Psychometric characteristics of the Italian Clinical Depression Questionnaire using a 5-point rating scale with undergraduates

The aim was to investigate the psychometric properties of a proposed experimental version of the 1979 Italian adaptation of the Clinical Depression Questionnaire (Krug & Laughlin, 1976). This version is composed of an increased number of choice alternatives (5 instead of 3), tested with 240 Italian undergraduates. An exploratory item-factor analysis yielded one factor, which accounted for 28.2% of the variance. Analysis of the relationship between this version and an experimental one in 2002 of the 1979 Italian edition of the Anxiety Scale Questionnaire showed the corrective factor was not effective in increasing the discriminative power of the questionnaire for anxiety.     

Stress-induced salivary cortisol secretion during hypobaric hypoxia challenge and in vivo urinary thromboxane production in healthy male subjects

Few studies have assessed the effects of stress on in vivo platelet activation. In the present study, hypobaric hypoxia induced by rapid decompression during high-altitude simulated flight in a hypobaric chamber was used to evaluate the effects of environmental stress on salivary cortisol and urinary thromboxane metabolite (TXM) excretion, a noninvasive marker of in vivo platelet function. Twenty-one male aviators (mean ± SD age = 36 ± 7 years) experiencing hypoxia by removing their oxygen mask for 4-5 min during a simulated flight to 25,000 ft (7,620 m; pO(2) = 59.17 mmHg) and a matched control group of thirteen flying instructors wearing oxygen masks during the challenge, were studied. Hypobaric hypoxia induced a transient significant increase (P < 0.001) in the aviators' salivary cortisol concentration; the overall pattern of diurnal cortisol fluctuation was maintained in both groups. Urinary TXM showed a significant ～30% reduction (P < 0.01) after the chamber session in aviators exposed to hypobaric hypoxia, but not in controls. A significant inverse correlation was found between salivary cortisol and urinary TXM in aviators (r = - 0.64, P = 0.0015). Salivary cortisol was a significant predictor (P < 0.001) for urinary TXM concentrations in aviators. In conclusion, here we observed that an acute stress-induced salivary cortisol increase was associated with reduced urinary thromboxane biosynthesis, providing the first indirect evidence for an inhibitory effect of acute stress on in vivo platelet function.     

Happiness and well-being: shifting the focus of the current debate

The point of departure of this paper is the recently emphasised distinction between psychological theories of happiness, on the one hand, and normative theories of well-being, on the other. With this distinction in mind, I examine three possible kinds of relation that might exist between (psychological) happiness and (normative) well-being; to wit, happiness may be understood as playing a central part in (1) a formal theory of well-being, (2) a substantive theory of well-being or (3) as an indicator for well-being. I note that, in the relevant literature, happiness is mostly discussed in terms of either (1) or (2). In this paper, I attempt to motivate a shift of focus away from such accounts of happiness and towards (3), i.e. its epistemic role. When examined in connection to (normative) well-being, (psychological states of) happiness and unhappiness should be understood as psychological states that inform individuals about the contribution of various activities, pursuits, or situations to their well-being or ill-being.     

Metacognitive Interpersonal Therapy for Treating Auditory Verbal Hallucinations in First-onset Schizophrenia

Auditory verbal hallucinations (AVHs) are perceptive-like experiences happening without appropriate stimuli, occurring in two thirds of schizophrenia patients, where they often cause emotional suffering and dangerous behaviors, and interfere with social relationships. Patients with schizophrenia involving AVHs can also be drug-resistant or they may discontinue medications. The most well-known psychotherapeutic intervention for voice-hearing is cognitive behavioral therapy (CBT), which focuses on reducing distress by modifying hearers’ beliefs about their voices. We hypothesize that it is possible to reinforce the clinical approach to AVHs by taking into consideration (a) that patients generally hear voices in particular interpersonal contexts where they experience negative emotions; (b) the relationship between AVHs and metacognition, namely the ability to make sense of mental states. On this basis, AVHs can be seen not just as a cause of emotional distress as CBT postulates, but the outcome of difficulties in meta-cognitively making sense of interpersonal exchanges. In this paper, we describe the treatment of a young man at the onset of schizophrenia with pervasive negative AVHs. The patient was treated with metacognitive interpersonal therapy (MIT), aimed to promote the patient’s metacognition. With this aim, in the first part of the treatment, each time AVHs emerged, the patient’s level of arousal was high and his metacognitive ability very low, the therapist treated AVHs helping the patient to understand and cope with the emotional suffering connected with AVHs. At a more advanced stage of therapy, the therapist helped the patient reach the point of understanding the social triggers which, together with the patient’s self-schemas, ignited his auditory hallucinations; this created the conditions for a significant reduction of the pervasiveness of AVHs.     

Do Mixed Unions Foster Integration? The Educational Outcomes of Mixed-Parentage Children in Italy

We investigate the nexus between intermarriage and immigrant integration by analyzing mixed-parentage children’s educational outcomes. We use Italian Labor Force Survey data to compare the upper secondary school participation of children of different types of mixed unions with that of children of two native and two migrant couples. Our results show that mixed-parentage children perform halfway between natives and immigrants, but their educational careers are highly heterogeneous. Among families with non-Western origins, mixed-parentage children improve substantially with respect to their peers with two migrant parents. But if the mother was born abroad, the children still exhibit higher dropout risks and lower general school enrolment as compared to children of natives and all other mixed-parentage children. A pivotal role in accounting for this educational disadvantage is played by the higher incidence in this specific type of union of nonstandard family dynamics and household fragilities that may give rise to less parental monitoring and lower educational performance. This finding is consistent with a prediction based on the status exchange theory, according to which such unions are more likely affected by instability and conflict.     

When REBT Goes Difficult: Applying ABC-DEF to Personality Disorders

ABC-DEF framework is at the core of rational emotive behavior therapy. It is a highly flexible framework and has proven to be applicable to many emotional disorders. We cannot take for granted, however, that this framework can be used successfully with all clients, particularly with those suffering from severe disorders or personality disorders. In fact, the difficulties of these clients in recognizing, naming and reflecting upon states of mind, their dysregulated emotions and self-defeating behavior, and their difficulty in establishing a strong working alliance with a therapist may hamper the correct implementation of the ABC-DEF framework and the disputing of their irrational beliefs. This paper aims to describe in detail the challenges that clients with personality disorders may pose during treatment and offer possible technical suggestions, derived from either REBT or non-REBT literature, that can help REBT and CBT practitioners adapting their interventions to resistant clients.     

Reauthoring One's Own Life in the Face of Being HIV+: Promoting Healthier Narratives with Metacognitive Interpersonal Therapy

We describe here a narrative-based psychotherapy for a woman in her 40s who had been HIV+ since the age of 21 and who suffered from posttraumatic symptoms related to having received the diagnosis. She had also suffered from self-stigma and had lost the capacity to envision a future filled with hope. Treating individuals with HIV who face posttraumatic symptoms and stigma can be challenging for the clinician. A narrative approach to therapy can be helpful for these persons, in order to overcome symptoms, build a more benevolent self-image, feel accepted by society, and promote posttraumatic growth. Current evidence indicates that such an approach is mostly lacking. We describe how we applied metacognitive interpersonal therapy—an approach rooted in narrative constructivism. By using this treatment, the patient could overcome posttraumatic symptoms, participate in social activities after years of avoidance and isolation, and recover her sense of being a person able to make plans for the future with strength and dignity. Discussion includes ideas of how to generalize some of the mechanisms that have likely been effective in this therapy to other individuals with HIV.     

On the Importance of Well-being

Many among philosophers and non-philosophers would claim that well-being is important in moral theory because it is important to the individual whose well-being it is. The exact meaning of this claim, however, is in need of clarification. Having provided that, I will present a charge against it. This charge can be found in the recent work of both Joseph Raz and Thomas Scanlon. According to the latter the concept of well-being plays an unimportant role in an agent’s deliberation. As I will show, to claim this much is to undermine our initial claim; and to do that is to undermine some of the most central theories in normative ethics. I will focus on Scanlon’s discussion in particular because it affords us with two criteria for the assessment of the importance for a person of a value-concept such as well-being. I will claim that much of Scanlon’s case rests on the idea that well-being is an inclusive good, a good constituted by other things that are good in and for themselves. Then, I will put forward a case against Scanlon’s challenge by (1) showing that inclusiveness, when properly understood, does not lead to the conclusion Scanlon is led to and (2) showing that on at least the reading Scanlon prefers, his criteria are inappropriate.

Adopting Metacognitive Interpersonal Therapy to Treat Narcissistic Personality Disorder with Somatization

Narcissistic personality disorder (NPD) is characterized by an intellectualizing narrative style, poor metacognition, maladaptive interpersonal schemas, a restricted set of states of mind, impaired agency and perfectionism. Metacognitive Interpersonal therapy targets these dysfunctions with a series of formalized procedures aimed at first forming a shared formulation of functioning which patients and therapists can then use to plan change. We describe here the core NPD pathology and illustrate the therapy process of a patient with NPD and a somatization disorder. Implications for treatment of NPD are discussed together with a call for empirical testing of therapies for this severe condition.