This study aims to longitudinally investigate the effects of individual's factors on subsequent burn-out/psychological distress in a sample of mental health practitioners, testing if higher attachment anxiety and avoidance and lower reflective functioning (i.e., certainty and uncertainty of mental states) and well-being at baseline may lead to a greater psychological distress and burn-out 1 year later.The sample consisted of 40 experienced psychotherapists (females: 72.5%; mean age: 47.40 ± 9.48 years) who completed a battery of questionnaires at baseline and 1 year later. Statistical analyses were conducted with Bayesian multiple linear regressions.Greater attachment anxiety and certainty about mental states and lower individual's well-being at baseline predicted greater burn-out 1 year later. Similarly, greater attachment anxiety and lower individual's well-being at baseline predicted psychological distress at 1 year follow-up. Of note, uncertainty of mental states and avoidant attachment were not associated with outcomes.These findings suggest that the levels of burn-out and psychological distress among psychotherapists may be alleviated with interventions targeting attachment insecurity, specific aspects of reflective functioning (i.e., certainty about mental states) and well-being.
Measuring dispositional optimism in patients with chronic heart failure and their healthcare providers: the validity of the Life Orientation Test-Revised Patrizia Steca,1 Dario Monzani,1 Antonia Pierobon,2 Giulia Avvenuti,2 Andrea Greco,1 Anna Giardini2 1Department of Psychology, University of Milano – Bicocca, Milan, 2Psychology Unit, Istituti Clinici Scientifici Maugeri Spa SB, IRCCS Montescano, Montescano, Italy Abstract: The Life Orientation Test-Revised (LOT-R) measures dispositional optimism (DO) – an individual difference promoting physical and psychological well-being in healthy adults (HAs) as well as in patients with chronic heart failure (CHF) and healthcare providers (HPs). Controversy has arisen regarding the dimensionality of the LOT-R. Whereas DO was originally defined as a one-dimensional construct, empirical evidence suggests two correlated factors in the LOT-R. This study was the first attempt to identify the best factor structure of the LOT-R in patients with CHF and HPs and to evaluate its measurement invariance among subsamples of patients with CHF, HPs, and a normative sample of HAs. Its validity was also evaluated in patients with CHF. The sample comprised 543 participants (34% HAs; 34% HPs; and 32% CHF patients). Congeneric, two correlated factor, and two orthogonal factor models for the LOT-R were compared by performing confirmatory factor analysis (CFA). Measurement invariance was evaluated by considering differential item functioning (DIF) among subsamples of HPs, patients with CHF, and HAs. In patients with CHF, validity was assessed by considering associations with anxiety and depression. The CFA demonstrated the superior fit of the two orthogonal factor model. Moreover, across patients with CHF, HPs, and HAs, the results highlighted a minimal DIF with only trivial consequences. Finally, negative but weak correlations of DO with anxiety and depression confirmed the validity of the LOT-R in patients with CHF. In summary, these findings supported the validity and suitability of the LOT-R for the assessment of DO in patients with CHF, HPs, and HAs. Keywords: Life Orientation Test-Revised, dispositional optimism, validity, measurement equivalence, chronic heart failure
The topic of lactation following cancer diagnosis will become increasingly more current.Although oncological research confirms that breastfeeding after cancer might be possible, there is a lack of guidelines and a good recommendation for oncological women.In the absence of specific recommendations, women with past cancer may be at higher risk for psychological distress related to breastfeeding.The objective of this article was to analyse the experience of breastfeeding in new mothers with a history of cancer compared to women without a cancer diagnosis.First, we explored the impact of the cancer diagnosis on the breastfeeding choice.Second, we evaluated the relationship between different feeding methods and the mother's mood states in women with and without a history of cancer.The sample was composed of 74 mothers divided into two groups: 34 with a cancer history (clinical sample) and 40 without a cancer diagnosis (control group).Participants were requested to complete a questionnaire three months after childbirth which assessed: socio-demographic and clinical data, feeding modes (breastfeeding, formula and mixed feeding) and the profile of mood states (POMS).Results showed that women in the clinical group breastfeed significantly less and use formula more than those in the control group.Moreover, in the clinical group, women who breastfeed feel reported higher levels of confusion (according to POMS) than mothers who bottle-feed or use a mixed feeding method.On the contrary, in the control sample, women who breastfeed feel significantly more vigorous than puerperae who bottle-feed or use mixed methods according to POMS.
Background: the way a chronic patient thinks about his condition plays a fundamental role in the clinical evolution of CV diseases, including arterial hypertension (HT). Some previous studies suggested that HT is related to a range of psychological characteristics, including anxiety, which could lead to noncompliance with medical treatment. The aim of this study was to evaluate if illness perception dimensions and their variations over time could predict anxiety. Design and methods: a total of 345 outpatients followed by the Hypertension Unit of S. Gerardo Hospital (Monza, Italy) affected by essential hypertension were recruited and assessed at the baseline and a total of 196 at a 5-years follow-up. Patients were asked to complete a battery of psychological questionnaires under the guidance of a psychologist; moreover, anamnestic and clinical data were evaluated. The associations between illness perception domains, clinical risk factors and anxiety were explored using multivariate hierarchical regression analyses. Findings: at t0 the mean age was 55.40±11.2years.The results from hierarchical regression showed that the variation over time of the HT consequences (beta=0.233, p<.01) and of the disease identity (beta=0.184, p<.05) were significantly and independently associated with anxiety at the follow-up. Furthermore, identity (beta=0.202, p=0.53) and emotional representation (beta=0.184, p=0.57) showed a trend that approached significance. These associations with anxiety were independent of clinical risk factors and of the time of the HT diagnosis. Discussion: Current findings may contribute to the development of interventions, targeted on specific domains of illness perception, against the risk of anxiety disorders in HT patients.
This study is aimed at testing the measurement properties of the Life Orientation Test-Revised (LOT-R) for the assessment of dispositional optimism by employing item response theory (IRT) analyses. The LOT-R was administered to a large sample of 2,862 Italian adults. First, confirmatory factor analyses demonstrated the theoretical conceptualization of the construct measured by the LOT-R as a single bipolar dimension. Subsequently, IRT analyses for polytomous, ordered response category data were applied to investigate the items’ properties. The equivalence of the items across gender and age was assessed by analyzing differential item functioning. Discrimination and severity parameters indicated that all items were able to distinguish people with different levels of optimism and adequately covered the spectrum of the latent trait. Additionally, the LOT-R appears to be gender invariant and, with minor exceptions, age invariant. Results provided evidence that the LOT-R is a reliable and valid measure of dispositional optimism.
Cardiovascular disease (CVD) is the leading cause of morbidity and mortality globally. A physically active lifestyle can improve the health-related quality of life (HRQoL) of people with CVD. Nevertheless, adherence to a physically active lifestyle is poor. This study examined the longitudinal (pre-event, 6-, 12-, 24-, and 36-month follow-ups) physical activity profiles in 275 patients (mean age = 57.1 years; SD = 7.87; 84% men) after the first acute coronary event. Moreover, it investigated the associations among physical activity, sense of coherence (SOC), and HRQoL. Physical activity profiles were identified through latent class growth analysis, and linear regressions were then performed to explore the association between physical activity, SOC, and HRQoL. After the cardiovascular event, 62% of patients reached adequate physical activity levels and maintained them over time (virtuous profile). The remaining 38% could not implement (23%) or maintain (15%) a healthy behavior. A strong SOC at baseline (standardized β = 0.19, p = 0.002) predicted the probability of belonging to the virtuous profile. Moreover, a strong SOC at baseline (standardized β = 0.27, p < 0.001), together with the probability of belonging to the virtuous profile (standardized β = 0.16, p = 0.031), predicted a better HRQoL at the final follow-up. Findings showed a strong relationship between SOC, the ability to adopt a physically active lifestyle stably over time, and HRQoL in patients with CVD. They suggest the importance of tailoring physical activity interventions by promoting resilience resources such as SOC to improve patients’ quality of life after an acute coronary event.
Background Self-efficacy plays a major role in the management of cardiovascular disease (CVD). The original Cardiovascular Management Self-efficacy Scale (CMSS) was developed in 2016 in Italian patients with CVD; however, no such scale exists for Iranian patients with CVD. Objective We translated the CMSS into Persian and assessed its validity, reliability, and psychometric properties in Iranian patients with CVD. Methods This study was conducted for 4 months in 2017 on a group of consenting patients with CVD (N = 363) recruited from a cardiovascular hospital in Kermanshah, Iran. The reliability of the Persian CMSS was evaluated. We assessed validity, including face, content, construct, convergent, divergent, and discriminate validity, using the General Self-efficacy Scale, the Hospital Anxiety and Depression Scale, and the 36-item Short Form Health Survey Scale. Known-group validity was assessed among patients with high blood pressure. Results The Persian CMSS had acceptable face and content validity. No floor or ceiling effects were found for the total scale. Cronbach α was calculated as .68. Test-retest reliability was confirmed by intraclass correlation coefficient (ICC 1,3 = 0.98, P < .001). Using exploratory factor analysis, 3 subscales were identified, similar to the original version. Significant correlations were found between the Persian CMSS and both the General Self-efficacy Scale ( r = 0.94, P < .001) and Hospital Anxiety and Depression Scale ( r = −0.35, P < .05). Self-efficacy measured using the Persian CMSS was statistically different between 2 levels of patients' health status ( P < .05). Patients with hypertension had a lower level of self-efficacy than those in the healthy group ( P < .05). Conclusions The Persian version of CMSS provides a practical, reliable, and valid scale for evaluating self-efficacy in the clinical management of Persian Iranian patients with CVD.
Healthy lifestyles are important in the secondary prevention of acute
coronary syndrome (ACS). Behavioral change following ACS has been analyzed only considering
separate behaviors at time. However, previous research on healthy population demonstrated that
unhealthy behaviors tend to co-occur. Our aim was to identify lifestyle profiles of ACS
patients and their pathways of change following the ACS by adopting a typological approach.
Three hundred and fifty-six ACS patients were recruited. Healthy habits, depression, anxiety,
illness perception and clinical outcomes were collected immediately after the ACS and 6 months
later. The I-States of Objects of Analysis was performed to identify lifestyle clustering and
to analyze its change over time. We also assessed associations of cluster membership with
depression, anxiety, illness perception and clinical outcomes. We identified seven profiles,
ranging from more maladaptive to healthier cluster. The results demonstrated a moderate
individual and group stability of cluster membership. Healthier clusters displayed better
psychological adjustment and less biomedical and anthropometric factor risks 6 months after the
ACS. These results underline the importance of developing secondary prevention programs
targeting multiple lifestyles at time.
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