Gabriele Melli

The Italian version of the Obsessive Compulsive Inventory: Its psychometric properties on community and clinical samples

The aim of the study was to evaluate psychometric properties of the Obsessive Compulsive Inventory (OCI) on Italian community and clinical samples. The Italian version of the 42-item OCI was administered to a sample of 340 individuals belonging to the general population and to 88 patients with obsessive compulsive (OCD) or other anxiety disorders. Four different internal structures of the OCI were compared through confirmatory factor analysis (CFA): the figures for the model with six factors and 18 items (OCI-R) met the best criteria for adequacy of fit. The six scales showed on average a 10% of common variance in the community sample and 8% in the clinical sample. The OCI-R subscales showed good internal consistency and temporal stability, with the exception of washing and mental neutralizing subscales which showed a strong alpha coefficient only in the OCD sample. Psychometric data for the OCI-R were insensitive to age and sex, whereas an effect of education was found. Concurrent validity was demonstrated, since the OCI-R subscales showed a pattern of specific correlations with another conceptually related self-report measure. Moreover, although the OCI-R was positively correlated with measures of depression, anxiety, and worry, the correlations were weaker than those with the other measure of OCD symptoms. The OCI-R clearly differentiated OCD patients from non-OCD anxious patients and nonclinical controls with the exception of hoarding subscale. However, the hoarding scale discriminated OCD patients who presented hoarding symptoms from OCD counterparts without such symptoms. Thus, the OCI-R proved to be a reliable and valid measure of obsessive compulsive symptoms in the Italian context.

The Italian version of the Depression Anxiety Stress Scales-21: Factor structure and psychometric properties on community and clinical samples

OBJECTIVE The Depression Anxiety Stress Scales-21 (DASS-21) is the short version of a self-report measure that was originally developed to provide maximum differentiation between depressive and anxious symptoms. Despite encouraging evidence, the factor structure and other features of the DASS-21 are yet to be firmly established. METHOD A community sample of 417 participants and two clinical groups (32 depressive patients and 25 anxious patients) completed the Italian version of the DASS-21 along with several measures of psychopathology. RESULTS Confirmatory factor analyses suggested that the DASS-21 is a measure of general distress plus three additional orthogonal dimensions (anxiety, depression, and stress). The internal consistency and temporal stability of the measure were good; each DASS-21 scale correlated more strongly with a measure of a similar construct, demonstrating good convergent and divergent validity. Lastly, the DASS-21 demonstrated good criterion-oriented validity. CONCLUSION The validity of the Italian DASS-21 and its utility, both for community and clinical individuals, are supported.

Hoarding behaviour in an Italian non-clinical sample.

BACKGROUND Hoarding is associated with significant impairment. Although traditionally considered as a symptom of obsessive-compulsive disorder (OCD), some authors have proposed that pathological hoarding could be considered as a stand alone condition. The prevalence of pathological hoarding behaviour has been shown to be high in some countries, but little is known about the prevalence and correlates of hoarding in the non-clinical population in Italy. METHOD We studied the prevalence of self-reported hoarding behaviour using the Italian version of the Saving Inventory-Revised, as well as the association between hoarding and various clinical correlates, including obsessive-compulsive symptoms, compulsive buying, anxiety, and depression. RESULTS The prevalence of pathological hoarding behaviour in two studies was between 3.7 and 6.0%. No differences were found between hoarding and non-hoarding participants with regard to gender, age, marital status, level of education, and employment status. Significant correlations were found between compulsive hoarding and obsessive-compulsive symptoms and also between hoarding and a measure of compulsive buying, even after controlling for anxiety and depressive symptoms. CONCLUSIONS These results indicate that pathological hoarding may also be prevalent in Italy and highlight the need for further epidemiological studies using validated instruments to assess hoarding disorder.

Fear of self and unacceptable thoughts in obsessive-compulsive disorder

UNLABELLED Cognitive-behavioural models have linked unacceptable or repugnant thoughts in obsessive-compulsive disorder (OCD) with vulnerable self-themes and fear-of-self concerns. To investigate this notion, Aardema and coworkers recently developed and validated the Fear of Self-Questionnaire (FSQ) in non-clinical samples, finding it had strong internal inconsistency, and good divergent and convergent validity, including strong relationships to obsessional symptoms and with other processes implicated in cognitive models of OCD (e.g., obsessive beliefs and inferential confusion). The current article describes two studies that aim to replicate and extend these findings in clinical OCD and non-clinical samples. Study 1 investigated the psychometric properties of an Italian translation of the FSQ in a non-clinical sample (n = 405). Results of confirmatory factor analysis supported the unidimensionality of the scale; the FSQ also showed very good internal consistency and temporal stability. Study 2 investigated the role of fear of self in OCD symptoms, and unacceptable thoughts and repugnant obsessions in particular, using a clinical OCD sample (n = 76). As expected, fear of self was a unique, major predictor of unacceptable thoughts independent of negative mood states and obsessive beliefs. Moreover, even when considered with obsessive beliefs, anxiety and depression, the feared self was the only unique predictor of obsessionality, providing support for the notion that self-themes could explain why some intrusions convert into obsessions, whereas others do not. Implications for current cognitive-behavioural models are discussed. Copyright

Validation of the Italian version of the Yale-Brown Obsessive Compulsive Scale-Second Edition (Y-BOCS-II) in a clinical sample

OBJECTIVE The Yale-Brown Obsessive Compulsive Scale (Y-BOCS) is the most widely accepted measure of obsessive-compulsive disorder (OCD) symptom severity. Recently, the scale has been revised into a second edition (Y-BOCS-II) in order to improve its measurement properties. The present study aimed to evaluate the psychometric properties of the Italian version of the Y-BOCS-II Severity Scale (SS) in a large clinical sample. METHOD The original version of the Y-BOCS-II was translated into Italian, which involved forward and back-translation procedures. The Italian Y-BOCS-II-SS was administered to one hundred twenty-five treatment-seeking adults with OCD, together with the original Y-BOCS-SS and a battery of self-report measures assessing OCD symptom severity and depressive and anxious symptomology. The factor structure, internal consistency, temporal stability, and construct validity were investigated on the whole sample, while inter-rater and test-retest reliability were assessed on a subsample of participants. RESULTS Factor analyses revealed a two-factor structure different from those of the original scale, comprising (1) symptom severity; and (2) interference from symptoms. Internal consistency, test-retest reliability over a 2-week period and inter-rater reliability were satisfactory. The Y-BOCS-II-SS also showed excellent construct validity (and better than the Y-BOCS-SS), with good convergent and discriminant validity when assessed against other OCD symptom measures and measures of depression, anxiety and worry. CONCLUSIONS These findings suggest that the Italian version of the Y-BOCS-II-SS retains the adequate psychometric properties of the original and that it can be confidently used as an assessment tool of OCD symptoms in both clinical and research settings.

Factor structure and temporal stability of the Vancouver Obsessional Compulsive Inventory-Mental Contamination Scale (VOCI-MC) and psychometric properties of its Italian version.

OBJECTIVE The Vancouver Obsessional Compulsive Inventory-Mental Contamination Scale (VOCI-MC) is a self-report instrument that assesses symptoms of mental contamination. The aim of this study was to investigate the psychometric properties of the Italian version of the VOCI-MC in non-clinical and clinical samples. METHOD Factor structure, internal consistency, temporal stability, construct and criterion validity were investigated in 541 participants from the general population, 120 participants diagnosed with OCD and 31 participants diagnosed with other anxiety disorders (OAD). For some of these analyses, our OCD sample was subdivided into those with contamination-related symptoms and concerns (n=39) and those whose OCD excluded concerns related to contamination fear (n=81). Exploratory and confirmatory factor analyses supported the expected one-factor structure of the VOCI-MC both in non-clinical and OCD sample. RESULTS VOCI-MC scores showed good internal consistency, temporal stability, construct validity and criterion validity. In particular, the VOCI-MC successfully discriminated between those with OCD who reported contamination-related concerns and all other groups of participants. CONCLUSION These findings suggest that the Italian version of the VOCI-MC retains the adequate psychometric properties of the original, provide preliminary evidence of its one-factor structure and temporal stability, and suggest that it can be confidently used as an assessment tool of mental contamination symptoms in both clinical and research settings.

Second-Order Factor Structure of the Vancouver Obsessive Compulsive Inventory (VOCI) in a Non-Clinical Sample

BACKGROUND The Vancouver Obsessive Compulsive Inventory (VOCI) is a self-report measure of the severity of obsessive-compulsive problems such as contamination, checking, obsessions, hoarding, needing things to be just right, and indecisiveness. In the seminal paper a six-correlated-factor structure was found in a sample of OC patients, but the issue of the factor structure of the VOCI in non-clinical populations was not addressed. AIM This study assesses the psychometric properties and the factor structure of the Italian version of the VOCI in a non-clinical sample. METHOD The VOCI was administered to a large community sample (n = 445). Some participants also completed a battery including measures of OC behaviour, worry, anxiety and depression (n = 89) and were administered the VOCI twice at an 8-week interval (n = 46). RESULTS Confirmatory factor analyses replicated the six-correlated-factor structure originally found in a patient sample, but a more parsimonious, second-order-factor model showed a statistically higher fit, suggesting that VOCI subscales can be considered as facets of a higher-order OCD factor. The whole item pool and each of the subscales showed good internal consistency, unidimensionality, test-retest reliability and convergent construct validity. As in the original version, limited support for discriminant validity was found. Scores were weakly associated with age, gender and education. CONCLUSIONS Although some key issues still need to be investigated (e.g. sensitivity to change), the VOCI seems to be a psychometrically sound instrument for the assessment of OCD-related behaviours and thoughts and can be used in cultural contexts different from the original.

The differential relationship between mental contamination and the core dimensions of contact contamination fear.

Two types of contamination fear are recognized: contact and mental contamination. Contact contamination appears to be motivated both by harm avoidance and disgust avoidance. This study aimed to examine the relationships between disgust propensity, mental contamination and contact contamination while differentiating between harm avoidance and disgust avoidance in contact contamination. 169 OCD patients completed a set of questionnaires assessing mental contamination, contact contamination, disgust propensity, OCD, anxiety and depression. 1) Contact contamination based on disgust avoidance was more strongly associated with mental contamination and disgust propensity than contact contamination based on harm avoidance; 2) mental contamination significantly predicted contact contamination based on disgust avoidance, while it did not predict contact contamination based on harm avoidance; 3) mental contamination had a significant mediational role in the relationship between disgust propensity and contact contamination motivated by disgust avoidance. Mental contamination plays a role in contact contamination fear when disgust is primarily experienced.

Factor Structure and Psychometric Properties of the Anxiety Sensitivity Index-3 in an Italian Community Sample

Anxiety Sensitivity (AS) is defined as the fear of anxiety and of arousal-related bodily sensations, arising from erroneous beliefs that these sensations will have adverse consequences. AS plays a key role both in the onset and in the maintenance of several disorders, particularly anxiety disorders. To date, only two studies on American samples have examined the bifactor structure of the Anxiety Sensitivity Index-3 (ASI-3); therefore, findings on different cultures are needed. The main purpose of the present study was to assess the factor structure and psychometric properties of the ASI-3 in an Italian community sample. Participants were recruited from the general population (N = 1507). The results of a series of confirmatory factor analyses indicated that the bifactor structure fitted the data better than the most commonly accepted structure for the measure and that it was invariant across gender. Moreover, the current study provided evidence regarding the ASI-3’s reliability and its convergent and divergent validity. Lastly, results pertaining incremental validity of the ASI-3 Physical and Cognitive Concerns subscales above and beyond the total showed that the former was not associated with a measure of physiological anxiety, whereas the latter was weakly associated with a measure of worry. Findings suggest that the ASI-3 is comprised of a dominant general factor and three specific independent factors; given the dominance of the general factor, the use of the ASI-3 total score as a measure of the general fear of anxiety is recommended in both clinical and research settings.

Development and Validation of the Morphing Fear Questionnaire (MFQ)

Morphing fears (also called transformation obsessions) involve concerns that a person may become contaminated by and acquire undesirable characteristics of others. These symptoms are found in patients with obsessive-compulsive disorder (OCD) and are thought to be related to mental contamination. Given the high levels of distress and interference morphing fears can cause, a reliable and valid assessment measure is needed. This article describes the development and evaluation of the Morphing Fear Questionnaire (MFQ), a 13-item measure designed to assess for the presence and severity of morphing fears. A sample of 900 participants took part in the research. Of these, 140 reported having a current diagnosis of OCD (SR-OCD) and 760 reported never having had OCD (N-OCD; of whom 24 reported a diagnosis of an anxiety disorder and 23 reported a diagnosis of depression). Factor structure, reliability and construct and criterion-related validity were investigated. Exploratory and confirmatory factor analyses supported a one-factor structure replicable across the N-OCD and SR-OCD group. The MFQ was found to have high internal consistency and good temporal stability and showed significantly greater associations with convergent measures (assessing obsessive-compulsive symptoms, mental contamination, thought-action fusion and magical thinking) than with divergent measures (assessing depression and anxiety). Moreover, the MFQ successfully discriminated between the SR-OCD sample and the N-OCD group, anxiety disorder sample and depression sample. These findings suggest that the MFQ has sound psychometric properties and that it can be used to assess morphing fear. Clinical implications are discussed. Copyright