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Objective: Fear of moral guilt and conseque:nt increased attention to personal actions and intentions are the main ingredients of the self-criticism in patients suffering from obsessive-compulsive disorder (OCD). This pathogenic attitude takes shape in a typical guilt-inducing self-talk. The purpose of this work is to describe in detail a novel cognitive therapeutic procedure for OCD called "Dramatized Socratic Dialogue" (DSD). Method: DSD is a theory-oriented intervention that combine elements of Socratic dialogue, chairwork, and cognitive acceptance strategies derived from Mancini's model, which posits that obsessive-compulsive (OC) symptoms stem from a fear of deontological guilt. Results: DSD appears to have many strengths, being a theory-oriented treatment and focusing, as a therapeutic target, on the cognitive structures that determine pathogenic processes and OC symptoms. Furthermore, it is a short, flexible and tailormade intervention. Conclusions: Detailed description of the intervention could foster future research perspectives and thus be used in evidence-based effectiveness studies to establish whether DSD reduces OC symptoms and to investigate its mechanism of action. [ABSTRACT FROM AUTHOR]

This paper describes the impasses occurring in the treatment of Obsessive-Compulsive Disorder, being the special object of our analysis the patient's representations. In particular we shall try to answer the following questions: how does the obsessive-compulsive patient evaluate the psychological help provided by the psychotherapist? Which are the peculiar evaluations that hinder or even nullify this kind of help? We shall answer starting from one of the most substantiated thesis in the field of clinical cognitivism, the one according to which the obsessive symptomatology can be traced back to evaluations due to an hypertrophic sense of responsibility (Arntz et al. 2007; Ladouceur et al. 1997; Lopatka & Rachman 1995; Mancini et al. 2004; Salkovskis 1985, 1989; Salkovskis & Forrester 2002; Shafran 1997) and more specifically to a fear of moral guilt (Basile e Mancini 2011; Gangemi et al. 2007; Mancini 2005; Mancini & Gangemi 2004; Mancini et al. 2008; Rachman 1993; Shafran et al. 1996; Shapiro & Stewart 2011). We shall maintain, consistently with the above-mentioned thesis and on the basis of the clinical observation, that it is possible to explain most of the resistances to change and of the relational deadlocks as effects of evaluations amenable to those very same psychological structures implied in the genesis of the obsessive symptomatology (Saliani & Mancini 2010) and we shall provide, through clinical examples and excerpts of self-dialogue reported by patients, a thorough description of these kind of evaluations occurring in the various phases of treatment. [ABSTRACT FROM AUTHOR]

This article describes the clinical case of a patient with Pathological Affective Dependence (PAD). The interest in reporting this case is related to some specific aspects of PAD: (a) the overinvestment in avoiding loneliness, meant as loss of nurture, unworthiness and sufferance, due to the cross-scope of not losing relationships; (b) the role of the intrapsychic conflict in explaining the psychological suffering, and (c) the intergenerational transmission of PAD. Giving the lack of an effective treatment for PAD, guideline to treat Dependent Personality Disorder (DDP) were considered adequate in this case. However, even if DDP shares some common traits with PAD, it does not totally overlap with it. From a clinical point of view, this treatment overlap between PAD and DDP, shows some limitations such as objectives and behavioural patterns not shared between the two disorders. As such, there is the need of creating a specific treatment protocol for PAD that takes into account objectives, believes, and maladaptive behaviours to prevent longlasting difficulties and pathological relapses. Such protocol in currently under validation with the authors of the PAD cognitive model. [ABSTRACT FROM AUTHOR]

Guilt plays a role in various forms of psychopathology. However, different types of guilt might be involved in different mental disorders. Obsessive-compulsive (OC) patients are prone to a type of guilt in which the violation of an internalized moral norm is necessary and sufficient, whereas data suggest that depression might be linked to more interpersonal types of guilt. However, the extent to which a specific guilt phenomenology is involved in each condition is yet to be determined. Here we assessed the association between different types of guilt and different diagnostic groups. Two clinical samples (33 OCD and 35 non-OCD) filled in the Moral Orientation Guilt Scale (MOGS) along with other OCD and depression measures. Regression was employed to test group differences in the MOGS subscales and to test the influence of MOGS subscales on OCD and depression levels. Results confirm that different types of guilt might be implicated in different psychopathological conditions. Specifically, moral norm violation guilt is more present in OC patients than in other disorders. Depression seems to be associated with different guilt feelings depending on the psychopathological condition, specifically in non-OC patients, with types of guilt involving a "victim", supporting the accounts viewing interpersonal guilt as involved in the emergence of depressive symptomatology and hyper-altruistic behavior as a vulnerability factor for depression. [ABSTRACT FROM AUTHOR]

Cognitive–behavioral therapy is a well-established treatment for obsessive–compulsive disorder (OCD). There are a variety of cognitive and behavioral strategies, and it is necessary to analyze the outcomes of the treatments. The aim of the present study is to verify the effectiveness of a treatment that combines evidence-based procedures and specific cognitive interventions highlighting the issue of acceptance. Forty patients with OCD were recruited and underwent a specific treatment procedure. All patients had a psychodiagnostic assessment for OCD using the Y–BOCS (Yale–Brown obsessive–compulsive scale) performed twice: before treatment (t0) and after nine months (t1). Data analysis showed a decrease in the scores between t0 and t1 according to the Y–BOCS in terms of the interference, severity, and impairment of obsessive–compulsive symptoms. A repeated-measures ANOVA showed a significant reduction in symptoms after treatment, with values of F (1, 39) = 137.56, p < 0.001, and η2 = 0.78. The ANOVA results were corroborated by a Wilcoxon signed-rank test. A reliable change index analysis indicated that 33 participants reported improvements in symptoms, of which 23 were clinically significant. The results showed clinical relevance for OCD treatment and highlighted how this cognitive procedure favored positive outcomes. [ABSTRACT FROM AUTHOR]

Objective: The aim of this work is to explore the issue of online psychotherapy as a means of intervention which has become necessary due to the COVID-19 emergency. Research was conducted with the aim of investigating, from the point of view of therapists and patients, the quality, self-efficacy and difficulties related to the online setting, highlighting their limitations and advantages. Method: Two macro-samples, a first composed by therapists (Tp) (n=364) and a second by patients (Pz) (n = 226) filled out a questionnaire built ad hoc, sent with a remote link that investigated different areas. Exploratory and parametric analyses were carried out on the two samples (Tp and Pz) obtaining different comparisons and correlations. Results: From the comparison made between the total sample of therapists and patients on a set of investigated variables (quality of interaction/communication, sharing, perception of setting, COVID selfdisclosure, perceived self-efficacy, impotence, frustration, optimism, willingness to continue online) it emerges that the group of therapists shows higher scores, with respect to the group of patients, on all the variables investigated, maintaining an optimistic attitude and a willingness to continue psychotherapy with online modality also following the quarantine. The comparison analysis between therapists with expertise and without, shows less impotence in the former than in the latter without previous experience in the online setting. Finally, interesting meaningful correlations emerge between the negative prejudice of the patients, the course of the therapy, the negative emotional experiences of the patient and the perception of the therapist during the therapy in online mode. Conclusions: This study highlights interesting results, highlighting the point of view of psychotherapists and patients on online psychotherapy. In this regard, there are some difficulties found in both therapists and patients. However, it highlights the difficulties encountered most in both therapists and patients. That is to say, the therapists' concerns about the perceived self-efficacy of the intervention, the quality of communication with their patients, greater in therapists without previous experience of online therapy. In addition, therapists see greater use of self-disclosure interventions than the COVID-19 issue and in response to perceived difficulties. Furthermore, the prejudice and negative beliefs of patients seem to have an influence on the perception of the quality of therapy. The study highlights the advantages of the online psychotherapy as functional to emergency management and as a possible alternative to the standard setting. It provides food for thought regarding the management of this type of setting emphasizing how the difficulties encountered are not only patients-experience-related but also therapists-experience-related, both forced by the emergency COVID-19 to adapt to this change of setting. [ABSTRACT FROM AUTHOR]

Objective: The close link between obsessive symptomatology, guilt and inflated responsibility is well documented, although one might suppose that guilt sensitiveness and dysfunctional beliefs about responsibility are rooted further in time. Imagery with rescripting (IWR) is an emotion-focused technique that binds actual stressful emotions to past memories where similar feelings were activated. It is used to change the meaning of emotionally distressing memories, turning aversive mental images into positive ones, and achieving a healthier prospective on the event. the aim of this study was to compare the content of IWR exercises, collected during an on-going cognitive-behavioral psychotherapy, in OCD and non-OCD patients, in order to explore eventual differences in their early negative childhood memories. We expected guilt and blame-related childhood episodes to be more frequent in OCD, compared against non-OCD patients. Method: forty-one imagery exercises were collected and categorized according to their content, emotions, needs, type of re-scripting, and final cognitive re-attribution. Results: OCD patients reported significantly more blame/reproach memories, expressing more guilt emotion and needs for acceptance. Within the re-scripting phase, all patients, regardless of their diagnosis, concluded the exercise protecting, reassuring and fostering emotional and needs expression, with no specific difference between groups. Conclusions: this work has several limitations, including the subjective nature of the study, the small sample size and unbalanced gender distribution across samples. However, our findings are in line with cognitive models on OCD, supporting the role of guilt-related early experiences that seem to be specific to this disorder. [ABSTRACT FROM AUTHOR]

In this study we examined the gender differences in self-reported forgiving behaviours in a sample of Italian preadolescents (aged 11 to 14 years), who were either involved or not involved in religious practises. Were asked 289 Catholic, Italian preadolescent students were asked about their involvement in the religious practises. They also completed measures of forgiveness, avoidance and revenge motivations. The results showed that forgiveness was negatively correlated to avoidance and revenge, as expected, given that these constructs represent two different forms of non-forgiveness. Avoidance and revenge motivations were positively inter-correlated, highlighting how these forms of non-forgiveness are two distinct, but related pathways, leading away from forgiveness. Regarding age, younger participants reported higher degrees of forgiveness than their older counterparts. Lastly, regarding the association between involvement in one’s faith and gender as predictors of forgiving behaviours, only girls actively practising their faith emerged as significantly more forgiving than the other participants. [ABSTRACT FROM AUTHOR]

Objective: Much research and theorizing suggest that compulsive acquisition is a central component of hoarding disease. The Compulsive Acquisition Scale (CAS; Frost et al. 2002) is a self-rating scale measuring the extent to which individuals acquire and feel compelled to acquire possessions. The present study aimed to evaluate the psychometric properties of the CAS, in terms of reliability and construct validity. Method: The scale was administered to a sample of 491 non-clinical adults along with a battery of selected selfreport measures. Participants were randomly divided into two subsamples. Both exploratory and confirmatory factor analyses were performed. Support for construct validity was provided by correlations between CAS and the other administered measures. Results: Unlike the originally suggested 2-factor structure, both exploratory and confirmatory factor analyses revealed an underlying 3-factor structure (Emotions, Time and Money, and Free Stuff). Our outcomes showed good subscales homogeneity; support for concurrent validity was provided by significantly positively correlations between CAS scores and the other measures of hoarding severity; convergent validity was gathered examining correlations between CAS and measures of depression, anxiety, and obsessive compulsive disorder. Conclusions: Overall, empirical results indicated promising psychometric properties of the CAS Italian version in a nonclinical sample. Limitations of the study and the need for further research are discussed. [ABSTRACT FROM AUTHOR]

Guilt emerges as the emotional result of a conflict between our behavior and internalized morality. Since morality is best conceptualized as a multidimensional construct, guilt results in different phenomena depending on the moral values internalized by the "guilty". Indeed, mounting evidence supports the distinction between guilt feelings emerging from deontological morality and guilt feelings emerging from altruistic morality. Most measures fail to consider moral orientation when assessing guilt. Our aim was to develop a reliable and valid tool, able to independently measure different types of guilt feelings. We presented the 17-items Moral Orientation Guilt Scale (MOGS) to a large subclinical sample, along with other questionnaires. Analyses included measures of classical test theory and innovative techniques of network analysis. This cross-validation approach pointed at four factors: "Moral Norm Violation", "Moral Dirtiness", "Empathy" and "Harm". Results suggested MOGS good reliability and a strong construct and convergent validity. Importantly, "Moral Norm Violation" and "Moral Dirtiness" scores were positively correlated with disgust sensitivity, supporting the link between disgust and deontological guilt. Differently, "Harm" scores were negatively correlated with disgust sensitivity scores, in line with the notion that altruism and disgust possibly evolved as part of contrasting motivational systems. • MOGS measures different types of guilt considering individual moral orientation. • Deontological guilt shows a positive association with disgust sensitivity. • Altruistic guilt shows a negative association with disgust sensitivity. [ABSTRACT FROM AUTHOR]