in the Eyes” test (henceforth, Eyes test) is a simple but advanced Theory of Mind test, and it is widely used across different cultures. This study assessed the reliability and construct (convergent and discriminant) validity of the Eyes test in Italy. Methods. A sample of 18- to 32-year-old undergraduate students of both sexes (N=200, males=46%) were invited to fill in the Italian version of the Eyes test, the Empathy Quotient (EQ), the Toronto Alexithymia Scale (TAS), and the Marlowe-Crowne Social Desirability Scale (SDS). Results. Internal consistency (Cronbachs alpha) was .605. Confirmatory factor analysis provided evidence for a unidimensional model, with maximal weighted internal consistency reliability=.719. Test–retest reliability for the Eyes test, as measured by intraclass correlation coefficient, was .833 (95% confidence interval=.745 to .902). Females scored significantly higher than males on both the Eyes test and the EQ, replicating earlier work. Those participants who scored lower than 30 on the EQ (n=10) also scored lower on the Eyes test than those who did not (p<.05). Eyes test scores were not related to social desirability. Conclusions. This study confirms the validity of the Eyes test. Both internal consistency and test–retest stability were good for the Italian version of the Eyes test.

From disablement to enablement: Conceptual models of disability in the 20th century

Purpose. The aim of this work is to provide a general view of the conceptual elaborations on disablement in the 20th century and to discuss the role of these different contributions in developing the current concepts of disablement. Method. A review of the literature on conceptual models of disablement in the past century has been performed. Results. The 20th century has witnessed important theoretical considerations on health, diseases and their consequences. These considerations have generated various conceptual models, some of which share the same focus and point of arrival, the so-called ‘Disablement Process’. Among the models that were developed, two stand out, which were drafted and disseminated under the aegis of the World Health Organization, namely the International Classification of Impairments, Disabilities and Handicaps (ICIDH) and the International Classification of Functioning, Disability and Health (ICF), but these are just one part of the conceptual elaboration in the field. Further conceptualization was produced in health and social settings by specialists, self-advocacy associations and activist groups. Conclusions. The current ICF model of the World Health Organization has been translated and recognized in 191 countries; it also incorporates the contribution of self-advocacy associations and it is now recognized by most of them. This model has enjoyed higher visibility than other conceptual models, though its level of development was not higher or more original. To our opinion the ICF is not very clear on the essential choice of the model, i.e., to see disablement as a dynamic process that happens when personal limits collide with socio-environmental needs, rather than as a personal feature. This choice is instead clearer in other models, like Nagis 1991, the Institute of Medicine (IOM) model by Brandt and Pope, where the identification of three dimensions (the individual, the environment and the individual-environment interaction) clarifies the role played by all three dimensions within the process of disablement and introduces major hints for further considerations on how to create virtuous processes of enablement.

Suicidal ideation and aggressiveness in school-aged youths.

This study set out to explore the frequency and correlates of suicidal ideation in a community sample of school-aged adolescents living in a northeastern area of Italy. The study involved a mixed male-female sample of 1,000 adolescents, corresponding to 10% of the young population aged 15-19 in the district. We investigated psychological distress through the revised Symptom Checklist (SCL-90-R), from which we also derived our indicators on suicidality (items concerning hopelessness and suicidal ideation). Propensity to aggression was measured with an Italian version of the Aggression Questionnaire. Females scored significantly higher than males on all SCL-90-R subscales, with the exception of the hostility subscale. In our sample, 30.8% of females and 25.3% of males reported having thought about suicide; one adolescent out of 20 reported suicidal ideation of high intensity (5% out of the total sample in both genders). Males scored significantly higher than females on the Aggression Questionnaire. Both males and females who reported suicidal feelings had significantly higher scores on the Aggression Questionnaire than did those who denied suicidal ideation. Suicidal ideation is a rather widespread occurrence among adolescents and correlates with other indicators of psychological distress. Psychological distress in adolescence might also be expressed through turbulent behaviors and conduct disorders. Identification of the mental disorders underlying a higher propensity to aggression might help to prevent other negative outcomes such as suicide.

Schizophrenia: from Epidemiology to Rehabilitation

Purpose/Objective: We discuss recent evidences about schizophrenia (frequency, onset, course, risk factors and genetics) and their influences to some epidemiological myths about schizophrenia diffuse between psychiatric and psychopathology clinicians. The scope is to evaluate if the new acquisitions may change the rehabilitation approaches to schizophrenia modifying the balance about the neurodevelopmental hypothesis of schizophrenia accepting that the cognitive deficits are produced by errors during the normal development of the brain (neurodevelopmental hypothesis) that remains stable in the course of illness and the neurodegenerative hypothesis according of which they derived from a degenerative process that goes on inexorably. Research Method/Design: A review of the literature about epidemiology of schizophrenia has been performed and the contributions of some of these evidence to neurodevelopmental hypothesis and to rehabilitation has been described. Results: It cannot be definitively concluded for or against the neurodevelopmental or degenerative hypothesis, but efforts in understanding basis of schizophrenia must go on. Until now, rehabilitation programs are based on the vulnerability-stress model: supposing an early deficit that go on stable during the life under favorable circumstances. So, rehabilitation approaches (as neuro-cognitive approaches, social skill training, cognitive-emotional training) are focused on the individual and micro-group coping skills, aiming to help people with schizophrenia to cope with environmental stress factors. Conclusions/Implications: Coping of cognitive deficits in schizophrenia may represents the starting-point for further research on schizophrenia, cohort studies and randomized trials are necessary to defined the range of effectiveness and the outcome of the treatments.

Hallucinatory experiences, delusional thought proneness, and psychological distress in a nonclinical population.

Despite evidence that the reporting of delusion-like or hallucinatory experiences are predictive of the future development of a mental disorder in the spectrum of psychosis, the exact nature of such a kind of unusual subjective experience in the general population is still disputed. We investigated the multidimensionality of these experiences with the Peters et al. Delusions Inventory (PDI) and a modified Italian version of the Launay-Slade Hallucination Scale (LSHS-R) in 250 subjects of both genders drawn from the normal population, using the General Health Questionnaire (GHQ) as a measure of psychic distress of a clinically relevant nature. We found that GHQ scores are positively related to both the PDI and the LSHS-R scores, but the GHQ did not act as a mediator in the links between the 2 psychosis-proneness measures. Conversely, the LSHS-R scores fully mediated the links between GHQ and PDI scores. It can be argued that hallucination proneness and psychosis proneness do not overlap in the nonclinical population but can both cause distress separately.

Eating disorders and aggressiveness among adolescents

Objective: To explore the links between propensity to aggression and eating disorders in a sample of school‐aged adolescents in a northeastern area of Italy.

Hallucination-like experiences in the nonclinical population

Abstract Unusual subjective experiences are relatively common in the general population and have been associated with an increased level of vulnerability to psychosis. The current study aimed to a) determine the distribution of hallucination-like experiences (HLEs) in a community sample of young adults, b) investigate their dimensional subtypes, and c) test the association of HLEs with indicators of poor mental health. Four hundred thirty-seven participants (men, 41%) completed a battery of questionnaires including the 16-item Launay-Slade Hallucination Scale (LSHS), the 12-item General Health Questionnaire (GHQ-12) and the 21-item Peters et al. Delusions Inventory (PDI). The LSHS correlated significantly with GHQ-12 and PDI. Individuals with higher levels of psychological distress were found to report higher frequencies of the HLEs compared with those in the reference range. Exploratory factor analysis of LSHS produced a four-factor solution: a) “auditory and visual HLEs,” b) “multisensory HLEs,” c) “intrusive thoughts,” and d) “vivid daydreams.” The current results provide further support for the multidimensional nature of hallucination proneness in the general population and indicate that some HLEs (particularly those related to intrusiveness of thought) are associated with a lower level of perceived well-being.

Rural/urban differences in the distribution of eating disorder symptoms among adolescents from community samples

Objective: Rural/urban differences in the prevalence of mental disorders have often been reported in the last 30 years, among others in the distribution of eating disorder symptoms and suicide rates. The role of sex, age and socioeconomic status in the differences by place of residence has often been neglected in past studies. Method: Two independent community samples of students (mean age=17.4 years, SD=1.4), taken from among those attending high school in an urban district (Cagliari; n=817) and in a rural one (Carbonia; n=507) of south Sardinia, Italy, were invited to fill in the Eating Attitudes Test (EAT), the Bulimic Investigatory Test of Edinburgh (BITE), the Body Attitudes Test (BAT) and the revised Hopkins Symptom checklist (SCL-90-R). Results: Female students scored higher than male students on all inventories. In male participants, the scores on the EAT were higher in the urban than in the rural sample. Conversely, in both male and female students the rural sample reported higher scores on the BITE symptoms subscale. When the comparison was confined to the fraction of those who scored higher than the suggested cut-off on the EAT and the BITE, students in the urban sample outnumbered those in the rural sample. No other differences were found. Socioeconomic status and age did not influence the differences in the reporting of eating disorder symptoms by place of residence. Conclusions: Although caution is required when reading the findings drawn from self-report instruments, it is evident that the factors influencing the distribution of eating disorder symptoms and their psychological correlates by place of residence are far more complex than currently thought.

Beliefs and attitudes among Italian high school students toward people with severe mental disorders.

Abstract The negative attitudes surrounding mental disorders and their treatment are a major obstacle to the correct identification and treatment of emerging psychopathologies. The purpose of this study was to investigate mental health literacy in a large and representative sample of high school students in Italy, via a booklet containing several questionnaires delivered to 1032 teenagers. The items in the questionnaires probed knowledge about mental health and illness, stigmatization, stereotypes, behaviors, opinions, and attitudes. In general, the students had a reasonable knowledge of mental disorders and were able to distinguish these from somatic disorders. However, a large portion of the students nourished some misconceptions about mental disorders and was also rather skeptical about the effectiveness of treatment or the chance of recovery for people with severe mental disorders. Nevertheless, roughly half of the students reported being willing to provide help to someone with a mental disorder when in need. Poor mental health literacy is a major barrier to seeking help and receiving effective treatment. Young people are the ideal target of raising awareness and antistigma campaigns because they are at a higher risk for developing a psychopathology.

Confirmatory factor analysis and measurement invariance by gender, age and levels of psychological distress of the short TEMPS-A

BACKGROUND The Temperament Evaluation of Memphis, Pisa, Paris and San Diego - Autoquestionnaire (TEMPS-A) is a widely used self-reported tool aimed at measuring the affective temperaments that define the bipolar spectrum, with cyclothymic, depressive, irritable, hyperthymic, and anxious subscales. Confirmatory factor analysis (CFA) was rarely used to confirm the expected five-factor model. Measurement invariance was never tested. METHODS Cross-sectional, survey design involving 649 Italian college students (males: 47%). The short 39-item TEMPS-A and the 12-item General Health Questionnaire (GHQ-12) were used as measures of the affective temperaments and of psychological distress, respectively. CFA was applied to the TEMPS-A. Measurement invariance by gender, age and levels of psychological distress on the GHQ-12 was calculated with the establishment of subsequent equivalence constraints in the model parameters across groups. RESULTS The expected five-factor model had the best fit for all CFA indexes. Configural, metric and scalar invariance of the five-factor model of the TEMPS-A was proved across gender, age and levels of psychological distress of the participants. The hyperthymic temperament subscale has low or no links with the other affective temperament subscales, which were interrelated with medium to large effect sizes. LIMITATIONS College students might be not representative of the general population. No information on the clinical status of the students was available beyond self-report data. CONCLUSION The study proved the measurement invariance of the (short) TEMPS-A, which is a pre-requisite to compare groups or individuals in cross-sectional and longitudinal surveys. Generalizability cannot be assumed without replication of the findings in clinical samples.