Papers by Chiara De Panfilis
Journal of Psychiatric Practice, Mar 1, 2016
Introduction: A growing literature suggests that obsessive-compulsive (OC) phenomena represent a ... more Introduction: A growing literature suggests that obsessive-compulsive (OC) phenomena represent a distinct dimension in schizophrenia, independent of nuclear psychotic symptoms. Nevertheless, the OC psychopathologic profile in schizophrenia, compared with "pure" obsessive-compulsive disorder (OCD), has not yet been investigated extensively. This study investigated the clinical features of the OC dimension in patients with schizophrenia compared with patients with pure OCD. Methods: The main psychopathologic features of obsessions and compulsions were rated in 35 patients with schizophrenia and 31 patients with OCD, using the Structured Clinical Interview for DSM-IV Axis I Disorders, the Positive and Negative Syndrome Scale, the Yale-Brown Obsessive-Compulsive Scale, and the Leyton Obsessional Inventory. Results: OC phenomena were indistinguishable in terms of their severity, resistance, interference, and control in both groups. However, patients with OCD showed higher rates of aggressive, contamination-related, sexual, and somatic themes; moreover, in the group with schizophrenia, a positive relationship was found between washing compulsions and delusions and between hoarding obsessions and delusions. Conclusions: These results indicate that patients with schizophrenia exhibit a narrower range of obsessive content compared with patients with OCD; in addition, OC and delusional themes tend to be related in schizophrenia as a unique symptomatic phenomenon.
Journal of Personality, 2021
IntroductionEffortful control (EC) is the self‐regulatory aspect of temperament that is thought t... more IntroductionEffortful control (EC) is the self‐regulatory aspect of temperament that is thought to reflect the efficiency of executive attention (EA). Findings on relationship between EC and performance on EA tasks among adults are still contradictory. This study used a computational approach to clarify whether greater self‐reported EC reflects better EA.MethodsFour hundred twenty‐seven healthy subjects completed the Adult Temperament Questionnaires and the Attention Network Task‐revised, a conflict resolution task that gauges EA as the flanker effect (FE), that is, the difference in performances between incongruent and congruent trials. Here we also employed a drift‐diffusion model in which parameters reflecting the actual decisional process (drift rate) and the extra‐decisional time are extracted for congruent and incongruent trials.ResultsEC was not correlated with the FE computed with the classic approach, but correlated positively with drift rate for the incongruent trials, eve...
Comprehensive Psychiatry, 2018
The relationship between personality and Delusional Disorder in still debated. The present study ... more The relationship between personality and Delusional Disorder in still debated. The present study aimed to evaluate the role of personality features and emotional dispositions on the proneness to delusional beliefs, through the lens of a dimensional approach. 91 outpatients were administered the Structured Interview for DSM-IV Personality Disorders, the Pathological Narcissism Inventory, the Positive and Negative Affect Schedule and the Peters et al. Delusions Inventory. Delusion proneness was positively related to the "Hiding the Self" domain of narcissistic vulnerability and to paranoid traits and negatively related to "Positive Affect". Paranoid traits and "Hiding the Self" significantly interacted in influencing delusion ideation. These data suggest that proneness to delusion depends, at least in part, on a complex interplay between specific emotional and paranoid dispositions within personality.
Psychoanalytic Psychology, 2018
Despite robust findings identifying impairments in interpersonal functioning associated with reje... more Despite robust findings identifying impairments in interpersonal functioning associated with rejection sensitivity (RS), the object representations (OR) of self in relation to others from which such rejection expectancies and anxieties arise have not been evaluated. Our study was the first effort to evaluate the structural aspects of object representations in RS, which may provide a crucial link in understanding why interpersonal distress may translate to rejection expectancies. Participants included 56 ethnically diverse undergraduate students who self-reported interpersonal distress and RS, and were assessed using the Social Cognition and Object Relation Scale. Results showed greater disparities in levels of integration in OR predicted greater RS. Furthermore, a moderation model was supported in which heightened interpersonal distress predicted higher levels of rejection sensitivity only for those with greater disparities in levels of OR integration. Thus, individuals with unstable OR integration may find it difficult to accurately attribute accepting or rejecting dispositions to others in distressing interpersonal contexts.
Personality and Individual Differences, 2018
Rejection sensitivity (RS) was evaluated as a moderator of the relationship between perceptions o... more Rejection sensitivity (RS) was evaluated as a moderator of the relationship between perceptions of others and interpersonal behavior over the course of a week. Participants (n = 240) were non-clinical young adults who completed a 7-day event-contingent experience sampling study of interpersonal perception and affect. Multilevel linear models indicated that those with high RS were less agentically responsive to their interaction partner's agency and positive affect. Further, those with high RS exhibited cold, unfriendly behavior in response to their interaction partner's negative and subdued affect. Findings suggest an avoidant stance in those with high RS, which may aim to avoid but likely invites the very rejection they fear. Implications and limitations of these findings are discussed.
Journal of Contemporary Psychotherapy, 2019
The present research case sought to illustrate how self-regulatory patterns of interpersonal beha... more The present research case sought to illustrate how self-regulatory patterns of interpersonal behavior manifest within a rejection sensitive individual at the daily level. Cross-sectional research has demonstrated negative relational outcomes associated with rejection sensitivity, but less attention has been paid to how this manifests in daily relational events. Expanding upon prior research evaluating the daily interpersonal functioning of those with high rejection sensitivity in a large sample, the research case study of Mary demonstrates how findings from research may manifest within a rejection sensitive individual who was asked to rate her interpersonal events over the course of a week. For Mary, covariations among her interpersonal perceptions suggest a negativity bias that may be basis of a self-fulfilling prophecy, in which her rejection expectancies come to be realized through her treating agency as unfriendly behavior. The implications for psychotherapy of interpersonal patterns typically observed in rejection sensitive clients are discussed.
Health Psychology, 2018
Objective. Depression is an established risk factor for Acute Coronary Syndrome (ACS) with an imp... more Objective. Depression is an established risk factor for Acute Coronary Syndrome (ACS) with an impact on cardiac prognosis, nonetheless the literature disagrees on the role played by anxiety. No study evaluated this relationship in a cardiac population with no history of depression and after their first ACS. The aim of this study is to explore these associations without the confounding role of long-lasting heart disease or psychiatric illnesses. Methods. Two-hundred-sixty-six patients with no history of depression completed the Hospital Anxiety and Depression Scale and the PRIME-MD at baseline and at 1, 2, 4, 6, 9, 12 and 24 months follow-up after their first ACS. During the follow-up period, we collected information regarding the major adverse cardiac events. Results. Developing a first-ever depressive episode, in a proportional hazard model, was associated with almost three times the risk of a recurrent cardiac event (OR=2.590; 95%CI=1.321, 5.078; p=.006). Furthermore, a moderation analysis revealed that increasing levels of baseline anxiety had opposing effects on cardiac outcomes, being protective only in those who did not develop incident depression (B=-0.0824; 95%CI=-0.164,-0.005; p=.048). No dose-response effect between depressive or anxious symptoms and cardiac outcomes emerged. Conclusion. Our results confirm the detrimental effect of depression on cardiac prognosis in a selected population and suggest that anxiety after the first ACS might have different roles depending on the illness' course.
Journal of personality disorders, Jan 30, 2018
Narcissistic personality disorder (NPD) is associated with both seeming indifference and hypersen... more Narcissistic personality disorder (NPD) is associated with both seeming indifference and hypersensitivity to social feedback. This study evaluated whether rejection sensitivity and empathic difficulties in NPD are accounted for by altered facial emotion recognition (FER). Two-hundred non-clinical individuals self-reported NPD features, rejection sensitivity, and empathy and performed an FER task assessing the ability to determine the presence or absence of an emotion when viewing neutral and negative facial stimuli presented at varying emotional intensities (25%, 50%, 75%). Those with higher NPD features were faster at accurately recognizing neutral and low, 25%-intensity emotional stimuli. This response pattern mediated the association between NPD features and increased anger about rejection. Thus, individuals with high NPD traits are hypervigilant toward subtle negative emotions and neutral expressions; this may explain their tendency to experience intense angry feelings when faci...
European Psychiatry, 2017
ObjectiveThe relationship between personality and delusional ideation in still debated. The prese... more ObjectiveThe relationship between personality and delusional ideation in still debated. The present study was aimed to evaluate the role of personality features and trait affectivity on the severity of delusional beliefs, through the lens of a dimensional approach. In fact, robust evidence suggests that delusional experience presents a dimensional structure rather than an all-or-nothing fashion with a severity gradient of delusional beliefs from general population to full-blown delusional disorder (DD).MethodForty-nine inpatients affected by DD and 42 non-delusional outpatients were administered the structured interview for DSM-IV Personality Disorders, the Pathological Narcissism Inventory–Italian Version, the Positive and Negative Affect Schedule and the Peters et al. 33–Italian version.ResultsSeverity of delusional ideation was positively related to “hiding the self” (HS) domain of narcissistic vulnerability and to paranoid traits and negatively related to “positive affect” (PA)....
Psychiatry research, Sep 30, 2017
The impact of borderline personality pathology on facial emotion recognition has been in dispute;... more The impact of borderline personality pathology on facial emotion recognition has been in dispute; with impaired, comparable, and enhanced accuracy found in high borderline personality groups. Discrepancies are likely driven by variations in facial emotion recognition tasks across studies (stimuli type/intensity) and heterogeneity in borderline personality pathology. This study evaluates facial emotion recognition for neutral and negative emotions (fear/sadness/disgust/anger) presented at varying intensities. Effortful control was evaluated as a moderator of facial emotion recognition in borderline personality. Non-clinical multicultural undergraduates (n = 132) completed a morphed facial emotion recognition task of neutral and negative emotional expressions across different intensities (100% Neutral; 25%/50%/75% Emotion) and self-reported borderline personality features and effortful control. Greater borderline personality features related to decreased accuracy in detecting neutral ...
European Archives of Psychiatry and Clinical Neuroscience, 2016
sample of 921 patients with schizophrenia collected in a nationwide Italian study, with the aim t... more sample of 921 patients with schizophrenia collected in a nationwide Italian study, with the aim to identify, among a large set of personal resources, those that may have an association with symptom severity or psychosocial functioning.
Journal of Personality Assessment, 2016
Individuals high in rejection sensitivity (RS) are at risk for experiencing high levels of interp... more Individuals high in rejection sensitivity (RS) are at risk for experiencing high levels of interpersonal distress, yet little is known about the interpersonal profiles associated with RS. This investigation examined the interpersonal problems, sensitivities, and values associated with RS in 2 samples: 763 multicultural undergraduate students (Study 1) and 365 community adults (Study 2). In Study 1, high anxious RS was associated with socially avoidant interpersonal problems, whereas low anxious RS was associated with vindictive interpersonal problems. In Study 2, we assessed both anxious and angry expectations of rejection. Circumplex profile analyses showed that the high anxious RS group reported socially avoidant interpersonal problems, sensitivities to remoteness in others, and valuing connections with others, whereas the high angry RS group reported vindictive interpersonal problems, sensitivities to submissiveness in others, and valuing detached interpersonal behavior. Low anxious RS was related to domineering interpersonal problems, sensitivity to attention-seeking behavior, and valuing detached interpersonal behavior, whereas low angry RS was related to submissive interpersonal problems, sensitivity to attention-seeking behavior, and valuing receiving approval from others. Overall, results suggest that there are distinct interpersonal profiles associated with varying levels and types of RS.
Schizophrenia Research, 2016
Recent research has suggested a dual impact of obsessive-compulsive dimension on functioning in s... more Recent research has suggested a dual impact of obsessive-compulsive dimension on functioning in schizophrenia with a gradual transition from an improving to a worsening effect depending on obsessive-compulsive symptoms (OCS) severity (from mild to moderate-severe). Aim of the present study was to investigate whether this varying effect of OCS on functioning might be mediated or moderated by schizophrenia symptom dimensions or occur independently. Method: Seventy-five patients affected by schizophrenia were administered the Structured Clinical Interview for DSM-IV Disorders, the Positive and Negative Syndrome Scale, the Yale-Brown Obsessive-Compulsive Scale and the Social and Occupational Functioning Assessment. The sample was divided into two groups according to the severity of OCS (absent/mild and moderate/high OCS group). Results: In both groups, the effect of OCS on functioning was not mediated by their effect on positive, negative or disorganization symptoms. Conversely, a significant interaction between OCS and disorganization dimension was found: the dual effect of OCS on functioning occurred only among patients with low disorganization symptoms while it was no more apparent at high levels of disorganization. Conclusion: Data suggest that in patients with schizophrenia, functioning at least in part depends on the interaction between disorganization and OCS.
Psychiatry Research, 2015
Obsessive Compulsive Symptoms (OCS) and Disorder (OCD) occur frequently in patients with schizoph... more Obsessive Compulsive Symptoms (OCS) and Disorder (OCD) occur frequently in patients with schizophrenia. Nevertheless the impact of OCS/OCD on clinical characteristics and outcome of schizophrenia remains controversial. The aim of the present study is to examine the effect of obsessive-compulsive dimension on symptom expression and functioning in schizophrenia. Sixty patients affected by schizophrenia completed the SCID-IV, the Positive and Negative Syndrome Scale, the Yale-Brown Obsessive-Compulsive Scale, the Social and Occupational Functioning Assessment Scale and the Strauss and Carpenter Level of Functioning Rating Scale. Obsessive-compulsive dimension was associated neither with positive or disorganization symptoms nor with negative symptoms. By contrast, it adversely affected levels of functioning, with a major impact exerted by compulsions rather than obsessions. Obsessivecompulsive dimension appears to be independent from negative and positive symptoms of schizophrenia and independently decreases social functioning.
Psychiatry Research, 2015
The association between depression and acute coronary syndrome (ACS) is well-established and the ... more The association between depression and acute coronary syndrome (ACS) is well-established and the first seems to impact meaningfully on cardiac prognosis. Nonetheless only a few studies have evaluated the relationship between incident depression, defined as new cases in patients with no history of depression, and ACS. Therefore the aim of this study is to analyse the risk factors of incident depression in a sample of patients who were presenting their first ACS. 304 consecutive patients were recruited. The presence of major (MD) and minor (md) depression was assessed with the Primary Care Evaluation of Mental Disorders (PRIME-MD), whereas its severity was evaluated with the Hospital Anxiety and Depression Scale (HADS). Evaluations were collected both at baseline and at 1, 2, 4, 6, 9 and 12 month follow ups. Out of 304 subjects (80.6% males), MD was diagnosed in 15 (4.9%) and md in 25 patients (8.2%). At baseline risk factors for a post-ACS depressive disorder were being women (MD only), widowed (md only) and having mild anhedonic depressive symptoms few days after the ACS. Clinicians should keep in mind these variables when facing a patient at his/her first ACS, given the detrimental effect of depression on cardiac prognosis.
Journal of Nervous & Mental Disease, 2015
In schizophrenia, a better level of functioning has been generally associated with symptomatic re... more In schizophrenia, a better level of functioning has been generally associated with symptomatic remission. However, this association has been supported by cross-sectional studies or by studies with a short follow-up period. Forty-eight patients with schizophrenia were evaluated by the Positive and Negative Symptoms Scale and the Social and Occupational Functioning Assessment Scale (SOFAS) at the first episode and after a mean period of 16 years. At follow-up, patients were defined as remitters (R) or non-remitters (NR) according to the Remission Schizophrenia Working Group criteria. R (n = 18; 37.5%) compared to NR showed at the first episode a lower illness severity and a better level of functioning. A functional decline was found in both groups at follow-up, even though NR showed a more than twofold reduction than R. Better SOFAS scores at follow-up were predicted by baseline SOFAS score and less severe negative symptoms at follow-up. Schizophrenia implies a functional decline over time, regardless of the symptomatic remission status with negative symptoms playing a major role.
European Archives of Psychiatry and Clinical Neuroscience, 2015
European Psychiatry, 2015
Background: High levels of anhedonia have been found in patients with schizophrenia; specifically... more Background: High levels of anhedonia have been found in patients with schizophrenia; specifically they report higher levels of social anhedonia rather than physical anhedonia, and further, in the anticipatory rather than consummatory facets of pleasure. Nonetheless, contrasting results emerged regarding the underlying mechanisms of this deficit. Basic Symptoms (BS) disturb subjective experiences present for most of the illness' course; this impacts patients' daily lives leading to a loss of the ability to organize the experience of the self and the world in a fluid and automatic way. Considering the role played by negative emotions in the subjective evaluation of anhedonia, the aim of the study is to clarify the role of BS in the assessment of anhedonia in a sample of patients with schizophrenia (n = 53) compared with healthy controls (n = 46). Methods: Participants completed a self-administered trait questionnaire evaluating social anhedonia (Revised-Social Anhedonia Scale), physical anhedonia (Physical Anhedonia Scale), and the consummatory and anticipatory pleasure experiences (Temporal Experience of Pleasure Scale). BS were evaluated with the Frankfurter Beschwerde-Frageboden (FBF) whereas psychopathology was assessed with the Positive and Negative Syndromes Scale. Results: Patients scored higher than healthy controls in social, physical and anticipatory anhedonia, but not in consummatory anhedonia and these relationships were mediated by the FBF. Basic Symptoms of Memory, Overstimulation and Lack of Automatism were related to some facets of anhedonia, independently from depressive symptoms. Conclusions: We hypothesize that a subjective cognitive deficit and a reduced ability in information processing, could prevent patients from retaining a positive experience from past pleasant activities. Therefore the lack of pleasure would be, at least in part, related to an avoidance of potentially stressful new scenarios.
Personality and Individual Differences, 2015
This study examined whether personality disorders (PDs) are associated with alexithymic features ... more This study examined whether personality disorders (PDs) are associated with alexithymic features at varying levels of comorbid psychopathology distress. 167 psychiatric outpatients completed the Toronto Alexithymia Scale (TAS) and the General Severity Index (GSI) of the SCL90-revised. Bootstrapping analyses were performed to test whether the PD/alexithymia relationship was moderated by psychopathology distress (GSI). The overall number of PD criteria was associated with cognitive aspects of alexithymia (i.e., Externally Oriented Thinking, EOT) only at low/moderate levels of distress. Borderline criteria predicted EOT only when distress was low, while avoidant and dependent criteria were independently related with EOT. No association was found between other PDs and alexithymia facets. Thus, within clinical samples the alexithymia/PD association is mainly explained by comorbid psychopathology; however, individuals with avoidant, dependent and borderline features might have a specific difficulty with focusing on internal reality, even when their current symptom distress is low.
The Australian and New Zealand journal of psychiatry, Jan 16, 2015
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Papers by Chiara De Panfilis