Publications 1-2-3 Year XVI – 2021

La Terapia Comportamentale, divenuta ben presto Terapia Cognitivo-Comportamentale (TCC, ovvero la CBT in inglese), fu introdotta in Italia cinquanta anni fa. Le due principali associazioni di TCC italiane ricordano questo anniversario. L’AIAMC (l’Associazione Italiana di Analisi e Modificazione del Comportamento) tiene a Napoli, nell’ambito del XVIII Congresso “Ritorno al futuro dal comportamentismo al cognitivismo andata e ritorno”, una Tavola […]

Aims. Test anxiety is a psychological condition that has relevant consequences on epidemiological and clinical grounds. People experiencing test anxiety suffer from high levels of distress in different kinds of testing situations. This paper analyses available empirical evidence addressing the efficacy of psychotherapy programs aimed at reducing test anxiety symptoms and describes the variables that have positive effects in the treatment of test anxiety.
Method. A literature search has been performed in order to identify both the variables most frequently used in the treatment of test anxiety and the evidence based efficacy of test anxiety intervention programs.
Results. The present review included 9 papers describing test anxiety interventions conducted in various geographical and cultural contexts. The selected interventions were focused on the relation between test anxiety and the following variables: procrastination, self-efficacy, self-esteem, learning skills deficits, cognitive biases, perfectionism. The majority of intervention programs had a short duration, from a minimum of 2 sessions to a maximum of 12 sessions, were mostly articulated in weekly sessions and were based on cognitive-behavioural theories, models and techniques.
Conclusion. The analysed programs were found to have positive effects on the reduction of test anxiety symptoms. However, the present review reveals that researchers in the field do not agree about what variables have to be specifically addressed in test anxiety treatments and about what are the process that determine and maintain such a disorder.

Objectives: The “trans-diagnostic” approach to mental disorders is focused on the cognitive, emotional and behavioural dysfunctions underlying several psychopathological conditions. It has been recently introduced into clinical practice with the aim of overcoming limitations in classical nosography and in diagnosis-specific treatments. However, it is still unclear whether and to what extent such treatments have better outcomes when compared to classical diagnosis-specific approaches. The present review aims to analyse the clinical efficacy of cognitive-behavioural trans-diagnostic treatments in patients suffering from emotional disorders.

Method: The following bibliographic databases were searched: Pubmed, Google Scholar and Discovery Sapienza. The randomized clinical trials published from 2017 to 2020 and addressing the efficacy of the trans-diagnostic approach to emotional disorders were reviewed.
Results: The selected studies showed that the efficacy of trans-diagnostic approach in emotional disorders is higher when compared with classical treatments and that both trans-diagnostic and diagnosis-specific treatments are equally effective.

Discussion: The trans-diagnostic cognitive-behavioral treatments can be considered as an effective alternative to diagnosis-specific ones, especially when comorbidity between different emotional disorders is present.

The case of a homosexual patient sent to a psychology service for depressive-anxious symptoms is described. The patient had adopted an avoidance coping and a passive-anassertive attitude towards his sexual orientation, especially due to the shame deriving from a self-stigma. He had a brother who was married with three children and died 3 years earlier. The trans-diagnostic framework of the clinical case leads to the identification of short, medium and long-term therapeutic objectives such as: immediate psychological support, and then, once the mood had improved, reduction self-stigma for HIV, internalized homophobia, and then the coping with social problems and avoidance behaviors. Recognizing that his avoidance behaviors have been learned in the family context, psychotherapy proceeded rapidly, especially since the patient has started making decisions in his favor and following his preference. Today he has moved to a new home where he lives happily, he also bought a new car and meets a man he has been dating for a few months.

Vic Meyer, of Polish origin, was a British psychologist at the Middlesex Hospital Medical School of the University of London (now UCL Medical School) and is considered the “spiritual father” of clinical case formulation, an approach to understanding complex psychiatric problems using learning principles derived from experimental psychological research and idiographically adapted to the individual case to develop an effective intervention regimen.

These two posters have been selected from those presented at the 16th International Congress of Behavioral Medicine Medicine: “Interdisciplinary behavioral medicine: systems, network and interventions”, held in Glasgow in June 2021.

Aims: The presence of conflicts of interest in psychotherapy, with the consequent errors and/or falsifications, has not been adequately considered in psychotherapy. In this work, a much cited study by Jonathan Shedler of mega-analyses of efficacy studies of various treatments in psychiatry, both psychotherapeutic and pharmacological, is taken into consideration for in-depth examination, in which two Authors declared conflicts of interest: General psychotherapy, CBT, Psychodynamic Psychotherapy (PP), Antidepressant Psychopharmacotherapy (PTAD).

Method: Examination of the method and results of the studies considered in J. Shedler’s mega-analysis in the light of statistical methodology. We then proceeded to examine: a) the method used for merging the results, b) the correctness of the calculations, c) the congruence between results and conclusions.
Results: Numerous meta-analyses included in this study do not have the sufficient number to consider reliable the calculation of the Effect Size (ES or Degree of Effect), one in the PTAD group, six in the PP group. Furthermore, meta-analysis studies are included together with some mega-analyses, and a meta-analysis study of PP does not have control groups, therefore it is not comparable to the others. Therefore, only one of the meta-analyses has characteristics that can lend themselves to verifying the efficacy of the PP, that of Abbas & coll. (2006), but many sub-analyses of this study do not have the sufficient number to consider the calculation of the ES reliable, therefore they should be excluded. Finally, the final result (ES = .77) is erroneously reported in the conclusions as ES = .97.

Discussion: In view of the above, the study presents numerous errors, which can sometimes be interpreted as manipulation or falsification of data, and represents a real example of abuse of the meta-analysis method.