Ezio Sanavio

Obsessions and compulsions: The Padua inventory

The Padua Inventory (PI) consists of 60 items describing common obsessional and compulsive behavior and allows investigation of the topography of such problems in normal and clinical Ss. It was administered to 967 normal Italian Ss, ranging in age from 16 to 70 yr. Inventory consistency and 1-month reliability were satisfactory. Females reported more complaints, more intensely than males. Ss aged from 16 to 20 yr and Ss aged from 46 to 70 complain of more obsessions and compulsions than Ss of intermediate ages. Four factors were identified: impaired control of mental activities, becoming contaminated, checking behaviors, urges and worries of losing control over motor behaviors. The PI correlates with the Maudsley Obsessional-Compulsive Questionnaire (0.70), Leyton Obsessional-Compulsive Inventory (0.71 with Symptom and 0.66 with Trait scales) and Self-rating Obsessional Scale (0.61). Furthermore, it allows discrimination between a group of 75 outpatients with obsessive-compulsive disorders and a similar group of outpatients with other neurotic disorders. Relationships with fears and neuroticism traits were also found, reflected in moderately high correlations with the Fear Survey Schedule and the Neuroticism scale of the Eysenck Personality Questionnaire.

Development and initial validation of the Obsessive Beliefs Questionnaire and the Interpretation of Intrusions Inventory.

In 1995 the Obsessive Compulsive Cognitions Working Group initiated a collective process to develop two measures of cognition relevant to current cognitive-behavioural models of OCD. An earlier report (Behav. Res. Therapy, 35 (1997) 667) describes the original process of defining relevant domains. This article describes the subsequent steps of the development and validation process: item generation, scale reduction, and initial examination of reliability and validity. Two scales were developed. The Obsessive Beliefs Questionnaire consists of 87 items representing dysfunctional assumptions covering six domains: overestimation of threat, tolerance of uncertainty, importance of thoughts, control of thoughts, responsibility, and perfectionism. The Interpretation of Intrusions Inventory consists of 31 items that refer to interpretations of intrusions that have occurred recently. Three of the above domains are represented: importance of thoughts, control of thoughts, and responsibility. The item reduction and validation analyses were conducted on clinical and non-clinical samples from multiple sites. Initial examination of reliability and validity indicates excellent internal consistency and stability and encouraging evidence of validity. However, high correlations indicating overlap between some of the scales, particularly importance of thoughts, control of thoughts, and responsibility will need to be addressed in subsequent empirical and theoretical investigations.

Psychometric validation of the Obsessive Beliefs Questionnaire and the Interpretation of Intrusions Inventory: Part I

This article reports on the validation of the Obsessive Beliefs Questionnaire (OBQ) and Interpretations of Intrusions Inventory (III) developed by the Obsessive Compulsive Cognitions Working Group (OCCWG) to assess the primary beliefs and appraisals considered critical to the pathogenesis of obsessions. A battery of questionnaires that assessed symptoms of anxiety, depression, obsessive-compulsive symptoms and worry was administered to 248 outpatients with a DSM-IV diagnosis of Obsessive-Compulsive Disorder (OCD), 105 non-obsessional anxious patients, 87 non-clinical adults from the community, and 291 undergraduate students. Tests of internal consistency and test-retest reliability indicated that the OBQ and III assessed stable aspects of OC-related thinking. Between-group differences and correlations with existing measures of OC symptoms indicated that the OBQ and III assess core cognitive features of obsessionality. However, the various subscales of the OBQ and III are highly correlated, and both measures evidenced low discriminant validity. The findings are discussed in terms of the relevance and specificity of cognitive constructs like responsibility, control and importance of thoughts, overestimated threat, tolerance of uncertainty and perfectionism for OCD.

The development of a short form of the EMBU: Its appraisal with students in Greece, Guatemala, Hungary and Italy

Abstract Out of the necessity of having an abbreviated form of the EMBU, a measure of perceived parental rearing behaviour, a short form (s-EMBU) consisting of three scales (rejection, emotional warmth and protection) with, respectively, 7, 6 and 9 items (plus 1 unscaled item) was developed from the original 81-item version. The factorial and/or construct validity and reliability of this s-EMBU were examined among samples of 2373 students from Italy, Hungary, Guatemala and Greece. The data were presented for the four national groups separately. The 23-item s-EMBU is recommended as a reliable functional equivalent to the 81-item early EMBU. Attention was drawn to the need for further research to explain some of the observed cross-national differences in the correlations between parental rearing styles and personality.

Religiousness and obsessive-compulsive cognitions and symptoms in an Italian population

Fifty-four individuals with a high degree of religiosity, 47 with a medium degree of religiosity and 64 with low religiosity completed anonymously the Italian versions of well-established measures of obsessive-compulsive (OC) cognitions and symptoms, depression and anxiety. After controlling for anxiety and depression, religious groups scored higher than individuals with a low degree of religiosity on measures of obsessionality, overimportance of thoughts, control of thoughts, perfectionism and responsibility. Moreover, measures of control of thoughts and overimportance of thoughts were associated with OC symptoms only in religious subjects. It is concluded that religion might play a role in obsessive-compulsive disorder phenomenology. Additional research is warranted because it is plausible that only a few aspects of religious teachings (e.g., inflexibility and prohibition) are linked to OC phenomena.

Semantics of pain in Italy: the Italian version of the McGill Pain Questionnaire

&NA; The Italian version of the McGill Pain Questionnaire (MPQ) is presented. Unlike Melzacks version, it was developed by employing 3 groups of normal subjects, excluding physicians or patients suffering from chronic pain. The verbal scale of pain intensity was obtained by 78 descriptors which form the semantic key and their rank values within each subclass were thus obtained. Melzacks subdivision of the descriptors into classes and subclasses was respected. Procedure was also basically the same. The Italian version of the MPQ joins the English, French and Finnish ones and might provide the basis for future cross‐cultural studies.

Coping strategies: Evidence for cross-cultural differences? A preliminary study with the Italian version of coping orientations to problems experienced (COPE)

Abstract The internal structure of the COPE inventory (Carver, Scheier & Weintraub, 1989), a questionnaire which measures 15 different coping strategies, was studied. The Italian version of COPE was administered to 521 undergraduate students. Alpha and test-retest reliabilities were very similar to those obtained in the above American study. A rotated factor analysis resulted in 13 factors, which came out in a different order with respect to those obtained in the original study. A second-order factor analysis yielded five factors similar to those obtained by Carver etal., except for ‘Turning to religion’, which was present in the Italian study only. It is concluded that the Italian version of COPE has good construct validity and that the traditional taxonomy of coping strategies should also be studied in the light of transcultural differences.

Pre-sleep cognitive intrusions and treatment of onset-insomnia

Abstract The importance of differences in pre-sleep cognitive intrusions in the treatment of sleep-onset insomnia were investigated. Twenty-four patients suffering from persistent psychophysiological insomnia were assessed on a pre-sleep cognitive intrusion inventory and divided into high and low scorers. Within these groups Ss were randomly assigned to either a cognitively focused program (cognitive restructuring. paradoxical instructions and thought stopping) or a psychophysiologically focused method, EMG-biofeedback training. Patients were treated individually for 6 sessions. Within-group comparisons showed that both treatments yielded significant improvement in latency to falling asleep, pre-sleep tension, hours of sleep and sleep quality. Between-group comparisons showed a greater reduction of pre-sleep intrusions in patients treated by the cognitive method and of pre-sleep tension in patients trained in biofeedback, but no differential results were found in outcome variables either after treatments or at 3- and 12-month follow-ups. The results indicate that the use of differential treatments added little to the outcome of therapy, and do not support the hypothesis that greater benefits are gained when the treatment matches the patients claims of cognitive hyperarousal.

The components of the Maudsley Obsessional-Compulsive Questionnaire

Abstract The Maudsley Obsessional-Compulsive Questionnaire was given to 868 Italian students. Response analysis revealed three factors: checking behavior and worries, problems of contamination and cleaning, and doubts and intrusive thoughts. In males a fourth component was also recognized—the ‘obesssional slowness’ which Hodgson and Rachman (1977) found in obsessive patients, but not in normal and neurotic English patients.

Predicting Burnout Among HIV/AIDS and Oncology Health Care Workers

Psychological stress and coping strategies in staff working with AIDS and with cancer patients were assessed using self-report methods. The Maslach Burnout Inventory (MBI), Coping Orientations to Problems Experiences (COPE), State-Trait Anxiety Inventory (STAI) and Depression Questionnaire (DQ) were completed by staff from 20 hospitals of North-Center Italy, including 268 doctors and nurses working with people with AIDS and 260 doctors and nurses working in oncology. Few significant differences were found between two units on the MBI, COPE subscale and depression/anxiety. When a Bonferroni corrected p level of p < 0.0025 was used, the difference on Emotional Exhaustion (EE) subscale of MBI still remained statistically significant, indicating greater exhaustion in the oncology staff. The regression analysis suggested that the negative aspects of burnout were predicted primary by professional status (being a doctor), type of unit (oncology), depression and the use of the humor as a coping strategy. In contrast personal accomplishment was better predicted by positive coping strategies (i.e. planning, restraint coping, non-denial) and low level of anxiety.