Maria Cristina Verrocchio

Mental Pain and Suicide: A Systematic Review of the Literature

Background Mental pain, defined as a subjective experience characterized by perception of strong negative feelings and changes in the self and its function, is no less real than other types of grief. Mental pain has been considered to be a distinct entity from depression. We have performed a systematic review analyzing the relationship between mental pain and suicide by providing a qualitative data synthesis of the studies. Methods We have conducted, in accordance with PRISMA guidelines, a systematic search for the literature in PubMed, Web Of Science, and Scopus. Search terms were “mental pain” “OR” “psychological pain” OR “psychache” combined with the Boolean “AND” operator with “suicid*.” In addition, a manual search of the literature, only including the term “psychache,” was performed on Google Scholar for further studies not yet identified. Results Initial search identified 1450 citations. A total of 42 research reports met the predefined inclusion criteria and were analyzed. Mental pain was found to be a significant predictive factor of suicide risk, even in the absence of a diagnosed mental disorder. Specifically, mental pain is a stronger factor of vulnerability of suicidal ideation than depression. Conclusion Mental pain is a core clinical factor for understanding suicide, both in the context of mood disorders and independently from depression. Health care professionals need to be aware of the higher suicidal risk in patients reporting mental pain. In this regard, psychological assessment should include a clinimetric evaluation of mental pain in order to further detect its contribution to suicidal tendency.

Psychological factors, including alexithymia, in the prediction of cardiovascular risk in HIV infected patients: results of a cohort study.

Background Psychological factors are known predictors of cardiovascular disease in many clinical settings, but data are lacking for HIV infection. We carried out a prospective cohort study to evaluate potential psychological predictors of preclinical and clinical vascular disease in HIV patients. Methodology/Principal Findings HIV patients were consecutively enrolled. Demographics, viral and immune parameters and traditional cardiovascular predictors were considered; Intima-Media Thickness (c-IMT, continuous measure) and Carotid Plaques (CPs, focal thickening ≥1.5 mm) were investigated by B-mode ultrasonography; depressive symptoms by the Beck Depression Inventory (BDI-II), Type D personality (Distressed Personality or Type D) by the DS14, alexithymia by the Toronto Alexithymia Scale (TAS-20). Vascular outcomes included transient ischemic attacks or stroke, acute coronary syndrome, myocardial or other organ infarction. We enrolled 232 HIV subjects, 73.9% males, aged 44.5±9.9 y, 38.2% with AIDS diagnosis, 18.3% untreated. Mean Nadir CD4 T-cell counts were 237.5±186.2/mmc. Of them, 224 (96.5%) attended IMT measurements; 201 (86.6%) attended both IMT assessment and psychological profiling. Mean follow-up was 782±308 days. Fifty-nine patients (29.4%) had CPs at baseline. Nineteen patients (9.5%) had ≥1 vascular event; 12 (6.0%) died due to such events (n = 4) or any cause. At baseline cross-sectional multivariate analysis, increasing age, total cholesterol, current smoking and Alexithymia score≥50 were significantly associated with both increased cIMT (linear regression) and CPs (logistic regression). At follow-up analysis, log-rank tests and Cox’s regression revealed that only older age (p = 0.001), current smoking (p = 0.019) and alexithymia score≥50 (p = 0.013) were independently associated with vascular events. Conclusions/Significance In HIV-infected subjects, the Alexithymic trait emerges as a strong predictor of increased IMT, presence of CPs and vascular events. Such results are preliminary and require confirmation from studies with larger sample size and longer follow-up.

Assessing child sexual abuse allegations: An exploratory study on psychological reports

Abstract This study examines several psychological reports to verify whether consultant psychologists use scientifically based procedures during clinical assessment of sexually abused children. To address our aims, first we propose a methodological premise on mixed-method approaches and on the methodological appropriateness paradigm. We then provide a content analysis (run using the T-LAB software) of psychological reports produced by a sample of Italian consultant psychologists. Results show a biased use of some word associations that may lead to confirmatory interpretations.

Anxiety in adolescent epilepsy. A clinimetric analysis

Abstract Background Anxiety and depression have been considered to be neglected disorders in epilepsy. Because panic disorder is one of the most important anxiety disorders, it has been problematic to use very comprehensive anxiety questionnaires in epilepsy patients, as panic attacks and epileptic seizures, although two distinct clinical entities from a diagnostic point of view, show a significant overlap of symptoms. Aims We have focused on single items for anxiety and depression as screening candidates in adolescent epilepsy. Methods The individual panic attack item in the Screen for Children Anxiety Related Emotional Disorders Scale (SCARED) and the single depression item in the Kellner Symptom Questionnaire were tested. Our samples consisted of adolescent patients with epilepsy and a matched control group with healthy participants, as well as two numerical groups acting as controls. Results The single panic attack item identified panic anxiety in 24.1% in the group of patients with epilepsy and 0.0% in the matched control group (p = 0.01). The single depression item identified 52.2% with depression in the epilepsy group and 6.2% in the matched control group (p = 0.001). Conclusion As screening instruments, single items of panic attack and depression are sufficient to screen for these affective states in adolescent epilepsy. The clinical implications are that it is important to be quite specific when screening for depression and panic attacks in adolescent patients with epilepsy.

Associations between Exposure to Alienating Behaviors, Anxiety, and Depression in an Italian Sample of Adults

The aim of this study was to examine associations between exposure to alienating behaviors (ABs) and anxiety and depression as mediated through psychological maltreatment and parental bonding in a sample of Italian adults in the community. Five hundred and nine adults were given a measure of exposure to ABs, the Baker Strategy Questionnaire; the Psychological Maltreatment Measure; the Parental Bonding Instrument; the State‐Trait Anxiety Inventory‐Y; and the Beck Depression Inventory‐II. Exposure to ABs was associated with psychological maltreatment, which was associated with parental bonding, which was associated with each of the three mental health outcomes: depression, state anxiety, and trait anxiety. The authors conclude that exposure to ABs in childhood represents a risk factor for subsequent poor mental health.

Psychometric evaluation of the Italian translation of the Gamblers’ Beliefs Questionnaire

Abstract Italy has experienced a rapid growth in gambling accessibility, expenditures and problems. Gambling-related cognitive distortions are established risk factors for disordered gambling, although little is known about the role of gambling-related cognitive distortions among Italians. To establish a valid tool for assessing these distortions, an Italian version of the Gamblers’ Beliefs Questionnaire (GBQ-I) was translated and psychometrically evaluated in a sample of 749. Eighty-five percent had gambled recently and 110 were identified as probable disordered gamblers. Good reliability, internal consistency and test-retest reliability were demonstrated. Concurrent, convergent and predictive validities also suggested that the GBQ-I is a valid and reliable measure for assessing gambling-related cognitive distortions among clinical and non-clinical Italian samples. Factor analysis explored the two-factor structure from the measures’ initial validation but was unable to replicate it. The validation of this translation of the GBQ allows for future cross-cultural research on the role of cognitive distortions in the study and treatment of gambling problems.

Perceived Parental Functioning, Self-Esteem, and Psychological Distress in Adults Whose Parents are Separated/Divorced

Objective: The objective of this research was to identify retrospectively the alienating behaviors and the parental bonding that occurred in an Italian sample of adults whose had parents separated or divorced and their associations with self-esteem and psychological distress. Methods: Four hundred seventy adults in Chieti, Italy, completed an anonymous and confidential survey regarding their childhood exposure to parental alienating behaviors (using the Baker Strategy Questionnaire), quality of the parent–child relationship (using Parental Bonding Instruments), self-esteem (using Rosenberg Self-Esteem Scale), and global psychological distress (using Global Severity Index of Symptom Checklist-90-Revised). Results: About 80% of the sample reported some exposure to parental alienating behaviors; about 65–70% of the sample has perceived non-optimal parenting by mother and by father; individuals who experienced affectionless control (low care and high overprotection) reported significantly higher exposure to parental loyalty conflict behaviors. Overall rates of reported exposure to low care, and overprotection and parental loyalty conflict behaviors were statistically significantly associated with self-esteem as well as the measure of current psychological distress. Results revealed that exposure to parental loyalty conflict behaviors and self-esteem were associated with psychological distress over and above the effects of parental bonding and age. Conclusion: The pattern of findings supports the theory that children exposed to dysfunctional parenting, and with low self-esteem are at risk for their long-term psychological functioning. Implications for health policy changes and strengthening social services are discussed.

Attachment Styles and Suicide-Related Behaviors in Adolescence: The Mediating Role of Self-Criticism and Dependency

Insecure attachment and the personality dimensions of self-criticism and dependency have been proposed as risk factors for suicide in adolescents. The present study examines whether self-criticism and dependency mediate the relationship between insecure attachment styles and suicidality. A sample of 340 high-school students (73.2% females), ranging in age from 13 to 20 years (M = 16.47, SD = 1.52), completed the Depressive Experiences Questionnaire for Adolescents, the Depressive Experiences Questionnaire for Adolescents, the Attachment Style Questionnaire, and the Suicidal Behaviors Questionnaire-Revised. The results partially support the expected mediation effects. Self-criticism, but not dependency, mediates the link between insecure attachment (anxiety and avoidance) and suicide-related behaviors. Implications for suicide risk assessment and management are discussed.

La valutazione del maltrattamento psicologico: proprietà psicometriche della Psychological Maltreatment Measure - Versione italiana

La presente ricerca si propone di verificare le proprieta psicometriche di una traduzione italiana della Psychological Maltreatment Measure (PMM-I) in un campione di popolazione generale, composto da 739 partecipanti di nazionalita italiana. E stata esplorata la struttura fattoriale dello strumento, indagata la coerenza interna ed esaminata sia la validita convergente, rispetto ad una misura di cura genitoriale, sia la validita predittiva, relativamente a due possibili esiti negativi del maltrattamento psicologico in eta adulta (ovvero il distress e la bassa autostima). I risultati, in linea con le nostre ipotesi e la letteratura sul tema, evidenziano una struttura a due fattori del PMM-I e suggeriscono che possa essere uno strumento attendibile e valido per valutare il maltrattamento psicologico nella popolazione adulta italiana.

The Reality of Parental Alienation: Commentary on “Judicial Decision-Making in Family Law Proceedings,” by Clemente, Padilla-Racero, Gandoy-Crego, Reig-Botella, and Gonzalez-Rodriguez

In the above article, the authors made several unsubstantiated assertions about the findings and contributions of child psychiatrist, Richard Gardner, who coined the term, Parental Alienation Syndrome (PAS). Moreover, there are conceptual and methodological flaws in their own research. Taken together, these two issues converge to call into question the theory, research, and conclusions presented in the Clemente, Padilla-Racero, Gandoy-Crego, Reig-Botella, and Gonzalez-Rodriguez (2015) article.