Trust or Distrust Toward Healthcare Services: Breast Screening in the North and South of Italy

This article follows a previous study that has recently been published in Narrare I Gruppi and explored the reasons for the large numeric gap between the regions of the North and South of Italy, referring to the breast cancer screening program adherence rate sponsored by the Italian Healthcare System, that addresses all women living in Italy ranging in age between 48 and 69 years, and proposes a free mammogram every two years. The effectiveness of cancer early detections has been widely demonstrated by medical research; this kind of diagnosis is particularly important in the case of breast cancer. A diagnosis of this form of cancer at its early phases in 97% of cases allows women to survive at least five years after it. However, the different level of trust women feel for healthcare structures is the discriminating element between the North and South of Italy for their access to the screening program. This topic will be thoroughly analyzed by presenting the results of research aimed at evaluating the meaning given to the outcomes of a first exploratory study, this second study also offers the opportunity to share our results within the social context that has generated them. The outcomes of the present research have been presented to a group of “privileged witnesses” living in the South (Naples and its surroundings): 12 women aging from 49 to 65, and 5 healthcare workers (one doctor, 25 two nurses, and two Local Health Authority supervisors); they took part in three Focus Groups for an in-depth look of the theme in question. The analyses of the groups' debates, carried out by means of a software for text analysis (T-LAB), confirmed the results of the previous research: the diffidence and lack of synergy between institutions and healthcare workers are the causes of southern women's lack of participation to the breast cancer screening program. In particular, the comparison between women's and workers' viewpoints shows a different emotional connotation about the possibility to improve participation to the screening: the workers' optimism countervails women's distrust and pessimism.     

The relationship between childhood adversity,psychiatric disorder and clinical severity: results from a multi-centre study

Although several studies have shown a clear association between childhood adversities and later development of a number of psychiatric disorders, a number of recent reports have cast doubts regarding the aetiological role played by abuse, neglect and loss, arguing that they are neither necessary nor sufficient to account for the development of subsequent psychopathology. In this study, we aimed to investigate the associations and predictive power of childhood adversities on later onset of Axis-I &-II psychiatric conditions and the impact on severity of psychiatric presentation in a large sample of patients. This cross-sectional multi-centre study evaluated patients (N = 1136) recruited in fourteen NHS psychotherapy departments in the UK. Patients were assessed using a number of rater-based questionnaires and self-rated measures. Multiple regression analyses showed that childhood experiences of loss and physical abuse were predictive of severe personality disorder and borderline personality disorder, but not of other less severe PD and Axis-I diagnoses. Sexual abuse predicted later onset of Post-traumatic Stress Disorder. In addition, we found that childhood abusive experiences were strongly associated with severity of psychiatric distress, interpersonal problems and global functioning. Having experienced two or more childhood adversities significantly increased severity of psychiatric distress, interpersonal malfunctioning and CORE scores.     

Early Change Trajectories in Cognitive-Behavioral Therapy for Binge-Eating Disorder

Rapid response is considered the most well-established outcome predictor across treatments of binge-eating disorder (BED), including cognitive-behavioral therapy (CBT). This study sought to identify latent trajectories of early change in CBT and compare them to common rapid response classifications. In a multicenter randomized trial, 86 adults with BED (DSM-IV) or subsyndromal BED provided weekly self-reports of binge eating over the first 4 weeks of CBT, which were analyzed to predict binge eating, depression, and body mass index at posttreatment, 6-, and 18-month follow-up. Using latent growth mixture modeling, three patterns of early change—including moderate and low decreasing—as well as low stable binge eating were identified, which significantly predicted binge-eating remission at 6-month follow-up. Other classifications of rapid response based on Receiver Operating Characteristics curve analyses or on the literature (≥ 10% reduction in binge eating at week 1, ≥ 70% reduction in binge eating at week 4) only predicted posttreatment remission or overall depression, respectively. Latent change trajectories, but not other rapid response classifications, predicted binge-eating frequency over time. A fine-grained analysis of change over the first 4 weeks of CBT for BED revealed different trajectories of early change in binge eating that led to an improved prediction of binge-eating outcome, compared to that of common rapid response classifications. Thorough monitoring of early change trajectories during treatment may have clinical utility.     

Lost in Translation?

Topoi - According to neo-Russellianism, in a sentence such as John believes that Mont Blanc is 4000 m high, any other proper name co-referring with Mont Blanc can be substituted for it...     

High test-retest reliability of a neural index of rapid automatic discrimination of unfamiliar individual faces

An important aspect of human individual face recognition is the ability to discriminate unfamiliar individual. Since many general processes contribute to explicit behavioural performance in individual face discrimination tasks, isolating a measure of unfamiliar individual face discrimination ability in humans is challenging. In recent years, a fast periodic visual stimulation approach (FPVS) has provided objective (frequency-locked) implicit electrophysiological indices of individual face discrimination that are highly sensitive at the individual level within a few minutes of testing. Here we evaluate the test-retest reliability of this response across scalp electroencephalographic (EEG) recording sessions separated by more than two months, in the same 30 individuals. We found no test-retest difference overall across sessions in terms of amplitude and spatial distribution of the EEG individual face discrimination response. Moreover, with only 4 stimulation sequences corresponding to 4 min of recordings per session, the individual face discrimination response was highly reliable in terms of amplitude, spatial distribution, and shape. Together with previous observations, these results strengthen the diagnostic value of FPVS-EEG as an objective and rapid flag for specific difficulties at individual face recognition in the human population.     

Identifying pre-service teachers’ profiles of conceptions of learning: a cluster analysis

Social Psychology of Education - This study was conducted to track conceptions of learning among pre-service teachers and to verify whether they can be grouped in profiles. A sample of 232...     

Hidden reality: sexual sphere in brain tumor patients

Most reports emphasize that tumors and their treatments affect sexual function. To date, no studies have focused on sexual functioning in patients with brain tumors. Our study’s objective is to describe the sexual sphere of patients with brain tumors and examine the possible differences between patients who reported sexual dysfunctions and those who did not with respect to their psychological and functional status. We tested 46 patients with brain tumors. We used an ad hoc questionnaire to assess patients’ subjective perception of their own sexual sphere. To assess patients’ psychological status, we used the following questionnaires: Hospital Anxiety and Depression Scale; Psychological Distress Inventory; EORTC QLQ-C30; EORTC QLQ-BN20. Fifty-eight percent of patients reported sexual disturbance. Our data showed that a lack of or decrease in sexual desire is the most common sexual problem reported by our patients (56%). Patients with sexual problems reported higher levels of anxiety and depression and a worse self-reported quality of life (QoL) than did those who did not perceive adverse changes in their sexual sphere. In addition, we found that patients with a better performance status (KPS) reported more changes in sexual behaviors than did those who had performance difficulties. Of the patients, 15.2% received information regarding possible changes in the sexual sphere by physicians. Additionally, 10.8 of 15.2% of the patients reported having explicitly requested information from physicians. The study demonstrated a relation between QoL and sexual function. Therefore, it would be important to encourage clinicians to ask questions regarding patients’ sexual issues, thus providing them with an opportunity to expose their difficulties and receive adequate support.     

Inhibition in motor imagery: a novel action mode switching paradigm

Motor imagery requires that actual movements are prevented (i.e., inhibited) from execution. To investigate at what level inhibition takes place in motor imagery, we developed a novel action mode switching paradigm. Participants imagined (indicating only start and end) and executed movements from start buttons to target buttons, and we analyzed trial sequence effects. Trial sequences depended on current action mode (imagination or execution), previous action mode (pure blocks/same mode, mixed blocks/same mode, or mixed blocks/other mode), and movement sequence (action repetition, hand repetition, or hand alternation). Results provided evidence for global inhibition (indicated by switch benefits in execution-imagination (E-I)-sequences in comparison to I-I-sequences), effector-specific inhibition (indicated by hand repetition costs after an imagination trial), and target inhibition (indicated by target repetition benefits in I-I-sequences). No evidence for subthreshold motor activation or action-specific inhibition (inhibition of the movement of an effector to a specific target) was obtained. Two (global inhibition and effector-specific inhibition) of the three observed mechanisms are active inhibition mechanisms. In conclusion, motor imagery is not simply a weaker form of execution, which often is implied in views focusing on similarities between imagination and execution.     

Transgender persons’ rights in Italy: Bernaroli's case

In April 2015, the Italian Court of Cassation decided on the case of a male to female transgender person to remain married to her wife. On that occasion the Court of Cassation decided that the married couple—Bernaroli, a transgender woman, and her wife, a cisgender woman—could remain married until the Italian Parliament institutionalized civil partnerships. This article presents the case study of transgender persons’ rights in Italy. In doing so, the article places the case study in the frame of the Council of Europe recognition of transgender persons’ rights, looks at the evolution of transgender persons’ rights in Italy, and finally, presents the groundbreaking decision in the Bernaroli's case.