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Spada M.M.,London South Bank University | Giustina L.,Servizio Tossicodipendendenze | Rolandi S.,University of Pavia | Fernie B.A.,King's College London | Caselli G.,Studi Cognitivi
Behavioural and Cognitive Psychotherapy | Year: 2015

Background: Preliminary research has indicated that general facets of metacognition are associated with problem gambling. In the present study we aimed to investigate whether specific facets of metacognition play a role in explaining gambling initiation and perseveration in individuals presenting with gambling disorder. Aim: To investigate: (1) the presence of metacognitive beliefs about gambling; (2) the goal of gambling, and its start and stop signals; and (3) the perceived impact of gambling on self-consciousness. Method: Ten individuals with a diagnosis of gambling disorder were assessed using metacognitive profiling, a semi-structured interview. Results: Findings indicated that all participants endorsed both positive and negative metacognitive beliefs about gambling. The primary goal of gambling was to relieve economic hardship and improve cognitive-emotional state. All participants reported that they did not know when this goal was achieved. Start signals for gambling included the ideas and feelings that gambling could solve problems and sensations that it might be the right time to win. The stop signal for gambling, for all participants, was running out of money. All participants also reported a perceived reduction in self-consciousness during a gambling episode. Conclusions: These findings provide preliminary evidence that specific facets of metacognition play a role in gambling disorder. © British Association for Behavioural and Cognitive Psychotherapies 2014.


Fernie B.A.,King's College London | Fernie B.A.,South London and Maudsley NHS Foundation Trust | Caselli G.,Studi Cognitivi | Giustina L.,Servizio Tossicodipendendenze | And 3 more authors.
Addictive Behaviors | Year: 2014

Desire thinking is a voluntary cognitive process involving verbal and imaginal elaboration of a desired target. A desired target can relate to an object, an internal state or an activity, such as gambling. This study investigated the role of desire thinking in gambling in a cohort of participants recruited from community and clinical settings. Ninety five individuals completed a battery of self-report measures consisting of the Hospital Anxiety and Depression Scale (HADS), the Gambling Craving Scale (GCS), the Desire Thinking Questionnaire (DTQ) and the South Oaks Gambling Screen (SOGS). Correlation analyses revealed that gender, educational level, recruitment source, anxiety and depression, craving and desire thinking were correlated with gambling. A hierarchical multiple regression analysis revealed that both recruitment source and desire thinking were the only independent predictors of gambling when controlling for all other study variables, including craving. These findings are discussed in the light of metacognitive therapy (MCT). © 2014 Elsevier Ltd.


Caselli G.,Roehampton University | Ferretti C.,Centro Alcologico | Leoni M.,University of Parma | Rebecchi D.,Studi Cognitivi | And 3 more authors.
Addiction | Year: 2010

Aims To investigate the role of depression and rumination in predicting drinking status (absence or presence of alcohol use) and level of alcohol use at 3, 6 and 12 months following a brief course of cognitive-behavioural therapy for alcohol abuse. Methods A total of 80 out-patients with a diagnosis of alcohol abuse completed measures of depression (Beck Depression Inventory), rumination (Ruminative Responses Scale) and alcohol use (Quantity-Frequency Scale). Results These indicated that rumination predicted drinking status and level of alcohol use at 3-, 6- and 12-month follow-up. The contribution of rumination was independent of depression and initial level of alcohol use. Conclusions The results confirm that rumination is an important prospective predictor of drinking status and level of alcohol use in alcohol abusers and highlight the potential relevance of targeting rumination in the treatment of alcohol abuse. © 2010 Society for the Study of Addiction.


Ottaviani C.,IRCCS Santa Lucia Foundation | Borlimi R.,University of Bologna | Brighetti G.,University of Bologna | Caselli G.,Studi Cognitivi | And 7 more authors.
International Journal of Psychophysiology | Year: 2014

The cognitive avoidance model of worry assumes that worry has the adaptive function to keep under control the physiological arousal associated with anxiety. This study aimed to test this model by the use of a fear induction paradigm in both pathological and healthy individuals. Thirty-one pathological worriers and 36 healthy controls accepted to be exposed to a fear induction paradigm (white noise) during three experimental conditions: worry, distraction, and reappraisal. Skin conductance (SCR) and heart rate variability (HRV) were measured as indices of sympathetic and parasympathetic nervous system functioning. Worriers showed increased sympathetic and decreased parasympathetic activation during the worry condition compared to non-worriers. There were no differences between groups for the distraction and reappraisal conditions. SCRs to the white noises during worry were higher in worriers versus controls throughout the entire worry period. Intolerance of uncertainty - but not metacognitive beliefs about worry - was a significant moderator of the relationship between worry and LF/HF-HRV in pathological worriers. Results support the cognitive avoidance model in healthy controls, suggesting that worry is no longer a functional attitude when it becomes the default/automatic and pathological response. © 2014 Elsevier B.V.


Spada M.M.,London South Bank University | Caselli G.,Studi Cognitivi | Nikcevic A.V.,Kingston University | Wells A.,University of Manchester | Wells A.,Manchester Mental Health and Social Care NHS Trust
Addictive Behaviors | Year: 2015

Background: Over the last twenty years metacognitive theory has provided a novel framework, in the form of the Self-Regulatory Executive Function (S-REF) model, for conceptualizing psychological distress (Wells & Matthews, 1994, 1996). The S-REF model proposes that psychological distress persists because of unhelpful coping styles (e.g. extended thinking and thought suppression) which are activated and maintained as a result of metacognitive beliefs. Objective: This paper describes the S-REF model and its application to addictive behaviors using a triphasic metacognitive formulation. Discussion: Evidence on the components of the triphasic metacognitive formulation is reviewed and the clinical implications for applying metacognitive therapy to addictive behaviors outlined. © 2014 Elsevier Ltd.


Caselli G.,Studi Cognitivi | Spada M.M.,London South Bank University
Addictive Behaviors | Year: 2014

Introduction: The aim of this study was to provide an overview of the construct of desire thinking and test a metacognitive model of desire thinking and craving, based on the work of Spada, Caselli and Wells (2012; 2013), which aims to explain the perseveration of desire thinking. Method: We conducted two studies involving four clinical samples (total N = 493) and a community sample (N = 494) presenting with different addictive behaviors. The relationships among variables were examined by testing the fit of path models within each sample. Results: In the model presented it was proposed that positive metacognitions about desire thinking are associated with, in turn, imaginal prefiguration and verbal perseveration, marking the activation of desire thinking. Verbal perseveration is then associated to negative metacognitions about desire thinking and craving denoting the pathological escalation of desire thinking. Finally, a direct association between positive metacognitions about desire thinking and negative metacognitions about desire thinking would mark those occasions where target-achieving behaviour runs as an automatized schemata without the experience of craving. Results indicated a good model fit in the clinical sample and a variation in the model structure in the community sample. Conclusion: These findings provide further support for the application of metacognitive theory to desire thinking and craving in addictive behaviors. © 2014 Elsevier Ltd. All rights reserved.


Caselli G.,Studi Cognitivi | Caselli G.,London South Bank University | Nikcevic A.,Kingston University | Fiore F.,Studi Cognitivi | And 2 more authors.
Addiction Research and Theory | Year: 2012

Introduction: Desire thinking is a voluntary cognitive process involving verbal and imaginal elaboration of a desired target. Recent research has highlighted the role of desire thinking in the maintenance of addictive disorders over and above that of other psychological antecedents including negative affect and urges. The goal of this research project was to explore the role of desire thinking across the continuum of nicotine dependence. Method: A sample of 156 smokers recruited from the general population completed measures of negative affect, smoking urges, desire thinking and nicotine dependence. Results: Individuals high on nicotine dependence reported significantly higher scores on desire thinking dimensions controlling for age, gender, negative affect and smoking urges. In addition, the verbal perseveration component of desire thinking was the strongest predictor of nicotine dependence independently of negative affect and smoking urges across the nicotine dependence spectrum. Conclusions: Findings suggest that desire thinking may be a risk factor for nicotine dependence and that cognitive-behavioural interventions for treating nicotine dependence may benefit from targeting specifically desire thinking. © 2012 Informa UK Ltd.


Spada M.M.,London South Bank University | Spada M.M.,North East London NHS Foundation Trust | Caselli G.,Studi Cognitivi | Slaifer M.,University of Pavia | And 2 more authors.
Social Science Computer Review | Year: 2014

This study investigated the role of desire thinking in predicting problematic Internet use (PIU) independently of weekly Internet use, anxiety, depression, and craving for Internet use. A sample of 250 Internet users completed the following self-report instruments: Hospital Anxiety and Depression Scale, Internet Use Craving Scale, Desire Thinking Questionnaire, and Internet Addiction Test. The sample was then divided into two subgroups: problematic Internet users (n = 90) and nonproblematic Internet users (n = 140). Mann-Whitney U tests revealed that all variable scores were significantly higher for problematic Internet users than nonproblematic Internet users. A logistic regression analysis indicated that imaginal prefiguration was a predictor of classification as problematic Internet user over and above weekly Internet use, anxiety, depression, and craving for Internet use. A hierarchical regression analysis, on the combined sample, indicated that both verbal perseveration and imaginal prefiguration predicted PIU independently of weekly Internet use, anxiety, depression, and craving for Internet use. These results add to the argument that the construct of desire thinking is relevant in understanding of addictive behaviors including PIU. © The Author(s) 2013.


Fiore F.,Studi Cognitivi | Ruggiero G.M.,Psicoterapia Cognitiva e Ricerca | Sassaroli S.,Studi Cognitivi
Frontiers in Psychiatry | Year: 2014

Emotional dysregulation is a process which consists in mitigating, intensifying, or maintaining a given emotion and is the trigger for some psychological disorders. Research has shown that an anxiety control plays an important role in emotional expression and regulation and, in addition, for anorexia nervosa (AN) and, more in general, in drive for thinness. Scientific literature suggests that in AN there is a core of emotional dysregulation and anxiety control. The aim of this study is to explore the roles of emotional dysregulation and anxiety control as independent or third variables in a mediational regression model related to drive for thinness. One hundred fifty-four clinical individuals with anorexia participated in the study and all completed a set of self-report questionnaires: eating disorders inventory version 3 (EDI-3), DERS, and the anxiety control questionnaire. The data confirmed a mediational model in which the relation between emotional dysregulation and drive for thinness is mediated by anxiety control. The current study partially supports a clinical model in which emotional dysregulation is a distal factor in eating disorders while the mediator variable anxiety control is a proximal factor in the psychopathological process underlying it. © 2014 Fiore, Ruggiero and Sassaroli.


PubMed | University of Pavia and Studi Cognitivi
Type: Comparative Study | Journal: Neuro endocrinology letters | Year: 2016

The aim of this nested case-control study was to compare the effectiveness of cognitive-behavioral treatment (CBT) for treatment-resistant obese (body mass index [BMI] 30 kg/m) women compared with standard dietary treatment. The main outcome measures were attrition and weight loss success.We designed a 6-month case-control study, nested within a cohort of adult (age 18 years) treatment-resistant (history of at least two previous diet attempts) obese women. Cases were 20 women who were offered CBT sessions. Controls (n=39) were randomly selected from the source population and matched to cases in terms of baseline age, BMI, and number of previous diet attempts.Compared with controls, cases were significantly more likely to complete the 6-month program in both age-adjusted (odds ratio [OR]=2.94, 95% confidence interval [CI]=1.05-8.97) and multivariate-adjusted (OR=2.77, 95% CI=1.02-8.34) analyses. In contrast, cases were not more likely to achieve weight loss success in age-adjusted (OR=1.32, 95% CI=0.86-1.67) and multivariate-adjusted (OR=1.21, 95% CI=0.91-1.44) analyses.Compared with a standard dietary treatment, CBT was significantly more effective in reducing attrition in treatment-resistant obese women, without differences in terms of weight loss success.

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