Intellectual and cognitive profiles in patients affected by schizophrenia

Intellectual abilities display high heterogeneity in patients with schizophrenia that might depend on the interaction among neurodevelopmental processes, environmental factors and neurocognitive decline. This study aimed to disentangle the interplay between intellectual level, cognitive status and each cognitive domain, with a focus on speed-related abilities, also including pre-morbid factors. In details, by means of cluster analysis, we identified both in global sample of 452 patients affected by schizophrenia and in a subsample with high pre-morbid functioning, different profiles based on current intellectual level and global cognitive status, analysing the distribution of deficits in each cognitive domains between groups. Then, through regression models, we analysed the contribution of speed-related domains and global cognitive profile to each other cognitive function. Considering the whole sample, results highlight three groups (high, medium and low cognitive level), while among patients with high pre-morbid level, the heterogeneity was best captured by two groups (high and medium level). Still, within each group, a small to high percentage of patients achieved normal score in neurocognitive abilities depending on the cluster they belong to. Speed of processing and psychomotor coordination resulted impaired in all clusters, even in patients with high pre-morbid functioning. The regression analyses revealed significant effects of both cognitive profile and speed-dependent domains on the other cognitive abilities. This study confirms, in a large sample, previous data about the heterogeneity of intellectual and neurocognitive functioning in schizophrenia and highlights the main role of speed-dependent neurocognitive functioning, also as an important target of rehabilitation.     

The Italian Five Facet Mindfulness Questionnaire: A Contribution to its Validity and Reliability

Mindfulness refers to the ability to be aware of and attentive to internal and external events, without becoming overwhelmed or feeling the need to react automatically. Recent studies indicate that this ability is associated with the following factors: mental health, psychological functioning, and stress reduction. Although questionnaires have been developed to measure mindfulness, so far these have not been adapted for use within the Italian population. Thus, the aim of our studies was to investigate the reliability and validity of an Italian version of the Five Facet Mindfulness Questionnaire (FFMQ; Baer et al. Assessment, 13, 27–45, 2006). The FFMQ is a self-report measure that is based on a five-facet model (i.e., Observe, Describe, Act with Awareness, Nonjudge, and Nonreact). In the first study, internal consistency, factor structure, and concurrent validity analyses were carried out on a sample of 559 volunteers. The second study entailed test–retest analyses on a different sample of 43 students. The results showed that the Italian FFMQ: (a) has a similar factor structure to the original English version; (b) has good to excellent internal consistency as a whole (alpha?=?0.86) with sub-scale consistency ranging from 0.65 to 0.81, and test–retest stability for the total score being 0.71; (c) has good concurrent validity as demonstrated by significant correlations between the FFMQ scores and a number of self-report measures related to mindfulness. Our findings support both the adaptation of the FFMQ to the Italian context as well as the conceptualization of mindfulness in multi-faceted terms.     

Measuring psychological mindedness: validity,reliability, and relationship with psychopathology of an Italian version of the Balanced Index of Psychological Mindedness

Psychological mindedness (PM) is an underinvestigated, but important construct in psychoanalytic psychotherapy research and practice. It refers to the interest in and ability for reflecting on one's thoughts and feelings, and it represents an important precondition for insight-oriented therapy to be successful. Notwithstanding, very few instruments are available to measure PM. The current investigation aimed at evaluating the validity and reliability of the Balanced Index of Psychological Mindedness (BIPM; Nyklí?ek & Denollet, 2009, Psychological Assessment, 21, 32–44), a brief measure of PM. In a first study, factor structure, internal consistency, and concurrent validity of the BIPM were tested, along with the relationship between the BIPM and a continuous measure of general distress, using a sample of 298 Italian students. In a second study, test-retest stability analyses were completed using a new, different, Italian student sample (N = 58). In a third study, the BIPM scores of a clinical sample with diagnosis of mood spectrum disorders (N = 30) were compared to those of an age-, gender-, and education-matched nonclinical sample. Overall, results indicate that the BIPM is a psychometrically sound instrument that can be used in clinical practice to obtain rapid information about the client's mentalization skills and assess PM.     

Theory and the Object: Making Sense of Adorno’s Concept of Mediation

Abstract

This article examines Adorno’s use of the notion of mediation, which at first glance appears to be problematic and aporetic. While the emergence of such a concept marks Adorno’s renewed interest in Hegelian philosophy, and a distancing from Walter Benjamin’s thought, the understanding of mediation should not be reduced to the Hegelian model. This article will argue that Adorno introduces such a concept to explain theory’s necessity and verifiability, as well as the experience of the object. Only by taking these two issues (the mediation between concepts and between subject and object) in their interconnection is it possible to explain the role of mediation in Adorno. I will argue that the idea of ‘constellations’ put forward in the Dialectics furnishes us with a model of mediation that goes beyond its original Hegelian formulation.     

Reasoning in moral conflicts

Following the assumptions of the mental model theory and its account of moral judgements, we argue for a main role of reasoning in moral judgements, especially in dealing with moral conflicts. In four experiments, we invited adult participants to evaluate scenarios describing moral or immoral actions. Our results confirm the predictions deriving from our assumptions: Given a moral or immoral scenario, the manipulation of the propositions which refer to norms and values results in a scenario eliciting a moral conflict (Experiment 1); when invited to create conflict versions from no-conflict versions of moral or immoral scenarios, individuals manipulate the propositions in the scenario which describe norms and values rather than emotional factors (Experiment 2); the evaluation of conflict scenarios takes longer than the evaluation of no-conflict scenarios (Experiment 3), and this is because conflict scenarios involve more deliberative reasoning (Experiment 4). We discuss our results in relation to competing theories of moral judgements.     

Promoting Mild Physical Exercise in a Person with Profound Multiple Disabilities

Prompt/orientation cues delivered through an automatic system were combined with one or two reinforcement events in order to promote mild physical exercise independent of staff in a man with profound multiple disabilities. The exercise sessions were gradually extended to 60 minutes. Data indicated that the man achieved high levels of exercise engagement. There were minimal differences in terms of engagement between sessions with one reinforcement event and those with two reinforcement events. Yet, in the latter sessions, the man had higher levels of positive mood. Implications of the findings are discussed.     

Ezekiel Emanuel,Andrew Steinmetz,and Harald Schmidt (eds): Rationing and resource allocation in healthcare: essential readings

Theoretical Medicine and Bioethics -     

Identifying violence among women patients attending family practices: the role of research in community change

Violence against women has serious consequences. Although victims use health facilities more frequently than others, violence is still not recognized in most services and in the larger community. This study had three aims: (1) to estimate the prevalence of violence among women patients in primary care, (2) to evaluate the feasibility of asking all women about violence, and (3) to make violence visible, and thereby initiate a process of professional and community change on the issue of violence against women. The study was carried out in a small Italian town, at the initiative of a local family doctor. We conducted a cross‐sectional survey among patients of six family practices and 444 women responded to a self‐administrated questionnaire. Five per cent of respondents experienced physical or sexual violence in the last year, and 25% had experienced it in the past. Nineteen per cent had experienced psychological violence in the last 12 months. Risk factors for current violence were: younger age, being pregnant or with young children, being separated or divorced, or lack of stable employment. Most women were in favour of being asked about violence by their doctor. The study's results were disseminated in public meetings, with good press coverage. This resulted in a dramatic increase in the visibility of victims of violence, the development of a training course for health professionals, and the creation of the first women's group in the town. Along with advocacy work, the group has prepared a booklet on violence addressing women, and is now raising funds to start an ‘anti‐violence’ telephone line. Overall, the study has become a tool for change within the health services and the community. Copyright © 2004 John Wiley & Sons, Ltd.     

Food for Boys and Food for Girls: Do Preschool Children Hold Gender Stereotypes about Food?

Sex Roles - Family meals are occasions for socializing children to gender roles and the symbolic meaning of food and eating. One of the relevant symbolic meaning of food concerns its gender...