Publications by authors named "Giulio Vidotto"

51 Publications

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

Visual Feedback Effectiveness in Reducing Over Speeding of Moped-Riders.

Front Psychol 2021 11;12:611603. Epub 2021 Mar 11.

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

The use of assistance systems aimed at reducing road fatalities is spreading, especially for car drivers, but less effort has been devoted to developing and testing similar systems for powered two-wheelers (PTWs). Considering that over speeding represents one of the main causal factors in road crashes and that riders are more vulnerable than drivers, in the present study we investigated the effectiveness of an assistance system which signaled speed limit violations during a simulated moped-driving task, in optimal and poor visibility conditions. Participants performed four conditions of simulated riding: one baseline condition without Feedback, one Fog condition in which visual feedback was provided so as to indicate to the participants when a speed limit (lower than that indicated by the traffic signals) was exceeded, and two post-Feedback conditions with and without Fog, respectively, in which no feedback was delivered. Results showed that participants make fewer speeding violations when the feedback is not provided, after 1 month, and regardless of the visibility condition. Finally, the feedback has been proven effective in reducing speed violations in participants with an aggressive riding style, as measured in the baseline session.
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http://dx.doi.org/10.3389/fpsyg.2021.611603DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7990878PMC
March 2021

The Italian COVID-19 Psychological Research Consortium (IT C19PRC): General Overview and Replication of the UK Study.

J Clin Med 2020 Dec 25;10(1). Epub 2020 Dec 25.

Department of General Psychology, University of Padua, 35122 Padova PD, Italy.

The COVID-19 pandemic represents a major stressor for the psychological health of people worldwide. In the UK, the COVID19-Psychological Research Consortium Study (C19PRC) launched to evaluate the psychological impact of COVID-19 in the general population and its implications. The project was then extended to Italy and several other countries. This article provides an overview of the Italian C19PRC study and its replication of two specific findings from the UK C19PRC. In the first part, the relationship between anxiety and somatic symptomatology is examined. In the second part, we analyze the association between several factors and psychological health outcomes: depression/anxiety, traumatic stress, COVID-19 anxiety. In line with the study conducted in the UK, an online survey was administered to the adult Italian general population. The sample included 1038 respondents (age, mean = 49.94, SD = 16.14, 51.15% females) taken from four regions: Lombardia, Veneto, Lazio, and Campania. The relationship between predictors and outcomes was evaluated by means of logistic regression models. Somatic indices showed a positive association with anxiety, worse somatic symptoms were associated with mourning a loss of a beloved one due to COVID-19 and with precarious health conditions. Females showed a higher incidence of psychological issues. No differences in anxiety, depression, and traumatic stress were found across regions but the Campania region showed the most severe somatic symptomatology. In the second analysis, the factors associated with more severe psychological outcomes (i.e., anxiety and/or depression, traumatic stress, and COVID-19 related anxiety) were younger age, the presence of minors in the household, traumatic stressors, and precarious health conditions. No differences across regions emerged. The Italian results correspond to the UK findings for anxiety, depression, and traumatic stress. Both in the UK and Italy, the factors associated with worse psychological health were gender (female), younger age, having children, pre-existing health issues (both for oneself or someone close), and the moderate/high perceived risk of contracting COVID-19 within one month. In Italy, unlike the UK, lower household income and having (had) COVID-19 were not associated with poorer mental health. The psychological impact of COVID-19 can last for months; future research should explore all aspects of the psychological burden of COVID-19 in order to implement psychological interventions and promote psychological health.
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http://dx.doi.org/10.3390/jcm10010052DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7796148PMC
December 2020

On the Implementation of Computerized Adaptive Observations for Psychological Assessment.

Assessment 2020 Oct 5:1073191120960215. Epub 2020 Oct 5.

Department of General Psychology, University of Padova, Italy.

The use of observational tools in psychological assessment has decreased in recent years, mainly due to its personnel and time costs, and researchers have not explored methodological innovations like adaptive algorithms in observational assessment. In the present study, we introduce the behavior-driven observation procedure to develop, test, and implement observational adaptive instruments. In Study 1, we use a preexisting observational checklist to evaluate nonverbal behaviors related to psychotic symptoms and to specify the adaptive algorithm's model. We fit the model to observational data collected from 114 participants. The results support the model's goodness of fit. In Study 2, we use the estimated model parameters to calibrate the adaptive procedure and test the algorithm for accuracy and efficiency in adaptively reconstructing 58 nonadaptively collected response patterns. The results show the algorithm's good accuracy and efficiency, with a 40% average reduction in the number of administered items. In Study 3, we used real raters to test the adaptive checklist built with behavior-driven observation. The results indicate adequate intrarater agreement and good consistency of the observed response patterns. In conclusion, the results support the possibility of using behavior-driven observation to create accurate and affordable (in terms of resources) observational assessment tools.
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http://dx.doi.org/10.1177/1073191120960215DOI Listing
October 2020

Exploring Diener's Multidimensional Conceptualization of Well-Being Through Network Psychometrics.

Psychol Rep 2021 Apr 10;124(2):896-919. Epub 2020 Apr 10.

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

Previous research has addressed the study of the well-being structure focusing on the separability among hedonic and eudaimonic dimensions by means of latent variable approaches. Diener's tripartite model of Subjective Well-Being has often been identified with hedonic well-being, while flourishing (i.e., positive functioning) has been classified as a proxy for eudaimonic well-being. Instead of pursuing a theory-driven approach, the structure of well-being dimensions can be retrieved by means of network psychometrics that is a highly informative, data-driven approach that allows the model structure to spontaneously emerge from the relationships among indicators. Furthermore, we propose a strength centrality decomposition that is able to summarize the influence of a specific indicator within its dimension and between the other dimensions. Contrary to the theoretical conjecture that the separability among well-being dimensions can be grounded on a hedonic and eudaimonic distinction, our results point to a categorization of the Diener's well-being indicators based on the type of information they convey, that is global evaluation of life satisfaction, positive and negative affective experiences, and perceived positive functioning in life.
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http://dx.doi.org/10.1177/0033294120916864DOI Listing
April 2021

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

New Perspectives in Computing the Point of Subjective Equality Using Rasch Models.

Front Psychol 2019 17;10:2793. Epub 2019 Dec 17.

Department of Philosophy, Sociology, Education and Applied Psychology, University of Padua, Padova, Italy.

In psychophysics, the point of subject equality (PSE) is any of the points along a stimulus dimension at which a variable stimulus (visual, tactile, auditory, and so on) is judged by an observer to be equal to a standard stimulus. Rasch models have been found to offer a valid solution for computing the PSE when the method of constant stimuli is applied in the version of the method of transitions. The present work provides an overview of the procedures for computing the PSE using Rasch models and proposes some new developments. An adaptive procedure is described that allows for estimating the PSE of an observer without presenting him/her with all stimuli pairs. This procedure can be particularly useful in those situations in which psychophysical conditions of the individuals require that the number of trials is limited. Moreover, it allows for saving time that can be used to scrutinize the results of the experiment or to run other experiments. Also, the possibility of using Rasch-based fit statistics for identifying observers who gave unexpected judgments is explored. They could be individuals who, instead of carefully evaluating the presented stimuli pairs, gave random, inattentive, or careless responses, or gave the same response to many consecutive stimuli pairs. Otherwise, they could be atypical and clinically relevant individuals who deserve further investigation. The aforementioned developments are implemented using procedures and statistics that are well established in the framework of Rasch models. In particular, computerized adaptive testing procedures are used for efficiently estimating the PSE of the observers, whereas infit and outfit mean-squares statistics are used for detecting observers who gave unexpected judgments. Results of the analyses carried out on simulated data sets suggest that the proposed developments can be used in psychophysical experiments.
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http://dx.doi.org/10.3389/fpsyg.2019.02793DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6927926PMC
December 2019

Enhancement of unsafe behaviors in simulated moped-riding performance under the influence of low dose of alcohol.

Accid Anal Prev 2020 Mar 28;136:105409. Epub 2019 Dec 28.

Department of General Psychology, University of Padua, Italy.

The effects of low levels of blood alcohol concentration (BAC) on motorcyclist performance are still not fully comprehended. The great majority of the studies are, in fact, focused on car driving. So far, it is known that even BAC levels below the legal limit negatively affect riding motor skills correlated with crash rate. In the present study, we used a moped riding simulator to investigate the effects of low alcohol dosages (under the limits established in Italy, and in most European countries) on the defensive riding ability of light drinkers, particularly focusing on the degree of danger characterizing their riding performance. We recruited 24 participants through a double-blind, random distribution, balanced, cross-over design. We administered moderate amounts of alcohol to participants during two sessions of moped riding simulation. The results showed that even though BAC levels were always below (mean value: 0.03 g/dL) the limit allowed by Italian traffic law (0.05 g/dL), alcohol induced a reduction in safe riding behaviors, as indicated by the greater amount of hazardous scenes faced with dangerous riding behaviors when participants were under the influence of alcohol than when they were sober. Moreover, low BAC levels had a greater detrimental influence when a certain amount of learning had already been achieved by the participants (i.e., in the last experimental session). The results suggest that the effect of a low dose of alcohol interacts with participants' self-confidence.
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http://dx.doi.org/10.1016/j.aap.2019.105409DOI Listing
March 2020

Development and psychometric properties of a short form of the Illness Denial Questionnaire.

Psychol Res Behav Manag 2019 22;12:727-739. Epub 2019 Aug 22.

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

Background: Coping with chronic illness can be overwhelming for patients and caregivers, and may be inhibited by the denial mechanism, and therefore, denial represents a critical issue for health professionals. Assessing illness denial is far from easy, and brief tools suitable for medical settings are lacking. In this paper, the development of a short form of the Illness Denial Questionnaire (IDQ) for patients and caregivers is presented.

Methods: In study 1, the IDQ was administered to 118 patients and 83 caregivers to examine the internal structure of denial; then the properties of the items (DIF, fit, and difficulty) were evaluated according to the Rasch model in order to select the best items for the Illness Denial Questionnaire-Short Form (IDQ-SF). Study 2 included 202 participants (113 patients and 89 caregivers). The internal structure of the IDQ-SF was tested via confirmatory factor analysis (CFA). Reliability and concurrent validity were also studied using the Anxiety and Depression Questionnaire-Reduced Form (AD-R).

Results: The CFA showed a two-factor structure encompassing "Denial of negative emotions" and "Resistance to change". Results of the Rasch analyses led to the selection of 4 items for each dimension. The resulting IDQ-SF (8 items) showed a two-factor structure as well as good reliability and concurrent validity with AD-R.

Conclusion: The IDQ-SF represents a valid tool for quickly evaluating the core of illness denial in patients and caregivers. This brief and easily administrable questionnaire allows health professionals to outline the presence and severity of illness denial in order to set individually tailored interventions.
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http://dx.doi.org/10.2147/PRBM.S207622DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6709814PMC
August 2019

Neurocognitive and behavioral markers in DUI recidivists.

Traffic Inj Prev 2019 1;20(sup2):S185-S189. Epub 2019 Nov 1.

Legal Medicine and Toxicology, Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padova, Padova, Italy.

Driving under the influence (DUI) of alcohol recidivism may be a risk-taking behavior motivated by a change in decision-making capacity. Decision-making capacity has been investigated by event-related potentials (ERPs) acquisition and specifically by analyzing feedback-related negativity (FRN) reflecting the activity of medial prefrontal cortex. Thus, the aim of our study was to test the role of FRN as a possible neurophysiological marker of underestimation of risk associated with DUI recidivism to provide novel insights into the influence of neurocognitive aspects of driving ability. The research was structured as a case-control study. The total cohort (30 Italian male subjects) was divided into 2 groups, according to positive or negative history of DUI recidivism. The protocol included informed consent collection, medical history and clinical examination, ERP registration, and sensation-seeking scale administration. ERPs were acquired during a gambling task. The data were analyzed with 2 analysis of variance (ANOVA) repeated measures. Statistical analyses were conducted using R to test the participants' risk behaviors. A multivariate ANOVA was run to compare the personality traits of the groups. ANOVAs and planned comparisons were performed with StatSoft software. FRN amplitude analyses showed that the interaction Reward Magnitude × Valence (large vs. small × gains vs. losses) was significant for recidivists ((1,13) = 11.75,  < .01) but not for controls ((1,14) = 0.04,  = .84). The results of the logistic generalized linear models analysis showed that the 2 groups differed in risk-taking behavior ( = -3.65;  < .001) with an average of 70 risky choices for recidivists and 63 for controls. Both groups were homogeneous for personality traits. The FRN and gambling task results suggest that DUI recidivists seemed attracted by the prospect of a large reward and appeared unable to recognize small losses read as wins These results, if confirmed in a larger sample, could indicate the usefulness of ERP analysis in clinical and forensic evaluation of DUI subjects.
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http://dx.doi.org/10.1080/15389588.2019.1659591DOI Listing
June 2020

Interventions for Psychological Health of Stroke Caregivers: A Systematic Review.

Front Psychol 2019 6;10:2045. Epub 2019 Sep 6.

General Psychology Department, Università degli Studi di Padova, Padova, Italy.

The increasing number of stroke patients (SPs) requires informal caregivers to bear a high burden of responsibilities and heavy (di)stress. Moreover, these issues could lead to the development of serious psychological problems (e.g., depressive and/or anxious) that in turn could give rise to poor health-related quality of life outcomes. However, although the value of psychological interventions has been widely recognized for SPs, the scientific literature lacks an updated synthesis of interventions addressing the psychological health of their caregivers. The aim of this review is to summarize the interventions for the psychological health of stroke caregivers and provide a resume of literature-based evidence of their efficacy. A literature review from 2005 to date was conducted in three online databases: PubMed, Scopus, and Google Scholar. Eligibility criteria for studies were (A) English language, (B) caregivers and patients aged 18 years or above, (C) SP's caregiver beneficiating of a specific intervention, and (D) outcome measures addressing depressive and/or anxiety symptomology, quality of life, well-being, or burden. Across the selected 45 studies, substantial differences are observable in three main categories: (a) type of intervention (b) techniques, and (c) operators. Interventions' advantages and results are discussed. Overall, studies using psychological techniques, such as cognitive-behavioral therapy, coping skill-training, and problem-solving therapy, showed their usefulness and efficacy in reducing the caregivers' depressive and anxious symptoms, and burden. Interventions led by psychologists and tailored to meet caregivers' specific needs showed more positive outcomes. This review underlines the usefulness of psychological interventions aimed at reducing the psychological burden, such as anxious and depressive symptomatology, of SPs' informal caregivers. Hence, psychological interventions for caregivers should be integrated as part of the stroke rehabilitation process to improve informal caregivers' and patients' quality of life and well-being.
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http://dx.doi.org/10.3389/fpsyg.2019.02045DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6743500PMC
September 2019

Influence of visually perceived shape and brightness on perceived size, expected weight, and perceived weight of 3D objects.

PLoS One 2019 8;14(8):e0220149. Epub 2019 Aug 8.

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

In the size-weight illusion, when two objects of identical weight but different volume are lifted, the smaller object is typically perceived to weigh more than the larger object. A well-known explanation for this and other weight illusions is provided by the hypothesis that perceived weight results from the contrast between actual and expected weight. More recently, it has been suggested that an object's size may exert a direct and automatic effect on its perceived weight, independently of expected weight. Here we test these two hypotheses by exploring two illusions that have been known for a long time but have remained relatively underexplored, namely the shape-weight and brightness-weight illusions. Specifically, we measured the influence of visually perceived shape and brightness on the perceived size, the expected weight, and the perceived weight of 3D plastic objects. A numerical rating task was used in Experiment 1, and a paired comparison task was used in Experiment 2. The results showed that spheres were perceived to be heavier than tetrahedrons and cubes, and cubes were perceived to be heavier than tetrahedrons. We did not find any consistent relationship between brightness and perceived weight. A systematic comparison between perceived size, expected weight, and perceived weight showed that the visual shape-weight and brightness-weight illusions are partially inconsistent with the hypothesis that perceived weight results from the contrast between actual and expected weight and with the hypothesis that perceived weight results from the contrast between actual weight and perceived size. The results appear to suggest that there may be a dissociation between the processing of variables that contribute to the conscious experience of size, such as brightness and vertical height, and the processing of variables that contribute to perceived weight, such as surface area.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0220149PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6687149PMC
April 2020

Measuring cognitive vulnerability to depression: Further evidence on the factorial and predictive validity of negative cognitive style.

J Behav Ther Exp Psychiatry 2019 12 3;65:101479. Epub 2019 May 3.

NEUROFARBA, Psychology Section, University of Florence, Florence, Italy.

Background And Objectives: Previous research has provided insufficient evidence on the factorial validity of the negative cognitive style questionnaires, which is a problem for the validity of the total score's computation. In Study 1, we focused on the relationship between internality and the other dimensions of negative cognitive style. In Study 2, we explored the predictive validity of negative cognitive style for negative interpretation bias.

Methods: In Study 1, 770 participants completed the Cognitive Style Questionnaire - Short Form (CSQ-SF). In Study 2, from a prescreening data collection (N = 300) we selected participants with low (N = 40) and high (N = 32) cognitive vulnerability to depression who were primed with negative mood induction and who completed a generative interpretation task.

Results: In Study 1, a confirmatory factor analysis (CFA) indicated that the best fitting model for the CSQ-SF was a bifactor model without the internality dimension. In Study 2, a CFA replicated the factorial structure of Study 1 and individuals with a high negative cognitive style exhibited a negative interpretation bias after controlling for depressive symptoms.

Limitations: The university-age sample limited the generalizability of our results to different populations, and the lack of longitudinal data prevented us from discussing further implications on the relationship between the negative interpretation bias and negative cognitive style in predicting depression.

Conclusions: Together, the results of our two studies support the construct validity of the CSQ-SF and recommend the use of a composite score of negative cognitive style without internality.
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http://dx.doi.org/10.1016/j.jbtep.2019.04.005DOI Listing
December 2019

Personality Traits and Beliefs About Peers' On-Road Behaviors as Predictors of Adolescents' Moped-Riding Profiles.

Front Psychol 2018 7;9:2483. Epub 2018 Dec 7.

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

Several efforts aimed at discriminating between different degrees of on-road risky attitudes have been devoted to the identification of personality profiles among young drivers. However, the results are often inconsistent because of the limits of self-report measures. To overcome these limits, we tried to identify different profiles based on our study participants' driving performances in a virtual environment and to look for psychological predictors of inclusion in one of three profiles. One-hundred and fourteen inexperienced adolescents were involved in this study, which included two experimental sessions. During the first, before riding along five virtual courses on a moped simulator, participants' sensation seeking, locus of control, aggressiveness and beliefs about their peers' on-road behaviors were measured by means of self-report tools. During the second session, the participants drove the simulator along six courses that were different from those faced in the first session. A cluster analysis was run on a wide number of indexes extracted from the participants' performances to detect different riding profiles. Three profiles emerged (Imprudent, Prudent and Insecure), with specific riding patterns. The profiles also differed in terms of riding safety, assessed by means of the scores automatically given by the simulator to the participants' performances. Reporting an external locus of control, underestimating peers' on-road risky behaviors and showing less concern for fate among the possible causes of crashes are predictors that increase the risk of being included in the Imprudent profile. Low levels of dangerous thrill seeking predict inclusion in the Prudent profile, whereas high rates of self-reported anger play a role in discriminating the Insecure riders from the other profiles. The study indicates that it is possible to identify riding profiles with different degrees of on-road safety among inexperienced adolescents by means of simulated road environments. Moreover, inclusion in these profiles is predicted by different patterns of personality variables and beliefs. Further research is needed to verify the validity of these conclusions in real road conditions.
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http://dx.doi.org/10.3389/fpsyg.2018.02483DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6293198PMC
December 2018

New Perspectives in the Adaptive Assessment of Depression: The ATS-PD Version of the QuEDS.

Front Psychol 2018 6;9:1101. Epub 2018 Jul 6.

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

Measurement is a crucial issue in psychological assessment. In this paper a contribution to this task is provided by means of the implementation of an adaptive algorithm for the assessment of depression. More specifically, the Adaptive Testing System for Psychological Disorders (ATS-PD) version of the Qualitative-Quantitative Evaluation of Depressive Symptomatology questionnaire (QuEDS) is introduced. Such implementation refers to the theoretical background of Formal Psychological Assessment (FPA) with respect to both its deterministic and probabilistic issues. Three models (one for each sub-scale of the QuEDS) are fitted on a sample of 383 individuals. The obtained estimates are then used to calibrate the adaptive procedure whose performance is tested in terms of both efficiency and accuracy by means of a simulation study. Results indicate that the ATS-PD version of the QuEDS allows for both obtaining an accurate description of the patient in terms of symptomatology, and reducing the number of items asked by 40%. Further developments of the adaptive procedure are then discussed.
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http://dx.doi.org/10.3389/fpsyg.2018.01101DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6043690PMC
July 2018

Using Overt and Covert Items in Self-Report Personality Tests: Susceptibility to Faking and Identifiability of Possible Fakers.

Front Psychol 2018 3;9:1100. Epub 2018 Jul 3.

Department of Psychological, Humanistic and Territorial Sciences, Università degli Studi "G. d'Annunzio" Chieti-Pescara, Chieti, Italy.

Self-report personality tests widely used in clinical, medical, forensic, and organizational areas of psychological assessment are susceptible to faking. Several approaches have been developed to prevent or detect faking, which are based on the use of faking warnings, ipsative items, social desirability scales, and validity scales. The approach proposed in this work deals with the use of overt items (the construct is clear to test-takers) and covert items (the construct is obscure to test-takers). Covert items are expected to be more resistant to faking than overt items. Two hundred sixty-seven individuals were presented with an alexithymia scale. Two experimental conditions were considered. Respondents in the faking condition were asked to reproduce the profile of an alexithymic individual, whereas those in the sincere condition were not asked to exhibit a particular alexithymia profile. The items of the scale were categorized as overt or covert by expert psychotherapists and analyzed through Rasch models. Respondents in the faking condition were able to exhibit measures of alexithymia in the required direction. This occurred for both overt and covert items, but to a greater extent for overt items. Differently from overt items, covert items defined a latent variable whose meaning was shared between respondents in the sincere and faking condition, and resistant to deliberate distortion. Rasch fit statistics indicated unexpected responses more often for respondents in the faking condition than for those in the sincere condition and, in particular, for the responses to overt items by individuals in the faking condition. More than half of the respondents in the faking condition showed a drift rate (difference between the alexithymia levels estimated on the responses to overt and covert items) significantly larger than that observed in the respondents in the sincere condition.
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http://dx.doi.org/10.3389/fpsyg.2018.01100DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6037895PMC
July 2018

ATS-PD: An Adaptive Testing System for Psychological Disorders.

Educ Psychol Meas 2017 Oct 15;77(5):792-815. Epub 2016 Jun 15.

University of Padua, Padua, Italy.

The clinical assessment of mental disorders can be a time-consuming and error-prone procedure, consisting of a sequence of diagnostic hypothesis formulation and testing aimed at restricting the set of plausible diagnoses for the patient. In this article, we propose a novel computerized system for the adaptive testing of psychological disorders. The proposed system combines a mathematical representation of psychological disorders, known as the "formal psychological assessment," with an algorithm designed for the adaptive assessment of an individual's knowledge. The assessment algorithm is extended and adapted to the new application domain. Testing the system on a real sample of 4,324 healthy individuals, screened for obsessive-compulsive disorder, we demonstrate the system's ability to support clinical testing, both by identifying the correct critical areas for each individual and by reducing the number of posed questions with respect to a standard written questionnaire.
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http://dx.doi.org/10.1177/0013164416652188DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5965628PMC
October 2017

Sensation Seeking, Non-contextual Decision Making, and Driving Abilities As Measured through a Moped Simulator.

Front Psychol 2017 11;8:2126. Epub 2017 Dec 11.

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

The general aim of the present study was to explore the relations between driving style (assessed through a moped riding simulator) and psychological variables such as sensation seeking and decision making. Because the influences of sensation seeking and decision making on driving styles have been studied separately in the literature, we have tried to investigate their mutual relations so as to include them in a more integrated framework. Participants rode the Honda Riding Trainer (HRT) simulator, filled in the Sensation Seeking Scale V (SSS V), and performed the Iowa Gambling Task (IGT). A cluster analysis of the HRT riding indexes identified three groups: Prudent, Imprudent, and Insecure riders. First, the results showed that Insecure males seek thrills and adventure less than both Prudent males and Insecure females, whereas Prudent females are less disinhibited than both Prudent males and Insecure females. Moreover, concerning the relations among SSS, decision making as measured by the IGT, and riding performance, high thrill and adventure seekers performed worse in the simulator only if they were also bad decision makers, indicating that these two traits jointly contribute to the quality of riding performance. From an applied perspective, these results also provide useful information for the development of protocols for assessing driving abilities among novice road users. Indeed, the relation between risk proneness and riding style may allow for the identification of road-user populations who require specific training.
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http://dx.doi.org/10.3389/fpsyg.2017.02126DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5732172PMC
December 2017

The assessment of nonverbal behavior in schizophrenia through the Formal Psychological Assessment.

Int J Methods Psychiatr Res 2018 03 3;27(1). Epub 2017 Nov 3.

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

The nonverbal behavior (NVB) of people diagnosed with schizophrenia consistently interacts with their symptoms during the assessment. Previous studies frequently observed such an interaction when a prevalence of negative symptoms occurred. Nonetheless, a list of NVBs linked to negative symptoms needs to be defined. Furthermore, a list of items that can exhaustively assess such NVBs is still needed. The present study aims to introduce both lists by using the Formal Psychological Assessment. A deep analysis was performed on both the scientific literature and the DSM-5 for constructing the set of nonverbal behaviors; similarly, an initial list of 138 items investigating the behaviors was obtained from instruments used to assess schizophrenia. The Formal Psychological Assessment was then applied to reduce the preliminary list. A final list of 23 items necessary and sufficient to investigate the NVBs emerged. The list also allowed us to analyze specific relations among items. The present study shows how it is possible to deepen a patient's negative symptomatology, starting with the relations between items and the NVBs they investigate. Finally, this study examines the advantages and clinical implications of defining an assessment tool based on the found list of items.
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http://dx.doi.org/10.1002/mpr.1595DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6877208PMC
March 2018

The Maugeri Stress Index - reduced form: a questionnaire for job stress assessment.

Neuropsychiatr Dis Treat 2017 24;13:917-926. Epub 2017 Mar 24.

Psychology Unit, ICS Maugeri, IRCCS, Tradate, Italy.

Introduction And Objectives: A multidimensional self-report questionnaire to evaluate job-related stress factors is presented. The questionnaire, called Maugeri Stress Index - reduced form (MASI-R), aims to assess the impact of job strain on a team or on a single worker by considering four domains: wellness, resilience, perception of social support, and reactions to stressful situations.

Material And Methods: The reliability of a first longer version (47 items) of the questionnaire was evaluated by an internal consistency analysis and a confirmatory factor analysis. An item reduction procedure was implemented to obtain a short form of the instrument, and the psychometric properties of the resulting instrument were evaluated using the Rasch measurement model.

Results: A total of 14 items from the initial pool were deleted because they were not productive for measurement. The analysis of internal consistency led to the exclusion of eight items, while the analysis performed using structural equation models led to the exclusion of another six items. According to the Rasch model, item properties and the reliability of the instruments appear good, especially for the scales for wellness and resilience. In contrast, the scales for perception of social support and negative coping styles show a lower internal consistency.

Conclusions: The Maugeri Stress Index - reduced form provides a reliable and valid measure, useful for early identification of stress levels in workers or in a team along the eustress-vadistress continuum.
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http://dx.doi.org/10.2147/NDT.S107030DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5373830PMC
March 2017

Illness denial questionnaire for patients and caregivers.

Neuropsychiatr Dis Treat 2017 23;13:909-916. Epub 2017 Mar 23.

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

Purpose: Interest in assessing denial is still present, despite the criticisms concerning its definition and measurement. We tried to develop a questionnaire (Illness Denial Questionnaire, IDQ) assessing patients' and caregivers' denial in relation to their illness/disturbance.

Patients And Methods: After a preliminary study, a final version of 24 dichotomous items (true/false) was selected. We hypothesized a theoretical model with three dimensions: denial of negative emotions, resistance to change, and conscious avoidance, the first two composing the actual Denial and the last representing an independent component of the illness denial behavior. The IDQ was administered to 400 subjects (219 patients and 181 caregivers) together with the Anxiety-Depression Questionnaire - Reduced form (AD-R), in order to assess concurrent validity. Confirmatory factor analysis (CFA), internal consistency indices (Cronbach's α and McDonald's ω), and test-retest analysis were performed.

Results: CFA and internal consistency indices (Cronbach's α: 0.87-0.96) indicated a clear and meaningful three-factor structure of IDQ, for both patients and caregivers. Further analyses showed good concurrent validity, with Denial and its subscale negatively associated with anxiety and depression and avoidance positively associated with anxiety and depression. The IDQ also showed a good stability ( from 0.71 to 0.87).

Conclusion: The IDQ demonstrated good psychometric properties. Denial of negative emotions and resistance to change seem to contribute to a real expression of denial, and conscious avoidance seems to constitute a further step in the process of cognitive-affective elaboration of the illness.
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http://dx.doi.org/10.2147/NDT.S128622DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5367559PMC
March 2017

Improving Major Depressive Episode Assessment: A New Tool Developed by Formal Psychological Assessment.

Front Psychol 2017 17;8:214. Epub 2017 Feb 17.

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

Major depressive episode (MDE) can manifest with different features. Discriminating between different types of MDEs is crucial for proper treatment. The aim of this study is to propose a new tool for MDE assessment in bipolar disorder (BD) or major depressive disorder (MDD) to overcome some limitations of current rating scales. The proposed tool investigates all of the clinical features of different MDEs and gives qualitative information, differentiating patients with the same score but different symptoms and psychopathology severity. To achieve this purpose authors used a new methodology called Formal Psychological Assessment (FPA). FPA allows creating relations between the items of an assessment tool, and the set of diagnostic criteria of a given clinical disorder. In the application at hand, given the capability to analyze all clinical features, FPA appears a useful way to highlight and differentiate between inhibited and agitated depressive symptoms. The new tool contains 41 items constructed through 23 clinical criteria from the DSM-5 and literature symptoms. In line with FPA, starting from a set of items and a set of clinical criteria, a Boolean matrix was built assigning to each item its own set of clinical criteria. The participants include 265 in the control group and 38 patients with MDE (diagnosed with MDD or BD) who answered the QuEDS. After 1 month, 63 participants performed the test again and 113 took the Depression-Anxiety-Stress Scale to analyze convergent-divergent validity. The scale showed adequate reliability and validity. A hierarchical confirmatory factor analysis highlighted the presence of three sub factors (affective, somatic, and cognitive) and one high-order factor (depression). The new tool is potentially able to inform clinicians about the patients' most likely diagnostic configuration. Indeed, the of a patient consists of the subset of items he/she answered affirmatively, along with his/her subset of specific symptoms. Qualitative information is fundamental from a clinical perspective, allowing for the analysis and treatment of each patient according to his/her symptoms in an effective way.
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http://dx.doi.org/10.3389/fpsyg.2017.00214DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5313503PMC
February 2017

Long-lasting virtual motorcycle-riding trainer effectiveness.

Front Psychol 2015 29;6:1653. Epub 2015 Oct 29.

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

This work aimed to test the long-lasting effects of learning acquired with a virtual motorcycle-riding trainer as a tool to improve hazard perception. During the simulation, the rider can interact with other road actors and experience the most common potential accident situations in order to learn to modify his or her behavior to anticipate hazards and avoid crashes. We compared performance to the riding simulator of the two groups of participants: the experimental group, which was trained with the same simulator one year prior, and the control group that had not received any type of training with a riding or driving simulator. All of the participants had ridden a moped in the previous 12 months. The experimental group showed greater abilities to avoid accidents and recognize hazards in comparison to their performance observed a year before, whereas the performance of the control group was similar to that of the experimental group 1 year before in the first two sessions, and even better in the third. We interpreted this latter result as a consequence of their prior on-road experience. Also, the fact that the performance of the experimental group at the beginning of the follow-up is better than that recorded at the end of the training-1 year before-is in line with the idea of a transfer from the on-road experience to the simulator. The present data confirm our main expectation that the effectiveness of the riding training simulator on the ability to cope with potentially dangerous situations persists over time and provides additional evidence in favor of the idea that simulators may be considered useful tools for training the ability to detect and react to hazards, leading to an improvement of this higher-order cognitive skill that persists over time. Implications for the reciprocal influence of the training with the simulator and the on-the road experience are discussed as well.
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http://dx.doi.org/10.3389/fpsyg.2015.01653DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4625563PMC
November 2015

Metric qualities of the cognitive behavioral assessment for outcome evaluation to estimate psychological treatment effects.

Neuropsychiatr Dis Treat 2015 24;11:2449-60. Epub 2015 Sep 24.

Salvatore Maugeri Foundation, IRCCS, Scientific Institute, Veruno, NO, Italy.

Background: Cognitive behavioral assessment for outcome evaluation was developed to evaluate psychological treatment interventions, especially for counseling and psychotherapy. It is made up of 80 items and five scales: anxiety, well-being, perception of positive change, depression, and psychological distress. The aim of the study was to present the metric qualities and to show validity and reliability of the five constructs of the questionnaire both in nonclinical and clinical subjects.

Methods: Four steps were completed to assess reliability and factor structure: criterion-related and concurrent validity, responsiveness, and convergent-divergent validity. A nonclinical group of 269 subjects was enrolled, as was a clinical group comprising 168 adults undergoing psychotherapy and psychological counseling provided by the Italian public health service.

Results: Cronbach's alphas were between 0.80 and 0.91 for the clinical sample and between 0.74 and 0.91 in the nonclinical one. We observed an excellent structural validity for the five interrelated dimensions. The clinical group showed higher scores in the anxiety, depression, and psychological distress scales, as well as lower scores in well-being and perception of positive change scales than those observed in the nonclinical group. Responsiveness was large for the anxiety, well-being, and depression scales; the psychological distress and perception of positive change scales showed a moderate effect.

Conclusion: The questionnaire showed excellent psychometric properties, thus demonstrating that the questionnaire is a good evaluative instrument, with which to assess pre- and post-treatment outcomes.
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http://dx.doi.org/10.2147/NDT.S86855DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4590581PMC
October 2015

An iterative procedure for extracting skill maps from data.

Behav Res Methods 2016 06;48(2):729-41

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

The methodologies for the construction of a knowledge structure mainly refer to the query to experts, the skill maps, and the data-driven approaches. This last method is of growing interest in recent literature. In this paper, an iterative procedure for building a skill map from a set of data is introduced. This procedure is based on the minimization of the distance between the knowledge structure delineated by a given skill map and the data. The accuracy of the proposed method is tested through a number of simulation studies where the amount of noise in the data is manipulated as well as the kind of structure to be reconstructed. Results show that the procedure is accurate and that its performance tends to be sufficiently stable even with high error rates. The procedure is compared to two already-existing methodologies to derive knowledge structures from a set of data. The use of the corrected Akaike Information Criterion (AICc) as a stopping criterion of the iterative reconstruction procedure is tested against the app criterion introduced by Schrepp. Moreover, two empirical applications on clinical data are reported, and their results show the applicability of the procedure.
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http://dx.doi.org/10.3758/s13428-015-0609-9DOI Listing
June 2016

Measurement of change in health status with Rasch models.

Health Qual Life Outcomes 2015 Feb 7;13:16. Epub 2015 Feb 7.

Psychology Unit, Maugeri Foundation, Via Roncaccio 16, 21029, Tradate, VA, Italy.

Background: The traditional approach to the measurement of change presents important drawbacks (no information at individual level, ordinal scores, variance of the measurement instrument across time points), which Rasch models overcome. The article aims to illustrate the features of the measurement of change with Rasch models.

Methods: To illustrate the measurement of change using Rasch models, the quantitative data of a longitudinal study of heart-surgery patients (N = 98) were used. The scale "Perception of Positive Change" was used as an example of measurement instrument. All patients underwent cardiac rehabilitation, individual psychological intervention, and educational intervention. Nineteen patients also attended progressive muscle relaxation group trainings. The scale was administered before and after the interventions. Three Rasch approaches were used. Two separate analyses were run on the data from the two time points to test the invariance of the instrument. An analysis was run on the stacked data from both time points to measure change in a common frame of reference. Results of the latter analysis were compared with those of an analysis that removed the influence of local dependency on patient measures. Statistics t, χ(2) and F were used for comparing the patient and item measures estimated in the Rasch analyses (a-priori α = .05). Infit, Outfit, R and item Strata were used for investigating Rasch model fit, reliability, and validity of the instrument.

Results: Data of all 98 patients were included in the analyses. The instrument was reliable, valid, and substantively unidimensional (Infit, Outfit < 2 for all items, R = .84, item Strata range = 3.93-6.07). Changes in the functioning of the instrument occurred across the two time, which prevented the use of the two separate analyses to unambiguously measure change. Local dependency had a negligible effect on patient measures (p ≥ .8674). Thirteen patients improved, whereas 3 worsened. The patients who attended the relaxation group trainings did not report greater improvement than those who did not (p = .1007).

Conclusions: Rasch models represent a valid framework for the measurement of change and a useful complement to traditional approaches.
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http://dx.doi.org/10.1186/s12955-014-0197-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4341816PMC
February 2015

Formal psychological assessment in evaluating depression: a new methodology to build exhaustive and irredundant adaptive questionnaires.

PLoS One 2015 15;10(4):e0122131. Epub 2015 Apr 15.

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

Psychological Assessment can be defined as a complex procedure of information collection, analysis and processing. Formal Psychological Assessment (FPA) tries to improve this procedure by providing a formal framework to build assessment tools. In this paper, FPA is applied to depression. Seven questionnaires widely used for the self-evaluation of depression were selected. Diagnostic criteria for major depressive disorder were derived from the DSM-5, literature and Seligman's and Beck's theories. A Boolean matrix was built, including 266 items from the questionnaires in the rows and 20 selected attributes, obtained through diagnostic criteria decomposition, in the columns. In the matrix, a 1 in a cell meant that the corresponding item investigated the specific attribute. It was thus possible to analyze the relationships between items and attributes and among items. While none of the considered questionnaires could alone cover all the criteria for the evaluation of depressive symptoms, we observed that a set of 30 items contained the same information that was obtained redundantly with 266 items. Another result highlighted by the matrix regards the relations among items. FPA allows in-depth analysis of currently used questionnaires based on the presence/absence of clinical elements. FPA allows for going beyond the mere score by differentiating the patients according to symptomatology. Furthermore, it allows for computerized-adaptive assessment.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0122131PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4398546PMC
January 2016

Memantine: New prospective in bipolar disorder treatment.

World J Psychiatry 2014 Dec;4(4):80-90

Giulia Serra, Department of Psychiatry, Harvard Medical School, Boston, MA 02115, United States.

Unlabelled: We review preclinical and clinical evidences strongly suggesting that memantine, an old drug currently approved for Alzheimer's dementia, is an effective treatment for acute mania and for the prevention of manic/hypomanic and depressive recurrences of manic-depressive illness. Lithium remains the first line for the treatment and prophylaxis of bipolar disorders, but currently available treatment alternatives for lithium resistant patients are of limited and/or questionable efficacy. Thus, research and development of more effective mood stabilizer drugs is a leading challenge for modern psychopharmacology. We have demonstrated that 21 d administration of imipramine causes a behavioural syndrome similar to a cycle of bipolar disorder, i.e., a mania followed by a depression, in rats. Indeed, such treatment causes a behavioural supersensitivity to dopamine D2 receptor agonists associated with an increase sexual activity and aggressivity (mania). The dopamine receptor sensitization is followed, after imipramine discontinuation, by an opposite phenomenon (dopamine receptor desensitization) and an increased immobility time (depression) in the forced swimming test of depression. Memantine blocks the development of the supersensitivity and the ensuing desensitization associated with the depressive like behavior. On the basis of these observations we have suggested the use of memantine in the treatment of mania and in the prophylaxis of bipolar disorders. To test this hypothesis we performed several naturalistic studies that showed an acute antimanic effect and a long-lasting and progressive mood-stabilizing action (at least 3 years), without clinically relevant side effects. To confirm the observations of our naturalistic trials we are now performing a randomized controlled clinical trial. Finally we described the studies reporting the efficacy of memantine in manic-like symptoms occurring in psychiatric disorders other than bipolar.

Limitations: A randomized controlled clinical trial is needed to confirm our naturalistic observations.

Conclusion: We believe that this review presents enough pharmacological and clinical information to consider the administration of memantine in the treatment of bipolar disorders that no respond to standard mood stabilizers.
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http://dx.doi.org/10.5498/wjp.v4.i4.80DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4274590PMC
December 2014

Beyond the score: clinical evaluation through formal psychological assessment.

J Pers Assess 2015 25;97(3):252-60. Epub 2014 Sep 25.

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

Questionnaires generate numerical scores, but endorsing different sets of items could produce the same score despite reflecting qualitatively different configurations of clinical features. Formal psychological assessment (FPA) attempts to overcome this by identifying the clinical features entailed by observed response patterns. This study illustrates an application of FPA to the cleaning subscale of a questionnaire assessing obsessive-compulsive symptoms and DSM-IV-TR diagnostic criteria for obsessive-compulsive disorder. A deterministic model of the items-criteria relationships was constructed by mapping each item to each diagnostic criterion. The resulting model was tested on a large community sample (N = 4,412). Results indicate that the theoretical model has adequate fit; item error rates and probabilities for each of the criteria are examined. Clinically relevant examples of the items-criteria relationships are discussed. Possible applications of FPA to personality assessment are also discussed, including long multidimensional questionnaires and questionnaires that use subtle item content.
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http://dx.doi.org/10.1080/00223891.2014.958846DOI Listing
January 2016

An analysis of item response theory and Rasch models based on the most probable distribution method.

Psychometrika 2014 Jul 11;79(3):377-402. Epub 2013 Jul 11.

Assessment Center, University of Verona, Verona, Italy,

The most probable distribution method is applied to derive the logistic model as the distribution accounting for the maximum number of possible outcomes in a dichotomous test while introducing latent traits and item characteristics as constraints to the system. The item response theory logistic models, with a particular focus on the one-parameter logistic model, or Rasch model, and their properties and assumptions, are discussed for both infinite and finite populations.
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http://dx.doi.org/10.1007/s11336-013-9348-yDOI Listing
July 2014