Publications by authors named "Gioia Bottesi"

49 Publications

Validation of the Muscle Dysmorphic Disorder Inventory (MDDI) among Italian Women Practicing Bodybuilding and Powerlifting and in Women Practicing Physical Exercise.

Int J Environ Res Public Health 2022 Aug 2;19(15). Epub 2022 Aug 2.

Department of General Psychology, University of Padova, 35131 Padova, Italy.

Studies pertaining to muscle dysmorphia (MD) have concentrated the most on males. However, a new body ideal for women is emerging: a very toned, athletic body with flat, smooth muscles. The emphasis on the level of muscularity represents a contribution to the growth of MD symptoms in women. The aim of this study was to evaluate the factorial structure and psychometric properties of the muscle dysmorphic disorder inventory (MDDI) in two samples of physically active Italian women. One-hundred and sixty-five women practicing non-competing bodybuilding/powerlifting and 353 women practicing physical exercise completed the MDDI and measures of features associated with MD. Findings of the confirmatory factor analysis showed a three-factor structure with acceptable fit and invariant across groups. Omega coefficients revealed adequate internal consistency for all the scales and for the total score of the MDDI. Furthermore, convergent and divergent validity as well as retest reliability emerged to be good. MDDI represents a reliable measure of MD symptoms in physically active Italian women.
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http://dx.doi.org/10.3390/ijerph19159487DOI Listing
August 2022

Cognitive training via a mobile application to reduce some forms of body dissatisfaction in young females at high-risk for body image disorders: A randomized controlled trial.

Body Image 2022 Jul 27;42:297-306. Epub 2022 Jul 27.

Department of General Psychology, University of Padova, Padova, Italy; U.O.C. Hospital Psychology, University-Hospital of Padova, Padova, Italy.

Body dissatisfaction has been related to Body Image Disorders (BIDs) such as Eating Disorders (EDs) and Body Dysmorphic Disorder (BDD). This study investigates the efficacy of a mHealth app in reducing body dissatisfaction, BDD/ED symptoms and related features. Ninety-five women who were identified as high-risk of developing BIDs (using the Structured Clinical Interview for DSM-5) were randomized into: immediate-use App (iApp group; n = 47) and delayed-use App (dApp group; n = 48). The iApp group started using the app at baseline for 16 days (T1). The dApp group started using the app at T1 for 16 days. Participants completed questionnaires at baseline (T0), 16 days from baseline (T1), and 32 days from baseline (T2). Repeated measure Multivariate Analysis of Variance (MANOVA) showed Group (iApp vs. dApp) × Time (T0 vs. T1) interactions indicating decrease in BDD symptoms and body dissatisfaction related to EDs in the iApp group at T1. The Reliable Change Index indicated changes on extreme body dissatisfaction/BDD symptoms for 34.74% of participants. Although preliminary, these findings highlight that a mHeatlh app might reduce BDD symptoms and body dissatisfaction related to EDs in women at high-risk for BIDs. Effects on ED symptoms and associated features seem more limited.
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http://dx.doi.org/10.1016/j.bodyim.2022.07.010DOI Listing
July 2022

Latent variable model of triarchic psychopathy constructs in an incarcerated offender sample: Factor reliability and validity.

Psychol Assess 2022 Jul 18. Epub 2022 Jul 18.

Department of Psychology.

The triarchic model of psychopathy posits that three distinct trait dispositions-disinhibition, meanness, and boldness-contribute to the interpersonal, affective, and impulsive-unrestrained features of this condition and is represented to varying degrees in all conceptualizations and measures of psychopathy. Using data for incarcerated males ( = 273) and females ( = 83) from 10 different prisons in Italy, we specified a latent variable model of the triarchic trait constructs in which scale measures of disinhibition, meanness, and boldness composed of items from the following inventories served as indicators: Triarchic Psychopathy Measure, Psychopathic Personality Inventory-Revised, Minnesota Multiphasic Personality Inventory-2 Restructured Form, and NEO Five Factor Inventory. A correlated three-factor solution evidenced adequate model fit, with individual triarchic trait scales loading strongly onto their target factors. The model exhibited comparable fit and factor loadings when specified using data for males only, and its factors showed expected relations with pertinent criterion variables, including measures of normative personality and clinical dysfunction along with staff ratings of prison behavior and release prognosis. Extending prior research with nonclinical participants from the U.S., present study results demonstrate the viability of a latent variable model of the triarchic traits in an incarcerated offender sample from a separate culture (Italy). The significance of this work lies in the potential of the triarchic traits to serve as conceptual-empirical points of reference for integrating findings across studies of psychopathy employing diverse samples and assessment measures. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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http://dx.doi.org/10.1037/pas0001158DOI Listing
July 2022

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

Curr Psychol 2022 Jun 26:1-12. Epub 2022 Jun 26.

Hospital Guglielmo da Saliceto, Via Taverna 49, Piacenza, Italy.

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.
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http://dx.doi.org/10.1007/s12144-022-03344-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9243771PMC
June 2022

The assessment of Intolerance of uncertainty in youth: An examination of the Intolerance of Uncertainty Scale-Revised in Italian nonclinical boys and girls.

Res Child Adolesc Psychopathol 2022 Jul 2. Epub 2022 Jul 2.

Department of Psychology of Developmental and Socialisation Processes, Sapienza University of Rome, via dei Marsi 78, 00185, Rome, Italy.

Intolerance of Uncertainty (IU) is a transdiagnostic factor involved in several psychological disorders. Adolescence is characterized by elevated uncertainty and psychopathological vulnerability, but insufficient attention has been paid to IU at this age. This study aimed to investigate the factor structure and psychometric properties of the Intolerance of Uncertainty Scale-Revised (IUS-R) in Italian preadolescents and adolescents. 862 Italian students (57.3% girls) aged 11-17 (M = 14.8 ± 1.91) completed the IUS-R and measures of internalizing and externalizing symptoms, and psychological well-being. To test the factor structure of the IUS-R, one-factor, two-factor, and bifactor models were compared; measurement invariance, reliability, and validity were also addressed. Results showed that the bifactor model outperformed alternative factor models, and a general factor was needed to model the IUS-R. Bifactor model indices supported using the total score to assess IU reliably. Configural and metric invariance by age and sex were fully supported, while the IUS-R achieved partial scalar invariance. Significant correlations emerged for the IUS-R total score with psychopathological constructs, while no relationships with psychological well-being were found. Compared to adult normative data, higher total IUS-R scores were detected, suggesting that IU may be a phase-specific characteristic of adolescence. Our findings support using the IUS-R to measure IU across the lifespan. The recommended use of the total score and its associations with psychopathological dimensions highlight the transdiagnostic nature of IU in adolescence. Therefore, including IU when implementing interventions to prevent maladaptive outcomes in teenagers would be beneficial.
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http://dx.doi.org/10.1007/s10802-022-00944-yDOI Listing
July 2022

Broad and Narrow Transdiagnostic Risk Factors in Eating Disorders: A Preliminary Study on an Italian Clinical Sample.

Int J Environ Res Public Health 2022 06 4;19(11). Epub 2022 Jun 4.

Department of General Psychology, University of Padova, 35131 Padova, Italy.

Eating disorders are multifaceted psychopathologies and the transdiagnostic approach is currently considered a useful framework to understand their complexity. This preliminary study aimed to investigate both broad (i.e., intolerance of uncertainty and emotion dysregulation) and narrow (i.e., extreme body dissatisfaction) transdiagnostic risk factors underlying eating disorders. 50 Italian female patients seeking treatment for an eating disorder were involved ( = 31.6 years ± 12.8, 18-65). They completed self-report measures assessing emotion regulation difficulties, intolerance of uncertainty, extreme body dissatisfaction, general psychological distress, and eating disorder symptomatology. To explore whether the abovementioned transdiagnostic factors predicted patients' psychological distress and eating disorder symptoms, two linear regressions were performed. Emotion dysregulation emerged as the only significant predictor of distress, while extreme body dissatisfaction was the only significant predictor of overall eating disorder symptomatology. Then, to analyze the differences between patients with anorexia nervosa and bulimia nervosa in intolerance of uncertainty and emotion regulation problems, -tests were conducted. The two groups differed significantly in intolerance of uncertainty levels only, with higher scores obtained by patients with anorexia nervosa. Overall, our findings suggest that emotion dysregulation and extreme body dissatisfaction may be relevant constructs in eating disorders in general, while intolerance of uncertainty may be more involved in restrictive eating disorders. The clinical implications of such results are discussed.
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http://dx.doi.org/10.3390/ijerph19116886DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9180279PMC
June 2022

Facing distress in Coronavirus era: The role of maladaptive personality traits and coping strategies.

Pers Individ Dif 2021 Jul 14;177:110833. Epub 2021 Mar 14.

Department of General Psychology, University of Padova, via Venezia, 8, 35131 Padova, Italy.

The aim of the current study was to investigate the intersecting roles of dysfunctional personality traits and coping styles in relation to psychological distress during the Italian national lockdown caused by the COVID-19 pandemic. Participants included 633 adults who completed questionnaires of maladaptive personality traits, coping styles, and psychological distress. Results indicated that all the maladaptive traits were associated with psychological distress with magnitude of associations strongest for Negative Affect and weakest for Antagonism. Maladaptive traits were also generally positively associated with avoidant/maladaptive and negatively associated with acceptance and positive reframing, forms of coping. A series of path analyses further demonstrated that coping strategies partially explained associations between maladaptive personality traits and psychological distress. All told, results suggest that during an unprecedented stressful time, associations between maladaptive personality traits and psychological distress may be, at least in part, explained by maladaptive coping strategies.
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http://dx.doi.org/10.1016/j.paid.2021.110833DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8570824PMC
July 2021

The relationship between body dysmorphic disorder symptoms and 'not just right' experiences in a sample of individuals seeking cosmetic surgery and aesthetic medicine procedures.

Clin Psychol Psychother 2022 May 11;29(3):1034-1049. Epub 2021 Nov 11.

Department of General Psychology, University of Padova, Padova, Italy.

Background: Body dysmorphic disorder (BDD) is characterized by concerns for perceived defects in physical appearance that appear to others as mild or unobservable. Individuals with BDD frequently refer concerns with their physical appearance being 'not right' (not just right experiences; NJREs), and BDD-related behaviours may be performed until their appearance is perceived as 'right'. The aim of the study was to explore the relationship between BDD and NJREs in cosmetic surgery and aesthetic medicine settings.

Methods: Individuals requesting cosmetic procedures with BDD symptoms (BDD-symptoms group; n = 24), without BDD symptoms (cosmetic intervention [CI] group; n = 45), and individuals that have never required these procedures (no cosmetic intervention [NCI] group; n = 53) entered the study.

Results: Results showed a greater number of past-month NJREs, higher NJREs severity, higher drive for thinness, and greater general distress in the BDD-symptoms group. Pertaining to features associated with NJREs (perfectionism and obsessive-compulsive disorder symptoms) and ED core features, the BDD-symptoms group scored higher only with respect to NCI. Regression analyses showed that BDD symptoms were predicted by age, NJREs severity, and drive for thinness above and beyond general distress, perfectionism, obsessive-compulsive disorder symptoms, bulimia, and body dissatisfaction related to weight and shape in the BDD-Symptoms group (in comparison with the CI and NCI groups).

Conclusions: NJREs may represent a potential vulnerability factor for BDD symptoms in cosmetic settings.
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http://dx.doi.org/10.1002/cpp.2683DOI Listing
May 2022

Maladaptive Consequences of Mental Intrusions with Obsessive, Dysmorphic, Hypochondriac, and Eating-disorders Related Contents: Cross-cultural Differences.

Int J Clin Health Psychol 2022 Jan-Apr;22(1):100275. Epub 2021 Oct 12.

Department of Human Health Science, University of Firenze, Italy.

Background/objective: Unwanted mental intrusions (UMIs) with contents related to Obsessive-Compulsive Disorder (OCD), Body Dysmorphic Disorder (BDD), Illness Anxiety Disorder (IAD), and Eating Disorders (EDs) are highly prevalent, independently of the cultural and/or social context. Cognitive-behavioral explanations for these disorders postulates that the escalation from common UMIs to clinically relevant symptoms depends on the maladaptive consequences (i.e., emotions, appraisals, and control strategies) of experiencing UMIs. This study examines, from a cross-cultural perspective, the cognitive-behavioral postulates of the maladaptive consequences of having UMIs.

Method: Non-clinical 1,473 participants from Europe, the Middle-East, and South America completed the Questionnaire of Unpleasant Intrusive Thoughts to assess the maladaptive consequences of experiencing highly disturbing OCD, BDD, IAD, and EDs-related UMIs.

Results: Findings revealed main effects for both the country and the consequences associated with the four UMI contents. Interaction effects between the consequences of each UMI content and the sample location were also observed.

Conclusions: Cognitive-Behavioral models for OCD, BDD, IAD, and EDs should be implemented along with socio-cultural variables that increase the understanding of the role of these variables in the phenomenology of UMIs and their associated consequences.
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http://dx.doi.org/10.1016/j.ijchp.2021.100275DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8517547PMC
October 2021

Evaluating the validity of brief prototype-based informant ratings of triarchic psychopathy traits in prisoners.

Behav Sci Law 2021 Oct 17;39(5):641-662. Epub 2021 Oct 17.

Department of Health Sciences, Psychology Section, University of Firenze, Firenze, Italy.

The validity of self-report psychopathy assessment has been questioned, especially in forensic settings where clinical evaluations influence critical decision-making (e.g., institutional placement, parole eligibility). Informant-based assessment offers a potentially valuable supplement to self-report but is challenging to acquire in under-resourced forensic contexts. The current study evaluated, within an incarcerated sample (n = 322), the extent to which brief prototype-based informant ratings of psychopathic traits as described by the triarchic model (boldness, meanness, disinhibition; Patrick et al., 2009) converge with self-report trait scores and show incremental validity in predicting criterion measures. Self/informant convergence was robust for traits of boldness and disinhibition, but weaker for meanness. Informant-rated traits showed incremental predictive validity over self-report traits, both within and across assessment domains. These findings indicate that simple prototype-based informant ratings of the triarchic traits can provide a useful supplement to self-report in assessing psychopathy within forensic-clinical settings.
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http://dx.doi.org/10.1002/bsl.2542DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9297945PMC
October 2021

Psychological distress in the context of the COVID-19 pandemic: the joint contribution of intolerance of uncertainty and cyberchondria.

Psychol Health 2021 Jul 19:1-18. Epub 2021 Jul 19.

Division of Psychology, School of Applied Sciences, London South Bank University, London, UK.

Objective: To explore the direct and indirect associations between intolerance of uncertainty, health anxiety (HA), and psychological distress through problematic internet use (PIU) and cyberchondria, both before and during the first months of the COVID-19 pandemic.

Design: Two Italian samples were enrolled via an online questionnaire. Sample 1 (N = 556; 69.3% females, M 29.6 years, SD = 13.2) was recruited in non-pandemic times, whereas Sample 2 (N = 575; 74% females, M 31.9 years, SD = 13.4) was recruited during the COVID-19 lockdown.

Main Outcome Measures: Self-report measures assessing HA and psychological distress.

Results: Two distinct path analyses showed that intolerance of uncertainty was directly associated with HA and psychological distress in both samples. Moreover, cyberchondria partially mediated the relationship between intolerance of uncertainty and HA and PIU partially mediated the relationship between intolerance of uncertainty and psychological distress in both samples. The link between cyberchondria and psychological distress was significant in Sample 2 but non-significant in Sample 1. The model accounted for a substantial variance of HA and psychological distress in both samples.

Conclusion: Our findings suggest that problematic online behaviors might exacerbate the negative consequences of intolerance of uncertainty in terms of higher levels of HA and psychological distress both in pandemic and non-pandemic contexts.
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http://dx.doi.org/10.1080/08870446.2021.1952584DOI Listing
July 2021

Dimensionality and psychometric properties of an Italian translation of the Intuitive Eating Scale-2 (IES-2): An assessment using a bifactor exploratory structural equation modelling framework.

Appetite 2021 11 2;166:105588. Epub 2021 Jul 2.

Department of General Psychology, University of Padova, Padova, Italy. Electronic address:

The construct of intuitive eating is most often measured using the 23-item Intuitive Eating Scale-2 (IES-2), but previous studies have typically relied solely on confirmatory factor analysis (CFA) to understand IES-2 dimensionality. In contrast, a bifactor exploratory structural equation modelling (B-ESEM) framework offers a more realistic account of IES-2 multidimensionality. Here, we assessed the psychometric properties of a novel Italian translation using a combination of exploratory factor analysis and B-ESEM. A total of 950 adults completed the IES-2 alongside measures of positive body image, disordered eating, and psychological well-being. Results indicated that a 4-factor B-ESEM model had adequate fit to the data and that fit was improved when the correlated uniqueness of seven negatively worded IES-2 items was accounted for. This model of IES-2 scores showed adequate internal consistency and good test-retest reliability up to three weeks. Evidence of construct validity was good in terms of a global IES-2 factor, and broadly supported in terms of its specific-factors. These results highlight the utility of a B-ESEM framework for understanding the dimensionality of IES-2 scores and may help scholars better understand the extent to which the IES-2 adequately operationalises the construct of intuitive eating.
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http://dx.doi.org/10.1016/j.appet.2021.105588DOI Listing
November 2021

Towards a model of uncertainty distress in the context of Coronavirus (COVID-19).

Cogn Behav Therap 2020 7;13:e31. Epub 2020 Jul 7.

School of Psychology, Newcastle University, Newcastle upon Tyne, NE1 7RU, UK.

The paper forms part of a series of papers outlining the theoretical framework for a new model of uncertainty distress (this paper), treatment implications arising from the model, and empirical tests of the model. We define uncertainty distress as . In the first paper we draw on a robust body of research on distinct areas including: threat models of anxiety, perceived illness uncertainty and intolerance of uncertainty. We explore how threat and uncertainty are separable in anxiety and how we can understand behaviours in response to uncertainty. Finally, we propose a clinically, theoretically and empirically informed model for uncertainty distress, and outline how this model can be tested. Caveats, clinical applications and practitioner key points are briefly included, although these are more fully outlined in the treatment implications article. While we outline this model in the context of novel coronavirus (COVID-19), the model has broader applications to both mental and physical health care settings.

Key Learning Aims: (1)To define the concept of uncertainty distress.(2)To understand the role of threat, over-estimation of threat, perceived uncertainty, actual uncertainty, and intolerance of uncertainty in distress maintenance.(3)To understand how people may behave in response to uncertainty distress.(4)To describe a model of uncertainty distress.
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http://dx.doi.org/10.1017/S1754470X2000029XDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7426588PMC
July 2020

The Relevance of Assessing Subjective Experiences of Skin Toxicity During Adjuvant Radiotherapy for Breast Cancer.

Front Oncol 2021 15;11:645921. Epub 2021 Apr 15.

Department of General Psychology, University of Padua, Padua, Italy.

Purpose: Radiodermatitis is likely to be an inevitable side effect of radiotherapy (RT) but experiencing pain relief during RT might contribute making treatment more acceptable and less impairing. The current study aimed to assess the subjective perceptions and experiences of skin toxicity in a sample of women undergoing adjuvant RT for breast cancer.

Methods: Eighty patients were randomly assigned to one out of two groups: treatment (i.e., a newly developed topical product) and control (i.e., standard-of-care). Patients underwent adjuvant RT for 3 weeks. Clinical assessment of radiodermatitis and self-reported levels of pain, relief, and perceptions of treatment response were collected at the initiation of RT (T1), during RT (T2 and T3), and 2 weeks after treatment completion (T4). To assess changes in skin-related QoL, a subgroup of patients completed the Padua Skin-Related QoL questionnaire at T0 (before the initiation of RT) and at T4.

Results: A comparable timing of onset and severity of radiodermatitis during treatment was observed in both groups. The treatment group reported lower levels of pain and higher levels of relief compared to the control group when skin toxicity was at its highest levels (T2 and T3). Independent of the group, levels of perceived improvements in clinical status increased over time, whereas skin-related QoL worsened from T0 to T4.

Conclusion: Current findings outline the relevance of integrating clinical evaluations of radiodermatitis with patients' subjective experiences of skin toxicity in interventional studies. Moreover, they provide preliminary evidence about the soothing effect of a newly developed topical product, thus supporting its usefulness of as a supportive care.
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http://dx.doi.org/10.3389/fonc.2021.645921DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8083130PMC
April 2021

Health Anxiety Predicts the Perceived Dangerousness of COVID-19 over and above Intrusive Illness-Related Thoughts, Contamination Symptoms, and State and Trait Negative Affect.

Int J Environ Res Public Health 2021 02 17;18(4). Epub 2021 Feb 17.

Department of General Psychology, University of Padova, Via Venezia, 8, 35131 Padova, Italy.

This study sought to evaluate the specificity of health anxiety, relative to other forms of psychopathology, in perceptions of COVID-19 as dangerous. Measures of health anxiety, COVID-19 perceived dangerousness, negative affect, anxiety, depression, stress, contamination-related obsessions and compulsions, and intrusive illness-related thoughts were administered online to 742 community individuals during the Italian national lockdown. Results showed that, after controlling for demographic variables and other internalizing problems, health anxiety was the single most important factor associated with the perceived dangerousness of COVID-19. Moreover, a comparison between the current sample's scores on various symptom measures and scores from prepandemic Italian samples revealed that, whereas other internalizing symptoms increased by a large or very large magnitude during the pandemic, levels of health anxiety and negative affect increased by a medium amount. This result may indicate that health anxiety is relatively trait-like, increasing the likelihood that our correlational data support the model of health anxiety as a vulnerability rather than an outcome. Together, these results indicate that health anxiety may be a specific risk factor for COVID-related maladjustment and support the distinction of health anxiety from other psychological problems.
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http://dx.doi.org/10.3390/ijerph18041933DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7922316PMC
February 2021

Psychopathy and COVID-19: Triarchic model traits as predictors of disease-risk perceptions and emotional well-being during a global pandemic.

Pers Individ Dif 2021 Jul 12;176:110770. Epub 2021 Feb 12.

Department of Psychology, Florida State University, 1107 W. Call St., Tallahassee, FL, United States.

This study extended recent research showing that perceptions of disease risk are associated with emotional well-being during COVID-19 by examining how psychopathic traits of boldness, meanness, and disinhibition influence these perceptions and psychological outcomes. During the Italian national lockdown, a large community sample (  = 31.3 years) completed online questionnaire measures of the triarchic psychopathic traits, perceptions of disease susceptibility and danger, and recent well-being. Path analyses revealed differing roles for the triarchic traits: boldness and meanness predicted greater well-being (lower stress, higher positive affect) and disinhibition predicted lower well-being. Further, boldness and meanness were linked to well-being through distinct indirect pathways of low perceived susceptibility to infection (boldness) and low perceived dangerousness of COVID-19 (boldness and meanness). Findings speak to the triarchic model's utility in explaining socioemotional phenomena during times of crisis and support the distinct biobehavioral conceptualizations of boldness as low threat sensitivity, meanness as low affiliative capacity, and disinhibition as deficient affective and behavioral control.
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http://dx.doi.org/10.1016/j.paid.2021.110770DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7879152PMC
July 2021

Cognitive Behavioral Training Using a Mobile Application Reduces Body Image-Related Symptoms in High-Risk Female University Students: A Randomized Controlled Study.

Behav Ther 2021 01 17;52(1):170-182. Epub 2020 Apr 17.

Baruch Ivcher School of Psychology, Interdisciplinary Center Herzliya. Electronic address:

Body dissatisfaction is prevalent in young women, and is associated with symptoms of body dysmorphic disorder (BDD) and eating disorders (EDs). The aim of the study was to assess the efficacy of a mobile application, based on cognitive behavioral principles, in reducing body dissatisfaction and BDD/ED symptoms in female university students considered at high-risk of developing body image disorders (BIDs). Fifty university students at high-risk of developing BIDs (using self-report questionnaires assessing BIDs and the Structured Clinical Interview for DSM-5 Clinical Version) were randomized in two groups: immediate-use App group (iApp group; n = 25) and delayed-use App group (dApp group; n = 25). The iApp group started using the app at baseline for 16 days (T0 to T1). The dApp group waited for 16 days before starting to use the app (T1 to T2). Participants completed questionnaires at baseline (T0), 16 days from baseline (T1), and 32 days from baseline (T2). Repeated measure Analyses of Variance (ANOVAs) showed a Group (iApp vs. dApp) × Time (T0 vs. T1) interaction on BDD symptoms indicating medium effect size (partial eta squared) reductions in the iApp group compared to dApp group at T1; post-intervention means for BDD symptoms were under the cut-off for extreme body dissatisfaction/BDD symptoms in both groups. Pertaining to ED symptoms, no significant Group × Time interaction was detected. Training 3 minutes a day for 16 days with a CBT-based mobile application may lead to reductions in some forms of body dissatisfaction, including BDD symptoms in female university students at high-risk of developing BIDs. On the other hand, effects of the intervention on ED symptoms seem more limited.
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http://dx.doi.org/10.1016/j.beth.2020.04.002DOI Listing
January 2021

How is intolerance of uncertainty related to negative affect in individuals with substance use disorders? The role of the inability to control behaviors when experiencing emotional distress.

Addict Behav 2021 04 16;115:106785. Epub 2020 Dec 16.

Department of Social and Developmental Psychology, Sapienza University of Rome, Rome, Italy. Electronic address:

We used structural equation modeling to assess the role of impaired emotional awareness and clarity (Impaired Awareness/Clarity) and inability to control behaviors when experiencing emotional distress (Inability to Control Behaviors) as an account for the relationship between intolerance of uncertainty (IU) and negative affect (NA) in individuals with Substance Use Disorders (SUDs) and healthy controls (HCs) used for comparison. One-hundred and thirty-one individuals with SUDs (42.75% female; mean age = 39.74 ± 11.83) and 131 sex-matched HCs (mean age = 40.02 ± 12.34) entered the study. Participants completed questionnaires assessing the constructs of interest. Single-group analyses aimed to identify a baseline model for each group and test the hypothesized direct/indirect relations' overall significance. Then, a multigroup analysis tested the invariance of model parameters between SUD and HC groups. The model in which IU had both direct and indirect relationships with NA through Impaired Awareness/Clarity and Inability to Control Behaviors was a good fit to the data. The indirect relationship of IU with NA through Inability to Control Behaviors was significant and moderate-sized. The relationship involving Impaired Awareness/Clarity and Inability to Control Behaviors was small-sized and significant in single group analysis only. The multigroup analysis supported the association of IU with NA through Inability to Control Behaviors in the SUD group. Overall, our study highlights the crucial role of the Inability to Control Behaviors in SUDs and suggests that its association with IU might fuel NA in this population.
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http://dx.doi.org/10.1016/j.addbeh.2020.106785DOI Listing
April 2021

What is the internal structure of intolerance of uncertainty? A network analysis approach.

J Anxiety Disord 2020 10 19;75:102293. Epub 2020 Aug 19.

Department of General Psychology, University of Padova, via Venezia 8, 35131 Padova, Italy. Electronic address:

Intolerance of uncertainty (IU) is a transdiagnostic vulnerability factor spanning psychological disorders. Although IU has been extensively studied, its internal structure is still not fully understood. In the current study, we applied network analysis to investigate IU - as measured by the Intolerance of Uncertainty Scale-Revised (IUS-R) - in two large non-clinical samples, consisting of undergraduates (N = 1172) and community individuals (N = 1759). Network analysis revealed that feeling a general internal uncertainty aversion and the belief that things have to be planned in advance are the most central nodes in both samples. Moreover, the community analysis revealed that, in both samples, the network of IU consists of three communities referring to negative beliefs about uncertainty, behavioral reactions to uncertainty, and emotional reactions to uncertainty. Lastly, the network was highly similar in undergraduates and community individuals in terms of network similarity, global connectivity, and structure and items mean levels; only minimal-to-negligible differences were found. The way current findings expand our knowledge of the internal structure of IU, along with theoretical and clinical implications, are discussed.
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http://dx.doi.org/10.1016/j.janxdis.2020.102293DOI Listing
October 2020

Reaching reliable change using short, daily, cognitive training exercises delivered on a mobile application: The case of Relationship Obsessive Compulsive Disorder (ROCD) symptoms and cognitions in a subclinical cohort.

J Affect Disord 2020 11 21;276:775-787. Epub 2020 Jul 21.

Baruch Ivcher School of Psychology, Interdisciplinary Center Herzliya, PO Box 167, Herzliya 46150, Israel. Electronic address:

Background: Relationship Obsessive Compulsive Disorder (ROCD) is a presentation of OCD centering on interpersonal relationships. The aim of this Randomized Control Trial (RCT) was to assess the efficacy of short, game like, daily cognitive interventions delivered via mobile application in reducing subclinical ROCD symptoms and associated phenomena.

Methods: Fifty university students identified as having subclinical levels of ROCD symptoms (using the Structured Clinical Interview for DSM-5 Clinical Version) were randomized into: immediate-use group (iApp group; n = 25) and delayed-use group (dApp group; n = 25). The iApp group started using the evaluated cognitive-behavioral training application at baseline for 15 days (T0 to T1). The dApp group commenced using the application at T1 for 15 days (T1 to T2). All participants completed questionnaires at baseline (T0), 15 days from baseline (T1), and 30 days from baseline (T2).

Results: Repeated measure MANOVAs showed significant Group (iApp vs. dApp) × Time (T0 vs. T1) interactions. These interactions indicated greater decrease in ROCD symptoms, OCD beliefs and social anxiety symptoms, as well as a greater increase in self-esteem in the iApp group compared to dApp group at T1. Moreover, the Reliable Change Index (RCI) indicated reliable change on ROCD symptoms for a significant portion of participants (42-52%).

Limitations: Sample size and the use of self-report measures limits the generalizability of the results.

Conclusions: Short, daily cognitive training interventions delivered via mobile applications may be useful in reducing subclinical ROCD symptoms and associated features. Further testing is needed for clinical populations.
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http://dx.doi.org/10.1016/j.jad.2020.07.043DOI Listing
November 2020

Comprehensive Behavioral Therapy of Trichotillomania: A Multiple-Baseline Single-Case Experimental Design.

Front Psychol 2020 10;11:1210. Epub 2020 Jun 10.

Department of General Psychology, University of Padova, Padova, Italy.

Despite rapidly increasing knowledge about Trichotillomania (TTM), no gold-standard evidence-based psychological intervention has been identified. In the current study, we evaluated the potential efficacy of an eight-session psychological intervention for TTM, namely the Comprehensive Behavioral Model (ComB) treatment, using a multiple-baseline single-case experimental design with three Italian women with TTM. The study included three phases: baseline, intervention, and 3-month follow-up. We assessed the intervention using daily self-monitoring of number of hair-pulling episodes, number of pulled hairs per episode, degree of resistance to pulling urges, and degree of associated distress. We also assessed for reliable improvement in general distress from baseline to post-intervention. All participants completed treatment and showed improvements on those symptom measures that were most relevant to their individualized case conceptualization. However, no participants recovered completely or demonstrated reliable improvement in general distress. Our results provide initial evidence for the utility of the ComB treatment for TTM in an Italian clinical setting. Furthermore, they support the delivery of individualized and flexible psychological treatments when treating TTM.
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http://dx.doi.org/10.3389/fpsyg.2020.01210DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7298435PMC
June 2020

Health-Related Lifestyles, Substance-Related Behaviors, and Sexual Habits Among Italian Young Adult Males: An Epidemiologic Study.

Sex Med 2020 Sep 7;8(3):361-369. Epub 2020 May 7.

Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padova, Italy.

Introduction: Young adult males are more likely to demonstrate health-risk behaviors than other individuals. The use of specific data about health-risk behaviors within this population might be important to promote effective preventive psychosocial and educational programs and interventions.

Aim: To provide a detailed description of health-related lifestyles, substance-related behaviors, and sexual habits that can negatively affect fertility, sexual sphere, and health in a large sample of Italian young adult males.

Methods: A sample comprising 2,170 males aged 18-21 years, attending the last year of high school, was administered an online questionnaire made up of 39 multiple-choice questions. The questionnaire explored health-related lifestyles, substance-related behaviors, and sexuality and sexual habits. Descriptive analyses were conducted.

Main Outcome Measure: The outcome measures included data about health-related lifestyles, substance-related behaviors, and sexuality and sexual habits reported by Italian young adult males.

Results: Health-related lifestyles: 92.9% of the sample reported practicing some physical activity during the week. 90.3% declared a Mediterranean diet and 8.1% a hyperproteic diet. Substance-related behaviors: 33.8% of the sample reported having smoked tobacco at least once in their lives; among them, 71% reported current daily smoking. 40.2% declared drinking alcohol from 5 to 7 days in a week. 32.9% of the sample reported currently using a substance. Sexuality and sexual habits: 97.1% of the sample self-defined themselves as heterosexual. 73.3% of participants rated their knowledge about sexuality as "excellent/good," 58.7% about sexually transmitted infections. Only 4.8% reported having had a seminal liquid examination. Half of the sample (52.2%) declared having had sexual intercourses, in the largest proportion protected sex. 14.7% of the sample reported having at least one sexual dysfunction. 88.6% of participants reported having used pornography, 18.7% every day.

Conclusion: The present study highlighted the need to empower the number and efficacy of preventive interventions to promote health-related behaviors among Italian young male population. Flesia L, Cavalieri F, Angelini S, et al. Health-Related Lifestyles, Substance-Related Behaviors, and Sexual Habits Among Italian Young Adult Males: An Epidemiologic Study. Sex Med 2020;8:361-369.
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http://dx.doi.org/10.1016/j.esxm.2020.03.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7471067PMC
September 2020

Testing the Italian version of the Cyberchondria Severity Scale and a metacognitive model of cyberchondria.

Clin Psychol Psychother 2020 Jul 20;27(4):581-596. Epub 2020 Mar 20.

Division of Psychology, School of Applied Sciences, London South Bank University, London, UK.

Cyberchondria refers to the tendency to excessively and compulsively search for online medical information despite the distress experienced, with consequent impairment of daily-life activities. The current two studies sought to explore (i) the factor structure of the Italian version of the Cyberchondria Severity Scale (CSS) and (ii) a metacognitive model of cyberchondria. Participants were Italian community adults who reported using the Internet to search for health-related information (Study 1: N = 374, Study 2: N = 717). Results from Study 1 supported the Italian version of the CSS exhibiting a five-factor structure, with the resulting scales demonstrating good internal consistency, 5-week test-retest reliability, and generally strong correlations with indices of health anxiety. In Study 2, results of a path analysis showed that the negative metacognitive belief domain ("thoughts are uncontrollable") shared the strongest direct association with each of the five dimensions of cyberchondria, followed by beliefs about rituals. Consistently, the strongest indirect associations were found between "thoughts are uncontrollable" and all the five cyberchondria dimensions via beliefs about rituals. These results provide support for an Italian version of the CSS and the metacognitive conceptualization of cyberchondria.
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http://dx.doi.org/10.1002/cpp.2444DOI Listing
July 2020

"The Italian Study on Recovery 2" Phase 1: Psychometric Properties of the Recovery Assessment Scale (RAS), Italian Validation of the Recovery Assessment Scale.

Front Psychiatry 2019 5;10:1000. Epub 2020 Feb 5.

UCLA Psych REHAB program, University of California, Los Angeles, Los Angeles, CA, United States.

Background: The achievement of recovery is related to the notion of developing personal potential and restoring a legitimate social role, even against the backdrop of mental illness limitations. It is still difficult to fully understand this highly subjective and dynamic process. Therefore, in order to test the recovery process, specific tools, still only marginally used in our country, are needed.

Aims: The Italian Study on Recovery is the first study aimed at confirming the validity of the Italian version of the Recovery Assessment Scale (RAS), an instrument developed with the goal of detecting recovery among patients.

Method: This multicentric research involved several Mental Health Services from various parts of Italy. The first phase of the study consisted in the administration of the Italian translation of RAS, previously used in a pilot study conducted in 2009. RAS was administered to 219 patients diagnosed with psychosis, whose mental disorder lasted for at least 5 years.

Results: Findings supported the good psychometric properties of the Italian version of RAS, demonstrating its capability of identifying patients matching the "in recovery" operational criteria.

Conclusions: In consideration of the results highlighting the good psychometric properties of RAS, the present study may contribute to the diffusion of instruments to be included in Mental Health Service planning in the Italian context, in order to start a recovery-oriented transformation.
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http://dx.doi.org/10.3389/fpsyt.2019.01000DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7013090PMC
February 2020

The Psychosocial Assessment of Transplant Candidates: Inter-Rater Reliability and Predictive Value of the Italian Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT).

Psychosomatics 2020 Mar - Apr;61(2):127-134. Epub 2019 Dec 4.

Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA.

Background: The Stanford Integrated Psychosocial Assessment for Transplantation (SIPAT) is a comprehensive instrument developed to accurately assess the main pretransplant psychosocial risk factors that may impact transplant outcomes.

Objective: As neither established assessment procedures nor standardized tools designed to perform pretransplant psychosocial evaluation are currently available in Italy, the present study was designed to develop and preliminarily validate the Italian version of the SIPAT.

Methods: First, our team developed the Italian version of the SIPAT, following standard forward-back translation procedures. Then, the Italian version of the SIPAT was retrospectively and blindly applied to 118 randomly selected transplant cases (40 heart, 40 lung, and 38 liver) by 2 independent examiners. Information about the patients' final transplant listing recommendation (i.e., listing vs. deferral) was independently collected from the respective transplant teams.

Results: The inter-rater reliability of the Italian version of the SIPAT scores was substantial (Cohen's kappa = 0.77; P < 0.001). Moreover, the predictive value of the SIPAT ratings on the final transplant listing recommendation (i.e., listing vs. deferral) for each examiner was significant (both P < 0.05).

Conclusion: Current findings suggest that SIPAT is a promising and reliable instrument in its Italian version. Given these excellent psychometric characteristics, the use of the SIPAT as part of the pretransplant psychosocial evaluation in Italian medical settings is highly encouraged.
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http://dx.doi.org/10.1016/j.psym.2019.11.008DOI Listing
February 2021

Personality, Schizophrenia, and Violence: A Longitudinal Study: The Second Wave of the VIORMED Project.

J Pers Disord 2021 04 14;35(2):236-254. Epub 2019 Oct 14.

Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.

This study investigated the association between maladaptive personality traits, personality disorders (PDs), schizophrenia, and the risk of aggressive behavior. Ninety-four patients with a history of violence and 92 patients with no history of violence underwent a multidimensional baseline assessment. Aggressive behavior was monitored during a 1-year follow-up through the Modified Overt Aggression Scale. The Violent group scored significantly higher than the Control group on the Millon Clinical Multiaxial Inventory (MCMI-III) Antisocial, Sadistic, Borderline, and Paranoid personality scales. Irrespective of any history of violence, patients with PD as a primary diagnosis displayed more aggressive behaviors than those with a primary diagnosis of schizophrenia during the follow-up. Furthermore, the most significant predictor of aggressive behaviors over time was endorsing a primary diagnosis of PD. Identifying the crucial risk factors for violent recidivism would contribute to reducing aggressive behavior in this population.
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http://dx.doi.org/10.1521/pedi_2019_33_436DOI Listing
April 2021

The cross-cultural and transdiagnostic nature of unwanted mental intrusions.

Int J Clin Health Psychol 2019 May 11;19(2):85-96. Epub 2019 Mar 11.

Department of Human Health Science, University of Firenze, Italy.

Background/objective: Unwanted mental intrusions (UMIs), typically discussed in relation to Obsessive-Compulsive Disorder (OCD), are highly prevalent, regardless of the specific nationality, religion, and/or cultural context. Studies have also shown that UMIs related to Body Dysmorphic Disorder (BDD), Illness anxiety/Hypochondriasis (IA-H), and Eating Disorders (EDs) are commonly experienced. However, the influence of culture on these UMIs and their transdiagnostic nature has not been investigated.

Method: Participants were 1,473 non-clinical individuals from seven countries in Europe, the Middle-East, and South America. All the subjects completed the Questionnaire of Unpleasant Intrusive Thoughts, which assesses the occurrence and discomfort of four UMI contents related to OCD, BDD, IA-H, and EDs, and symptom questionnaires on the four disorders.

Results: Overall, 64% of the total sample reported having experienced the four UMIs. The EDs intrusions were the most frequently experienced, whereas hypochondriacal intrusions were the least frequent but the most disturbing. All the UMIs were significantly related to each other in frequency and disturbance, and all of them were associated with clinical measures of OCD, BDD, IA-H, and EDs.

Conclusions: UMIs are a common phenomenon across different cultural contexts and operate transdiagnostically across clinically different disorders.
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http://dx.doi.org/10.1016/j.ijchp.2019.02.005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6517647PMC
May 2019

Seeking certainty about Intolerance of Uncertainty: Addressing old and new issues through the Intolerance of Uncertainty Scale-Revised.

PLoS One 2019 11;14(2):e0211929. Epub 2019 Feb 11.

Department of General Psychology, University of Padova, Padova, Italy.

Intolerance of Uncertainty is a trans-diagnostic process that spans a range of emotional disorders and it is usually measured through the Intolerance of Uncertainty Scale-12. The current study aims at investigating some issues in the assessment of Intolerance of Uncertainty (IU) through the Italian Intolerance of Uncertainty Scale-Revised, a measure adapted from the Intolerance of Uncertainty Scale-12 to assess IU across the lifespan. In particular we address the factor structure among a large community sample, measurement invariance across gender, age, and over time, together with reliability and validity of the overall scale and its subscales. The questionnaire was administered to community (N = 761; mean age = 35.86 ± 14.01 years) and undergraduate (N = 163; mean age = 21.16 ± 2.64 years) participants, together with other self-report measures assessing constructs theoretically related to IU. The application of a bifactor model shows that the Italian Intolerance of Uncertainty Scale-Revised possesses a robust general factor, thus supporting the use of the unit-weighted total score of the questionnaire as a measure of the construct. Furthermore, measurement invariance across gender, age, and over time is supported. Finally, the Italian Intolerance of Uncertainty Scale-Revised appears to possess adequate reliability and validity. These findings support the unidimensionality of the measure, a conceptually reasonable result in line with the trans-diagnostic nature of Intolerance of Uncertainty. In addition, this study and comparison with published factor structures of the Intolerance of Uncertainty Scale-12 and of the Intolerance of Uncertainty Scale-Revised identify some issues for the internal structure of the measure. In particular, concern is expressed for the Prospective IU subscale. In light of the promising psychometric properties, the use of the Italian Intolerance of Uncertainty Scale-Revised as a univocal measure is encouraged in both research and clinical practice.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0211929PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6370219PMC
November 2019

Muscle Dysmorphia and its Associated Psychological Features in Three Groups of Recreational Athletes.

Sci Rep 2018 06 11;8(1):8877. Epub 2018 Jun 11.

Department of General Psychology, University of Padova, via Venezia 8, 35131, Padova, Italy.

Muscle Dysmorphia (MD) is a psychological disorder characterized by the preoccupation with the idea that one's body is not lean and muscular. The current study aimed to explore MD behaviours and symptoms in three groups of recreational athletes: bodybuilders (BB; n = 42), strength athletes (SA; n = 61), and fitness practitioners (FP; n = 22). Furthermore, we assessed MD-related psychological features as well as possible psychological predictors of MD among groups. Results highlighted that the BB group reported more beliefs about being smaller and weaker than desired compared to the other groups, whereas individuals in the SA group reported setting higher standards for themselves than the FP group. Lastly, orthorexia nervosa and social anxiety symptoms emerged as predictors of MD symptoms in the BB group. Taken together, our findings suggest that individuals in the BB group are characterized by more MD general symptomatology than those in the other groups; furthermore, only orthorexia nervosa and social anxiety may play a specific role in predicting MD general symptoms in bodybuilders.
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http://dx.doi.org/10.1038/s41598-018-27176-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5995876PMC
June 2018

Non-weight-related body image concerns and Body Dysmorphic Disorder prevalence in patients with Anorexia Nervosa.

Psychiatry Res 2018 09 31;267:120-125. Epub 2018 May 31.

Department of General Psychology, University of Padova, Padova, Italy.

Patients with Anorexia Nervosa (AN) and patients with Body Dysmorphic Disorder (BDD) are both characterized by body image disturbance and dissatisfaction; furthermore, these disorders share clinical features and frequently co-occur. However, few studies have explored the relation between AN and BDD. Therefore, the first aim of the study was assessing the prevalence of BDD and presence of non-weight-related body image concerns in patients with AN. Second, we were interested in comparing patients with AN and non-weight-related body image concerns, patients with weight-related body image concerns only, and a healthy control group with respect to several psychological and psychopathological features. Sixty-one female patients with AN were divided in two subgroups: 39 with non-weight-related body image concerns and 22 with weight-related body image concerns only. Sixteen (26.23%) patients with AN had probable comorbid BDD. Moreover, patients with AN and non-weight-related body image concerns reported, overall, greater psychopathology than patients with AN and weight-related body image concerns only, with the exception of AN core features and general distress. In conclusion, patients with AN and non-weight-related body image concerns showed a more severe body image disturbance unrelated to a more severe eating disorder pathology.
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http://dx.doi.org/10.1016/j.psychres.2018.05.068DOI Listing
September 2018
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