Martina Ceccarini | Università degli Studi di Bergamo (University of Bergamo) (original) (raw)
Papers by Martina Ceccarini
SUMMARY Individuals who suffer from Borderline Personality Disorder (BPD) experience intense mood... more SUMMARY Individuals who suffer from Borderline Personality Disorder (BPD) experience intense mood shifts, emotional liability, uncontrolled impulses, and self-harming behaviors to soothe the pain caused by feelings of emptiness in response to a real or imaginary abandonment. These coping strategies initially reduce emotional activation , though they can lead to serious consequences later. Cognitive-behavioural Therapy (CBT) for BPD aims at creating a therapeutic alliance to establish, together with the patient, clear therapeutic objectives. Among these, dysfunctional beliefs cognitive restructuring, identifying early maladaptive Schemas and improving readiness to change in substance use. Skills training promotes the acquisition of interpersonal effectiveness, emotion regulation, distress tolerance, and mindfulness. Schema Therapy also helps patients with BPD developing adap-tive coping strategies since it enables to work on the unsatisfied emotional needs during childhood, especially those concerning neglect or abuse. The main objective of the Schema Therapy is to provide patients with the functional fulfilment of their primary emotional needs through healthy interpersonal relationships.
Frontiers in Psychology, 2015
Obesity is one of today's... more Obesity is one of today's most diffused and severe public health problems worldwide. It affects both adults and children with critical physical, social, and psychological consequences. The aim of this review is to appraise the studies that investigated the effects of motivational interviewing techniques in treating overweight and obese children. The electronic databases PubMed and PsychINFO were searched for articles meeting inclusion criteria. The review included studies based on the application of motivational interviewing (MI) components and having the objective of changing body mass index (BMI) in overweight or obese children from age 2 to age 11. Six articles have been selected and included in this review. Three studies reported that MI had a statistically significant positive effect on BMI and on secondary obesity-related behavior outcomes. MI can be applicable in the treatment of overweight and obese children, but its efficacy cannot be proved given the lack of studies carried out on this specific sample.
Frontiers in Psychology, 2015
Obesity and being overweight could be real chronic conditions above all if there are other compli... more Obesity and being overweight could be real chronic conditions above all if there are other complications such as type 2 diabetes, cardiovascular diseases, hypertension, dyslipidemia, hypercholesterolemia, cancer, and various psychosocial and psychopathological disorders. Due to the multifactorial etiology of obesity, evidencebased interventions to improve weight loss, maintain a healthy weight, and reduce related comorbidities combine different treatment approaches: dietetic, nutritional, physical, behavioral, psychological, and, in some situations, pharmacological and surgical. There are significant limitations in this multidisciplinary chronic care management of obesity, most notably those regarding costs and long-term adherence and efficacy. Programs including eHealth platforms and new technologies could overcome limitations connected to the traditional in-patient chronic care management of obesity, thus providing promising opportunities in enhancing weight reduction and reducing complications in terms of long-term efficacy and effectiveness across clinical, organizational, and economic perspectives.
Journal of Medicinal Food, 2015
Addiction is a compulsive need for and use of a specific substance leading to a habit, tolerance,... more Addiction is a compulsive need for and use of a specific substance leading to a habit, tolerance, and psychophysiological symptoms. Excessive food consumption is similar to that of substance addiction. Some individuals who have trouble losing weight display addictive eating symptoms. To investigate food addiction in a sample of obese adults referred to hospital for a 1-month-weight-loss treatment. The Italian version of the Yale Food Addiction Scale (YFAS-16) was used as a screening tool in 88 obese inpatients. The construct validity of the YFAS-16 was assessed by testing its correlations with measures of binge eating (Binge Eating Scale), impulsiveness (Barratt Impulsiveness Scale), and emotional dysregulation (Difficulties in Emotion Regulation Scale). 34.1% of our sample was diagnosed with YFAS food addiction. Such diagnosis was also supported by strong associations between FA and psychological and behavioral features, typically descriptive of classic addiction. Patients who endorsed the YFAS-16 criteria for food addiction (FA) had significantly higher binge eating levels, greater emotional dysregulation, and nonacceptance of negative feelings; they lacked goal-oriented behavior, had little impulse control, had difficulty in emotion recognition, and attentional impulsivity; and they were unable to concentrate and lacked inhibitory control behavior, unlike participants who did not meet the FA criteria. Further research is needed to support the reliability of the YFAS-16. This measure has the potential to be applied in epidemiological research, estimating the prevalence of FA within the Italian population and to assess new treatments' efficacy for obese patients with food addiction symptoms seeking weight-loss treatments.
Frontiers in Psychology, 2015
It is highly recommended to promptly assess motivation and readiness to change (RTC) in individua... more It is highly recommended to promptly assess motivation and readiness to change (RTC) in individuals who wish to achieve significant lifestyle behavior changes in order to improve their health, overall quality of life, and well-being. In particular, motivation should be assessed for those who face the difficult task to maintain weight, which implies a double challenge: weight loss initially and its management subsequently. In fact, weightcontrol may be as problematic as smoking or drugs-taking cessation, since they all share the commonality of being highly refractory to change. This paper will examine three well-established tools following the Transtheoretical Model, specifically assessing RTC in weight management: the University of Rhode Island Change Assessment Scale, the S-Weight and the P-Weight and the Decisional Balance Inventory. Though their strengths and weaknesses may appear to be rather homogeneous and similar, the S-Weight and P-Weight are more efficient in assessing RTC in weight management and control. Assessing motivation and RTC may be a crucial step in promptly identifying psychological obstacles or resistance toward weight-management in overweight or obese hospitalized individuals, and it may contribute to provide a more effective weight-control treatment intervention.
Chronic diseases and conditions typically require long-term monitoring and treatment protocols bo... more Chronic diseases and conditions typically require long-term monitoring and treatment protocols both in traditional settings and in out-patient frameworks. The economic burden of chronic conditions is a key challenge and new and mobile technologies could offer good solutions. mHealth could be considered an evolution of eHealth and could be defined as the practice of medicine and public health supported by mobile communication devices. mHealth approach could overcome limitations linked with the traditional, restricted, and highly expensive in-patient treatment of many chronic pathologies. Possible applications include stepped mHealth approach, where patients can be monitored and treated in their everyday contexts. Unfortunately, many barriers for the spread of mHealth are still present. Due the significant impact of psychosocial factors on disease evolution, psychotherapies have to be included into the chronic disease protocols. Existing psychological theories of health behavior change have to be adapted to the new technological contexts and requirements. In conclusion, clinical psychology and medicine have to face the “chronic care management” challenge in both traditional and mHealth settings.
Chronic diseases and conditions typically require long-term monitoring and treatment protocols bo... more Chronic diseases and conditions typically require long-term monitoring and treatment protocols both in traditional settings and in out-patient frameworks. The economic burden of chronic conditions is a key challenge and new and mobile technologies could offer good solutions. mHealth could be considered an evolution of eHealth and could be defined as the practice of medicine and public health supported by mobile communication devices. mHealth approach could overcome limitations linked with the traditional, restricted, and highly expensive in-patient treatment of many chronic pathologies. Possible applications include stepped mHealth approach, where patients can be monitored and treated in their everyday contexts. Unfortunately, many barriers for the spread of mHealth are still present. Due the significant impact of psychosocial factors on disease evolution, psychotherapies have to be included into the chronic disease protocols. Existing psychological theories of health behavior change have to be adapted to the new technological contexts and requirements. In conclusion, clinical psychology and medicine have to face the “chronic care management” challenge in both traditional and mHealth settings.
Frontiers in Psychology, 2015
Chronic diseases and conditions typically require long-term monitoring and treatment protocols bo... more Chronic diseases and conditions typically require long-term monitoring and treatment protocols both in traditional settings and in out-patient frameworks. The economic burden of chronic conditions is a key challenge and new and mobile technologies could offer good solutions. mHealth could be considered an evolution of eHealth and could be defined as the practice of medicine and public health supported by mobile communication devices. mHealth approach could overcome limitations linked with the traditional, restricted, and highly expensive in-patient treatment of many chronic pathologies. Possible applications include stepped mHealth approach, where patients can be monitored and treated in their everyday contexts. Unfortunately, many barriers for the spread of mHealth are still present. Due the significant impact of psychosocial factors on disease evolution, psychotherapies have to be included into the chronic disease protocols. Existing psychological theories of health behavior change have to be adapted to the new technological contexts and requirements. In conclusion, clinical psychology and medicine have to face the "chronic care management" challenge in both traditional and mHealth settings.
Frontiers in psychology, 2015
Psychological interventions in cardiac rehabilitation programs appear relevant in as much they si... more Psychological interventions in cardiac rehabilitation programs appear relevant in as much they significantly contribute to achieve the goals of rehabilitation, to reduce the risk of relapses and to improve patients' adherence to therapy. To this aim, motivational interviewing (MI) has shown promising results in improving motivation to change and individuals' confidence in their ability to do so. The purpose of this article is to integrate theory with practice by describing a three-session case scenario. It illustrates how MI's skills and strategies can be used to enhance heart-healthy habits. MI may be synergistic with other treatment approaches and it is used here in conjunction with brief strategic therapy. By the use of MI principles and techniques, the patient reported an increase in his motivation and ability to change, developing a post discharge plan that incorporates self-care behaviors. MI may be effective in motivating and facilitating health behavior change am...
Procedia - Social and Behavioral Sciences, 2014
Background: Obesity and being overweight are often associated with Binge Eating Disorder (BED). C... more Background: Obesity and being overweight are often associated with Binge Eating Disorder (BED). Cognitive-Behavioral Therapy (CBT) has shown solid results in reducing binge eating, but it does not traditionally encourage weight loss. Since Brief Strategic Therapy (BST) has shown to be effective in treating obese people suffering from Binge Eating Disorder (BED), our objective is to compare the BST protocol as an alternative and/or integrative treatment to the traditional Cognitive-Behavioral Therapy, for inpatient and telephone-based outpatient treatment. Method: A two arm randomized controlled clinical trial including 6, 12 and 18 months post-treatment follow up is proposed. 60 participants meeting criteria for obesity and BED will be recruited from a single clinical center (Saint Joseph Hospital -Istituto Auxologico Italiano IRCCS) and randomly allocated in the CBT or BST group. The primary end point is the global change of patients' progress score (Outcome Questionnaire -OQ 45.2), while the secondary outcome measures are patients' weekly binge episodes and weight loss. Data will be collected before and after hospitalization (after 1 month) as well as at 6, 12 and 18 months from the end of the in-hospital treatment. Data at follow-up time points will be collected through telesessions. Conclusion: The present study represents the first randomized controlled trial aimed at comparing the effectiveness of BST with the gold standard CBT. These findings will advance current knowledge in both treatment for BED and telecommunication providing distant clinical healthcare.
Frontiers in Psychology, 2015
SUMMARY Individuals who suffer from Borderline Personality Disorder (BPD) experience intense mood... more SUMMARY Individuals who suffer from Borderline Personality Disorder (BPD) experience intense mood shifts, emotional liability, uncontrolled impulses, and self-harming behaviors to soothe the pain caused by feelings of emptiness in response to a real or imaginary abandonment. These coping strategies initially reduce emotional activation , though they can lead to serious consequences later. Cognitive-behavioural Therapy (CBT) for BPD aims at creating a therapeutic alliance to establish, together with the patient, clear therapeutic objectives. Among these, dysfunctional beliefs cognitive restructuring, identifying early maladaptive Schemas and improving readiness to change in substance use. Skills training promotes the acquisition of interpersonal effectiveness, emotion regulation, distress tolerance, and mindfulness. Schema Therapy also helps patients with BPD developing adap-tive coping strategies since it enables to work on the unsatisfied emotional needs during childhood, especially those concerning neglect or abuse. The main objective of the Schema Therapy is to provide patients with the functional fulfilment of their primary emotional needs through healthy interpersonal relationships.
Frontiers in Psychology, 2015
Obesity is one of today's... more Obesity is one of today's most diffused and severe public health problems worldwide. It affects both adults and children with critical physical, social, and psychological consequences. The aim of this review is to appraise the studies that investigated the effects of motivational interviewing techniques in treating overweight and obese children. The electronic databases PubMed and PsychINFO were searched for articles meeting inclusion criteria. The review included studies based on the application of motivational interviewing (MI) components and having the objective of changing body mass index (BMI) in overweight or obese children from age 2 to age 11. Six articles have been selected and included in this review. Three studies reported that MI had a statistically significant positive effect on BMI and on secondary obesity-related behavior outcomes. MI can be applicable in the treatment of overweight and obese children, but its efficacy cannot be proved given the lack of studies carried out on this specific sample.
Frontiers in Psychology, 2015
Obesity and being overweight could be real chronic conditions above all if there are other compli... more Obesity and being overweight could be real chronic conditions above all if there are other complications such as type 2 diabetes, cardiovascular diseases, hypertension, dyslipidemia, hypercholesterolemia, cancer, and various psychosocial and psychopathological disorders. Due to the multifactorial etiology of obesity, evidencebased interventions to improve weight loss, maintain a healthy weight, and reduce related comorbidities combine different treatment approaches: dietetic, nutritional, physical, behavioral, psychological, and, in some situations, pharmacological and surgical. There are significant limitations in this multidisciplinary chronic care management of obesity, most notably those regarding costs and long-term adherence and efficacy. Programs including eHealth platforms and new technologies could overcome limitations connected to the traditional in-patient chronic care management of obesity, thus providing promising opportunities in enhancing weight reduction and reducing complications in terms of long-term efficacy and effectiveness across clinical, organizational, and economic perspectives.
Journal of Medicinal Food, 2015
Addiction is a compulsive need for and use of a specific substance leading to a habit, tolerance,... more Addiction is a compulsive need for and use of a specific substance leading to a habit, tolerance, and psychophysiological symptoms. Excessive food consumption is similar to that of substance addiction. Some individuals who have trouble losing weight display addictive eating symptoms. To investigate food addiction in a sample of obese adults referred to hospital for a 1-month-weight-loss treatment. The Italian version of the Yale Food Addiction Scale (YFAS-16) was used as a screening tool in 88 obese inpatients. The construct validity of the YFAS-16 was assessed by testing its correlations with measures of binge eating (Binge Eating Scale), impulsiveness (Barratt Impulsiveness Scale), and emotional dysregulation (Difficulties in Emotion Regulation Scale). 34.1% of our sample was diagnosed with YFAS food addiction. Such diagnosis was also supported by strong associations between FA and psychological and behavioral features, typically descriptive of classic addiction. Patients who endorsed the YFAS-16 criteria for food addiction (FA) had significantly higher binge eating levels, greater emotional dysregulation, and nonacceptance of negative feelings; they lacked goal-oriented behavior, had little impulse control, had difficulty in emotion recognition, and attentional impulsivity; and they were unable to concentrate and lacked inhibitory control behavior, unlike participants who did not meet the FA criteria. Further research is needed to support the reliability of the YFAS-16. This measure has the potential to be applied in epidemiological research, estimating the prevalence of FA within the Italian population and to assess new treatments' efficacy for obese patients with food addiction symptoms seeking weight-loss treatments.
Frontiers in Psychology, 2015
It is highly recommended to promptly assess motivation and readiness to change (RTC) in individua... more It is highly recommended to promptly assess motivation and readiness to change (RTC) in individuals who wish to achieve significant lifestyle behavior changes in order to improve their health, overall quality of life, and well-being. In particular, motivation should be assessed for those who face the difficult task to maintain weight, which implies a double challenge: weight loss initially and its management subsequently. In fact, weightcontrol may be as problematic as smoking or drugs-taking cessation, since they all share the commonality of being highly refractory to change. This paper will examine three well-established tools following the Transtheoretical Model, specifically assessing RTC in weight management: the University of Rhode Island Change Assessment Scale, the S-Weight and the P-Weight and the Decisional Balance Inventory. Though their strengths and weaknesses may appear to be rather homogeneous and similar, the S-Weight and P-Weight are more efficient in assessing RTC in weight management and control. Assessing motivation and RTC may be a crucial step in promptly identifying psychological obstacles or resistance toward weight-management in overweight or obese hospitalized individuals, and it may contribute to provide a more effective weight-control treatment intervention.
Chronic diseases and conditions typically require long-term monitoring and treatment protocols bo... more Chronic diseases and conditions typically require long-term monitoring and treatment protocols both in traditional settings and in out-patient frameworks. The economic burden of chronic conditions is a key challenge and new and mobile technologies could offer good solutions. mHealth could be considered an evolution of eHealth and could be defined as the practice of medicine and public health supported by mobile communication devices. mHealth approach could overcome limitations linked with the traditional, restricted, and highly expensive in-patient treatment of many chronic pathologies. Possible applications include stepped mHealth approach, where patients can be monitored and treated in their everyday contexts. Unfortunately, many barriers for the spread of mHealth are still present. Due the significant impact of psychosocial factors on disease evolution, psychotherapies have to be included into the chronic disease protocols. Existing psychological theories of health behavior change have to be adapted to the new technological contexts and requirements. In conclusion, clinical psychology and medicine have to face the “chronic care management” challenge in both traditional and mHealth settings.
Chronic diseases and conditions typically require long-term monitoring and treatment protocols bo... more Chronic diseases and conditions typically require long-term monitoring and treatment protocols both in traditional settings and in out-patient frameworks. The economic burden of chronic conditions is a key challenge and new and mobile technologies could offer good solutions. mHealth could be considered an evolution of eHealth and could be defined as the practice of medicine and public health supported by mobile communication devices. mHealth approach could overcome limitations linked with the traditional, restricted, and highly expensive in-patient treatment of many chronic pathologies. Possible applications include stepped mHealth approach, where patients can be monitored and treated in their everyday contexts. Unfortunately, many barriers for the spread of mHealth are still present. Due the significant impact of psychosocial factors on disease evolution, psychotherapies have to be included into the chronic disease protocols. Existing psychological theories of health behavior change have to be adapted to the new technological contexts and requirements. In conclusion, clinical psychology and medicine have to face the “chronic care management” challenge in both traditional and mHealth settings.
Frontiers in Psychology, 2015
Chronic diseases and conditions typically require long-term monitoring and treatment protocols bo... more Chronic diseases and conditions typically require long-term monitoring and treatment protocols both in traditional settings and in out-patient frameworks. The economic burden of chronic conditions is a key challenge and new and mobile technologies could offer good solutions. mHealth could be considered an evolution of eHealth and could be defined as the practice of medicine and public health supported by mobile communication devices. mHealth approach could overcome limitations linked with the traditional, restricted, and highly expensive in-patient treatment of many chronic pathologies. Possible applications include stepped mHealth approach, where patients can be monitored and treated in their everyday contexts. Unfortunately, many barriers for the spread of mHealth are still present. Due the significant impact of psychosocial factors on disease evolution, psychotherapies have to be included into the chronic disease protocols. Existing psychological theories of health behavior change have to be adapted to the new technological contexts and requirements. In conclusion, clinical psychology and medicine have to face the "chronic care management" challenge in both traditional and mHealth settings.
Frontiers in psychology, 2015
Psychological interventions in cardiac rehabilitation programs appear relevant in as much they si... more Psychological interventions in cardiac rehabilitation programs appear relevant in as much they significantly contribute to achieve the goals of rehabilitation, to reduce the risk of relapses and to improve patients' adherence to therapy. To this aim, motivational interviewing (MI) has shown promising results in improving motivation to change and individuals' confidence in their ability to do so. The purpose of this article is to integrate theory with practice by describing a three-session case scenario. It illustrates how MI's skills and strategies can be used to enhance heart-healthy habits. MI may be synergistic with other treatment approaches and it is used here in conjunction with brief strategic therapy. By the use of MI principles and techniques, the patient reported an increase in his motivation and ability to change, developing a post discharge plan that incorporates self-care behaviors. MI may be effective in motivating and facilitating health behavior change am...
Procedia - Social and Behavioral Sciences, 2014
Background: Obesity and being overweight are often associated with Binge Eating Disorder (BED). C... more Background: Obesity and being overweight are often associated with Binge Eating Disorder (BED). Cognitive-Behavioral Therapy (CBT) has shown solid results in reducing binge eating, but it does not traditionally encourage weight loss. Since Brief Strategic Therapy (BST) has shown to be effective in treating obese people suffering from Binge Eating Disorder (BED), our objective is to compare the BST protocol as an alternative and/or integrative treatment to the traditional Cognitive-Behavioral Therapy, for inpatient and telephone-based outpatient treatment. Method: A two arm randomized controlled clinical trial including 6, 12 and 18 months post-treatment follow up is proposed. 60 participants meeting criteria for obesity and BED will be recruited from a single clinical center (Saint Joseph Hospital -Istituto Auxologico Italiano IRCCS) and randomly allocated in the CBT or BST group. The primary end point is the global change of patients' progress score (Outcome Questionnaire -OQ 45.2), while the secondary outcome measures are patients' weekly binge episodes and weight loss. Data will be collected before and after hospitalization (after 1 month) as well as at 6, 12 and 18 months from the end of the in-hospital treatment. Data at follow-up time points will be collected through telesessions. Conclusion: The present study represents the first randomized controlled trial aimed at comparing the effectiveness of BST with the gold standard CBT. These findings will advance current knowledge in both treatment for BED and telecommunication providing distant clinical healthcare.
Frontiers in Psychology, 2015